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  • prompts
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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.

Productive Meetings in Home ABA ProgramsDevelop 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: Consider Response Effort in Your Intervention

Several previous posts have discussed how important it is to have a multi-pronged approach to behavior interventions, including definitions for how caregivers will respond to undesirable behavior, the replacement behavior, and reinforcement. One thing I have not shared is considering response effort when choosing a replacement behavior.

Response effort describes how easy or difficult it is to engage in a behavior. For example, I frequently check my e-mail on my phone. Occasionally, I get an e-mail that requires a lengthy reply. The response effort for typing on the tiny touchpad is much greater than sitting down at my laptop and using the keyboard, so I wait until I can go to my computer to reply to that e-mail. Typing on the keyboard requires less response effort.

In general, when we make choices about how to behave, whether we are aware of it or not, we choose the behavior that gets the best results with the least response effort. But if a low response effort achieves poor results, we’re probably not going to engage in that behavior. Let’s look at an example of choosing a higher response effort. Let’s say I live down the street from a hair salon, and I go there once but hate my hair cut. I’ll engage in the higher response effort to drive 30 minutes to a salon that gives me a great cut. I want the lowest response effort, but not if it achieves poor results.

So how does this apply to interventions in your environment? When you’re choosing a replacement behavior, you should try to make it require less response effort than the undesirable behavior. Here are a couple of examples:

  • Every time you teach a math lesson, your learner breaks his pencil and throws it across the room. You’ve identified that the behavior of breaking the pencil functions as escape, meaning that in the past, when he broke his pencil, his consequence was a break, a walk to “calm down,” or a trip to see the dean. You’ve provided a replacement behavior of holding up a stop sign that stays on his desk. When he holds up the stop sign, he is provided with a break. Holding up the stop sign requires much less response effort than breaking a pencil.
  • You are the director of a center for learners with autism. Many of your students are being toilet trained during the day. It is important that the providers working with the students wear gloves during the toilet training process. The gloves are on the wall when you enter the bathroom, but you’ve noticed that several providers are still not wearing gloves. One provider tells you that if she forgets to grab the gloves as she’s coming in and the child is already in the stall, it’s too difficult to backtrack and keep an eye on the child. You decrease the response effort by placing a box of gloves inside each stall in the bathroom.

Decreasing the response effort for the desired behavior while simultaneously increasing the response effort for the undesirable behavior can produce even better results. There have been several studies related to increasing response effort for self-injurious behavior such as hand-biting while providing replacement behaviors with a lower response effort.

As you’re developing behavior intervention plans or thinking of ways to improve your teaching environment, you should think through the possibilities of using response effort to encourage appropriate behaviors.


WRITTEN BY SAM BLANCO, MSED, BCBA

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

Tip of the Week: How to Implement a Successful Behavioral Intervention

Creating a successful behavior intervention is more challenging than it first appears. Below, I’ve listed four essential parts for changing maladaptive behaviors and increasing desired behaviors. Most of the time, when a behavior intervention is not working, one or more of these steps has been neglected.

1.  Find a BCBA or ABA provider who can guide you through the process. Getting help from someone with experience in addressing challenging behaviors is an essential first step. They should be a wealth of information about each of the following steps, provide check-ins and troubleshooting during the intervention process, and maintain data on the behavior to insure the intervention is working.

2.  Identify the function of the behavior. There are four reasons that any of us behave: attention, escape/avoidance, access to a tangible (such as chips or a toy train), and automatic reinforcement (meaning physical sensations that are not related to social interactions, including sound, taste, touch, or a response to movement). A BCBA can be especially useful in helping to identify the function of the behavior. They may utilize an ABC chart to determine the function, which means they observe the behavior and note it’s antecedent, what the behavior looks like, and the immediate consequence. If the ABC chart is not helpful, they may perform a more formal Functional Analysis. Before any intervention is put in place, all parties interacting with the child should understand the function (or reason) for the problematic behavior.

3.  Provide a replacement behavior. As a part of the intervention, a replacement behavior should be provided. A BCBA or ABA provider should be able to help you find appropriate replacement behaviors for the problematic behavior. For example, with one student who was chewing his shirt, we introduced a replacement behavior of chewing gum. With another student who was throwing his iPad, we used tape to put an “X” on his desk and taught him to place it on the “X.” The idea is to provide an appropriate behavior that is incompatible with the problematic behavior. But that’s not always possible. For example, one of my former students was banging her head on the table during instruction. We taught her to request a break by touching a picture of a stop sign. Realistically, she was able to bang her head while simultaneously touching the stop sign, but once she learned that she got to escape the activity by touching the stop sign, she stopped banging her head in order to escape. It’s important to note that using the stop sign wouldn’t work for all head-banging behavior, but we had identified the function of the behavior and were able to introduce a replacement behavior that served the same function while meeting the skill level and needs of that individual student.

4.  Provide reinforcement for appropriate behavior. A specific plan for providing reinforcement for use of a replacement behavior and any other desired behaviors is essential. The reinforcement for the appropriate replacement behavior should serve the same function as the problematic behavior. This can sometimes be difficult to achieve, but without this aspect of intervention, you may see slow success, or no success at all.

Again, creating a multi-pronged intervention can be a challenge. It’s important to seek out help, and to take a look at research related to the problem behavior you are trying to address. It is possible to create a strong intervention that has a huge impact on your learner, but it must include the aspects listed above to have the highest potential for success.

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.

Tip of the Week: Choose When to Battle

Instead of choosing your battles, choose when to battle.

Recently at a workshop I was providing, a parent shared a difficult behavior that her 8 year old son with autism was exhibiting. When it was time to play with trains, he wanted a specific train. He would scream and cry until his mom found the specific train he wanted, and sometimes she was unable to find it at all. The screaming often lasted 30-60 minutes. She said this frequent behavior was stressful for both her, her son, and her other two children.

My suggestion to her was to tell her son “wait quietly,” and that she not search for the train while he was screaming or crying. As long as he was quiet, she would search, but when he started screaming or crying she would stop searching. We talked about the importance of just asking one time to “wait quietly,” and whether or not her son would benefit from a textual prompt (such as a paper that said “Wait quietly. I’m looking.”) As we discussed this, the parent said, “I just know I can’t do that all the time. I have to pick my battles.”

It’s important to note here that I have very different expectations for teachers and parents when it comes to implementing interventions. A teacher’s sole purpose when they’re with your child is to teach in a way to meet their unique needs. Teachers should be implementing an intervention 100% of the time.

Parents, on the other hand, are in a very different situation. Parents are frequently trying to implement the intervention while also cooking dinner, answering the phone, taking care of other children, etc. Unless the intervention is addressing a dangerous behavior, I don’t expect parents to be implementing the intervention 100% of the time. It’s unrealistic given the different environment the parent is working within.

But I’m not letting parents off the hook! Let’s go back to the example from the workshop.

My response to this parent was that picking your battles doesn’t necessarily mean choosing to address other, less stressful behaviors instead of this behavior. Instead of picking your battles, think of it as picking when to battle. For this parent, she would direct her son to “Wait quietly” when she knew she was ready to implement the intervention. When she knew she wouldn’t be able to implement the intervention (because she was excessively tired or she had the other two siblings with her and no other adult support) she would not say “Wait quietly.”

This may seem a bit silly at first, but over time, the child learns that when mom says “Wait quietly,” she means it. I also suggested that the first time she tries it, she should set herself up for success. Have her mother babysit the other two children, have a therapist or teacher come provide support or coaching if possible, and make sure she has enough time to follow through on implementing the intervention successfully the first time. While it takes some time and planning, the long term benefits can be powerful for the whole family.

I do not know if this particular parent tried out any of my suggestions after the workshop, but I have used this strategy with many other parents over the years. Two things tend to happen. One: the child figures out the parent means what he/she says. Two: As the child learns this and the parent experiences success, the parent uses the intervention more frequently creating a calmer, less stressful environment for both parents and children.