Different Roads to Learning

Creating opportunities for interactions is key when working with any child, but it is especially important when working with children with autism. ABA often gets a bad rap for being staid or leaving a kid stuck at a table doing discrete trials for hours on end. In reality, it should be neither! While I do discrete trials in my practice, my biggest priority is always focused on increasing learning opportunities by taking advantage of the child’s natural motivations. This typically means leaving the table, so I alternate between discrete trials and lots of teaching through games and activities. Here are a few of my favorites:

Toss & Talk

For this activity, I usually use a large ball, a soft ring, or something else the child can toss. I name a category, and we take turns tossing the ball (or other item) and naming an item from that category. The game can be easily modified for whatever you’re working on: counting, skip counting, or even vocal imitation. I like the game because it’s simple, it provide a back-and-forth that is similar to a conversation, and it can easily be modified to include peers, siblings, or parents. This is particularly great if your learner likes throwing balls, but I’ve also modified it to push a train back and forth or take turns hopping towards one another.

Play Dough Snake

This game is one I saw a preschool teacher use years ago and have had great success with. In this game, I simply create a snake out of play dough. I make a large opening for the snake’s mouth, then roll up little balls of dough that will be “food.” I tell the child that we are going to pretend the play dough is food. I have a silly snake voice, and I tell the child “I’m so hungry. Do you have something I can eat?” The child picks up a piece of the rolled-up play dough, tells me what kind of food it is, and then feeds it to the snake. I pretend to love it, and the little ball of play dough becomes incorporated into the snake’s play dough body (which is great, because the more “food” the snake eats the bigger it gets.)

I can expand the game to have the snake dislike certain foods or tell the child he is too full. On several occasions, the learner has asked if they can be the snake, which is fantastic! This is another great game for peer play, sibling play, and modeling.

Pete’s A Pizza/You’re A Pizza

One of my favorite books for young learners is Pete’s A Pizza by William Steig. In this book, it’s a rainy day and Pete’s parents entertain him by pretending they are making him into a pizza: they roll up the “dough,” toss him in the air, add toppings, etc.
This is another game I saw a preschool teacher using during play time, and one I’ve used with many, many students. Sometimes I read the book beforehand, but if my learner’s level of comprehension or attention span is not appropriate for the book, I can just introduce it as a standalone game. I say, “It’s time to make a pizza!” Then, we get into the fun part of rolling the learner around, tossing him on a couch or mat, etc. This can generate a lot of language, work on sequencing, and provide a lot of opportunity for requesting activities.

Anything with a Parachute

My parachute is one of my best purchases of all time. I use it often and it allows me to play a wide range of games. Besides just having the learner lay on the floor and have the parachute float down onto his/her body, it is a highly motivating toy for a range of activities. Many of my learners love just pulling that large item out of its small bag. I’ve already written about three games I frequently play with the parachute. You can see that here.

Songs

Repeating rhymes and songs with motions that your learner loves can provide anticipation of an activity that may increase eye contact and manding. One of my favorites is shown in a video here. While this video is shown with toddlers, I’ve used it with kids up to 6 or 7 years old. Similar activities might include Going on a Bear Hunt; Heads, Shoulders, Knees, and Toes; and Animal Action.

It’s important to note that none of these activities is beloved by every learner I encounter. The idea is to have a range of possible activities to learn which ones are motivating to your learner, then use those to create opportunities for language and interaction.

Written By Sam Blanco, Phd, LBA, BCBA 

Sam is an ABA provider for students ages 3-15 in NYC. Working in education for sixteen 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, and she is the Senior Clinical Strategist at Chorus Software Solutions

Over the past two decades, dozens of task forces, panels, and independent research studies have found that Applied Behavior Analysis (ABA) is the only effective intervention for autism spectrum disorder (ASD).  Although ABA is helpful for many issues other than autism, and in fact is not a treatment of autism in and of itself, the practice of the science is often linked to ASD.  I’d like to share some of the core principles of ABA that are associated with the many ways in which ABA is helpful for supporting individuals on the autism spectrum.

First, ABA works from the crucially important framework of determinism.  This means that behavior analysts see behavior as being determined by the environment.  In other words, the reasons for behavior are external, not particular to the person.  As we like to say, “The student is always right.”  This perspective is tremendously helpful because it means that there’s always something that can be done to help.  If an individual is having difficulty learning, we can adjust the environment to improve his or her ability to learn.  If someone is engaging in behavior that is dangerous or upsetting, we can adjust the environment to reduce the likelihood of that behavior.  We never try to change a PERSON; rather we attempt to change the events that occur before and after behavior, making that behavior more or less likely.

Next, ABA is highly individualized.  One of the reasons that it is so effective as a practice in teaching and supporting individuals with ASD is that each person receives a tailor-made intervention that addresses his or her needs, strengths, and preferences.  ASD does not look the same in every person who has it, therefore intervention should not look the same.  Furthermore, continuous data collection and analysis allow for continuous updating and refining of interventions, so that each individual should be receiving the most effective strategies at all times.

Finally, ABA focuses on lifestyle changes and involves parents and significant others in all interventions.  ABA is not something that is done by behavior analysts to people with autism.  Rather, it’s the practical application of the science of behavior by the people who interact with – and care for – those in need of intervention the most.  In many cases, behavioral programming is carried out by teachers or paraprofessionals, but ABA is most effective when it’s also carried out by parents, siblings, grandparents, aunts, uncles, cousins, and friends.  The design of effective strategies and ongoing analysis of outcomes should be overseen by a well-qualified behavior analyst, but the strategies themselves should involve everyone in the individual’s life.  This helps to ensure generalization and maintenance of behavior change, and to provide the individual with ASD maximum exposure to supportive strategies throughout his or her day.

For these reasons and more, ABA is the intervention of choice for individuals on the autism spectrum.  It is humane, effective, and fair.  Given the right intervention, those with ASD can achieve personal goals and reach increased levels of independence in their lives.

About The Author

Dana Reinecke, Ph.D., BCBA-D 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 in the Applied Behavior Analysis department at Capella University.  She is also co-owner of SupervisorABA, an online platform for BACB supervision curriculum, forms, and hours tracking.  Dana provides training and consultation to school districts, private schools, agencies, and families for individuals with disabilities. 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, self-management training of college students with disabilities, and online teaching strategies for effective college and graduate education.  Dana is actively involved in the New York State Association for Behavior Analysis (NYSABA).

The timer is one of everyone’s favorite tools for structuring time and activities for children with autism. It can be incorporated into all parts of daily living.

It was once explained to me that a parent could blame the timer for everything that has to do with transitions.

“It’s not me, it’s the Timer.”

“I know you want to stay in the playground but the timer said it’s time to go home.” Or perhaps, “The timer thinks you might have to go to the potty again.” My favorite at Christmas is, “The timer will tell you when you can open another present.” At our house, the timer was the higher authority. The timer is a fair arbitrator. It didn’t respond to whining or behaviors and it very coolly and serenely had to be obeyed.

It works! You just have to remember to put it in place and use it before you enter the big struggle of wills.

It’s just a simple kitchen timer….BUT we needed one that could count down and count up, it had to have a magnet so it could be easily found on the refrigerator and a clip/stand so one of us could wear it or place it close to us at the table if we were working.

Along the way, we found the Time Timer, invented by a mom of mainstream kids who needed a visual for transitions to stop her kids from asking, “Are we there yet?” The Time Timer is a visual depiction of time elapsing. Kids on the spectrum have a tangible way to see time passing as the red dial disappears.

There are all kinds of timers, and implementing them into any aspect of the day can significantly help in cutting back problem behaviors and anxiety over what is happening next.

- Julie Azuma

Save 20% on timers and tally counters today only! 

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As a career behavior analyst who has learned, taught, and practiced in the field for over 25 years, I have heard many mischaracterizations of Applied Behavior Analysis (ABA). These are not new, but they are pervasive, divisive, and most importantly, may lead to people not accessing supports that could be life-changing for themselves and their families.  Here are five misconceptions that I still hear, and my considered response to each.

1. ABA is abusive

It is heart-breaking that this misconception still exists.  Yes, ABA professionals have engaged in abusive behavior towards individuals with disabilities.  So have doctors, priests, parents, teachers, psychologists, and literally anyone else in any position of power.  That doesn’t mean that medicine, religion, parenting, education, or psychology are abusive.  It doesn’t mean that the abusive practices were part of the practice of behavior analysis. 

The Professional and Ethical Compliance Code for Behavior Analysts clearly outlines behavior analysts’ responsibility to clients, which includes holding client rights in the highest regard, respectfully assessing behavior, obtaining informed consent for all assessments and interventions, and avoiding restrictive and harmful procedures (BACB, 2014).  If a behavior analyst is abusive towards a client, they should be reported and certification should be revoked, just as in any profession where abuse can occur.  Abusive acts are not part of the practice of ABA.

2. ABA is a treatment for autism spectrum disorder (ASD)

Although very frequently associated with the treatment of ASD, to say that ABA is a treatment for ASD is a gross misconception (Chiesa, 2006).  ABA is a science that leads to technology that is useful for teaching skills that are lacking and for helping people to overcome behavioral challenges.  That ABA is frequently applied to such teaching for individuals with ASD reflects the demonstrated effectiveness of these technologies in supporting individuals with ASD (NAC, 2009), and not that it is only effective for ASD.  

In fact, ABA is defined by its principles and methods (Lerman, Iwata, & Hanley, 2013) and not by the populations that it serves.  Decades of research have demonstrated that ABA is an effective means of helping people with a variety of concerns, including those resulting from various disabilities (e.g., ADHD, learning disabilities, intellectual disabilities), lifestyle and health challenges (e.g., obesity, medication adherence, addiction), organizational needs (e.g., staff training, safety), and even stages of life (e.g., parenting, geriatrics).  In short, ABA can help with any kind of behavior of any kind of person.

3. ABA is only for people with severe impairments 

This misconception is related to a view of ABA as a treatment of ASD.  Even within the ASD community, there is misunderstanding about the many levels of support that ABA can provide.  I have heard that students were “too high-functioning for ABA” and that some students have “graduated from ABA.”  The fact is that if anyone is learning anything, it is because of the principles of behavior, whether or not they are labeled as ABA in these situations.  

To appreciate how a systematic and well-supervised application of ABA technologies can help people at all levels of life, one needs only to look at the vast research on ABA in a variety of educational and organizational environments.  If ABA can teach a non-verbal child with ASD to speak, and also teach a college student to stay organized, what can it not do?

4. ABA violates autonomy and human rights

Sadly, the assumption is often made that behavior analysts force people to change their behavior against their will.  This could not be further from the truth.  If a behavior analyst is following the ethical code, then they are obtaining client input and informed consent for all behavior change procedures (BACB, 2014).  If a behavior analyst is not obtaining informed consent and failing to tailor the program to the clients’ needs, wishes, and preferences, then they are practicing unethically.  The ultimate goal of any ABA intervention is to fade out added supports and promote independence given the same supports and strategies that others in the natural environment benefit from.  For example, a token board might be implemented to support a child in learning from his teacher, but the goal is for that token board to eventually be systematically removed and for the child to learn from his teacher through the same naturally-occurring reinforcers as same-age peers (e.g., praise, grades, feeling of accomplishment).  To take a more extreme viewpoint, the ultimate goal of teaching someone to use the bathroom independently is to improve the likelihood of freedom, dignity, and safety for that person for a lifetime.

5. ABA leads to robotic, scripted responding

This misconception comes from the misuse of ABA strategies by poorly-trained, unethical providers.  Unfortunately, the terminology associated with ABA can be misused, such that consumers may have a hard time discriminating true ABA strategies (that are conceptually systematic with the science) from those that are mislabeled as ABA.  The scope of this discussion is much broader than can be addressed here, but the basic lesson is that ABA is not something that can be photocopied out of a book or downloaded from a website and applied to everyone in the same way.  Here are some red flags to watch out for as potential indicators that an intervention is not truly based in the science of behavior analysis:

• Extensive/excessive drilling; all intervention is 1:1, knee-to-knee, table-top
• No data collection, or data collected but not assessed
• Scripting of learner responses without plans for generalization
• Infrequent assessment of preferences (or not at all)
• Intervention is combined with other strategies or is practiced for limited time periods (e.g., “we do ABA for 1 hour per day”)
• Intervention is limited to one setting, with little or no parent/caregiver training or involvement
• Behavior reduction without prior assessment and proper consents

Hopefully misconceptions like these and others can be reduced by continuously representing ABA as an ethical, effective science.  True to the values of ABA, by spending more time talking about what ABA is, we can spend less time explaining what it is not.

References

Behavior Analyst Certification Board. (2014). Professional and ethical compliance code for behavior analysts. Littleton, CO: Author.

Chiesa, M.  (2006).  ABA is Not a Therapy for ASD.  In M. Keenan, M. Henderson, K. P. Kerr and K. Dillenburger (Eds.) Applied Behaviour Analysis and ASD:  Building a Future Together (pp. 225-240).  Jessica Kingsley.  

Lerman, D. C., Iwata, B. A., & Hanley, G. P. (2013). Applied behavior analysis. In G. J. Madden (Ed.), Handbook of applied behavior analysis: Vol. 1. Methods and principles (pp. 81–104). Washington, DC: American Psychological Association.

National ASD Center (2009). National Standards Report. Randolph, MA.

About The Author

Dana Reinecke, Ph.D., BCBA-D 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 in the Applied Behavior Analysis department at Capella University.  She is also co-owner of SupervisorABA, an online platform for BACB supervision curriculum, forms, and hours tracking.  Dana provides training and consultation to school districts, private schools, agencies, and families for individuals with disabilities. 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, self-management training of college students with disabilities, and online teaching strategies for effective college and graduate education.  Dana is actively involved in the New York State Association for Behavior Analysis (NYSABA).

Dear Families of ASD Children and Friends, 

We usually celebrate Autism Awareness in the month of April, but this year during the unprecedented pandemic our families are facing the challenge to provide supports for their ASD children.  Whether it’s continuing their school programs at home or creating more positive behavior, our ASD families are facing enormous challenges each day.

 In the 1990’s, a listserv called the Me List was created for parents who believed in Applied Behavior Analysis as the evidenced based intervention that works. There were few school programs, parents had to do it themselves. Through the Me List, we learned about what was helpful to our children and our families. We all came together from across the country and beyond to share what worked, so that others could benefit from our experiences Different Roads became an ABA resource due to the suggestions of these parents and what they had learned from their home programs.

This month, we’d like to honor the spirit of the original Me Listers who inspired the creation of Different Roads to Learning. We wish be able to help you in some small way find something that will help you get through the weeks to come.  It is with that spirit we extend this sale, in the hope that it will help you and your families and the children whose lives we hope to improve. If you have questions on science-based treatments or are having trouble sourcing supports for your learners please reach out to us. Our hearts and thoughts are with you.  ​

About The Author

When her daughter was diagnosed with autism at the age of six, Julie Azuma started Different Roads To Learning to support parents running ABA programs in their homes. Since then, schools across the country use Applied Behavior Analysis and Verbal Behavior in both contained and inclusion classrooms. Tens of thousands of children have been mainstreamed by the age of 5. Our children are more capable in every way. Today, we are proud that our mission remains to provide the most effective, informative, affordable and appropriate materials to support the students with Autism Spectrum Disorder in their social and academic growth. 

While ABA is generally a long term commitment that a client and his or her caregiver makes, oftentimes before the child reached his or her third birthday, it is still important to have a fade-out policy in place in for when the client reaches their treatment goals or the provider is no longer able to provide services. Unlike many professions, behavior analysts want our clients to reach a point where they no longer need our services! Here are some tips for developing an effective fade out policy that is supportive of your client’s transition out of services.

1. Clearly outline eligibility, timeline and fade out procedure

The fade-out policy should explicitly state the conditions that qualify a client for fade out of services (e.g. client is no longer benefitting, client no longer requires the services, client requests discontinuation, client violates terms of client-services agreement, etc.). In addition, a fade-out should provide the family with a transition plan detailing when caregivers will be notified of anticipated discharge date, rate of fade out (e.g. Decreasing frequency of sessions from once per week to once every two weeks) and resources provided for addressing remaining areas of deficit. Having a clear plan takes the guesswork out of the process of transitioning out of services for both clinicians and caregivers.

2. Communicate your fade-out policy to caregivers at the onset of treatment

Include your fade-out policy as part of the initial intake process. This informs caregiver expectations and prevents them from assuming the myth that formal ABA therapy is going to be part of the rest of their child’s life.

3. Planning ahead for at least 6 months prior to termination of services

Structure treatment plans to account for and support transition out of services to ensure that fade out does not feel sudden or disruptive. Treatment should always maximize opportunities to utilize natural teaching strategies and caregiver training and support. It is recommended that the provider adequately train caregivers to support generalization of mastered programs as well as provide training so they have the necessary skills to know how to prompt, reinforce, and adjust the environment when necessary. In addition, work with any new provider who will be supporting the client to ensure a smooth transition and continuity of services.

4. Support client independence and teach functional skills

The long-term goal of ABA therapy is to help clients learn functional skills that can help them integrate into an inclusive environment. Thus, treatment plans should address functional skills first in order to ensure that the client can achieve maximum independence if services are no longer available.

5. Develop a network of professionals and community partners to assist in transition of care beyond scope of practice

Collaborate with ABA-friendly providers to provide resources for clients after they transition out of formal ABA services to maximize skill maintenance and continuity of care. Some BHCOEs partner with adult transitional programs that assist in job-placement into sites that utilize ABA-strategies to ensure success.

6. Include an aftercare plan with follow-up consultations when possible

Schedule follow-up consultations with caregivers after transition out of services to troubleshoot issues that may have arisen.

This piece was written by the Behavioral Health Center of Excellence and has been shared with their permission. For more information, please visit www.bhcoe.org.

Many parents choose to “ground” their kids when they make poor decisions. Maybe they lose access to video games for a week, or can’t watch TV for a month. Grounding in and of itself is not necessarily a bad thing. Here are a few considerations:

• If you keep grounding your kid for the same behavior, then grounding is not changing the behavior. Sometimes grounding your child is a default response, but if it’s not working, you might want to consider some other options. You can take a look back at our series on differential reinforcement or our post on noncontingent reinforcement.
• When possible, the consequence should be connected to the behavior. If your child throws a controller, then not having access to video games makes great sense. However, if video games are taken away for any infraction, it may not be the most logical punishment and over time, it may even backfire. If the child is losing video games for everything, then he/she might stop trying to earn video games at all.
• Longer durations of grounding may make you miss out on opportunities for reinforcing appropriate behaviors. Remember that reinforcement is simply any consequence that increases the future likelihood of the behavior. If you have set a rule that your child is grounded from using video games for one year, then you are missing many, many opportunities to teach the appropriate behavior. The same can be said for one month or even for one week. Especially when considering children with autism, they may require multiple trials of the appropriate behavior before you see an increase in the appropriate behavior. In that case, grounding may just not be the best option.
• Longer durations of grounding may backfire if you experience fatigue. Often our kids are experts at asking the same question repeatedly until you finally give in. The last thing you want to do is set a standard that when you say your child is grounded for a week, they are really only grounded until they wear you down.
• Consider a different tactic. This isn’t possible for all behaviors, but if you are seeking a specific appropriate behavior, set a standard that if a certain duration or a certain number of appropriate behaviors results in more access to preferred items and activities. This is sort of the inversion of grounding and may be more successful.

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.