Tag Archive for: ABA

Why Is Following Through Important When Giving Instructions

One of the biggest concerns that parents have when raising children living with autism is that “their children just don’t listen.” Besides making instructions very clear and giving instructions only when the child is paying attention, the biggest most important thing a parent must do is follow through when the child does not respond.  Not following through when your child does not respond only teaches your child that there is no need to follow your instructions in the future.  This pattern, if not addressed, can be very frustrating and stressful.

Following through; however, can be difficult because many times parents are multitasking on a daily basis: cooking dinner, cleaning up the house, talking on the phone, and telling their kids to clean up in the other room et cetera.  Think about this before giving instructions: make sure you have your child’s full attention before giving your instruction and once you give your instruction, make sure you can immediately assist your child with completing the instruction you just gave.

Imagine this situation.  Mom gives Sally her clothes in the morning and tells her to get dressed.  Mom then leaves the room and tries to get lunches and other kids ready as well.  She comes back and Sally is still in her jammies playing with her dolls.  Mom tells Sally again that she really needs her to get dressed, this time making sure Sally is looking at her while she gives her instruction, points to the clothes, and then leaves again to finish getting things ready for school.  When she comes back five minutes later, Sally is still in her jammies playing with her dolls.  When Sally’s mom tells her to put her jammies on in the future, do you think Sally will comply?  Probably not.

Try this instead.  Mom tells Sally she has three more minutes to play with her dolls then it’s time to get dressed.  She sets a timer so the beep becomes a signal to transition to another activity (dressing).  When the timer goes off, mom is right there to take the dolls and give Sally her clothes.  She tells her “get dressed.”  Instead of leaving the room, mom stays to make sure Sally starts getting dressed.  If Sally just sits there, within about 10 seconds mom tells Sally again to get dressed but this time mom helps Sally start taking off her jammies, gradually backing away as Sally does more and more of the task herself.  Mom does not leave the room and does not repeatedly tell Sally “get dressed” without helping and making sure Sally does get dressed.  Once Sally is done getting dressed, Sally’s mom gives her the dolls back for 5 more minutes of play before school as a reward for getting dressed.  Here, Sally will learn, over repeated times of Sally’s mom following through, that when her mom tells her to get dressed, she cannot continue playing with her toys unless she does what her mom says.

Again, one of the most important factors when increasing your child’s compliance is follow through! How easy is this for you to do?

When You Start an ABA program, What Should You Reasonably Expect from Your Service Provider?

ABA programThe following are things that you should expect as a parent when you begin treatment for your child with Autism.

You and your child have a right to a therapeutic environment.  This means that the teaching environment set up to help your child is one in which socially significant learning occurs.  As a client, your child also has the right to services from an agency in which their number one goal is the personal welfare of your child (e.g., safety, treatment efficacy, advocacy). This means that all energy put into the program is to help your child become more independent and lead a better life.

It is also your child’s right to have a treatment program supervised by a competent behavior analyst. Unfortunately, as the rates of autism have increased, so have the number of treatment programs allegedly providing assistance to children with autism.  Furthermore, in many locations, the demand presently outweighs the supply for trained, experienced behavior analysts. It is imperative that the credentials and qualifications of your service provider be credible.

Your child has a right to be provided with a program that teaches functional skills. Functional skills are skills that a child can use in their everyday life and that furthers their independence (tying shoes, initiating conversation, engaging in cooperative play, etc.). There is little benefit in taking the time and dedication to teach a child something that cannot be incorporated or used in their everyday life.

Assessment and ongoing evaluation are crucial components of any ABA program, and should be expected.  This includes setting up a program based on the individual needs of a child and continuing a program based on the ongoing needs of a child. These needs will continually change, therefore ongoing assessments and modifications are imperative, necessary, and a right.

Parent and caregiver trainings should be included in the ABA program. These typically include meetings between parents or caregivers and their service provider in which valuable ABA strategies are discussed, demonstrated, and implemented. The focus of these meetings is to educate parents about various but individualized ABA based techniques they can implement with their child to address challenging behaviors, reinforce desirable behaviors, and promote generalization of progress.

Lastly, and perhaps most importantly, a child with autism has the right to the most effective treatment procedures available. In this case – scientifically validated treatment programs which today have only been shown to be based on ABA principles and techniques.

Parenting Survival Skills

Do you ever feel like your child or children take all of your energy and you therefore have no energy to give to your spouse, partner, or friends?  This is very normal although so important to pay attention to, be mindful of, and work at.  Humans are social beings and we need that support network to function in our daily lives.  Without it, we will get worn down and we will eventually see turmoil in our relationships, work, and ways of parenting.  Below are some relationship recommendations that are so important when raising children, more importantly, children with autism.

First, ensure that you have a close adult companion who you can confide in.  If you have a spouse or partner, it will most likely be them.  If you do not have a spouse or a partner, identify a close friend who you can have real, open conversations with and who can call on when in times of need.  It’s important to let someone know what you are going through and how you feel.  Someone who just listens can be a great source of strength.

Second, have high levels of communication with your partner about your parenting strategies, away from your child.  It is so important to have consistent parenting styles and strategies.  Disagreeing during an episode with your child will only increase the stress and make matters worse.  The communication needs to happen when you are alone with each other and you can come to resolutions.  This will help in times when one parent needs a break and the other parent can step right in and be consistent with the strategies that the first parent was just using.  Just as a marriage builds a relationship, a child builds a team.

Ask for help, especially at first. Don’t hesitate to use whatever support is available for you. Your family and friends are there to help, but may not know how.  Maybe you can just have someone take the kids out for an afternoon? Or cook dinner for your family one night.

If you can, allow yourself to take a break, take some time away.  It can be as simple as taking a walk or even going to see a movie, going shopping or visiting a friend can make a world of a difference. Schedule fun adult time on a regular basis, away from your child, with your partner or close friends.  This is so important!  Parenting is difficult and brings many challenges to relationships.  It is important to spend time together, focusing on the two of you and not worrying about your child in the next room.

Lastly, don’t forget to rest.  If you are getting regular sleep, you will be better prepared to make good decisions, be more patient with your child and deal with the stress in your life.

Remember that if you want to take the best possible care of your child, you must first take the best possible care of yourself. Relax, have fun, and focus on you!

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What Kinds Of Behavior Are Behavior Analysts Interested In

Behavior analysts are interested in behaviors which are observable and measurable. Voluntary behavior, or what is known as Operant Behavior, is of particular interest to behavior analysts. This is the kind of behavior that we are primarily concerned with when it comes to helping children with autism as it is the type of behavior that can be influenced or learned as a consequence of environmental events. We can manipulate a person’s learning of operant or voluntary behaviors by manipulating environmental events. For example, parents often reward their children for cleaning up their room (an attempt to reinforce the behavior). Cleaning a room is a voluntary behavior and by rewarding such voluntary behavior, the parent has set up the environment to increase the likelihood that their child will clean up the room again to get rewarded again. For the purposes of this post, we will use the terms reward and reinforce interchangeably, though reinforce is the correct term.

The second type of behavior is involuntary behavior, or a reflex. Technically, it is referred to as a Respondent Behavior (as opposed to an operant behavior). Reflexes are automatic behaviors that are physiological and not usually influenced by consequences. You as a person have little or no control in the behavior occurring. This includes behaviors such as a sneeze, becoming startled when something jumps out at you, or blinking. Since reflexive behavior is automatic and cannot be changed by environmental events or consequences, this type of behavior is rarely the focus of an ABA program.

In general, behavior analyst have an interest in reducing maladaptive, undesirable, challenging behaviors while increasing desirable replacement behaviors. Replacement behaviors are alternative behaviors we would like to teach individuals to take the place of the challenging behaviors. These behaviors should serve the same purpose (function) of the challenging behavior, be socially appropriate, and easier to engage in than the challenging behavior.

Some Components Of A Good ABA Program For Children With Autism

An effective ABA program should have the following components:

A Board Certified Behavior Analyst (BCBA) who designs and supervises the ABA program. A Board Certified Behavior Analyst (BCBA) is a person who has met the educational and professional training requirements established by the Behavior Analysis Certification Board (BACB). Many autism special interest groups also recommend that the supervising BCBA have experience working in the field.

A second common characteristic of an effective ABA program is a detailed and thorough assessment of the learner’s behavioral and clinical needs. Before an ABA treatment program begins, it is imperative to assess the clinical needs of a child to formulate treatment goals and a highly individualized curriculum. A Functional Behavior Assessment (FBA) typically includes direct observation of the client in their natural environments, interviews with parents and caregivers, record review, questionnaires, among other methods. In fact, assessment should not only occur before the onset of treatment but should be an ongoing process throughout treatment. This helps ensure that a child’s goals will remain individualized, and relevant to his or her needs at any given time.

From this detailed assessment comes the next common characteristic of an effective ABA program: meaningful and objectively defined skill development and behavioral goals. Goals in ABA typically fall under two general categories: Skill-development goals and behavioral goals.

  1. Skill-development goals are designed to address a child’s skill deficits and are based on their current needs, their developmental age, and their chronological age. A child’s developmental age is the age that represents their current abilities and adaptive levels, whether that be a year behind or two years behind their chronological age. Their chronological age is their actual age in years since they were born. Sometimes it is appropriate to teach a child skills that will match their developmental age. For example, when learning to speak, children will speak individual words before forming sentences. So, when teaching a child to speak, you begin at their developmental age for language and move forward from there. Other times, it makes more sense to teach a child skills according to their chronological age, as is the case much of the time when teaching toy play. You a teach a child to play with the same kinds of toys their friends play with so you can facilitate their friendships when they are around other children. Skill development goals should be highly individualized, socially valid, and address a child’s skill deficits across relevant domains (motor, academic, language, executive, play, adaptive, etc.) This is what is meant by meaningful goals, goals that are socially significant.
  2. Behavioral goals typically include reducing challenging, undesirable behaviors while simultaneously teaching desirable replacement behaviors. Identification of the function or “purpose” of the challenging behavior is an imperative first step in this process. An effective assessment will identify the function or functions of the challenging behavior(s). For example, after observation and data analysis, a BCBA may hypothesize that the function of a child’s tantrum behavior is “escape”. In other words, the hypothesis is that the child is engaging in tantrum behavior to escape or avoid a task, demand, or activity. From this point, a behavior intervention plan will be established to reduce the tantrum behavior and increase appropriate replacement behaviors such as asking for a break or requesting help. Replacement behaviors are alternative behaviors to the challenging behavior that should be functionally equivalent (serve the same purpose as the challenging behavior), socially appropriate, and easier to engage in. An effective behavior intervention plan should include proactive (before the challenging behavior occurs) and reactive (after the challenging behavior occurs) strategies.

Another part of goal setting in an ABA program is choosing objective goals. Objectively defined goals are important as it is a way of measuring an individual’s success and the appropriateness of how we are teaching an individual. When goals of the treatment program are defined in observable and quantifiable terms, a treatment program can make sure that a child is making progress towards the end goal. However, if the goal is vague, such as “teach social skills” rather than, “Billy will learn to initiate ball play games with his friends at school during recess time with 90% accuracy over a period of 4 consecutive weeks” it is difficult, or rather impossible to see if a child is making any progress. Therefore, goals have to be objective, observable, and quantifiable.

Measurement of the established goals is the next characteristic of an effective ABA program. Data collection and frequent review of progress are critical to effective ABA programs. When information on a child’s progress is collected while they are learning the task, their progress can be monitored to see if their learning rates are increasing, if their learning a new skill in an appropriate amount of time, or if progress is slow and the goal needs to be redefined or teaching techniques have to be altered. Without data collection, sound clinical decisions cannot be made.

Also, effective ABA programs will include numerous ABA techniques and principles into teaching a child to learn. ABA is more than just a discrete trial.

Further, an effective ABA program will promote independence across all areas of a child’s functioning. While initially a child may need help learning a new skill, once that skill is learned or ‘mastered’ a child will be expected to engage in that task all by themselves, or independently. The more independent a child becomes, the more they can navigate their surroundings without help.

The next two characteristics of an effective ABA program are that the program provides many learning opportunities for the child and that the intervention is consistent. When talking about learning opportunities it’s important to note that while a child is in an ABA therapy session, their mere presence alone is not enough to make sure that learning is occurring. It is up to the teacher to ensure that the child is absorbing the information provided and that the session is filled with such learning opportunities: in other words, ensure that the teaching session is productive. The goal is to get the most output or maximum learning in every session and to further the skill from where it was in the last session to a step closer in independence in the current session.

Consistency refers not only to  the number of treatment hours, but also to the notion that all team members are teaching a child using the same principles and techniques, and are working on the goals and instructions that were indicated to be effective when the assessment was undertaken or as directed by the leader of the team. So even though different people may work with a child across the span of a week, the child’s teaching will mimic that as if only one teacher was present the entire time.  For example, if teacher one is teaching a child the first step of brushing their teeth, which is to put the toothbrush in their mouth, teacher number two will continue where teacher number one finished, and teacher number three will continue where teacher number two left off.  This scenario actually shows one of the reasons why data collection is imperative. If the teachers did not take data on a child’s progress during their session, then the next teacher scheduled to work with a child would not be informed about what step to pick up from and/or which teaching techniques to use.

Another component of a good ABA program is the use of positive reinforcement.  While we will discuss positive reinforcement in more detail later in sessions, positive reinforcement basically means providing a reward for a behavior to increase the chances that the behavior will occur again. It is important that a child be in a positive learning environment, so that they are praised for their accomplishments and thus motivated to keep on learning. Children should be having fun during their sessions even though a lot is expected of them. Therefore, the use of positive reinforcement is essential.

Generalization is also a key component of an effective ABA program. Generalization refers to the concept that a child will demonstrate what they have learned in the ABA session outside of the ABA session; what they have learned to demonstrate with their ABA teacher with other people in their environment; and what they have learned to do using simple and concise language, to more complex language. Without generalization a child may only be
able to demonstrate a skill with a specific person, at a specific place, at a specific time. This is sometimes seen when a parent says, “oh he does it for me,” meaning that when a teacher asks a child to do something specific, say to clap, the child does not clap.  However, when the parent asks their child to ‘clap’ the child claps. This does not mean that a child does not know how to clap, it simply means that the child has not generalized clapping from his parents to another person. Generally speaking, it is more important for a child to do one thing with anyone and everyone asked, then a hundred things with only one person at one time and in one place.

Given this concept of generalization, good ABA programs will include parent training as a key part to the treatment program. Parents are key members of the ABA program and in a child’s life, they know their child best. As parents spend most waking hours with their child, it is important that they be educated and trained in continuing where the ABA session ended. An ABA therapy program is simply much more than the number of hours a professional agency works with a child – it should involve all environments in a child’s life. The principles of ABA should be incorporated into the child rearing practices in the families implementing this program so that there is consistency in a child’s environment and that as many learning opportunities during waking hours that can be captured, are in fact captured. That does not mean to say that parents become mini teachers outside of therapy and stop being parents, but it does mean that parents and other significant caregivers are an integral part of the treatment team.

Last but not least, an effective ABA program will hold regular meetings between all team members and the family to update a child’s curricula, targets, and goals, and will continually and consistently collaborate with other professionals working with a child in other domains.  This may include a child’s school teacher, speech therapist, medical doctor, psychiatrist, or anyone who has a say in helping a child. It is important that all members of a child’s team collaborate so that they are working together rather than unknowingly working in opposition to one another. And this is especially true when it comes to the area or domain of challenging behaviors. It is imperative for the welfare of a child that all persons interacting with a child are especially consistent in how they react when a child is engaging in an inappropriate behavior. So, by having consistent collaboration with other professionals on a child’s team, such consistency can be maintained.

Making Bedtime And Sleep An Easier Routine For Children With Autism and PDD

Bedtime can be one of those nightly events which many parents love or hate, or both!  It means that peace and quiet is 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.  As all of these difficulties can increase the stress and tension in the home, below are some strategies to help reduce this potential stress. Keep in mind that no single suggestion will for all children and 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 mom and dad get a fuller night of rest, too!

Probably the most important strategy is to create a consistent nightly routine around the same time each night.  A routine helps signal the body that it’s time for bed and it can be soothing if there’s a lot of stimuli around. The routine can consist of a bath/shower, getting dressed for bed, playing a board game with the family, and/or reading a few books to quiet down.   Whatever the routine, keep it consistent so the child learns what to expect each night.

To enhance your child’s understanding of the nightly routine, you may consider using a visual schedule so they understand what happens in the evenings.  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.

If your child is one that seems wound up, even when he is physically in bed, make sure that the activities in the nightly routine are calmer in nature.  Choose books over exciting and loud family games.  Dim the lights when reading books. Play soothing instrumental music (baby lullaby bedtime music works well!) throughout the bedtime routine.  Focus on making sure the environment is quiet and calm.

If your child has a hard time falling asleep, or wakes up in the middle of the night, first consider if she takes 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 his or her room.  This may take many sleepless nights by the parents but it will pay off in the end.

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

Parent Tips To Determining Why Behavior Problems Happen

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

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

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

  1. Access

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

Example

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

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

 

  1. Escape/Avoidance

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

Example 1 (Escape)

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

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

 

Example 2 (Avoidance)

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

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

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

Example

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

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

 

  1. Self-stimulatory

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

Example

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

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

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