Transition strategies for autistic students can be very beneficial when trying to help them move successfully from one activity to another. Every student has to transition multiple times through a given school day. By giving autistic students warnings about the time remaining in an activity can provide a helpful frame of reference. Individuals with autism spectrum disorders (ASD) may have greater difficulty in shifting attention from one task to another or changes in routine. The autistic child struggles with making the cognitive adjustments necessary to move on. As a consequence, transitions in autism are often plagued with stress, anxiety, and frustration. A number of supports to assist individuals with ASD during transitions have been designed both to prepare individuals before the transition will occur and to support the individual during the transition.
The benefits of transition strategies for students with ASD:
- Reduce the amount of transition time.
- Increase appropriate behavior during transitions.
- Rely less on adult prompting.
- Participate more successfully in school and community outings.
Why incorporate transition strategies for autistic students
Transitions are a large part of any school day, as we move to different activities or locations. Studies have shown that up to 25% of a school day may be spent engaged in transition activities, such as;
- moving from classroom to classroom
- coming in from the playground
- going to the cafeteria
- putting personal items in designated locations like lockers or cubbies
- gathering needed materials to start working
Some students with ASD may have difficulties associated with changes in routine or changes in environments, and may have a need for “sameness” and predictability. These difficulties may eventually hamper one’s independence and limit the student’s ability to succeed in a school setting. A variety of factors related to Autism Spectrum Disorder may lead to difficulties during transitions.
Additionally, the neuropsychological process known as the ‘Executive Function’ is heavily involved in making transitions. This function helps the brain to shift and reallocate attention and other brain resources when required. In autism, there are often gaps in this system. Because of these gaps, the brain may struggle with stopping one task and transferring attention and other thought processes onto another.
Different types of transition strategies for autistic students
When deciding which transition strategy to use, you need to think about the individual. Usually, verbal cues like “You have 5 more minutes to do your work” are harder for students with ASD to process. Verbal concepts relating to time are hard for them to grasp especially if telling time is not a strong point for them. Furthermore, it doesn’t allow them enough time to prepare themselves for the transition. Visual transitions seem to work better like:
- Visual Timer: A timer that visually shows in red how much time is left when the red indicator is gone then the student needs to transition to the next activity.
- Visual Countdown: A list of tasks that are removed until they are gone which means it is time to transition.
- Elements of a visual schedules: An actual schedule so the student can see the sequence of activities that will occur for a given period then they are able to transition better to the next activity.
- Use of Objects, Photos, Icons, or Words: An actual object or a photo of an image or words that the student can hold that explains the transition.
- Use of Transition Cards: The card represents what the student will be transitioning to next with the use of a word spelled out or an image of the transition displayed for the student to refer to. These are very helpful concrete learners.
- Fixed Container/Box: It is beneficial to have a container in a certain location that the student can put their materials in before transitioning to the next location or activity. Furthermore, teaching students to put away materials in the completion of an activity can function as a natural queue that one activity is ending, and that another is beginning.
Concrete cues help to answer any questions that autistic students might have about the transition and can reduce confusion and help in developing productive transition routines. Learn what cues work best for your student with autism. Team members should examine how the environment and the transition strategies are working best for the autistic student. You may need to use multiple cues to help the autistic student transition more smoothly. Be aware if an area is too crowded, loud, over stimulating or averse for some reason, individuals may resist transitioning to that location.
Structure and consistency will help reduce the amount of work that the brain needs to do to make a transition. It helps to keep materials for upcoming tasks in an easily identifiable and consistent place. Keeping the general order of daily tasks consistent can also help to make transitions become more automatic.
All of these simple, yet very effective support strategies are easy to use, and help both students and teachers during everyday classroom activities.
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?