What not to do with a child with autism

Oftentimes it is suggested what to do with a child with autism. However, equally as important is what not to do. It is necessary to know and understand what not to do in order to be able to provide the best environment for a child with autism.

ABA therapy programs are effective in treating children with autism because they create very structured environments where conditions are optimized for learning. Over time, these very structured environments are systematically changed so that the environment mimics what a child could expect if and when they are placed in other environments.

Let Leafwing professionals educate you and your child on some key components and techniques when raising a child with autism to reach their full potential.

Don'ts of Autism

What not to do with discipling a child with autism

It can be hard to know what to do and not do in terms of discipline with a child with autism. Their development is different from their neurotypical peers so it is vital to make the distinction.

  • Do not punish for typical autistic behaviors. Stimming, meltdowns from overstimulation, and spams are all behavior they cannot control. They are part of a normal every day for a child with autism.
  • Do not be confusing in your reasoning. When explaining to a child with autism a reason for the consequence, use clear logic they can understand. Avoid things like metaphors, hypothetical scenarios, and complex vocabulary.
  • Do not use punishments that are not age/developmentally appropriate. Use consequences to help your child grow and learn. Behavior is a form of communication. Learn what your child is trying to communicate and help them better communicate that next time with positive action.

Your child with autism may not understand the traditional discipline techniques as well as the consequences of their actions. As a parent you might feel frustrated by this, but you need to refrain from any kind of physical or verbal punishment that could have a negative effect on your child. Remember, all children learn from imitation, so try to respond to your child’s behavior clearly and gently. Consistency is the key for all children when it comes to discipline. Do it with a loving heart. When children know you are disciplining them because you love them and want what is best for them then it has a more positive outcome.

What not to do with tasks for a child with autism

What not to do with tasks for a child with autism

Children with autism are able to complete tasks and chores similar to other children. These are necessary to help them become independent and learn essential life skills. Practice tasks with Forward Chaining or Backward Chaining methodology. Use the method that your child feels more comfortable with.

  • Do not have too many expectations. Have a few clear expectations for a child to be able to remember and follow.
  • Do not only have verbal instructions. Many children with autism are visual learners. Therefore, provide both words and pictures. For example, a picture of a toothbrush with toothpaste on it to remind them to brush their teeth.
  • Do not make them do less just because they have autism. Children with autism are just as capable as their peers. They may need a little more help when completing a task but they can still do it. Holding a child back from their full potential will only hurt them in the long run.

Remember at the Leafwing Center your ABA therapist can put together an Acquisition Skill Plan to help hone in on a skill that needs to be refined to help your child progress in basic analysis tasks like getting dressed, brushing teeth, or combing their hair.

 

What not to do when interacting with a child with autism

What not to do when interacting with a child with autism

People can often feel awkwardness or uneasiness when interacting with a child who has autism. However, there are just a few key concepts to remember for the interaction to easily go smoothly.

  • Do not get into their personal space. Many children with autism do not like to be touched especially when it’s unexpected. Give them their space.
  • Do not only see them as a child with autism. Autism is part of their identity but it is not their whole identity. When interacting with a child with autism, treat them like you would treat anyone else with kindness.
  • Do not beat yourself up over making a mistake. As a parent of a child with autism (and just a person in general), you are going to make mistakes. So, give yourself grace, apologize, and move on.

Teaching children with ASD to improve their communication skills is essential for helping them reach their full potential. There are many different approaches, but the best treatment program begins early, during the preschool years, and is tailored to the child’s age and interests. It should address both the child’s behavior and communication skills and offer regular reinforcement of positive actions. Most children with ASD respond well to highly structured, specialized programs. Parents or primary caregivers, as well as other family members, should be involved in the treatment program so that it becomes part of the child’s daily life.

 

Autism Feeding Issues

What not to do during meal time with a child with autism

Meal times can be a stressful time for everyone in a household that has a child with autism. With all the different textures and flavors, it can be intimidating. Children with autism have an increased likelihood of possessing food sensitivities. Both food allergies and food intolerances are common in children with autism. These children are twice as likely to have some type of food sensitivity. Refer to your pediatrician about any food allergies with your child .

  • Do not make choices for them. Allow a child with autism to make choices for themselves within reason. This will give them the confidence and independence to do it on their own next time.
  • Do not yell at them. For any child, this can be overwhelming but for a child with autism, this increase in sound can trigger a meltdown. Additionally, it doesn’t help fix the situation in the end.
  • Do not rush or pressure them. Eating and meal times can be a very difficult time for a child with autism. Allowing them to go at their own pace and providing a safe environment for the child is a necessity.

Leafwing Center can work with you to design a plan for autism feeding issues that you may be facing with your child. Our ABA therapists are trained in creating personalized plans that match your child’s ability levels. ABA therapists are trained to address the behavior. If you are concerned about the health and wellness of your child then you need to contact your physician.

Having a child with autism is a learning process for everyone. You as a parent are going to be constantly learning the new and best way to help your child with autism navigate new experiences with the world around them. There is no one-size-fits-all when it comes to the approach of developing a child, alone a child with autism. Learn from these ‘What Not to Dos’ and adjust your approaches with your child.

Leafwing Center has professional BCBA therapists that can help you and your child navigate through the stages of development as your child grows. Call us today to see how we can help!

Other Related Articles:

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?

Strategies to use for the park with your child with autism

There are some simple strategies to use when going to the park with your child with autism. Going to the park can turn into a nightmare quickly if the child with autism starts to feel overwhelmed or surprised. Many parents don’t take the necessary steps to help minimize the meltdowns of children with autism and run into barriers when taking their children out into the community.

Strategies to Help You Go to the Park with Your Child with Autism

Challenges for children with autism at the park

The park is one place where children typically enjoy their freedom and thrive, which can be a nice relief for many parents. Although, for parents of children with autism, this can be a stressful situation for many reasons.

  • Children with autism may not have the social skills to play with other children and they may not interact in ways that are socially appropriate.
  • Some children might have the tendency to run or wander away (elope).
  • Other children may have difficulties with transitions and therefore, leaving the park is always a struggle for the parent of a child with autism, more so than that of a parent of a typically developing child.

Nevertheless, there are some strategies for parents of children with autism to practice to help relieve some of these stressors and make the park a more enjoyable experience for everyone.

How parents can prepare children with autism for the park

The key to going to the park is to plan and prepare ahead of time. Give lots of warnings to help minimize the meltdowns. Predictability allows the child to feel more secure. When they feel uncomfortable and out of control is when the meltdown is triggered.

Tips on how to prepare:

  • Let the child have a say. Ask them what they would like to try first at the park.
  • Share the schedule. Let them know what to expect. If transitions are difficult, let your child know from the time of arrival how much time he or she will have at the park. Have a visual countdown (e.g., boxes that are crossed off every 5 minutes) until it is time to leave. If your child prefers electronics and timers, start a timer on a phone or electronic device instead.
  • Stick to the schedule. Prepare to leave. Have an exit strategy. Provide reminders when time is almost up, so your child is not “surprised” when it is time to transition. When time is up, it helps to have something positive that your child can look forward to after the park (e.g., frozen yogurt, pick up brother, dinner, or treat in the car).
  • Start small. Try not to overload them by having them try everything at the park. Take one thing like the swings and show them how you use the swing.
  • Bring identification. If your child tends to wander or run away you might want to consider having identification. You might tell yourself that you will be close by, but it is always better to be safe than sorry.
  • Facilitate the play. Consider sparking interest in your child for other people, activities, toys, and conversations by pointing these out in his or her environment: “Wow, those kids are going down the slide really fast, that looks fun!” or “That boy has a really cool race car, maybe you can ask to see it?” These are minimally intrusive ways to promote engagement with surrounding people, objects, and activities.
  • Prepare a To-Go bag with calming tools.
    • Sunglasses
    • A wide-brimmed hat
    • Fidget toys
    • Stuffed toy
    • Chewing gum
    • Weighted blanket
    • Bottled water and healthy snacks

With repeated exposure and positive interactions with people and activities at the park, your child’s positive engagement at the park may be reinforced over time. In other words, it may get stronger, and more frequent, and trips to the park can turn into something he looks forward to.

Strategies to Help You Go to the Park with Your Child with Autism

How ABA therapy can help with your park experience

Kids learn through play. ABA therapy can build the skills children need to play by incorporating naturalistic teaching. We want them to experience a park setting in a safe environment and how to use the equipment at their own pace.

ABA therapy can help with:

  • Taking turns
  • Use equipment appropriately
  • Following directions

We hope that these strategies may help relieve some of the stress associated with going to parks and both you and your child can enjoy and have fun!
Don’t stress yourself out if your child does not enjoy being at the park. It is fine. It may not be a good fit. Don’t push the issue. Find something else that your child feels comfortable participating in that offers sensory-friendly activities like museums, theme parks, or movie theaters. Just make sure they are having fun during their playtime.

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?

Traveling with your child with autism

Traveling with your child with autism anytime soon? Does it involve a long car ride? It’s time to start planning how to keep your child busy and how to make the long drive as enjoyable as it can be. Some children with autism may do really well on car rides as it provides them with time to do enjoyable things such as looking out the window and watching the trees and other cars go by. Some may enjoy listening to the music in the car, or even sleeping throughout the trip! Other children may not do so well and parents may run into troubles such as crying, screaming, kicking seats, and even trying to get out of seat belts. Regardless of how easy or how difficult your car rides are, some of the below strategies may assist with making the ride a bit more enjoyable.

Traveling with your child with autism

Preparation before traveling with your child with autism

We all prepare in some fashion before taking a trip and it is no different when traveling with your child with autism. The unknown can be scary. Prepare your child for the trip.

What to discuss with your child with autism before the road trip

  1. Talk with your child about the purpose of the trip.
  2. Talk about where you are going. You might create social stories to present this information more clearly with visuals. Remember, any type of visual support will reduce anxiety and increase interest.
  3. How long it will take, and the stops along the way. Use schedules, maps, and even photo albums to help understand where you are going and whom you will see.
  4. Make it clear why you’re taking this trip together.

Keep it positive as something to look forward to. Prepare a snack bag as well as a toy bag ahead of time so you have food when your child is hungry and toys when your child is bored. Toys such as drawing boards, electronics (iPad or similar device) on which the child can play games or watch movies, travel games such as perfection, and books may work well to keep your child occupied.

What to bring on the trip

  • Hand sanitizer
  • Flushable wipes
  • Extra batteries and chargers
  • Changes of clothing in case of accidents
  • Plastic bags
  • Medicine for nausea or other physical ailments
  • Extra headphones

Traveling with your child with autism: Safety Tips

Before you leave your driveway remember to switch on the child lock so that the rear door cannot be opened from the inside. If your child is someone who tries to get out of the seat belt, then you may consider getting covers or locks for the buckles in the backseat. Also, make sure that the child’s car seat is installed correctly. You can also make the car seat more comfortable for the long car ride by adding more padding under the seat cover.

Traveling with your child with autism

Strategies to use throughout traveling with your child with autism

Remember to be realistic. Your child may need to take some regular breaks and be able to get out of the car to stretch or run around. Look for signs that your child may be anxious, such as body language, and take pit stops as needed. Take extra time if needed and break the trip up if possible. Plan to spend the night in a hotel, or take the scenic route and turn it into a mini-vacation where your family can enjoy a few sights along the way.

Planning out the mileage of the trip and dividing that mileage up into small chunks can be very helpful. If you are driving 300 miles, break this up into 10 chunks of 30 miles (or even 20 chunks of 5 miles, depending on how often your child may need positive reinforcement for good behavior). Every 30 miles that your child behaves well (define this for your child such as sitting nicely, no screaming, and no kicking) he or she is allowed to pull a prize out of a prize bag that you have prepared ahead of time with treats, small toys, and special items that your child will enjoy. Children with autism often dislike uncertainty and that uncertainty often creates overwhelm and behavior problems. To avoid this, draw out squares on a piece of paper so he knows how many squares are left until you arrive at your destination. Possibly make the halfway point a very large prize, if he or she earns it.

Trying to rush travel can lead to more stress and increases the chances for something to go wrong or for you to forget something. Take some deep breaths, relax, and listen to some soft music to help you unwind, especially if you get caught in a traffic jam. The theme is to plan ahead so you and your family can be prepared for the long trek ahead.

Have fun and Bon Voyage!

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?

Grocery shopping with your child with autism

Grocery shopping with your child with autism can be quite stressful for parents. A grocery store is a place that can be a sensory overload for your child who is autistic; the bright lights pulsating overhead, low-grade music, people, kids, and carts milling around, water sprayers misting the vegetables, and the coupon dispensers with their blinking red lights waving coupons at eye level just to name a few. Your approach to the shopping experience can make a world of difference for you and your child with autism. It will require some preparation from you to enhance the shopping experience for your child who is autistic. Some simple Grocery Shopping Preparation tips will help to relieve the stress that comes with shopping with your child with autism. However, depending on how you choose to look at it, this routine life skill can also be a wonderful learning experience if parents take the time to follow a few simple strategies.

Grocery shopping with your child with autism

Preparation before your grocery shopping with your child with autism

Before the shopping experience begins, it may be beneficial to state what is expected from your child. Provide clear rules and expectations for the shopping trip.

Suggestions for teaching three crucial parts of a grocery store visit:

  1. Safe walking to and from the car;
  2. Quiet in the car;
  3. Appropriate conduct in the store.

If this is your child’s first time to the grocery store and they are prone to meltdowns, then start small. Allow your child with autism to bring a small toy for comfort. Set a time of how long it will take.

Make a list of items in the order that you walk through the store, either drawn-out, printed out, or cut out from advertisements that your child can keep track of during the shopping trip. Keep in mind that it is hard to backtrack through the grocery store if you have forgotten an item with a child who is autistic. These can be items they prefer and would be interested in tracking and finding. Ask your child to cross out the items or put the picture in an envelope when you both find the item, signifying one step closer to being done with the shopping experience. Another option would be give your child a shortened list without all the items you need to get on it. A simple trick is to save the last item on your list to correlate to your child’s last item on their list so that they can directly relate that the grocery shopping trip is done when they cross out the last item on the list.

More and more grocery stores are trying out what is called ‘Quiet Hour’ which is a more autism-friendly atmosphere for individuals who need fewer distractions and sensory overload. Check out in your area if there are any participating.

Dad and son at the grocery store

Techniques to use while grocery shopping with your child with autism

Get your child involved in the shopping experience by allowing them to push the cart, select and put the items in the cart, place contents on the conveyor belt, and stay near the cashier until the groceries are bagged. Make the shopping experience fun.

Furthermore, use the experience to teach language skills. Grab a green and a red apple and ask your child to identify which one is red. Grab a big and a small can of tomatoes and ask your child to identify which one is bigger. Ask your child to label items that you grab from the shelves, especially preferable items. Based on how advanced your child’s speech is, tailor what you ask of them to their level.

Don’t forget, it is important to provide continuous positive feedback for when your child is participating in the shopping experience. Try not to draw attention to behavior that is not appropriate at the grocery store. This can be accomplished by providing a reward at the end of the shopping experience. When your child with autism masters the basic skills of shopping, reward them by having one of their favorite food items on the list and allowing them to pick it up. For example, if your child loves Hershey candy bars, then put them as the last item on the list and keep reminding them that good behavior then will allow them to have their favorite item. Keeping their “eyes on the prize” encourages them to stay motivated, attentive, and happy.

Have a backup enjoyable activity that your child can engage in while you are completing the remaining part of the shopping trip that is not on their list. A small coloring book, games on your phone, a squishy toy, or some music through headphones may work to keep them engaged.
Lastly, if your child has difficulties walking through an entire shopping experience, allow your child to catch a ride on the shopping cart only if they have walked and helped for a certain amount of time, or when all of their grocery lists are completed. If you base it on time, be sure to have a visual chart (e.g., have 5 boxes, each representing 2 minutes) or timer for them to know how much time they have left of walking.

Assess the grocery shopping with your child with autism experience

Remember to take your child often to the grocery store. Taking them to the grocery store once or twice each week is now part of their routine and something they expect and even look forward to.

Don’t be discouraged based on one trip to the grocery store with your child on the spectrum. Not all trips to the grocery store end in triumph and when things don’t go so well, tell yourself that success emerges from routine and persistence. Trying again (and again and again) is an important part of the learning process for your child with autism. It is important to learn life skills that they will need to know how to do later in life.

We all have good days and bad days and that holds true to our children. You’ll be pleasantly surprised when you see your child starts to take simple steps toward a positive grocery shopping experience as long as you don’t put limits on your time and expectations of your child with autism.

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?

Autism communication strategies

Autism communication strategies are techniques that help your autistic child develop their language and communication skills. Language impairment in communication is one of the main diagnostic criteria for a child with autism, specifically a delay in or total lack of spoken language. Many children may have difficulties not only expressing themselves but also understanding what other people say. Adults may think that the child is just ignoring them but in reality, the child may not understand what the adult is saying. Imagine going to a foreign country with people speaking a language that you do not understand and having no means of figuring out what the people are saying. If someone says, “Hey you, come here” in their language, would you respond? If you don’t understand what they are saying you probably would not respond. This is how your child might be feeling.

Let Leafwing professionals educate you and your child to develop the language skills that will help guide your child to reach their full potential.

Autism communication strategies

Interventions to improve communication with autistic children

A Speech Therapist or Pathologist is the lead professional in the assessment of an individual’s understanding and use of language and can provide information about you or your child’s level of language development. They can also provide support planning for intervention, and advise of which strategies can be the best use to support the development of communicative skills.

Applied behavioral analysis (ABA) is a type of therapy that can improve social, communication, and learning skills through reinforcement strategies. Many experts consider ABA to be the gold-standard treatment for children with autism spectrum disorder (ASD) or other developmental conditions.

ABA therapy programs are effective in treating children with autism because they create very structured environments where conditions are optimized for learning. Over time, these very structured environments are systematically changed so that the environment mimics what a child could expect if and when they are placed in the classroom.

Autism communication strategies: Visual supports

Visual supports are concrete cues that help communicate and build language skills. This can incorporate the use of symbols, photos, written words, and objects to help children with autism to learn and understand language, process information, and communicate.
We take for granted the different ways we communicate daily which include:

    • Language: The way we represent information – what words mean and how we put them together.
      • Receptive – refers to how your child understands language.
      • Expressive – refers to how your child uses words to express himself/herself.
    • Speech: A verbal means of communicating – using sounds to make words.
    • Non-verbal methods: gesture, facial, expression, eye contact, etc.
    • Pragmatics: The way in which individuals use language in social situations. It includes following the ‘unspoken’ rules of conversations, for example, taking turns.

Many children on the autism spectrum respond well to visual information. Visual information can be processed and referred to over time, whereas spoken communication is instant and disappears quickly.

Visuals can involve communication books or boards that use images and/or words on cards to help the individual learn the word and its meaning. The child can point to the image when they want to communicate. For example, if the child is thirsty, they can point to an image of a glass of water. As the child learns more symbols and words, they can use them to create sentences and to answer questions. Others can also use the images to communicate with the child. This is known as the Picture Exchange Communication System and can be used in the development of intentional and functional communication.

Another autism communication support tool is known as a visual or picture schedule. This helps individuals learn the steps of a routine, like getting ready for bed. A series of pictures show the steps in order and over time they learn each step.

Furthermore, visual schedules can be used to show a person on the spectrum what is happening next or show when there is a change in routine. As people on the spectrum generally don’t like change, this can help them prepare for a change and cope with it more easily. This enables the language surrounding change to be more easily understood and allows individuals to refer back to schedules throughout the task and throughout their day.

Augmentative and alternative communication (AAC)
Autism communication strategies: Augmentative and alternative communication (AAC)

Augmentative and alternative communication (AAC), helps individuals who cannot talk or are very hard to understand. AAC means all of the ways that someone communicates besides talking. People of all ages can use AAC if they have trouble with speech or language skills. This provides another way to help them communicate other than verbally. AAC includes:

  • Sign language
  • Gestures
  • Pictures, photos, objects, or videos
  • Written words
  • Computers, tablets, or other electronic devices

AAC can help children with autism and can even assist with developing spoken communication. A lot of people wonder if using AAC will stop someone from talking or will slow down language development. This is not true—research shows that AAC can actually help with these concerns! People who use AAC can also learn how to read and write.

Speech generation devices either play pre-recorded words via a switch or button or sound out text that is typed into them. Using the previous example, a child who is hungry can press the ‘food’ picture button and the device will say, ‘I want to eat.’
While these tools can be used to replace speech, they can also be used to help a child develop speech. They do this by helping the child to recognize sound patterns and can be used with visual aids to build language skills.

These systems can also help children learn words as they begin to associate the sound and picture with each other. They also help by slowing down communication, giving the child more time to process the information and avoid becoming overloaded.

Autism communication strategies: Guidelines for nonverbal autistic children

No matter where your child falls on the spectrum for autism, they have the ability to communicate in some manner. Here are some simple guidelines to consider when trying to help your child to communicate with you as well as with others.

  • Encourage play and social interaction. All children learn through play, and that includes learning the language. Interactive play provides a delightful chance for you and your child to communicate. Play games that your child enjoys. Incorporate playful activities that promote social interaction. For example singing, reciting nursery rhymes, and gentle roughhousing. During your interactions, crouch down close to your child so your voice and face are closer to them, increasing the chance of them looking at you.
  • Imitate each other. Copying your child’s sounds and play behaviors will encourage more vocalizing and interaction. It also encourages your child to copy you and take turns. Make sure you imitate how your child is playing – so long as it’s a positive behavior. For example, when your child rolls a car across the floor, then you too roll a car across the floor. If they crash the car, you crash your car too. Be sure not to imitate inappropriate behavior like throwing the car!
  • Focus on nonverbal communication. Gestures and eye contact can build a foundation for language. Encourage your child by modeling and responding to these behaviors. Exaggerate your gestures. Use both your body and your voice when communicating – for example, by extending your hand to point when you say “look” and nodding your head when you say “yes.” Use gestures that are easy for your child to copy. Examples include clapping, opening hands, reaching out arms, etc. Respond to your child’s gestures: When they look at or point to a toy, hand it to them or take the cue for you to play with it. Similarly, point to a toy you want before picking it up.
  • Give time for your child to talk. It’s natural for us to want to fill in the missing words when a child doesn’t quickly respond. It is important to give your child lots of opportunities to communicate, even if they are not talking. When you ask a question or see that your child wants something, pause for several seconds while looking at them enthusiastically. Watch for any sound or body movement and respond promptly. The promptness of your response helps your child feel the power of communication.
  • Simplify your language. Be literal and obvious in your choice of language. Say exactly what you mean. Speak in short phrases, such as “roll ball” or “throw ball.” You can increase the number of words in a phrase one your child’s vocabulary increases.
  • Follow your child’s interests. Rather than interrupting your child’s focus, follow along with words. Use simple words about what your child is doing. By talking about what engages your child, you’ll help them learn the associated vocabulary.
  • Consider assistive devices and visual supports. Assistive technologies and visual supports can do more than take the place of speech. They can foster its development. Examples include devices and apps with pictures that your child touches to produce words. On a simpler level, visual supports can include pictures and groups of pictures that your child can use to indicate requests and thoughts.

Remember, the more concise and simpler the instruction, the more successful the child will be. It is important to note that the simplicity or complexity of language used should be based on the child’s language repertoire at that particular time. Over time, and with success, simple and concise instructions will be elaborated and more language will be part of their communication.

Autism puzzle
Autism communication strategies: how ABA therapy can help

ABA therapy is effective through the identification and targeting of skill development goals. ABA therapy will typically address skill deficits across several domains. These domains will vary and depend on the individual needs of the learner.

As behavior analysts, it is our responsibility to only administer ABA-based treatment programs that have been proven to be effective given a specific difficulty. This is called evidence based practices. The specifics of a treatment program will vary from one person to another, but the foundations of treatment programs are the same. A foundation derived from sound, empirically proven methods repeatedly implemented in the applied setting over time.

Listen to:

The Advantages of Applied Behavior Analysis (Podcast Episode)

 

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?

Autism and bedtime routine

Design a bedtime routine that can be a win-win situation for your autistic child and yourself. Bedtime can be one of those nightly events which many parents love or hate or both! It means that peace and quiet are soon ahead, but it also can mean that a huge struggle is about to proceed. Many children with autism have difficulties either transitioning to bed, falling asleep, or even staying asleep all night long. Any of these difficulties can increase stress and tension in your home. Keep in mind that no single suggestion will be for all children but getting the right amount of sleep will allow your child to perform better academically, encourage the development of motor skills, and allow them to maintain a better mindset. Not to mention, it’ll help you get a fuller night of rest, too!


a child sleeping

Bedtime routine for children with autism

The first step to a healthy sleep starts with the daily routine. Be consistent. By creating a visual schedule, it helps to remind your child what they should be doing and what is to come. Take pictures of all events (e.g., dinner time at the table, bath time, reading books, and the child in bed), laminate the pictures and a piece of construction paper, and Velcro each picture either horizontally or vertically on the paper. When each event is completed, you can guide your child to take off the picture and point to the next event which helps them to actively check off their tasks.

Praise your child for successfully completing steps in their bedtime routine. Descriptive praise is when you tell your child exactly what it is that you like. For example, ‘I like the way you’ve found a spot for everything in your room’. This helps your child understand exactly what it is that they’ve done well. It’s also more genuine than non-specific praise like ‘You’re a good boy’. For younger children, you could use a reward chart.

A typical daily routine for better sleep

It is important for the daily routine to be consistent with time and order. Make sure your child wakes up every morning at the same time. They eat breakfast at the same time. Whatever the routine, keep it consistent so the child learns what to expect. A routine helps signal the body.

Morning routine

  • Wake up at 7 am
  • Brush teeth
  • Take a shower
  • Get dressed
  • Brush hair
  • Make bed
  • Eat breakfast

Afternoon routine

  • Eat lunch at 12 pm
  • Exercise for 1 hour
  • Plan activity

Evening routine

  • Eat dinner at 6 pm
  • Watch TV
  • Play a board game with the family
  • Read a few books to quiet down

Bedtime routine

  • Put on pajamas
  • Brush teeth
  • Go to the bathroom
  • Dim the lights
  • Put on the white noise machine
  • Give a massage
  • Go to bed

Remember there are triggers that might enhance alertness during bedtime like caffeine. Caffeine can stay active in our body for up to 12 hours. Monitor caffeine intake as well sugar consumption in foods. Watching TV, videos, or playing on the computer, especially if the shows or games are scary or violent, can lead to kids with autism having more trouble sleeping.

Problems sleeping happen more often in autistic children who have restricted and repetitive behaviors (lining up toys, rocking, hand-flapping), anxiety, or sensory problems and can lead to having trouble paying attention, feeling restless, getting angry, and throwing tantrums.


girl-sleeping

Autism and the successful bedtime routine

It can’t be stressed enough, to stick to a routine. Make bedtime routine no more than 20 to 30 minutes. The bedtime routine should be calming like reading a book, singing a song, or a massage. You know your child best. What is calming for one child may be stimulating for another. Design an area that encourages sleep. Make sure to only use your child’s bed for sleep. Keep the temperature in the room less than 75 degrees Fahrenheit. Don’t leave lamps or overhead lights on overnight. Nightlights can be used to provide some light. Using a white noise machine will help your child from being disturbed by noise around them.

If your child has a hard time falling asleep, or wakes up in the middle of the night, first consider if they take naps during the day. You may want to reduce these naps so your child is more tired at night time. If your child wakes up in the middle of the night, be sure to keep the sleeping environment calm and do not allow him or her to play games or leave their room. This may take many sleepless nights by the parents but it will pay off in the end. It is important that your child learn the skill of falling asleep without a parent present. All children and adults wake briefly during the night but quickly put themselves back to sleep by reestablishing associations used at bedtime. So if your child needs a parent present to fall asleep at bedtime, he might need a parent to help him fall back asleep during the normal awakenings.

The time you invest in putting a sleep routine for your autistic child now will save you many, many hours in the long run and you won’t have to do it forever. Once patterns are established, you will be able to reclaim a large part of your evening for yourself.

Autism and bedtime routines: other considerations

It is important to address medical or psychiatric issues that potentially interfere with sleep. Your child’s medications might need adjustment if they affect his sleep. If your child suffers from a sleep disorder such as sleep apnea, sleep walking, sleep terrors, restless legs syndrome, they may need a referral to a sleep specialist. Some children with persistent insomnia will need further behavioral or pharmacological treatment to improve their sleep.

Children and Adults with autism tend to have signs of insomnia: It takes them an average of 11-15 minutes longer than most people to fall asleep. Many wake up frequently during the night. Some adults and children with autism have sleep apnea as well, a condition that could potentially cause them to stop breathing several times during the night.

Let Leafwing Center help with the daily routine for your autistic child, so you can have a successful bedtime routine. Our ABA therapists are trained in creating personalized plans that match your child’s ability levels.

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?

Alternative Behavior Examples to Decrease Challenging Behaviors

What are alternative behavior examples? Alternative behavior examples are acceptable or positive behaviors taught to your autistic child to replace challenging behaviors.

Imagine this, your child climbs on the kitchen counter to reach for a box of cookies high in a cabinet. Can you implement a plan to decrease or eliminate the behavior of climbing on the counter? Yes, but simply stopping one behavior is not an alternative behavior example. Frequently, your child will just learn another challenging behavior to get the same result. Your child might yell or throw a tantrum because they want to eat cookies.

Let’s think of alternative behavior examples. An alternative behavior could include teaching your child to appropriately request the box of cookies. This might look like signing “food” or “cookies”, or pointing to a picture of the options in the cabinet. Or, your child may use some other mode of communication based on your child’s repertoire of skills.

Teach Alternative Behavior Solutions

Teach Alternative Behavior Solutions

Alternative behavior examples require teaching and repetition. At first, assist your child when you begin to see the signs of them seeking a snack by guiding them through the physical movements of communicating by pointing, exchanging a picture, signing, or modeling the words they should use. Gradually fade this assistance until they choose the alternative behavior on their own, without engaging in the challenging behaviors.

In practice, it is always best to teach alternative behavior examples. Caregivers can learn to ask, what is an alternative behavior for this challenge? Choosing individualized alternative behaviors that fit your child’s personality will help. Teaching alternative behavior examples can make unlearning the challenging behavior a faster process.

Types of Challenging Behavior in Children

There are four reasons why children may engage in challenging behaviors.

  • Access- to get something the child wants
  • Escape- to get out of doing something they don’t want
  • Attention- to get others to pay attention
  • Self-stimulatory/Automatic- because the behavior itself feels good or pleases them

Your child still needs to access what they want. Choose alternative behavior examples that do lead your child to obtain what they would like—access, escape, attention or self-stimulatory freedom.

Model Alternative Behavior Examples

Let’s say your child screams and throws objects when they are done with their dinner. What is your child seeking? Your child is trying to escape or get out of something—the dinner table. There are a number of alternative behavior examples you might teach your child instead of throwing and screaming.

  • Teach your child to signal that they are “all done” using whatever mode of communication is appropriate for your child.
  • Have your child pass you an acceptable object as a sign that they are finished at the table.
  • Teach your child to point at a picture that represents leaving the table.

It may be helpful for you to model the alternative behavior examples. If you point at the “all done” picture each time you are finished with your meal, your child will observe your alternative behavior example. It is important to allow your child to leave the table immediately, every time they choose the appropriate alternative behavior.
With consistency, challenging behaviors will decrease as your child learns they do get what they would like when choosing an alternative behavior example. As your child gets used to the process, acceptable behaviors become habits and the alternative behaviors become stronger over time.

Decrease Challenging Behaviors

For attention-based challenging behaviors, ask yourself what is something the child should be doing? To choose alternative behavior examples, consider your child’s repertoire of skills. Some children feel as though they are getting your attention even when being lectured or reprimanded about their choices.

When your child engages in a challenging behavior, state the problem in a sentence instead of lecturing. In addition, carve time out of your day to spend more time with your child when they are behaving appropriately.

It’s easy to assume your child should always make good choices while you get work done. Instead, schedule breaks to praise them and enjoy time with your child when they are engaged in appropriate behavior. You can spend time playing a favorite game, watching a favorite TV show or talking about school or life.

Alternative Behavior Examples to Decrease Challenging Behaviors

Manage Challenging Behaviors

When your child engages in challenging behavior because it feels good, this can require the caregiver to put more thought into choosing alternative behavior examples. Choices should include behaviors that are not harmful and tend to be controllable.

For example, your child may engage in repeating words or phrases, or vocalize sounds that are not socially appropriate. What is an alternative behavior that still allows your child freedom? You can allow your child to engage in these behaviors in a particular environment, like their bedroom.

One alternative behavior example is teaching your child to ask for “talking in my room”. This may help you both gain control over where they may engage in this behavior. When your child engages in the self-stimulatory behavior, you can work toward the child using the communication phrase and then going to the specified location. Self-stimulatory behaviors can be very difficult to address on your own, even with alternative behavior examples, especially when the behavior is self-injurious in nature.

Get Help Teaching Alternative Behavior Examples

Each time you find yourself facing a challenging behavior, take a deep breath and start to brainstorm, what are alternative behavior examples? You can make a list of alternative behavior examples to model and try. If one alternative behavior isn’t a great fit, try another alternative behavior example from your list. If you continue having difficulties addressing your child’s most challenging behaviors, it is a good idea to reach out to a trained professional as soon as possible.

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?

Using Structure and Scheduling for Your Child and Taking Much Needed Time for You

When you arrive home with the kids after school and work, the first thing you may want to do is relax!  Turning on the television for your child, letting her watch a movie, or allowing her to engage in her repetitive behaviors to her heart’s content is very tempting.  You have had a long day and rest is probably the first thing you would like to do.  Allowing these things just discussed though should be kept to a minimum and used as “earned” activities or used in emergency situations (i.e., when you just can’t take it anymore!).

So, what do you do instead?  When do you get “you” time?  First, focus on creating structure for your child during these down times.  Structure and routine are so important for children with autism. They are important for just about everyone but when it comes to children on the autism spectrum, they really thrive on routine and structure. You establish predictability with structure and routine and it can also help with meltdowns.

Create a visual schedule for your child for the evening routine using printed out photographs which you can Velcro in order to a piece of paper (a laminated paper is best).  A child can, by following clear pictures, recognize the order and importance of daily activities.  This reduces stress and anxiety because they know what to expect and what will be happening next. For example, you may allow 15 minutes of free play time, then homework, then dinner, then bath/shower, then bedtime routine activities, then bed.  It allows your child to see what to expect for the evening and also guides you as the parent, reminding you each evening what the structure should be.

What if your child does not follow visual schedules independently?  That’s okay!  It may take a few days, or even a few weeks, but after you guide them through the schedule each night, using a timer to signal the end of each activity, and guiding them to take off each picture as it is completed, they will learn to follow the schedule themselves and become independent before you know it.

Final tips: Be sure to include fun things that your child likes on the schedule, not just work activities and boring nightly activities.  Sometimes let them choose the activities during certain times (e.g., bedtime routine activities).  Lastly, be sure that when your child has successfully completed their schedule and is successfully in bed, do something good for you!  Enjoy that piece of cake that’s been sitting in the refrigerator or that glass of wine you’ve been waiting for all week.  Watch a movie with your partner.  Now it’s you time!

How to Make a Visit to the Grocery Store a Learning Opportunity for Your Child with Autism

A visit to the grocery store for parents with a child with autism can be quite stressful. On the other hand, it can also be a wonderful learning experience if parents take the time to follow a few simple strategies.

Before the shopping experience begins, it may be beneficial to state what is expected from your child, approximately how long it will take, and what can be expected afterwards. A method to increase motivation may be to state a clear if/then contingency. For example, “Johnny, if you stay next to mom/dad, help pick out your items, then after shopping we can get visit a nearby store you like.”

Make a list of items, either drawn out, printed out, or cut out from advertisements that your child can keep track of during the shopping trip. These can be items they prefer and would be interested in tracking and finding. Ask your child to cross out the items or put the picture in an envelope when you both find the item, signifying one step closer to being done with the shopping experience. Give your child a shortened list without all the items you need to get on it. Save the last item that you get for his list so that he can directly see when the last item is crossed out, you are done!

Have a back-up enjoyable activity that your child can engage in while you are completing the remaining part of the shopping trip that is not on his list. A small coloring book, games on your phone, a squishy toy, or some music through headphones may work to keep him engaged.

Use the experience to teach language skills. Grab a green and a red apple and ask your child to identify which one is red. Grab a big and a small can of tomatoes and ask your child to identify which one is bigger. Ask your child to label items that you grab from the shelves, especially preferable items. Based on how advanced your child’s speech is, tailor what you ask of them to their level.

Last, if your child has difficulties walking through an entire shopping experience, allow your child to catch a ride on the shopping cart only if he has walked and helped for a certain amount of time, or when all of his grocery list is completed. If you base it on time, be sure to have a visual chart (e.g., have 5 boxes, each representing 2 minutes) or timer for him to know how much time he has left of walking.

Hopefully these strategies will aid in creating a productive and enjoyable grocery shopping experience for you and your child!

How to Teach Children with Autism How to Play Independently

Do you ever wonder how you make it through each day, getting your child dressed and to school?  What about shopping, laundry, house cleaning, and dinner? Somehow you do it, and that is enough for anyone to be proud of.  We want to provide you with some additional techniques that may help with the time when your child with autism is home and needs to be looked after, but you also have things to accomplish.

Preparing dinner is a great scenario that many parents have difficulties with.  The solution for many parents is to put a movie on, give the child the iPad, or to allow the child to engage in whatever self-stimulatory behaviors they enjoy most (e.g., running around the house repeating phrases, flapping objects up and down, or rolling cars back and forth on the floor while lying down staring at them).  Although these may be activities that make your child happy and allow you to get dinner ready, there are additional techniques that foster appropriate independent engagement by your child with autism during times you cannot provide your full attention.

Activity schedules work wonders for this purpose. Activity schedules are visual guides that lead a person through a series of activities, leading to an ultimate prize.  Visual schedules help with transitioning from one activity to another with minimal prompting.

There are some pre-requisites to being able to utilize schedules although these can be worked on in the meantime if your child does not have them.  Your child should be able to independently play with some objects, even if the object is as simple as a peg board, or as complex as a 100-piece Lego structure.  Laminate pictures of these activities and velcro them to a vertical strip hanging on the wall.  At the bottom should be a picture of what your child really wants to do in the moment, even if it’s dinner!  If your child has never had experience with an activity schedule, guide them through the process of pointing to the first picture, finding the activity, playing with the activity, putting the activity away, taking that picture off the schedule, pointing to the next picture, and so on and so forth until the ultimate activity or item is achieved.

Some tips: start with only one or two activities until your child can independently utilize the schedule and transition from activity to activity.  Also, remember that the activities should be somewhat preferred by your child, as this is their independent time and we want to increase the success of them playing independently.  If they dislike activities, this increases the chance of challenging behaviors and the need for more of your attention.  It may take a few days, or even weeks to develop this skill. Over time, your child will be able to complete this task with increasing independence, practice decision making and pursue the activities that interest him or her and it will give you some much needed time to get things done while at the same time knowing that your child is being productive.