Preventing Bullying of Students with ASD

Did you know that October is National Bullying Prevention Month? In an effort to raise awareness around issues of bullying for students with autism, we’re honored to feature this article on preventing bullying of students with ASD by Lori Ernsperger, PhD, BCBA-D, Executive Director of Behavioral Training Resource Center, on some tips and information for parents on protecting their children from disability-based harassment in school. 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!


We have a nine-year old daughter with ASD who started 3rd grade in a new school. She is coming home every day very upset due to other students calling her names and isolating her from social activities. We wanted her to attend the neighborhood school but how can we protect her from bullying?

Answered by Lori Ernsperger, PhD, BCBA-D

Unfortunately, bullying and disability-based harassment is a common issue for individuals with ASD. As parents, you have a right to insure that the school provides a multitiered framework of protections for your daughter to receive a free appropriate public education (FAPE) in the least restrictive environment and free from disability-based harassment. Start with educating yourself on the current legal requirements and best practices for preventing bullying in schools.

 

Recognize
Recognizing the startling prevalence rates of bullying for students with ASD is the first step in developing a comprehensive bullying and disability-based harassment program for your daughter. According to the Interactive Autism Network (IAN, 2012), 63% of students with ASD were bullied in schools. An additional report from the Massachusetts Advocates for Children (Ability Path, 2011) surveyed 400 parents of children with ASD and found that nearly 88% reported their child had been bullied in school. According to Dr. Kowalski, a professor at Clemson University, “because of difficulty with social interactions and the inability to read social cues, children with ASD have higher rates of peer rejection and higher frequencies of verbal and physical attacks” (Ability Path, 2011).

In addition to recognizing the prevalence of bullying of students with ASD in schools, parents must also recognize the complexities and various forms of bullying. Bullying of students with ASD not only includes direct contact or physical assault but as with your daughter’s experience, it can take milder, more indirect forms such as repeated mild teasing, subtle insults, social exclusion, and the spreading of rumors about other students. All adults must recognize that laughter at another person’s expense is a form of bullying and should be immediately addressed.

Finally, recognizing the legal safeguards that protect your daughter is critical in preventing bullying. Bullying and/or disability-based harassment may result in the violation of federal laws including:

  1. Section 504 of the Rehabilitation Act of 1973 (PL 93-112)
  2. Title II of the Americans with Disabilities Act of 2008 (PL 110-325)
  3. The Individuals with Disabilities Education Improvement Act (IDEA) of 2004 (PL 108-446)

The Office of Civil Rights (OCR), along with the Office of Special Education and Rehabilitative Services (OSERS), have written guidance letters to all schools to clarify that educational institutions are held legally accountable to provide an educational environment that ensures equal educational opportunities for all students, free of a hostile environment. Any parent can access and print these Dear Colleague Letters and distribute them to school personnel working with their child.

  • US Department of Education/Office of Civil Rights (October 2014)
  • US Department of Education/Office of Special Education and Rehabilitative Services (August 2013)
  • US Department of Education/Office of Civil Rights (October 2010)
  • US Department of Education (July 2000)

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Simplifying the Science: Using SAFMEDS in Applied Behavior Analysis

When I first heard about SAFMEDS, I wondered how they were different from standard use of flashcards. What I learned, in fact, is that the process is quite different, and it’s evidence-based! SAFMEDS is actually an acronym that means “Say All Fast Minute Each Day Shuffled.” (I know, I know…it doesn’t exactly roll off the tongue.) Created by Ogden Lindsley, SAFMEDS are focused specifically on fluency, or, in other words, speed and accuracy.

While there are some things that don’t require fluency, there are many things that do: such as simple multiplication or letter recognition. This means that some tasks I teach my students will require the use of fluency training, which is often completed through the use of SAFMEDS. Lindsley outlined results of his experiments using SAFMEDS with students and demonstrated that this process of instruction resulted in faster acquisition of fluency than other, similar flashcard procedures (Lindsley, 1996) with his work having been replicated many times over.

So, how do you implement SAFMEDS?

First, get your materials together. Create your flashcards. (I typically use index cards where I’ve written the problem on one side and the correct response on the back.) Be sure to get a timer.

From there, the procedure is pretty straight forward:

  • You will have ALL the flashcards available and the student will respond to as many as he/she can in one minute.
  • The student can run the activity on their own, and will likely go much faster if they are the one turning the cards (Lindsley, 1996). The student looks at the card, provides the response, then puts the card in the correct or incorrect pile.
  • The cards should be shuffled between each fluency drill so that the student won’t learn the answers in order.

I’ve used actual flashcards, but also created SAFMEDS sets using different apps and websites. If you’re interested in learning more about implementing this simple strategy for building fluency, you should take a look here for more information.

REFERENCES

Lindsley, O. R. (1996). The four free-operant freedoms. The Behavior Analyst, 19(2), 199.

WRITTEN BY SAM BLANCO, MSED, BCBA

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

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Productive Meetings in Home ABA Programs

Creating effective meetings with your child’s BCBA and other service providers can be difficult. In this month’s ASAT feature, Preeti Chojar, Board Member of the Association for Science in Autism Treatment (ASAT), shares some valuable tips about how parents can make the most out of these meetings. To learn more about ASAT, please visit their website at www.asatonline.org. You can also sign up for ASAT’s free newsletter, Science in Autism Treatment, and like them on Facebook!


I am a parent who has a home-based ABA program.  We have monthly meetings with all of the providers that work with my child.  I am looking for some ideas on how to make the most of these meetings.  Any suggestions?
 

Answered by Preeti Chojar, Mother and ASAT Board Member

It is terrific that your team meets monthly! Collaboration and consistency amongst members of the professional team is the hallmark of a successful home program. I have found that a great way to build teamwork is to have regular meetings to keep the whole team on the same page. Here are some suggestions to help you use this time effectively and efficiently. In our particular case, we meet monthly, but keep in mind that some teams may need to meet more frequently (depending on the composition of the team, level of oversight required, and needs of the child).

Meeting composition
Ideally, a time should be scheduled when the entire team can be present. A supervisor like a behavior consultant (e.g., BCBA) or a family trainer should be present as well. It could also include any related service providers, such as the speech pathologist, occupational therapist, or physical therapist. Assembling the entire team can be difficult but try your best, as the benefits will make it worthwhile.

Develop the agenda
Always create an agenda well before a team meeting. Please note that this agenda should not side-step any other communication that should be occurring (e.g., the consultant may want to know right away if a new skill-acquisition program is not going well).

  • Start by writing down any new behaviors, both positive and negative. Also note if there is evidence of lost skills or discrepancies in skill levels across settings, situations or people.
  • Any data taken by instructors should be summarized and analyzed before the meeting.
  • Add anything that the supervisor or the collective wisdom of the group could help resolve.
  • One of the agenda items should always be to review last month’s meeting notes paying close attention to any open or unfinished items.
  • If the child is also receiving services in a school or center-based environment, it is beneficial to seek input from those providers as well. Any observations made by people in the community that highlight some skill or skill deficit which had gone unnoticed can be brought to the table too.
  • Finally, make sure the agenda is well balanced and addresses everyone’s concerns. Prioritize agenda items and if necessary suggest some time limits.

Circulate the agenda

  • Make sure to circulate the agenda to everyone attending the meeting, ideally a few days before the meeting.
  • Ask all team members to notify you ahead of time of any other agenda items they might have that were not added yet.

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Tip of the Week: Things You Should Know About BCBAs

Maybe you’ve never heard of Board Certified Behavior Analysts (BCBAs), or you’ve heard of them frequently but never been provided an explanation of how a BCBA differs from an ABA therapist. Here are a few things you should know:

  • BCBAs are required to take extensive coursework in applied behavior analysis and complete 1500 hours of supervised work. Furthermore, they are required to take a difficult comprehensive exam at the end of their coursework and supervision hours. Once they have completed the hours and passed the exam, they are officially a BCBA.
  • BCBAs must complete 32 units of continuing education every two years. There is a requirement that some of these hours pertain to ethics, but the rest can be focused on skills such as addressing verbal behavior, feeding issues, aggressive behaviors, and more.
  • BCBAs are required to utilize evidence-based practice. A BCBA should be aware of current research in the field and should be able to easily reference the literature when encountering a difficult problem or working on an intervention.
  • One of my favorite parts of the ethical code for BCBAs is that “clients have a right to effective treatment.” Your BCBA should be taking data and implementing interventions that are effective in creating behavior change for clients. If an intervention is not working, then adjustments should be made.

The goal of Behavior Analyst Certification Board is to ensure appropriate training and accountability for behavior analysts.

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: Oops Groups Categories — and more!

Can you find the “oops” to help complete the Oops Groups Express Train? Our new Oops Groups Categories is a unique puzzle game where players use concentration and memory to find same-color Oops Groups Express puzzle pieces. To win, players must sequentially build the train and identify the one item on each puzzle piece that does not belong with the other items. Categories include food, animals, tools, season, and colors.

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Promotion is valid until August 2, 2016 at 11:59pm ET. Offer cannot be applied to previous purchases, combined with any other offers, transferred, refunded, or redeemed and/or exchanged for cash or credit. Different Roads to Learning reserves the right to change or cancel this promotion at any time. To redeem offer at differentroads.com, enter promo code OOPS15 at checkout.

Teaching Social Skills to Teens on the Spectrum

This week, we’re pleased to share a piece from Kirt Manecke, author of one of our newest additions Smile & Succeed for Teenswho offers his advice and take on how to teach teens and tweens very important social skills such as handshaking and saying “please,” “thank you,” and “you’re welcome.”

Please, Thank You, and You’re Welcome:
Teaching Social Skills to Teens on the Spectrum

by Kirt Manecke

Saying “please”, “thank you”, and “you’re welcome” are extremely important for social and job interactions. Why then is it so rare to hear these words spoken by teens and tweens? I recently had breakfast with my friend and his two kids, who are 12 and 16, at a restaurant. Both kids frequently failed to say please, thank you or you’re welcome to the waitress. I found myself saying thank you to the waitress for them! Their father did not seem to notice their lack of manners.

Research from Harvard University (Deming, 2015) says social skills are the top factor for getting a job. In my former life, when hiring teens for my specialty retail business, I looked for friendly teens with good social skills. Teens who smiled and said “please” and “thank you” were often the ones I hired. I knew they could engage customers and keep them happy and coming back. Often, we are drawn to making friends with people who have these same good social skills.

 

Social skills are especially difficult for teens on the autism spectrum, but many of these skills can be learned, and with practice, can become habit. Social skills are critical to make friends, get a job, and to live a fulfilling life.

Recently I helped some teens and tweens with autism prepare to sell products at a local farmers’ market. I acted as the customer in the initial role playing scenarios and found that the kids did not say “please”, “thank you” or “you’re welcome”. I then used information from my book Smile & Succeed for Teens: Must-Know People Skills for Today’s Wired World to teach them these skills. We took turns being the customer and the employee while role-playing how to say “please”, “thank you” and “you’re welcome”. Using their new social skills, the kids were able to sell chips and salsa at the local farmers’ market the next day.

You can do the same type of role playing with your kids. To improve their social skills, role play the skill with them. For example, have your teen or tween read the section, “Shake Hands Firmly.” Then, practice shaking hands with them, being sure to show them how “Too Tight”, “Too Loose” and “Just Right” feels.

I spent nine months meeting with teens to get their input for the book, and that’s a big reason teens and tweens find it appealing and are reading it. The font is large enough to make reading easy, plus there are fun, informative illustrations with educational captions every few pages.

Since, the book has received praise from teachers and school administrators, as well as Temple Grandin, author of Thinking in Pictures, and The Autistic Brain, who called me one evening after reading Smile & Succeed for Teens. She urged me to use her testimonial, “Smile & Succeed for Teens is a fantastic resource to help teens be successful at work”, to get the book out to all teens and tweens.

A firm grasp on social skills is key to maneuvering through all stages of life. Mastering these skills boosts teens’ confidence and gives them the skills they need to succeed in school, work and relationships. Please share the following book excerpt with your teen or tween to give them a head start in mastering these important social skills.

REFERENCES

Deming, D.J. (2015). The growing importance of social skills in the labor market (Working Paper No. 21473). Retrieved from National Bureau of Economic Research website: https://www.nber.org/papers/w21473.

ABOUT THE AUTHOR

Kirt Manecke is a an award-winning author and sales, marketing, fundraising, and business development specialist with over 30 years of experience surprising and delighting customers. Kirt’s books have won 11 awards. Quick-easy social skills for teens! He spent nine months meeting with teens for his award-winning book on social skills for teens. Kirt is currently at work on two children’s books. For more information, contact Kirt at Kirtm@SmiletheBook.com.

Pick of the Week: NEW! FlipChex™ Social Studies Magnetic Games

Teach young learners all about the world around them with our new FlipChex™ Social Studies Magnetic Games! This week, you can take 15% off any FlipChex™ set by applying our promo code FLIPCHEX at check-out. Aligned to state and national science standards, these magnetic games are self-correcting and easy to use. Just place the five answer cards, flip the game strip, and check your answers!

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With Jobs People Do, students become aware that the world of work includes a very diverse range of jobs, and that different occupations are suited to different types of talents, skills, and interests.

Perfect for post-July 4th festivities, Around the U.S.A. teaches students many of the people, places, symbols, and events that have helped weave the fabric of the history and traditions of the United States.

Don’t forget to use our promo code FLIPCHEX at check-out this week to save 15% on any of these great matching games!

*Promotion is valid until July 12, 2016 at 11:59pm ET. Offer cannot be applied to previous purchases, combined with any other offers, transferred, refunded, or redeemed and/or exchanged for cash or credit. Different Roads to Learning reserves the right to change or cancel this promotion at any time. To redeem offer at differentroads.com, enter promo code FLIPCHEX at checkout.

Pick of the Week: NEW! Super Duper Flashcards & Fun Decks — Teach parts of speech, vocab & more

We’ve added a bunch of new Super Duper® flashcards and fun decks to our collection! This week, you can save 15% on any of these select card decks that teach parts of speech and vocabulary — everything from nouns and irregular verbs to prepositions and synonyms! Use our promo code SUPERJUNE to redeem your savings at check-out.

With the Webber BIG Vocabulary Nouns Photo Cards, students will learn how to name, describe, identify attributes, compare and contrast, and formulate sentences in conversation with 600 vivid photo cards. This enormous set contains 5″ x 7″ photo cards that cover 14 different categories: Alphabet (26 cards); Animals (68 cards); Around the Home (80 cards); Clothing and Accessories (55 cards); Colors (12 cards); Food (83 cards); Numbers (11 cards); Occupations (46 cards); Places (70 cards); Plants (20 cards); School (38 cards); Shapes (7 cards); Toys (36 cards); Transportation (34 cards).

 

 

Synonyms Photo Fun Deck contains 28 pairs of photo cards to teach synonyms. Each pair of photo cards helps illustrate one sentence using two synonyms. This set also comes with game ideas for extra practice!

Each of the cards measures 2½” x 3½” and all come stored in a sturdy storage tin.

 

 

Irregular Verbs Fun Deck is a wonderful resource for teaching past and present tense for 26 irregular verbs pairs. Students will learn the ins and outs of “eat/ate,” “buy/bought,” “spend/spent,” and so much more. This illustrated fun deck will make teaching these difficult verbs fun and accessible for learners of all ages!

 

 

Don’t forget to use our discount code SUPERJUNE at check-out this week to save 15% on any of our select Super Duper card decks! View the entire sale here.

*Promotion is valid through June 28, 2016 at 11:59pm ET. Offer cannot be applied to previous purchases, combined with anyother offers, transferred, refunded, or redeemed and/or exchanged for cash or credit. Different Roads to Learning reserves the right to change or cancel this promotion at any time. To redeem offer at differentroads.com, enter promo code SUPERJUNE at checkout.

Elopement and Neighborhood Safety

As the end of the school year approaches and students are let out on vacation, it’s important for us to consider the risks of elopement and overall neighborhood safety for children with autism. This month, we’re sharing a special feature from ASAT written by Kate Britton, EdD, BCBA and Bridget Taylor, PsyD, BCBA from Alpine Learning Group in New Jersey. Here, Kate and Bridget offer their guidelines on preventing potentially harmful situations and ensuring the safety of your children. 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!

Elopement and Neighborhood Safety
Bridget Taylor, PsyD, BCBA and Kate Britton, EdD, BCBA
Alpine Learning Group, NJ

You are not alone. In fact, according to an online survey conducted by the National Autism Association in 2007, 92% of the parents indicated their child with autism was at risk of wandering away from his or her home or care provider. More recently, Kiely et. al. (2016) reported survey results of families of children with Autism Spectrum Disorders which found that 49% of those children had made an attempt to elope since the age of four. Additionally, 62% of parents of children who elope reported that this behavior prevents them from participating in activities away from home. Children with autism are especially vulnerable if they wander away from caregivers, as they may not be able to communicate that they are lost, take steps to ensure their safety such as identifying who in the community is safe vs. unsafe, asking for assistance, or stating important information such as their phone number. We hope the following guidelines can help you in preventing potentially harmful situations.

Develop a “safety / reaction plan”. Develop a family safety plan and practice that plan. In the event of your child wandering, time is most important and a quick, efficient response can make a difference. For example:

  • Which family member will call the local police?
  • Which family member(s) will go out looking and where (e.g., the route to the child’s favorite park)?
  • Which family member will call neighbors of homes with pools?
  • Which family member will stay by the phone in case the child is found and returned home or to receive updates?

You can find a sample plan at the Autism Wandering Awareness Alerts Response and Education (AWAARE) Collaboration website (www.awaare.com). It would also be important for your child’s school or treatment center to implement an emergency plan for elopement.

Secure your home and yard. Secure your home and yard area so that your child is less likely to wander away. Sometimes standard locks are not enough as many children quickly learn how to operate standard locks on doors, windows and gates. Install locks on doors and gates in the yard that your child cannot open (consider location height and lock complexity). In addition, if your home has an alarm system, keep it set to go off whenever a door or window has been opened. If your home does not have an alarm, install an alarm system that signals when a door or window is opened. There are a variety of systems available, including high-tech and low-tech options. You may consider contacting a medical or educational provider, who can help identify resources to help obtain funding for such systems/equipment. Here are some suggested websites:

Install monitoring systems. Additionally, be sure to regularly monitor your child around the house by using a video monitoring system or a baby monitor that has video monitoring capability, such as:

Make the yard and pool area safe! If you have a pool or there is a pool nearby, ensure there is a locked fence surrounding the pool. You can also purchase a pool alarm for yours and/or your neighbors’ pools (e.g., www.poolguard.com). If your child goes into pools unsupervised, you can also use the Safety Turtle (www.safetyturtle.com), which is a wristband that locks securely around your child’s wrist and sounds an alarm if it becomes immersed in water.

Inform law enforcement. It is also critical to inform your police and fire departments that an individual with autism resides in your home. You can do this by calling your local non-emergency telephone number and asking personnel to note in the 911 database that someone with autism lives at your address. If there is ever an emergency, the emergency responders will know in advance that they need to respond accordingly. We also recommend giving local police and fire departments a picture of your child with your contact information on the back which can be helpful in identifying your child if s/he is ever brought to the station by someone else. Another suggestion would be to register with the National Child Identification Program (www.childidprogram.com). The program provides a kit that includes information on everything law enforcement would need in case of an emergency.

Educate neighbors. Another tip is to make sure your trusted neighbors are aware of your situation. Give them a picture along with some helpful information about your child (e.g., s/he is unable to speak, s/he responds to simple commands, s/he likes to swim so please keep your pool gate locked) and about autism in general. Also include your cell phone and home phone numbers, and ask them to call immediately in the event they ever see your child wandering away from the house or walking the street unaccompanied by an adult. Also, assess your child’s current level of communication. For example, can s/he answer social questions and be understood by novel listeners? Strangers will be most likely to ask your child, “What’s your name?” So it is important that your child can be understood by listeners who don’t know your child. If your child will not be understood or can’t relay enough information, you could use medical identification jewelry, such as a bracelet (e.g., www.medicalert.org).

Safety on vacations. Once your home is secure, vacations may still seem unrealistic. However, there are some steps you can take to allow your family to safely stay in a hotel or space other than the safe haven you have created. When planning for a vacation, really think about your vacation destination and determine the potential risks for your child with autism. Specifically, if your child has a history of wandering (especially towards pools or other swimming areas) you may want to ask for a room furthest from the pool area or without an ocean view-or maybe even choose a location that does not have a pool. When checking into the location, inform the hotel staff about your child and advise them that s/he will require supervision at all times and if they see him/her unsupervised to call you immediately. Also, consider using portable door alarms for hotel rooms, a child-locator systems and/or a global positioning systems (GPS). You can find low-tech tracking devices and high-tech devices online.

Teach skills to increase safety. Lastly, it’s essential to proactively teach your child skills that will increase his/her safety. Work with your child’s school or treatment program to include the important safety goals in your child’s individualized education plan (IEP) such as:

  • responding to “stop”
  • answering questions to provide information
  • responding to name
  • holding hands
  • requesting permission to leave the house
  • requesting preferred items/activities
  • waiting appropriately
  • using a cell phone
  • crossing the street safely (if appropriate given age and level of functioning)
  • seeking assistance when lost
  • cooperating with wearing identification jewelry
  • identifying outdoor boundaries (i.e., not leaving the front lawn)
  • learning clear rules about outdoor play (getting a parent if a stranger approaches, asking for help if ball goes into street)
  • swimming more proficiently
  • learning rules about pool use

Check out www.awaare.org for sample letters to submit to your case manager and attach to your child’s IEP. Finally, it cannot be overstated that children with autism require very close supervision when in harm’s way. We hope you find these proactive and teaching suggestions helpful in minimizing your child’s risk.

Additional toolkits and resources

References

Anderson, C., Law, J.K., Daniels, A., Rice, C., Mandell, D. Hagopian, L. & Law, P. (2012). Occurrence and family impact of elopement in children with autism spectrum disorders. Pediatrics, 130(5), 870-877.

Kiely, B., Migdal, T. R., Vettam, S., Adesman, A. (2016). Prevalence and correlates of elopement in a nationally representative sample of children with developmental disabilities in the United States. PLoS ONE 11(2): e0148337, doi:101371/journal. Pone.0148337

About the Authors

Dr. Bridget A. Taylor, PsyD, BCBA is Co-founder and Executive Director of Alpine Learning Group and is Senior Clinical Advisor for Rethink. Dr. Taylor has specialized in the education and treatment of children with autism for the past twenty-five years. She holds a Doctorate of Psychology from Rutgers University, and received her Master’s degree in Early Childhood Special Education from Columbia University. She is a Board Certified Behavior Analyst and a Licensed Psychologist. She is an Associate Editor for the Journal of Applied Behavior Analysis and serves on the editorial board of Behavioral Interventions. She is a member of the Behavior Analyst Certification Board and serves on the Autism Advisory Group for the Cambridge Center for Behavioral Studies. Dr. Taylor also serves on the Scientific and Community Advisory Board for SPARK a new program at the Simon’s Foundation Autism Research Initiative. Dr. Taylor is active in the autism research community and has published numerous articles and book chapters on effective interventions for autism. She is a national and international presenter and serves in an advisory capacity for autism education and treatment programs both locally and abroad. She has been influential in the development of autism treatment centers both locally and in Italy, India, Canada, France, Australia and Kosovo. Dr. Taylor’s current research interests are in identifying innovative procedures to increase the observational learning repertoires of children with autism.

Kate E. Cerino Britton, EdD, BCBA is a Board Certified Behavior Analyst and a certified teacher of the handicapped, and has worked with individuals with autism since 1997. She is currently the Principal of the education program at Alpine Learning Group. She holds a Masters in Education Administration from Caldwell College and Special Education from Long Island University and a doctoral degree in Educational Leadership, Management, and Policy from Seton Hall University. She serves on the New Jersey Association for Behavior Analysis Board of Directors as the Secretary and Continuing Education Chair and has presented at national and international conferences on increasing socializing, problem solving, small groups and dyad instruction, promoting safety, and augmentative communication.