Teaching Action Labels to Children with Autism

Oftentimes as a parent with a child with autism, it can be difficult when your child is struggling to meet normal child growth and development milestones. One way to help children with autism in the development of words and understanding of the world around them is through action labels. Giving a child with autism a way to communicate using action labels can aid in a more smoothly operating daily routine. These action labels also help to expand a child with autism’s vocabulary and increase their identification skills of people, objects, and actions.

Teaching Action Labels to Children with Autism

What are action labels?

Action labels are a way for a child with autism to communicate and be able to acquire language skills. The goal with action labeling is for the child to be able to label objects, people, and actions correctly as well as have an understanding of what the word means. For example, starting with the 5 senses during a child’s daily routine can help to identify common things they interact with and come in contact with in an everyday setting. When teaching action labels, it is important to reduce background noises and distractions as much as possible so that the child can solely focus on the objects being labeled.

When should you start teaching action labels?

When action labels should be taught is different for each child. However, there is a checklist that once completed is seen as a good time to begin teaching action labels.

Checklist includes:

  • beginning to show an interest and interacting with their environment
  • interacting with other people
  • having a daily routine
  • knows more than a few words or can demonstrate an understanding of more than a few words

A good way to start is using ongoing actions. For example, with the word jump. You would ask the child to show me jumping and they would start jumping. Then have them identify the action on someone or something else. Have mom start jumping, and ask what am I doing and the child would respond with jumping. When you begin teaching action labels it is important to practice over and over again. The correct and consistent use of the label does not happen overnight.


Teaching Action Labels to Children with Autism

Why are action labels important?

Action labels are one method to help children with autism communicate. Since children with autism typically develop language later than their peers, action labels can provide that missing piece to a child with autism. Neurotypical people use words as a form to label objects, actions, people, and concepts. Babies learn this from those around them, acquiring words and understanding what words mean by watching others. However, as stated prior children with autism typically have language deficits which makes learning these everyday word labels difficult. Therefore, teaching them how a label is a vital component to aid the child with their progress of language development and interaction with the world around them and others.

What are common challenges in teaching action labels?

Some common challenges in teaching action labels include a delay in using, limited imitation skills, lack of understanding, and difficulty inconsistent use.

  • Delay in use: As had been said children with autism typically have a delay in language use or use simpler language than the rest of their peers. This delay in language use can cause a delay in the child’s ability to acquire the skill of labeling and using action labels consistently.
  • Limited imitation skills: Most babies and young children acquire language through imitating others around them. When they hear adults using language, they try to repeat back what they said or use it at a later time. However, children with autism typically do not have the developmental interest in focusing on their parents and copying them.
  • Lack of understanding: Once children with autism are taught labels, they may use them through memorization rather than actually understanding what it is that they are labeling. They just use them out of habit or to appease rather than actually connecting what it is they are labeling with a word or action they understand.
  • Difficulty inconsistent use: Unless label teaching is consistent in all places of a child’s life, a child with autism will not be able to consistently use labeling. So, if labeling is taught at school, it should also be reinforced at home and vice versa.

Teaching a child to label correctly can truly expand their view of the world around them. Words are used as a way to communicate within the world, so giving that tool to a child with autism can be extremely vital. Using modeling, prompting, and reinforcement in all aspects and environments of a child’s life increases their consistent use and true understanding of the labels.

Let Leafwing Center help with developing some action labels for your autistic child, so they can be successful in communicating in the world around them. Our ABA therapists are trained in creating personalized plans that match your child’s ability levels.

 

 

Related Articles:

Autism Communication Strategies
Strategies For Autism In The Classroom

Glossary Terms:

Functional Communication Training (FCT)
Picture Exchange Communication System (PECS)

Frequently asked questions about ABA therapy

What is ABA Therapy used for?

ABA-based therapy can be used in a multitude of areas. Currently, these interventions are used primarily with individuals living with ASD; however, their applications can be used with individuals living with pervasive developmental disorders as well as other disorders. For ASD, it can be used in effectively teaching specific skills that may not be in a child’s repertoire of skills to help him/her function better in their environment whether that be at home, school, or out in the community.  In conjunction with skill acquisition programs, ABA-based interventions can also be used in addressing behavioral excesses (e.g., tantrum behaviors, aggressive behaviors, self-injurious behaviors). Lastly, it can also be utilized in parent/caregiver training.

In skill acquisition programs, a child’s repertoire of skills is assessed in the beginning phase of the services in key adaptive areas such as communication/language, self-help, social skills, and motor skills as well.  Once skills to be taught are identified, a goal for each skill is developed and then addressed/taught by using ABA-based techniques to teach those important skills. Ultimately, an ABA-based therapy will facilitate a degree of maintenance (i.e., the child can still perform the learned behaviors in the absence of training/intervention over time) and generalization (i.e., the learned behaviors are observed to occur in situations different from the instructional setting).  These two concepts are very important in any ABA-based intervention.

In behavior management, the challenging behaviors are assessed for their function in the beginning phase of the services. In this phase, the “why does this behavior happen in the first place?” is determined. Once known, an ABA-based therapy will be developed to not just decrease the occurrence of the behavior being addressed, but also teach the child a functionally-equivalent behavior that is socially-appropriate.  For example, if a child resorts to tantrum behaviors when she is told she cannot have a specific item, she may be taught to accept an alternative or find an alternative for herself. Of course, we can only do this up to a certain point—the offering of alternatives.  There comes a point when a ‘no’ means ‘no’ so the tantrum behavior will be left to run its course (i.e., to continue until it ceases).  This is never easy and will take some time for parents/caregivers to get used to, but research has shown that over time and consistent application of an ABA-based behavior management program, the challenging behavior will get better.

In parent training, individuals that provide care for a child may receive customized “curriculum” that best fit their situation.  A typical area covered in parent training is teaching responsible adults pertinent ABA-based concepts to help adults understand the rationale behind interventions that are being used in their child’s ABA-based services.  Another area covered in parent training is teaching adults specific skill acquisition programs and/or behavior management programs that they will implement during family time.  Other areas covered in parent training may be data collection, how to facilitate maintenance, how to facilitate generalization of learned skills to name a few.

There is no “one format” that will fit all children and their families’ needs. The ABA professionals you’re currently working with, with your participation,  will develop an ABA-based treatment package that will best fit your child’s and your family’s needs. For more information regarding this topic, we encourage you to speak with your BCBA or reach out to us at [email protected].

Who Can Benefit From ABA Therapy?

There is a common misconception that the principles of ABA are specific to Autism. This is not the case. The principles and methods of ABA are scientifically backed and can be applied to any individual. With that said, the U.S. Surgeon General and the American Psychological Association consider ABA to be an evidence based practice. Forty years of extensive literature have documented ABA therapy as an effective and successful practice to reduce problem behavior and increase skills for individuals with intellectual disabilities and Autism Spectrum Disorders (ASD). Children, teenagers, and adults with ASD can benefit from ABA therapy. Especially when started early, ABA therapy can benefit individuals by targeting challenging behaviors, attention skills, play skills, communication, motor, social, and other skills. Individuals with other developmental challenges such as ADHD or intellectual disability can benefit from ABA therapy as well. While early intervention has been demonstrated to lead to more significant treatment outcomes, there is no specific age at which ABA therapy ceases to be helpful.

Additionally, parents and caregivers of individuals living with ASD can also benefit from the principles of ABA. Depending on the needs of your loved one, the use of specified ABA techniques in addition to 1:1 services, may help produce more desirable treatment outcomes. The term “caregiver training” is common in ABA services and refers to the individualized instruction that a BCBA or ABA Supervisor provides to parents and caregivers. This typically involves a combination of individualized ABA techniques and methods parents and caregivers can use outside of 1:1 sessions to facilitate ongoing progress in specified areas.

ABA therapy can help people living with ASD, intellectual disability, and other developmental challenges achieve their goals and live higher quality lives.

What does ABA Therapy look like?

Agencies that provide ABA-based services in the home-setting are more likely to implement ABA services similarly than doing the same exact protocols or procedures. Regardless, an ABA agency under the guidance of a Board-Certified Behavior Analyst follows the same research-based theories to guide treatment that all other acceptable ABA agencies use.

ABA-based services start with a functional behavior assessment (FBA). In a nutshell, a FBA assesses why the behaviors may be happening in the first place. From there, the FBA will also determine the best way to address the difficulties using tactics that have been proven effective over time with a focus on behavioral replacement versus simple elimination of a problem behavior. The FBA will also have recommendations for other relevant skills/behaviors to be taught and parent skills that can be taught in a parent training format to name a few. From there, the intensity of the ABA-based services is determined, again, based on the clinical needs of your child. The completed FBA is then submitted to the funding source for approval.

One-on-one sessions between a behavior technician and your child will start once services are approved. The duration per session and the frequency of these sessions per week/month will all depend on how many hours your child’s ABA services have been approved for—usually, this will be the number recommended in the FBA. The sessions are used to teach identified skills/behaviors via effective teaching procedures. Another aspect of ABA-based services in the home-setting is parent training. Parent training can take many forms depending on what goals have been established during the FBA process. The number of hours dedicated for parent training is also variable and solely depends on the clinical need for it. If a 1:1 session is between a behavior technician and your child, a parent training session or appointment is between you and the case supervisor and with and without your child present, depending on the parent goal(s) identified. Parent training service’s goal is for you to be able to have ample skills/knowledge in order for you to become more effective in addressing behavioral difficulties as they occur outside of scheduled ABA sessions. Depending on the goals established, you may be required to participate in your child’s 1:1 sessions. These participations are a good way for you to practice what you have learned from the case supervisor while at the same time, having the behavior technician available to you to give you feedback as you practice on those new skills.

As mentioned in the beginning, no two ABA agencies will do the same exact thing when it comes to providing ABA services; however, good agencies will always base their practice on the same empirically-proven procedures.

How do I start ABA Therapy?

In most cases, the first item required to start ABA therapy is the individual’s autism spectrum disorder (ASD) diagnosis report. This is typically conducted by a doctor such as a psychiatrist, psychologist, or a developmental pediatrician. Most ABA therapy agencies and insurance companies will ask for a copy of this diagnosis report during the intake process as it is required to request an ABA assessment authorization from the individual’s medical insurance provider.

The second item required to start ABA therapy is a funding source. In the United States, and in cases where Medi-Cal or Medicare insurances are involved, there is a legal requirement for ABA services to be covered when there is a medical necessity (ASD diagnosis). Medi-Cal and Medicare cover all medically necessary behavioral health treatment services for beneficiaries. This typically includes children diagnosed with ASD. Since Applied Behavior Analysis is an evidence based and effective treatment for individuals with ASD, it is considered a covered treatment when medically necessary. In many cases, private insurance will also cover ABA services when medically necessary, however in these cases, it is best to speak directly with your medical insurance provider to determine the specifics of the coverage and to ensure that ABA is in fact, a covered benefit. Additionally, some families opt to pay for ABA services out-of-pocket.

The next step to starting ABA therapy is to contact an ABA provider whom you are interested in working with. Depending on your geographic location, ABA agencies exist in many cities across the United States. Your insurance carrier, local support groups, and even a thorough online search can help you find reputable and properly credentialed ABA agencies near you. Our organization, LeafWing Center, is based in southern California and is recognized for aiding people with ASD achieve their goals with the research based on applied behavior analysis.

Once you have identified the ABA provider with whom you wish to work, they should help you facilitate the next steps. These will include facilitating paperwork and authorizations with your funding source. Once the assessment process begins, a BCBA (Board Certified Behavior Analyst) or qualified Program Supervisor should get in contact with you to arrange times in which interviews with parents/caregivers and observations of your loved one can be conducted. This will help in the process of gathering important clinical information so that with your collaboration, the most effective treatment plans and goals can be established for your loved one. This process is referred to as the Functional Behavior Assessment (FBA) and is elaborated on in different blog posts on our website. With regard as to what can be expected once ABA therapy begins, please read our blog post titled: When You Start an ABA program, What Should You Reasonably Expect from Your Service Provider?

Parent Tips To Determining Why Behavior Problems Happen

A helpful way to effectively tackle a child’s problem behavior is to figure out why it is happening in the first place.  To implement an intervention without this important information may produce no results or even make the challenging behavior far worse than it was before implementing the tactic you’ve chosen.

To figure out a behavior’s possible function, first we have to look at the antecedent—whatever it is that happened right before the behavior. And secondly, we also have to pay attention to the consequence that happens while or after the behavior happened.  This relationship between antecedent àbehavior ß consequence over time may contribute to why a child does the problem behavior.

There are four likely reason “why” a behavior may happen: for access, to escape/avoid, for attention, and for self-stimulation.

  1. Access

A problem behavior can be strengthened or reinforced when it produces a consequence that increases the chance of the problem behavior from happening again over time.

Example

A child is told he cannot have his tablet to play video games on which results in the child engaging in tantrum behaviors.  The parent does not want to deal with the tantrums so the child is given the tablet.  In this example, tantrums after being told “NO, you can’t have ____” resulted in the child getting what he cannot have.

A B C
Told no tablet/video games Tantrums Got tablet video games

 

  1. Escape/Avoidance

A problem behavior can be strengthened or reinforced when it produces a removal of something a person does not like (Escape).  The same strengthening of the behavior may also happen if the behavior prevents something that a person does not like from happening at all (Avoidance). Providing the behavior with either consequence may strengthen the behavior over time.

Example 1 (Escape)

A child is asked by his parent if there is homework for the day.  The child says yes and with her parent, starts working on the homework.  As the work becomes more difficult, the child starts complaining to the parent.  The parent instructs the child to continue working, but the child just continues complaining and eventually starts throwing pencils towards the wall. Unsure about what to do, the parent takes the homework off the table and tells the child that she doesn’t need to work on it anymore.

A B C
Instruction to continue with school-work Continual complaints, throwing pencil at wall School-work removed

 

Example 2 (Avoidance)

Upon getting home, the parent asks the child if there is homework for the day.  The child replies, “No homework today, yay!”  There is homework for that day.

A B C
Parent asks about homework Lies about having no homework Homework avoided
  1. Attention

A problem behavior can be strengthened or reinforced when it produces any response from another person that leads to the likelihood on the problem behavior from happening again over time.

Example

A family is having dinner at the table.  The elder child starts playing with her food and manages to flick a pea from her plate across the table with her fork.  The younger child starts laughing at his sibling being funny.  The elder child then repeats the behavior which makes the younger child laugh hysterically.  The parent asks the elder child to stop, but to no avail—peas scattered all over the dining table.

A B C
Other people at the table Flicking pea across the table (elder child) Younger child laughing

 

  1. Self-stimulatory

A problem behavior can also be reinforced automatically by the pleasant sensations the action produces. Parents can have an idea if a problem behavior may function for self-stimulation if the child performs the behavior regardless whether the child is around individuals or—and most especially—if the child is all alone.

Example

A child watching a video on her tablet “rewinds” the video to a specific scene, watches the clip for a few seconds, then rewinds the video once again to watch the same scene.  This chain of behaviors may repeat for an indefinite length of time.

A B C
End of favorite clip (and “desire” to watch again Rewinds video to the beginning of favorite scene Watching favorite scene again

Although there are now many tools that we can use to figure out the specific function of a behavior, parents and caregivers can still use A-B-C data analysis to help them find out the function(s) of a problem behavior to help determine the best tactic to use in addressing the behavioral difficulty.   For complex or intense problem behaviors that can pose a hazard to a child’s and others’ safety, it is highly advised that parents/caregiver seek assistance from a qualified behavior analyst.

Leafwing Counseling

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World Autism Month

April is World Autism Month

Every April, Autism Speaks kicks off World Autism Month beginning with UN-sanctioned World Autism Awareness Day on April 2.Joined by the international community, hundreds of thousands of landmarks, buildings, homes and communities around the world, light blue in recognition of people living with autism. Autism-friendly events and educational activities take place all month to increase understanding and acceptance and foster worldwide support.