Different Roads to Learning

We certainly respect any individual’s right to his or her own opinion, and certainly for parents of children with autism to make decisions for their child regarding treatment; however, we believe that scientific evidence and the use of objective data should guide treatment options for all diseases and conditions, and autism is no exception. The late Senator Patrick Moynihan eloquently said, “Everyone is entitled to their own opinions, but not their own facts.” It is simply a matter of fact that theories, hypotheses, and testimonials do not provide adequate information to guide treatment decisions.

When friends or acquaintances hear about our experiences with autism, quite often the first thing they ask is, “What is your opinion of vaccines?” despite the retraction of Andrew Wakefield’s article by the Lancet (a very rare occurrence by this highly reputable journal). Sadly, the vaccine debate has long distracted the autism community from important discussions such as how best to help children already diagnosed with autism realize their fullest potential and live a happy and meaningful life.

In an ideal world, all treatment providers would make a commitment to science and evidence-based practices, and all members of the journalism community would make a commitment to responsible journalism. Until these ideals become the norm, those who do understand science-based treatments must do what they can to inform and educate others about the benefits of scientifically validated treatment, and the use of data to guide decision-making when assessing the benefits of any and all treatments.

Although applied behavior analysis is the treatment for autism with the most scientific support, we are rarely ever asked our opinion of this therapy, or if it is effective. Instead, every few months or so, some “new” treatment (or “repackaging” of a known treatment) will gain the attention of consumers. Given the large numbers of television reports, newspaper articles, blogs, and websites putting forth “miracle cures” and “breakthroughs,” it is not surprising that parents frequently receive advice and suggestions from extended family members, neighbors, and co-workers, particularly after a news item is broadcast, printed, or otherwise disseminated. Many of these individuals have the best intentions and are eager to share what they believe is “cutting edge” information about autism. In other cases, the advice is sometimes provided in a manner that comes across as critical of what you are choosing to do or not do for your child (i.e., it may be implied that you are not doing enough as a parent to help your child with autism).

If the information is offered by a more casual acquaintance, it may be best to simply thank him or her for their interest and concern and move on; however, such a strategy may not fare as well with individuals with whom you have a closer relationship. In these cases, you might consider sharing the following:

     • There are dozens of “miracle cures” and “breakthroughs” (i.e.,         pseudoscience) for autism that manage to receive widespread media attention,   even if they have not  been proven effective. In fact, there are over 500   treatments touted to address  autism;

     • It is important to be critical of all available information, regardless of the     source, and to recognize that not all information on the Internet is reliable and   accurate;

     • There is a large body of scientific research published in peer-reviewed     journals and carried out by hundreds of researchers that supports the choices   that you have made;

     • Numerous task forces (some are listed at the end) have looked closely and   objectively at the available research and have determined that the vast majority   of autism treatments lack any scientific support and, in fact, some may be   harmful;

     • Autism treatment is a multi-million dollar industry, and many treatment   proponents rely heavily on sensationalism and extraordinary claims to “sell” their products;

     • Interventions that are actually shown to be the most effective often receive   the least amount of media attention; and

     • For most other medical conditions, a provider that disregards proven   intervention and uses a fringe treatment may actually be sued for malpractice   (you may even consider drawing an analogy to a medical condition of particular   interest to the person providing the advice).

Of course, you may also consider addressing this matter proactively. This would involve clarifying your choices and commitment to science-based treatment to more significant family members and friends on your terms and at your convenience. It may be helpful to view this tactic as a series of tiny conversations. You may even consider sharing links to websites such as the Association for Science in Autism Treatment (ASAT), which will help your family members and friends separate the wheat from the chaff. We would like to draw your attention to a few sections of ASAT’s website that bear relevance to this discussion.

     • Learn more about specific treatments

     • Summaries of published research articles

     • Making sense of autism treatments: Weighing the evidence

     • Recommendations of expert panels and task forces

Finally, ASAT’s newsletter, Science in Autism Treatment, is a free publication, so encourage your friends and family to subscribe.

It is our hope that the information shared above may help your friends and family better understand the role that science should play in the treatment of autism, the need for objective data to drive decision making, how to better identify pseudoscience, and perhaps most importantly, why parents must be such savvy consumers.

David Celiberti, PhD, BCBA-D is the part time Executive Director of ASAT and Past-President, a role he served from 2006 and 2012. He is the Co-Editor of ASAT’s newsletter, Science in Autism Treatment. He received his PhD in clinical psychology from Rutgers University in 1993. Dr. Celiberti has served on a number of advisory boards and special interest groups in the field of autism, applied behavior analysis, and early childhood education, and been an active participant in local fundraising initiatives to support after school programming for economically disadvantaged children. He works in private practice and provides consultation to public and private schools and agencies in underserved areas. He has authored several articles in professional journals and presents frequently at regional, national, and international conferences. In prior positions, Dr. Celiberti taught courses related to applied behavior analysis (ABA) at both the undergraduate and graduate levels, supervised individuals pursuing BCBA certifications, and conducted research in the areas of ABA, family intervention, and autism.

Pamela Feliciano, PhD, joined the Simons Foundation in 2013 and serves as the scientific director of SPARK (Simons Foundation Powering Autism Research through Knowledge) and is a senior scientist at SFARI. SPARK is a SFARI initiative that seeks to accelerate autism research through a vibrant and informative online platform (SPARKforAutism.org). Previously, Feliciano worked as a senior editor at Nature Genetics, where she was responsible for managing the peer review process of research publications in all areas of genetics. Feliciano holds a B.S. from Cornell University, an M.S. from New York University and a Ph.D. in developmental biology from Stanford University. Feliciano is also the mother of an adolescent boy with autism spectrum disorder

“We have been working with a behavior analyst and it seems like every time they give us a new behavior intervention things just get worse, not better. What gives?”

Well, if you are working with a Board Certified Behavior Analyst, I’d like to believe that the interventions they are recommending for you are good ones. (i.e. research-based, effective, only have behavior analytic principles). So it’s likely that you are just experiencing an extinction burst.

Got it? Okay, now go do the steps your behavior analyst gave you.

Wait, what? You don’t know what an extinction burst is? Let me try to clear things up for you a bit.

Here is the definition of an extinction burst (Cooper, Heron, & Heward, 2007): an increase in the rate of responding when reinforcing consequences are withheld after the occurrence of the target behavior.

Basically, things usually get worse before they get better.  Great news, I know.  You’re welcome.

Why is this? Let’s try an example to make sense out of this technical stuff.

What if my daughter screeched and yelled every time she saw something on the kitchen counter? I could give her the item each time she screamed. She would then be quiet.  But who wants to live with a toddler who screams and yells constantly for things that are out of reach?

So one day I realize this isn’t a great plan and decide to teach her a replacement behavior- to ask nicely for things. I stop giving her the item every time she yells and instead wait for her to ask nicely for it.

What do you think will happen first? She’ll scream louder and longer. This has worked for her for so long that she just increases the intensity of the problem behavior to try to get access to the items out of reach (aka the reinforcers for the problem behavior). This is the extinction burst.

My daughter is probably thinking, “This screaming thing has worked forever. I just need to do it louder and more often to make sure she hears me and gives me what I want!” My girl gets louder and louder and eventually stops, realizing that the stuff just isn’t coming.

The behavior got worse before she recognized that screaming was not going to get her access to the desired item.

In behavior analytic terms:

Child screaming = problem behavior

Me giving her whatever she wanted= reinforcer

I stop providing the reinforcer to try to extinguish the behavior = intervention

Child screams louder and longer= extinction burst

Child stops screaming altogether= success

Now what would have happened had I given in to the louder screaming? Next time my daughter saw something she wanted, she would probably start screaming at the louder volume immediately to get access to the reinforcer, the preferred item.

I would have to stay strong and make it through the loud screaming without giving in so that the problem behavior would stop.

If I want this plan to be successful – if I want her to ask nicely for things – I need to stay strong through the increased screaming. Eventually she will realize that the screaming just isn’t working and that all she has to do is ask nicely for items. We can move on with our lives and be ready to teach more appropriate behaviors with less screaming and yelling involved.

The exact same thing applies to the interventions your behavior analyst is recommending. If the problem behavior gets stronger, more frequent, more intense, more anything as soon as you stop reinforcing it – you’re doing the right thing!

Stick to your guns, even though it can be really hard. Follow the steps your behavior analyst laid out and ride the wave of the extinction burst. To decrease that problem behavior and replace it with something appropriate will be so very worth it.

If an extinction burst leads to an increase in aggression, unsafe behaviors toward self or others, or a level of problem behavior you cannot reasonably live with – talk to your behavior analyst. Let them know what will or will not work for your child or your family and work together to create a plan that will work.

Extinction bursts aren’t fun for anyone. But replacing a problem behavior with something functional for your child is worth it. You can do it!

Cooper, J. O., Heron, T. E., & Heward, W. L. (2007). Applied behavior analysis.

Lerman, D.C., & Iwata, B.A. (1995). Prevalence of the extinction burst and its attenuation during treatment. Journal of Applied Behavior Analysis, 28, 93-94.

Lerman, D.C., Iwata, B.A., & Wallace, M.D. (1999). Side effects of extinction: Prevalence of bursting and aggression during the treatment of self-injurious behavior. Journal of Applied Behavior Analysis, 32, 1-8.

This piece originally appeared at www.bsci21.org. 

About The Author 

Leanne Page, MEd, BCBA, is the author of Parenting with Science: Behavior Analysis Saves Mom’s Sanity. As a Behavior Analyst and a mom of two little girls, she wanted to share behavior analysis with a population who could really use it- parents!

Leanne’s writing can be found in Parenting with Science and Parenting with ABA as well as a few other sites. She is a monthly contributor to bSci21.com , guest host for the Dr. Kim Live show, and has contributed to other websites as well.

Leanne has worked with children with disabilities for over 10 years. She earned both her Bachelor’s and Master’s degrees from Texas A&M University.  She also completed ABA coursework through the University of North Texas before earning her BCBA certification in 2011. Leanne has worked as a special educator of both elementary and high school self-contained, inclusion, general education, and resource settings.

Leanne also has managed a center providing ABA services to children in 1:1 and small group settings. She has  extensive experience in school and teacher training, therapist training, parent training, and providing direct services to children and families in a center-based or in-home therapy setting.

Leanne is now located in Dallas, Texas and is available for: distance BCBA and BCaBA supervision, parent training, speaking opportunities, and consultation. She can be reached via Facebook or at Lpagebcba@gmail.com.

ABA therapy can be used to teach/increase a variety of adaptive skills, such as tooth brushing, toileting, hair brushing, shoe tying, making a bed, etc. My favorite definition of an adaptive skill is anything that will have to be done for the learner, if the learner does not learn the skill. So if I don’t teach my child how to dress him/herself, then I will have to dress my child.

A common concern many of my clients have around adaptive functioning is the dreaded Morning Routine. Since my clients are usually school age, I have ample opportunity to help families target issues that regularly pop up during that frenzied time in the morning of trying to get the child out of the door on time. Issues like: task refusal, off task behavior, prompt dependency, skipping steps of the routine/completing the routine out of order, etc.

ABA interventions should always be individualized, but some of my most effective strategies for simplifying the morning routine include:

–          Visuals! Visuals are your friend :)

–          Use of auditory cues (timers)

–          ORGANIZATION

 With some simple tweaks here and there and adding in more supports, the morning routine can be less stressful, more efficient, and require less intrusive prompting which equals more independence for your child.

Let’s jump in:

Add visuals: I say “add visuals” and not “add more visuals”, because usually what I see is that families who struggle the most with the morning routine are not using any visual supports. If you are regularly struggling during the morning routine but you already have visual supports in place, then that’s a gold star for you. You are ahead of the game. If you are new to visual supports, just keep reading. Think of a visual support as a way to minimize prompting or assistance. If you have to stand in the bathroom doorway, physically assist your child, or keep giving the same demand over and over (“Make up your bed Evan ……. Evan, did you make your bed?”), then you definitely need to add some visuals. It is much easier to fade the prompt of a visual, than to fade your voice or your presence. Or to put it another way, do you want to have to stand in the doorway to make sure tooth brushing happens when your child is 25? Here are some awesome examples of visual supports, all were found on Pinterest.

Auditory cues: The use of a timer can be such a helpful addition to the morning routine because time is usually of the essence. We have to go, and we have to go now. For many of my defiant kiddos, those with attention issues, or those with lots of escape maintained behaviors, the simplest demand  (e.g. “Put your socks on”) can take ages and ages to actually happen. Decide on a specific amount of time for the skill to occur, and then set a timer. If the child can beat the timer, then allow them to contact reinforcement. Depending on the child, this could mean a treat, getting to pick what they wear that day, 2 minutes of TV time, etc. Make the concept of “hurry up” more concrete by helping the child understand how quickly tasks needs to be completed.

Organization: This tip is more for you than the child. Organization or proper set up for the morning routine does not begin that morning, it begins the night before. Part of the bedtime routine can include setting up items for the next day. This could mean lining up the soap, face towel, toothpaste, and toothbrush by the bathroom sink. Or this could mean putting the backpack by the front door, so there is no frantic search for it in the morning. How you organize will depend on the specific issues you are having in your home. The point is to set the child up for success. For younger children (especially if you want to increase independence) line up needed items/materials in their correct order so your assistance is not needed. For example, in the bedroom line up underwear, socks, pants, shirt, and shoes. In the kitchen, line up the bowl, spoon, and cereal box. For some children you may need to put number cards on each item (e.g. put a “1” card on the underwear). Any step you can do the night before will save precious time the next morning, and the materials being visible helps serve as a prompt of what to do next.

*Bonus Tip: A good way to practice the skills required for a successful morning routine is to incorporate weekend practice. If these skills are only performed M-F with a time crunch, then you’re setting yourself up for lots of frustration. On the weekends, still have your child go through the morning routine. Use this to fine- tune skills, or provide more repetition than is possible on a Monday morning. If tooth brushing is always a struggle, consider modifying the visuals or making them larger/more detailed. Try removing yourself, and only checking on your child periodically. If the child is older or needs less support, try implementing a checklist that the child completes. As they perform each skill, they check a box. When all the boxes are checked they bring the checklist to you for review.

About The Author: Tameika Meadows, BCBA

“I’ve been providing ABA therapy services to young children with Autism since early 2003. My career in ABA began when I stumbled upon a flyer on my college campus for what I assumed was a babysitting job. The job turned out to be an entry level ABA therapy position working with an adorable little boy with Autism. This would prove to be the unplanned beginning of a passionate career for me.

From those early days in the field, I am now an author, blogger, Consultant/Supervisor, and I regularly lead intensive training sessions for ABA staff and parents. If you are interested in my consultation services, or just have questions about the blog: contact me here.”

This piece originally appeared at www.iloveaba.com. 

This piece was originally posted at www.aba-interventions.com. 

• Reduce the amount of words used to explain yourself. During early learning, instead of “Tommy, I need you to pick up the green ball from under the table” try “pick up the ball.”
   
• Be concrete! The ASD brain sees the world in very black and white terms. It is best to speak in literal language to get your ideas across. Individuals on the spectrum often need specific training on how to understand idioms, metaphors and other popular phrases. Say exactly what you mean and what you want your child to do. Instead of “Run over and get your ball” try “get your ball.”
   
• Pair your voice with positive words! When your child hears your voice, you want them to think good things are available (not just task demands). When you use your words, tell your child what they SHOULD be doing not what they should NOT be doing. For instance, instead of yelling “Tommy, stop throwing Phil’s ball at Chuckie’s head!” try “let’s toss the ball into the hoop!” (This takes practice, patience and training!).
   
• Turn your voice OFF. Use nonverbal prompting as much as possible when your child is engaging in challenging behaviors. Make sure you are not reinforcing behaviors by giving them attention.
   
• Avoid using your child’s name when placing demands! This pairs his name with demands being placed. How responsive would you be if your name was always ONLY followed by “do my laundry, drive me to the movies, make me lunch!” Work on using your child’s name mostly with praise.
   
• During challenging behaviors, avoid asking for verbal responses. It is best to place demands that you can prompt immediately to ensure instructional control.These were my tips from an old blog, but worth publishing again!

About The Author

Elizabeth Ginder, MSSW, BCBA, LBA is the Clinical Director of ABA Interventions, LLC. Elizabeth specializes in working with children ages 2 through early adulthood. She has experience working with children diagnosed with intellectual and developmental disabilities, as well as children with severe, challenging behaviors. Elizabeth also has a strong background in parent, teacher and staff training. Her focus is on verbal behavior, skill acquisition and teaching children how to have fun! You can find more information on ABA Interventions at their Facebook page or at www.aba-interventions.com.

This piece was originally posted at www.aba-interventions.com. 

Play skills and social skills should be a part of an ABA treatment plan and are absolutely important for children with autism or I/DD. Many parents eagerly place their child in social groups, play dates, or insist that their child participates in group activities. These are WONDERFUL if your child is ready, but can be difficult and stressful if they are placed in these groups too soon. First, ask yourself these questions to determine if your child is ready for play dates and social groups:

Does my child allow peers into his space and allow peers to touch his toys?

Is my child able to successfully sit and engage in leisure activities?

Does my child have an interest in toys and activities?

Is my child able to engage in parallel play and turn taking?

If you responded “no”, work with your child’s therapist to write specific play date goals into the treatment plan. If your child engages in frequent, aggressive behaviors or stereotypic behaviors, they may also struggle in play groups.

Simply placing a child in a group environment is NOT social training or an effective play date. Our goal is to teach a child successfully without having to constantly do “damage control.” If a child has a history of negative experiences with peers, your child may be very averse towards peers. Imagine how you would feel if EVERY time you walked into Kroger people bumped into you, yelled and screamed around you, and followed you around asking questions and stealing your shopping cart. If this was your experience every single time, you would most likely avoid grocery shopping. It is our goal to turn that aversive peer experience into an experience that is motivating and positive.

When I first begin play dates and social skills groups with early learners, I like to start with a peer model or sibling. Once certain goals have been mastered with a peer model, we can begin generalizing skills to other peers and environments. Remember, we want successful peer interactions…even if our play date is 8 minutes long! We can work up to that 30 minute karate class, the birthday party at the zoo, or some of the other amazing social groups Knoxville has to offer!

Here is a fantastic blog article on special needs playdates!

Remember, appropriate play skills includes more than sharing and sitting next to a peer. Other goals may include:

• Keeping hands to self
• Greetings, initiating and reciprocating conversations, staying on topic
• Responding and asking questions
• Eye contact
• Imitating peers
• Social manners (i.e. asking “what happened” if someone is crying or very excited)
• Problem solving with peers

About The Author

Elizabeth Ginder, MSSW, BCBA, LBA is the Clinical Director of ABA Interventions, LLC. Elizabeth specializes in working with children ages 2 through early adulthood. She has experience working with children diagnosed with intellectual and developmental disabilities, as well as children with severe, challenging behaviors. Elizabeth also has a strong background in parent, teacher and staff training. Her focus is on verbal behavior, skill acquisition and teaching children how to have fun! You can find more information on ABA Interventions at their Facebook pageor at www.aba-interventions.com.

BY SAM BLANCO, PhD, LBA, BCBA

Recently I visited the home of one of my clients. I asked the RBT working there if our client was still throwing materials. She said he hadn’t thrown anything all week. I was excited to hear this news, until I heard her next sentence. “I realized he always throws the materials when he asks to be all done and I say ‘not yet.’ So now, whenever he says he’s all done, we just clean it up.”

While it is true that behavior analysts make changes to the environment to improve behaviors, that doesn’t mean we change the environment at the expense of teaching new skills. Our ultimate goal for any client is that they lead as independent a life as possible. For this particular client, I hope that one day he will be employed. This means that we need to start teaching him now that sometimes he will have to complete a task, even when he doesn’t feel like it.

So how do you know when you’re being realistic about changing the environment?  Here are a few questions you should ask yourself:

Is the environmental change I’m suggesting something that will be implemented in the natural environment? If no, then you should think about how to shape appropriate behaviors rather than simply avoid the problematic behavior. For this client, refusing to work further would not be acceptable in a school or in future work environments. It could also potentially result in more restrictive learning environments for the client.

In what future circumstances might this behavior cause problems for my client? If you can envision scenarios in employment, social situations, or in public, then you need to focus on teaching an appropriate behavior rather than simply avoiding the problematic behavior. Furthermore, thinking about these circumstances may help you identify potential replacement behaviors that you can teach.

How can I shape an appropriate behavior? Think about the steps you can plan for shaping a replacement behavior. For instance, with the example of my client, we could start by requiring him to complete one more simple instruction before putting the activity away (such as placing one more puzzle piece, responding to one more question, or imitating one more action.) After he’s mastered that step, we could increase the requirement to completing two more simple instructions, then to working for one more minute, then two more minutes, etc. We can implement a systematic plan for teaching an appropriate response and completing the work even if he doesn’t want to anymore.

Is what I’m asking reasonable? In another case, one of my clients’ goals was to pull her hair back into a ponytail independently. The intention behind this goal was to do it in situ, when she would naturally be pulling her hair back. However, the implementation of the goal resulted in her practicing pulling her hair back and taking it down multiple times. Her hair would often tangle and she would feel pain while taking her hair out of the ponytail. It’s fair to say that asking a client to put up and take down her hair several times is an unreasonable request. If your request isn’t reasonable, think about how to change it so the client still learns the skill without it becoming aversive.

Ultimately, we should not change the environment in order to avoid behaviors, unless there is something unreasonable or unnecessary about what we are requesting the client to do. It is our job to teach the client how to communicate effectively, as well as to teach and reinforce appropriate behaviors to promote independence.

About The Author 

Sam is an ABA provider for students ages 3-15 in NYC. Working in education for twelve years with students with Autism Spectrum Disorders and other developmental delays, Sam utilizes strategies for achieving a multitude of academic, behavior, and social goals. She is also an assistant professor in the ABA program at The Sage Colleges.

Punishment procedures are, with reason, very controversial. Today, I’d like to clear up a few concerns and issues about punishment procedures, especially in regards to the ethical obligations of behavior analysts.

First, it’s important to define the terms we’re discussing. In behavior analysis, when we refer to punishment, we mean any response to a behavior that decreases the future likelihood of that behavior. This means that we won’t categorize a particular intervention as punishment unless we have actual proof that it decreases the behavior. When I was a classroom teacher, I had a student who at the beginning of math class would break his pencil and begin cursing. My immediate response to this behavior was to send him out of the room. But this wasn’t actually punishment because it did not decrease the behavior. Instead, his ability to escape the math class actually maintained the pencil-breaking and cursing behavior. If I wanted to punish, or decrease, that behavior, then I needed to change my response.

Often, when we’re talking about interventions, we lump several responses into the punishment category (such as time out, verbal reprimands, or detention) without any evidence that they are actually decreasing the target behavior. So the question becomes, what is an aversive stimulus for the individual you’re working with?

 While this distinction is important in order to create effective interventions, it is also important to reference the Professional and Ethical Compliance Code for Behavior Analysts. Item 4.08 details the responsibilities of behavior analysts in regards to punishment. First, it states “behavior analysts recommend reinforcement rather than punishment whenever possible.” If behavior analysts have exhausted all possibilities and must use a punishment procedure, access to reinforcement must be a part of the intervention. This can be as part of reinforcing replacement behaviors that should be taught and reinforced in lieu of any problematic behavior.

Another important aspect of our ethical code is that when punishment procedures are being utilized, there is an increase in training, supervision, and oversight. A BCBA should not come in, explain a punishment procedure, and then not show up again for three months while teachers or practitioners are implementing the punishment procedure. Instead, there should be ongoing support and supervision and a plan to discontinue aversive procedures when they are no longer needed.

Ultimately, behavior analysts should be focused on reinforcement procedures. But when it becomes necessary to use aversive procedures to address dangerous behaviors, behavior analysts are required to be aware of and follow this compliance code.

WRITTEN BY SAM BLANCO, PhD, LBA, BCBA
Sam is an ABA provider for students ages 3-15 in NYC. Working in education for twelve years with students with Autism Spectrum Disorders and other developmental delays, Sam utilizes strategies for achieving a multitude of academic, behavior, and social goals. She is also an assistant professor in the ABA program at The Sage Colleges.

Many people are inspired by the start of the new year to set goals for themselves.  This is also an ideal time for parents to think about their goals for their children.  In setting goals for a child with a disability, there are a few important considerations that will improve the likelihood of the child’s success, as well as the parent’s satisfaction.

It’s usually a good idea to start with big picture goals, and then narrow them down.  You might start by asking yourself what your ultimate goal for your child is, and then where you would like to see him or her in 5 years.  Then, what would you like to be accomplished in this coming year? 

Let’s say your big picture goal is for your son to have a happy social life.  Your 5-year goal might then be for him to have at least 3 friends that he sees on a regular basis.  Your goal for this year might be to get him involved in an afterschool club on a regular basis. 

To take another example, your big picture goal might be for your daughter to communicate effectively with other people.  Your 5-year goal might be for her to have conversational exchanges with other people in the absence of prompts or augmentative communication.  And your goal for this year might be for her to ask for what she wants when she wants it (to “mand” for desired objects).

Starting with the big picture goal and thinking about the 5-year goal can help parents to maintain their focus.  If you start with small goals and build up, you might find yourself building in the wrong direction.  Most importantly, keeping the big picture and 5-year goals in mind help to keep your more immediate goals functional and meaningful.  When time and resources are precious, you want to make sure that you use them only to address goals that are going to help your child to attain his or her best, most important possible outcomes.

A second consideration in setting year-long goals is how realistic they are.  No one knows your child better than you, as his or her parent, but even parents can have difficulty gauging just where their child may wind up after a year.  Many factors can impact the success of any goal, including the interventions available and other, unexpected barriers or supports that may arise.  It can be helpful to break year-long goals down even further into smaller steps, which will be easier to predict and monitor. 

So, for the son who you want to see be more social, consider breaking the goal of joining an afterschool club down into its parts, each of which will be easier and faster for him to accomplish than the whole:  investigate the clubs that are available, discuss his top two choices with a guidance counselor, attend the first meeting, etc.  Each of these smaller goals can be measured and celebrated, helping to keep momentum and motivation towards the bigger year-long and further aspirations.  Similarly, the daughter who is working on communication can achieve smaller goals by learning to mand using prompts as earlier goals, and then continuing to mand independently as prompts are faded. 

Finally, each of the smaller goals set for the year should be measured so that progress can be tracked.  Seeing progress is not only motivating and exciting, but can help to guide when to advance to the next set of goals.  Measurement is also important for identifying when progress is not happening as quickly as desired, so that the supports and strategies in place can be updated for better success.

About The Author

Dana Reinecke is a doctoral level Board-Certified Behavior Analyst (BCBA-D) and a New York State Licensed Behavior Analyst (LBA).   Dana is a Core Faculty member and Associate Program Director in the Applied Behavior Analysis department at Capella University.  She is also co-owner of SupervisorABA, an online platform for BACB supervision curriculum and documentation.  Dana provides training and consultation to school districts, private schools, agencies, and families for individuals with disabilities.  She has presented original research and workshops on the treatment of autism and applications of ABA at regional, national, and international conferences.  She has published her research in peer-reviewed journals, written chapters in published books, and co-edited books on ABA and autism.  Current areas of research include use of technology to support students with and without disabilities and online teaching strategies for effective college and graduate education.  Dana is a past Board President of the New York State Association for Behavior Analysis (2018-2019).

This piece by Leanne Page MEd, BCBA originally appeared on bsci21.org.

“We recently hired a behavior analyst to work with our 4 year old son. She seems like a robot! Are all BCBAs so ‘professional’ and focused on data? Should I find someone else who can be more relaxed and friendly? Does this person exist? What’s the deal with BCBAs?“

Well, is your behavior analyst Vicki from the 80s sitcom, ‘Small Wonder’? If yes, then she is a robot. If not, then let’s look at this a little more closely. You aren’t the first person to think a BCBA (Board Certified Behavior Analyst) is a little too professional and data obsessed.  And you likely won’t be the last.

Just so you know it’s not simply my own opinions here, I’ve sought some input from some stellar BCBAs I happen to know. 

Behavior analysts hold ourselves to a higher code of ethics than a lot of other professions. We follow the Behavior Analyst Certification Board Ethics Code.  It’s 24 pages long. We’re serious about ethics around here. There are multiple sections in this code regarding professional relationships and cautions us against multiple relationships, conflicts of interest, and exploitative relationships. What does this mean? That to some extent a BCBA HAS to be too professional.

Becoming besties with our clients isn’t allowed. That would become a conflict of interest and your new bestie would have to drop your services and refer you to someone else.

Another robotic attribute of BCBAs- we love data. We live for data. All programming should come directly from data. All discussions of your child’s progress should be based on data. I kind of sound like a robot just typing this. Data. Data. Data.

“The key for anyone new to ABA is to understand that it’s a science. All of our decision making is based on data collection, analyzing that data, and then using it to help us decide what steps to take next.” – Kristin Fida, BCBA.

“We count on data to indicate to us whether what we are doing is working or if we could be doing something differently to increase your child’s success. Data provides immediate feedback ensuring precious time is not wasted. While our obsession with data may seem excessive, we put our heart and soul in to what we do and with each individual data point we are assured that your child is successful and achieving their goals!” – Brittany Keener, BCBA.

And finally, BCBAs can be too professional and robotic by not using user-friendly language describing the principles of ABA. We can forget that not everyone uses words like antecedent, mand, tact, reinforcement contingency, and etcetera. Behavior analysts who throw around these big words and don’t take the time to make sure they make sense to you probably do sound like robots.

But even with all these reasons listing why BCBAs are kind of like robots- here’s the truth of the matter. We love our jobs. We love behavior analysis. We love our clients. We love to help others make progress toward goals, reduce problem behaviors, and teach new behaviors and skills.

We cry over setbacks and celebrate every small step of progress with our clients. We jump for joy when a client spontaneously engages in a behavior we’ve been working on for eons. We lay awake at night thinking about programming, about how to help our clients make progress faster. We worry about our clients, we care about our clients, we do everything we can to make effective behavior change in our clients’ lives.

We are not robots. As a group, that is. There may be a few behavior analysts out there who don’t feel this way. Find one of the many who do; they (we) are the majority.  Find the BCBA who lives for positive behavior change. Work with a team that plans for your child’s future, that helps your child be more independent, that uses your child’s interests to promote learning.  Be an active part of that team- communication and collaboration between you and the behavior analyst are the keys to serious progress!

Behavior analysts are not robots.  We may like data a lot (bordering on obsession), but we use it to help people in real ways.

“Essentially, don’t give up. Talk to your BCBA and communicate your concerns and ask about what approach she is using and why she feels it is an appropriate intervention. The data should show that your son is making progress in goals that you want to increase while decreasing any maladaptive behaviors.  Just like with teachers, BCBAs all have a different style. If the style is working, don’t change it right away! Communication and being open with your BCBA is best!”- Jessi French, BCBA

“Developing positive relationships coupled with data driven decision making for our interventions is a sure recipe for success and progress with any client.”- Kristin Fida, BCBA

Talk to your BCBA. Tell them your concerns, listen to their explanations for why programming is done a certain way. If they use jargon- tell them you aren’t familiar with all the ABA terms. The more collaboration between you and your BCBA- the better for your son!

Leanne Page, MEd, BCBA, is the author of Parenting with Science: Behavior Analysis Saves Mom’s Sanity. As a Behavior Analyst and a mom of two little girls, she wanted to share behavior analysis with a population who could really use it- parents!

Leanne’s writing can be found in Parenting with Science and Parenting with ABA as well as a few other sites. She is a monthly contributor to bSci21.com , guest host for the Dr. Kim Live show, and has contributed to other websites as well.

Leanne has worked with children with disabilities for over 10 years. She earned both her Bachelor’s and Master’s degrees from Texas A&M University.  She also completed ABA coursework through the University of North Texas before earning her BCBA certification in 2011. Leanne has worked as a special educator of both elementary and high school self-contained, inclusion, general education, and resource settings.

Leanne also has managed a center providing ABA services to children in 1:1 and small group settings. She has  extensive experience in school and teacher training, therapist training, parent training, and providing direct services to children and families in a center-based or in-home therapy setting.

Leanne is now located in Dallas, Texas and is available for: distance BCBA and BCaBA supervision, parent training, speaking opportunities, and consultation. She can be reached via Facebook or at Lpagebcba@gmail.com.

This month’s ASAT feature comes to us from Melissa Taylor, BCaBA. To learn more about ASAT, please visit their website at www.asatonline.org. You can also sign up for ASAT’s free newsletter, Science in Autism Treatment, and like them on Facebook!

I recently accepted my first teaching position.  It’s a new classroom for the district serving students with autism. I have lots of materials, but nothing is organized or set up in my classroom. What are some tips to set up and organize the classroom to optimize learning opportunities and effective instruction?

Congratulations on your first teaching position! This is a common question for new teachers. When we talk about classroom organization, there are several things to take into account. Good classroom organization effectively makes use of space and barriers, has accessible materials for instruction and data collection, and facilitates efficient time management. It is critical that when you set up your classroom, you review the needs of your individual students as well as make sure to address the core characteristics of autism. You probably already know that many of your students will present with deficits in social interactions and communication, including challenges with requesting items from adults and peers. It will be important to create an environment that makes it necessary for students to interact frequently with other people to increase communication opportunities.  Once the environment is conducive to optimizing instruction, the instructors can implement effect behavioral strategies to teach desired behaviors.

Organizing the Space

Seating. When organizing a space, we want to make sure that the seating arrangement will allow students to access the materials needed for activities and respond accurately to instruction. For younger students, make sure the chairs allow their feet to touch the floor. Likewise, older students should be able to sit up straight with feet on the floor and legs at approximately 90-degree angle. Try to arrange seating so that you have space for group, as well as individual sessions. Also, allow enough room that additional support staff can sit behind students to make prompting less intrusive (e.g., sitting behind student and using physical guidance to help them learn the expected motor responses during the, “Wheels on the Bus” song).

Pathways for transitions. The furniture should be set up in a way that enables smooth transitions from one area to another without traffic jams. Walking between areas will be easier if there are not large dividers or barriers that slow down transitioning. Having open spaces and clear pathways between defined areas could also allow instructors to move quickly to different areas of the classroom if there is an episode of problem behavior or an unexpected opportunity to support a social interaction.

Defining areas. Some instructors find that using dividers helps clearly separate sections of the classroom. Keep in mind that every area should be open enough that the classroom teacher is able to see every student and classroom assistant. This will allow the teacher opportunities to provide immediate feedback to staff on interactions with students and to offer frequent student praise.  Try to avoid tall dividers that make it impossible to see into the other areas and dividers that are easily knocked over. Shelving units, desks, carpets, and tables can create more natural space dividers that can help define the areas. Keep in mind the function and purpose of each classroom area, and make sure that the instructional materials needed are in the area and replaced as needed. For example, if students are going to be required to request items during circle time, those items should be easy for the instructor to reach during group rather than requiring the instructor to get up, leave the group and look in a cabinet for items.  

Putting away preferred items. Children, including those with autism, are often good at finding and gaining access to the things they like without the help of other people. By keeping items out of reach, in clear containers that are difficult to open, and on high shelves, you can create new requesting opportunities and make communication with adults more valuable to students. Resalable plastic storage bags, totes, bins, shelving units, and aprons with pockets may all be useful to make it more likely that the students will need to request help from others to access the items they want or need. If the student already has a valuable item, you have lost an opportunity for communication.  By restricting access to valuable items, teachers can prompt requests for specific items and deliver items to students. Furthermore, when delivering the item, the teacher becomes more valuable to the student, who learns the significance of communicating. When these types of natural communication trials with preferred items occur in areas where instruction will occur, it becomes more likely that students will approach instructors and instructional areas. One important consideration with using such materials that in some cases, direct visibility to highly preferred items can be distracting to students or result in attempts to retrieve items outside of appropriate or scheduled times. In such instances, evaluate the situation and determine whether moving the student’s seat so that it is not facing those items or moving the items themselves will address the issue.

Organizing Materials

Materials for data collection. In preparing materials for instruction, we want to make sure that all instructors have easy access to necessary materials such as data collection tools and sheets. These items should be able to be easily accessed at any point of the day, so that instructors are more likely to capture all opportunities of the behaviors they are tracking. When data are recorded immediately following student behavior it is more likely to be accurate. Clipboards that have pockets attached to them are good for storing writing utensils, timers and additional data sheets. Student item lists, teaching stimuli, and data sheets can be kept in a cart with drawers to make it easily accessible during teaching. When collecting any type of data that require instructors to count the number of occurrences of a behavior, instructors can use clickers attached to their clothing with carabiner clips for convenience. Blank student specific datasheets can be carried with the student on clipboards, kept in a drawer on a cart, or hung on bulletin boards in centers where instructional activities occur.

Materials for instruction. Pencil cases or small craft boxes help organize small materials such as pieces of edibles, small toys, pencils, highlighters, picture cards, visual schedules or index cards for instruction.  For larger instructional items such as toys needed for teaching imitation skills, items needed for simply following direction tasks, or items needed to teach daily living skills, boxes, rolling carts with larger drawers, or labeled shelves can be used to organize materials by student or goal areas.

Consider posting wall cues, table/desk cue cards, or other reminders in places where staff will easily see them. These cues can be helpful to guide instruction without the need to flip through pages in consultation notes or program books to reference procedures. Types of items to post include specific teaching protocols and prompt hierarchies, reinforcement schedule reminders, behavior management strategies, toilet training schedules, reminders of how to teach play skills and student to student requesting, or other items that you want to generalize from one classroom area to another. Cue cards, wall cues, or student data sheets with specific targets listed can also guide instructor presentation during less structured teaching opportunities.  For example, if the student has been working on labeling the picture of gloves, and during circle time the teacher is dressing a weather bear, the instructor can ask that student to label the weather bear’s gloves. Additional targets to be posted for staff could include specific peer-to-peer requests or interactions (e.g., give item to peer, accept item from peer), specific motor skills (e.g., copying a line, opening a container), self-help skills (e.g., putting on shoes, washing hands), and other activities.  This allows for easy implementation of strategies such as natural environment teaching and incidental teaching.  Another point is to consider limiting other “wall clutter” that often serves as highly distracting stimuli to students. When possible, keep to salient items such as a classroom schedule, current student work or points of study (e.g., pictures of alphabet) but don’t feel the need to cover every available space with something!

Classroom Schedule

Time is valuable, and students with autism do not have time to waste. It is important to make the most of your day by having many opportunities to practice all targeted skills. Having a classroom schedule that allows for enough instructional time to make significant progress is critical. When creating a classroom schedule, make sure to address the who, when, what, and where questions. In other words, it should be easy to see who is working with a student at any given time as well as what skill they are working on and where they are working on that skill (e.g., red table, art table, hallway, etc.). Assigning student names to specific instructors can save valuable time during an emergency situation (student elopes, fire emergency).  Avoid unnecessary large chunks of non-academic or unstructured times. What each student will be working on should vary based on assessments conducted in the classroom. Instructors should consider posting the schedule on a wall, centrally located and large enough that all team members can see it. However, if you have many students and paraeducators going in and out of the room, you may consider having a master calendar but printing out individual copies for each staff member.  When you have a master schedule that is easy to change when students and staff are absent will cut down on unnecessary talk about who is with specific students and what they should be working on. Additionally, color-coding by students or staff will allow for staff member or administrators to easily follow from across the room or with a quick glance. Staff should be assigned to students at all time.  If a student is engaged in independent work, having a staff member still assigned to that child will help everyone know who is tracking data or responsible if an emergency occurs. 

If you take all of these suggestions into consideration when you begin planning your classroom, you will be well on your journey to make a big difference in the outcomes of your students. An organized classroom allows teachers to focus on effective instructional strategies and behavior management strategies that are individualized to each child and not waste valuable time locating materials, guiding staff behaviors, and planning groups.  We wish you well in your new teaching position and in the years to come.

About The Author

Melissa Taylor, BCaBA is a Consultant on the Autism Initiative for the Pennsylvania Training and Technical Assistance Network. Her current position focuses on training educators on the principles and implementation of behavior analysis within classroom settings. In addition, Melissa provides in-home behavior consultation to children and adults with autism. Currently, she serves as the Sponsorship Coordinator for the Association for Science in Autism Treatment.   

by Sam Blanco PhD, LBA, BCBA

Sometimes our learners don’t comply with instructions simply because they don’t fully understand what we are asking of them. At times, I find myself making the error of using too many words when I give directions, especially if I’m in a rush during a transition. For instance, I might say “Grab your shoes, put them on, and meet me by the door.” A few seconds later my learner meets me at the door, but with no shoes.

I may feel frustrated or irritated, but ultimately I realize my instructions are provided in a poor manner. I am at fault! It would have been more effective to point towards the shoes and say “Shoes on.” In his book Teach Like A Champion, Doug Lemov refers to this as Economy of Language, a phrase that essentially means the fewer words you use, the clearer your message. (It should be noted here that Teach Like A Champion is written for ALL teachers, not just special education teachers. This is a strategy that works across the board!) This is especially true when working with learners who struggle with listening comprehension, attention, or multi-step directions.

Here are a few suggestions to help you with economy of language:

Plan ahead. I actually write out instructions that I will be providing often and plan precisely how I will be giving them. I might plan a few variations, but, especially when working with young learners with autism, I want to provide lots of opportunities for success, then build to more complex instructions.

Consider hand signals. I often pair a hand signal with an instruction. For instance, one of my current students often sticks his fingers in his nose during instruction. I pair “Hands down” with a hand motion in which I move my hand from about shoulder-height to my lap (down). This is helpful because the learner also comprehends the signal, and I can begin providing the signal without the vocal statement. This allows me to provide instructions without interrupting the lesson.

One step at a time. Be aware of your learner’s listening comprehension and attending skills. If you notice that your learner is often only completing the first or the last thing you asked, this is a good indication that you provided too many instructions at the same time.

Avoid lengthy explanations. Sometimes I’ll hear an adult say something like “You need to hurry up and put your shoes on because your father is going to be here in a moment and we need to meet him outside and get in the car quickly so you’re not late for swim practice.” This is an easy trap to fall into, especially if vocalizing the explanation is helping you remember everything you need to do during a transition, but it may result in inaction from your learner.

Take a deep breath. If your learner is not responding correctly to instructions you’ve provided, step back, take a deep breath, and think about how to simplify the instruction.

WRITTEN BY SAM BLANCO, PhD, LBA, BCBA
Sam is an ABA provider for students ages 3-15 in NYC. Working in education for twelve years with students with Autism Spectrum Disorders and other developmental delays, Sam utilizes strategies for achieving a multitude of academic, behavior, and social goals. She is also an assistant professor in the ABA program at The Sage Colleges.

Helping students with autism and other communication disorders increase their expressive language skills can be overwhelming. It can be difficult to know what targets are the most important to start with. Every situation is so very individualized but following a general framework has made these decisions easier for me and has helped my students make progress in this area.

If we were to focus on the skill of labeling, for example, I would start with labeling items, people or places that are preferred for the student. If you have a student who really loves bubbles, chips and basketball – these would make wonderful first targets. Working on labeling can be difficult for students, so we want to make sure we make the programming fun and engaging. We should also include a plan for generalization at the start of this programming. Showing the student multiple pictures of bubbles, chips and basketball will allow for us to plan for the generalization of materials. This helps to build a bridge between the therapy environment and novel exemplars they may see in the natural environment.

When we start to work on labeling actions, the same framework can be implemented. Starting with preferred actions when available is a great idea. If the student is more motivated by the action or seeing the action, this may help to keep the student engaged in the task of labeling. We could choose targets that are related to the nouns chosen above: blowing, eating and playing. If the student enjoys these actions we could work on engaging in these actions and labeling them as they take place in real time, or we could show them pictures of these actions taking place.

When a student is able to label a variety of nouns and actions, it is time to combine these into action object or agent action phrases. To keep language instruction systematic, we start by combining previously mastered nouns and actions. Using the example from before, we would show the student pictures of the above action and nouns combined: blowing bubbles, eating chips and playing basketball. After the student has worked on creating these phrases with his/her words, pictures or device we can work on multiple exemplars to help plan for generalization. These could include blowing candles, blowing a kiss, eating pizza, eating an apple, playing soccer, playing tennis, etc.

Using a framework can help us plan for systematic language instruction for learners. This framework can help our learners have fun while learning, increase their expressive language, and help them generalize skills along the way.

About the Author

Rosemarie Griffin, MA, CCC/SLP BCBA, is an ASHA certified Speech-Language Pathologist and a Board Certified Behavior Analyst. She divides her time between a public school and a private school for students with autism in Ohio. She’s presented at the national, state and local level about systematic and collaborative language instruction for students with autism. Her professional mission is to help all students expand their communication step by step. She can be reached at www.abaspeech.org, on Facebook or Instagram.