Increasing & Decreasing Behavior With ABA

What behaviors does ABA seek to increase or decrease?

Applied behavior analysis (ABA) uses the principles of behavior for increasing and decreasing specific behaviors of social significance. Behaviors to increase or decrease are selected in collaboration with parents. Additionally, it is wise to involve other relevant stakeholders, like extended family or your child’s teacher.

When selecting ABA goals, it’s important to consider:

For challenging behavior, it’s crucial to consider how much is the behavior impacting the child’s functioning, learning, social opportunities, or ability to access the community. If parents cannot take a child to the store because of tantrums, it can impact a family significantly. (e.g., decreased access to social skills, difficulty completing common routines, or cost of childcare so the parent can go to the store). Similarly, if a child cannot communicate his or her wants or needs, this may cause problems for the family system as a whole.

It is important to consider the following points for increasing skills:

* What should the child be doing?

* How far outside of typical development is this behavior?

* Typically, what should a child this age be doing or expected to do?

* In what manner are these skills pivotal to future areas of development?

Small steps may lead to a larger goal

All goals should be prioritized based on some of the questions listed above. It is also essential to consider prerequisite skills and look at the larger picture. It may be that before you get to the big point of concern that there are other smaller goals to meet along the way. If your child cannot wait at home for five minutes, then waiting at a store for a toy may be more difficult. First, work on the smaller skills to build to the larger ones. With patience and practice, your child will be on their way to achieving their goals.

ABA therapy can be implemented in different environments, like home, our clinics, or in the classroom.

At NSPT, your child will receive 1:1 therapy along with the ongoing analysis of his/her progress to ensure he/she is continuing to progress and succeed.

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Neuropsychological Testing Day

Neuropsychological Testing Day at NSPT

We’ve put together a brief guide to what the day of a pediatric neuropsychological evaluation looks like at NSPT. Below you will find important details from what to bring to how to prepare. As always, if you have any questions simply get in touch.

What does the testing day look like?

  • The testing lasts approximately 4-5 hours.
  • Parents submit the parent and teacher rating scales that are provided during the intake.
  • Each testing battery is individually designed by the doctor based on your child’s specific needs.
  • Testing tasks include answering questions about various topics and requiring different skills including vocabulary, similarities between words, math, doing paper and pencil work, and doing work on a computer.
  • Lunch, snack, bathroom, and other breaks are given when needed, as well as at regularly planned intervals.
  • Note: Testing results are not available on the testing day, rather provided during the feedback appointment.

What to Bring on the Day of Testing:

  • Plenty of snacks and lunch
  • Rating forms and any paperwork that still needed to be completed
  • Any prior evaluations that were not brought to the intake

After testing is complete, you will return for a one-hour feedback session approximately two weeks later with the psychologist to review the testing data, any diagnoses determined based on your child’s profile, recommendations for home and school, and any intervention services to foster your child’s development.

How can I prepare for the evaluation day?

  • Please bring snacks and a lunch for your child.
  • Complete the parent/teacher rating scales that were provided during the intake.
  • If your child is under 4 years of age or not potty trained, we will ask you to stay in the clinic for the duration of the testing.

Q&A

Q: What if my child is sick the day of testing?
A: The appointment will need to be rescheduled as we want your child to test at optimal levels. Please contact us as soon as possible.

Q: Should my child take his or her regular medication(s) on the day of testing?
A: Yes, unless otherwise instructed.

Q; Should my child wear his or her glasses?
A: Yes.

What happens at the feedback appointment?

  • This is a parent-only session.
  • You will be given an explanation of your child’s testing results and, if warranted, a diagnosis. At this time, your doctor will identify the most appropriate interventions and accommodations for your child for the home and school settings.
  • A final copy of your child’s report will be mailed to you within two weeks of your feedback appointment. Should you need the report sooner, please let your doctor know and we will do our best to accommodate you.
  • Note: You will not receive a final report during the feedback appointment, because your doctor may need to add additional information from the feedback session to the report.
  • With parental consent, a copy will be sent to your child’s pediatrician.
  • We do not share reports with schools. Should you choose to share it, you will need to provide a copy to the school.

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Increase Your Child’s Executive Functioning Skills

As we previously learned in our blog What Are Executive Functioning Skills?, executive functioning skills are what help all of us achieve goal-directed behaviors. They are the building blocks of successful planning, appropriate communication and relationships, and task-oriented behaviors. Executive Functioning

To help your child increase his/her executive functioning skills, we must look at the whole child. If there are other issues, those must be addressed with qualified professionals, supportive family members and school staff.

To help your child become a prepared, organized individual, increase his self-esteem and aid him in social situations, executive functioning skills are crucial.

It is never too late to offer and obtain help; and for your child to learn the skills needed to increase his abilities. As with any skill, it will take effort, practice, praise and patience.

Try these tips to help your child improve their executive functioning skills:

Pre-school and Elementary School

Helping your child increase executive functioning skills may involve adding more structure to his environment.

Aid your child with putting out clothes the night before school or having her backpack ready at the door. Show your child how to put away her toys and allow her to do it on her own.

Do homework shortly after she gets home and in the same spot each time, with minimal distractions. If she is having trouble with staying on task at school, then the school may offer (and you can advocate for) accommodations through an Individual Education Plan.

Demonstrate through your actions and encouragement that being prepared is a positive message that creates less stress for her and the entire family. Model being on time and planning ahead. Use a calendar to plan playdates and appointments, and encourage your child’s participation in basic planning skills (like setting the table for dinner, studying for a spelling quiz, or writing a card for an upcoming party).

Help her notice when it is her turn to talk, and how others feel if she interrupts. Ask her to think about others’ feelings and behaviors and how her actions or words may impact them.

Middle School and High School

As your child gets older, help him to develop skills aimed at organization and time management. Continue encouraging your child to prepare for school the night before. Sit in the same place to do homework every day. Try to begin assigned work when still fresh and not wait until late at night.

Use an assignment notebook. If needed, have the teacher sign it, check it and give it back to provide accountability. Offer positive reinforcement for fulfilling goals. Limit electronics and distractions. Use a timer to discourage procrastination. Give praise.

Enlist help from the school. If your child’s grades are extremely inconsistent, his work is disorganized and he continually forgets to bring/do homework assignments, it is likely time to speak to your child’s teacher, counselor or social worker.

Your child may need further accommodations at school. These may be resource time to finish homework, meetings with the counselor for encouragement, checking his backpack and locker, preferential seating in class, checking of his assignment notebook to ensure he is writing down his assignments and knows what is expected.

College Years and Beyond

The goal is for our children to be prepared to not just handle the world of work and daily living on their own, but to be happy and successful doing so. Using executive functioning skills such as time management, planning, and organization enables kids to be successful when they are on their own. Being prepared for a work presentation takes planning, time constraint considerations, and organization.

Increase confidence in your child and help him build positive relationships as he learns to navigate social interactions, anticipate possible outcomes and problem-solve to come up with potential consequences of his behavior.

Executive functioning skills will allow your child to cope with many of the stresses presented in his daily life.

Let’s help our children now to increase executive functioning skills that will allow them to be productive and successful in their future. Help them continue to blossom!

NSPT offers services in BucktownEvanstonDeerfieldLincolnwoodGlenviewLake BluffDes Plaines, and Hinsdale! If you have any questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140!

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How to Teach Play Skills to a Child With Autism

Play skills are one of the most important areas that children, especially those with Autism, need to learn. These skills provide opportunities for the child to entertain themselves in meaningful ways, interact with others, and learn important cognitive skills. A successful way to teach play skills to children with autism is to initially teach the specific play skill in a very structured manner. Play Skills

  • Break the play skill into small, discrete steps and teach one step at a time. As the child demonstrates success in learning one step, add the next step. (After the child can add eyes to Mr. Potato Head, then add ears, then arms, etc.)
  • Use modeling to teach the skill (e.g. the adult builds a tower of Legos as the child watches, then the child builds his own tower).
  • Always provide reinforcement (behavior specific praise “Nice job putting the piece in the puzzle”, immediately following the child’s demonstration of the skill.). As the child exhibits improved accuracy of the skill, reinforce successive approximations.
  • The child should have plenty of opportunities to rehearse the skill in a structured setting. Practice, practice, practice!
  • In the structured setting, have the learning opportunities be short and sweet, so the task does not become aversive to the child.
  • Fade the adult prompting and presence out gradually, so the child can gain more independence. Systematically fade the reinforcement so that it is provided after longer durations.
  • Remember to keep the activity fun and exciting. You want your child to WANT to play with the toys and games.

Once the child masters the skill in the structured environment by independently completing the play tasks for extended periods of time, he or she can then begin to practice and develop the skill in more natural settings. Bring the toys and games into other rooms of the house, to school, and eventually have peers present, so the child can use the skills learned in a social setting.

NSPT offers services in BucktownEvanstonDeerfieldLincolnwoodGlenviewLake BluffDes PlainesHinsdale and Mequon! If you have any questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140!

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What Are Executive Function Skills?

Many of us have heard executive functioning used in terms of our children at school and at home. But what does it mean? Executive Function Blog

Executive Function – a Definition

Executive functions are necessary for goal-directed behavior. When we use the phrase “executive functioning skills,” we are describing a set of cognitive skills that control and regulate other behaviors and abilities. Our thought processes influence attention, memory and motor skills. (minddisorders.com).

Executive functioning skills help us to learn and retrieve information, plan, organize, manage our time, and see potential outcomes and act accordingly. When these processes work without difficulty, our brains do these tasks automatically, often without our awareness.

High Executive Function

In children and adults, those with high executive function skills are able to:

  • Initiate and stop actions
  • Make changes in behavior
  • Plan for the future
  • Manage time wisely
  • Anticipate possible consequences
  • Use problem-solving strategies
  • Use senses to gather information

For instance, the ability to initiate and stop actions may include working on a project for school or studying for an allotted time. Monitoring ones changes in behavior includes being able to act appropriately in a given situation and alter that behavior as needed. Planning for the future and managing time may include not procrastinating due to understanding the consequences of doing so.

Low Executive Function

When one is deficient in executive function skills, it may be difficult to plan and carry out tasks. The person may seem unable to sustain attention and feel overwhelmed by situations others find easier to navigate.

People with deficits in this area may also have comorbid diagnoses (meaning they go together). These include, but are not limited to: Attention Deficit Hyper-Activity Disorder, Autism, depression and obsessive-compulsive disorder. Executive functioning deficits may run in families (learningdisabilities.about.com).

So, a child with executive functioning deficits may be able to pay attention to a lesson, until something new is introduced that requires a shift in their attention or that divides their focus. Children lacking in executive functioning skills also may have issues with verbal fluency.

Additionally, a child (or adult) with low executive function may have social problems. Executive functioning skills allow us to anticipate how others might feel if we do or say something. Those with low executive function may have difficulty interacting with others. Because they sometimes do not think things through before saying them, people with executive functioning deficits may blurt out inappropriate or hurtful comments, leading others to avoid them.

Working with your child, a therapist, and creating structure at home and accommodation plans at school are all ways to provide help for your child.

Increasing executive functioning skills will enable her to become a more organized, less stressed and less frustrated individual as she grows into a world of ever-increasing pressures.

NSPT offers services in Bucktown, Evanston, Deerfield, Lincolnwood, Glenview, Lake Bluff, Des Plaines, and Hinsdale! If you have any questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140!

5 Things to Keep in Mind When Potty Training a Child with Autism

Potty training is a big milestone for any child. It definitely is an important milestone for parents as well! No more diapers!! However, there are some things to keep in mind prior to considering potty training as well as during potty training. Blog-Potty-Training-Main-Landscape

  1. When should you consider potty training?
    • On average you would consider potty training when the child is around 2.5 years of age and above, can hold urine for 60-90 minutes, recognize the sensation of a full bladder, and show some form of awareness that they need to go to the bathroom.
    • Do at a time when you can spend large amounts of time at home! Some parents find it best to do in the summer (less clothing!).
  2. What schedule should you use when potty training?
    • You want to take your child to the bathroom every 90 minutes, if your child urinates then you wait for the next 90 minute interval, if not you reduce the time by 30 minutes.
    • Consistency is extremely important to ensure success.
  3. While on the toilet what should we do?
    • Praise your child for sitting appropriately on the toilet.
    • You can do activities with them as long as they are not too engaging or involved.
    • If they do urinate you want to CELEBRATE!
    • You need to wait up to 15 minutes if there is still no urination, then you let them get off and bring them back after 60 minutes (this keeps decreasing by 30 minutes each time there is not urination).
  4. What should you do when there is an accident?
    • It happens! Make sure you have your child help you clean it up, this is not meant to be punishing but more a natural consequence of having an accident. Keep a neutral tone and assist your child if needed to clean up the mess.
    • If your child is having too many accidents you may need to shorten the intervals of going to the toilet, or it may be that your child is not ready to be potty trained yet. Always rule out any medical reasons as well!
  5. Things to remember!
    • When starting potty training you want to make sure you child can sit on the toilet for up to 15 minutes with minimal challenging behaviors.
    • The goal is INDEPENDECE, you want to work towards your child walking to the bathroom on their own and removing and putting on their underwear and pants independently as well as washing their hands.
    • Make sure you child is in underwear throughout potty training! NO DIAPERS/PULL UPS!
    • Diapers and pull-ups are okay during nap time and bed time.
    • Number one thing to remember is PATIENCE, try to be consistently upbeat and encouraging to your child and deal with accidents as calmly as possible!

It is important to ensure that potty training is as positive an experience as possible for your child! Maintain your positive energy and constantly praise appropriate behavior seen throughout the potty training process! This will encourage your child to become more independent as well as want to go to the bathroom more often on their own!

NSPT offers services in Bucktown, Evanston, Deerfield, Lincolnwood, Glenview, Lake Bluff, Des Plaines, Hinsdale and Mequon! If you have any questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140!

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How to Choose the Best ABA Provider for Your Child

Beginning ABA therapy services can be overwhelming and confusing. Below are a few things to consider when choosing an ABA provider to ensure you are finding the best fit for you and your child! Blog-ABA-Search-Main-Landscape

Scope of Practice

  • This is a term that simply means that healthcare professionals should ethically only treat populations and use procedures/processes in which they have specific education and training.
  • For example, if a BCBA has only worked with the pediatric population, it would be outside their scope of practice to treat adults.
  • Especially for children with intense behaviors, children who are older in age, larger in stature, etc., it is important to ask if the ABA therapy practice has BCBAs who have experience treating in these areas to ensure safety and maximum progress.

Location of Services

  • Some ABA therapy companies only offer in-home or in-clinic services exclusively. Other places, like NSPT, offer ABA services in homes, clinics, schools, etc.
  • It is important to consider where your child might need support and choose an ABA company that is able to offer services where therapy will be most appropriate, beneficial, and consistent.

Insurance Coverage

  • ABA therapy is recommended 10-40 hours per week, based on BCBA recommendations. This range of hours is what has been proven to be most effective for progress.
  • Because of the large number of hours, therapy can be very costly if paid for out of pocket.
  • When calling ABA therapy providers, be sure to let them know which insurance you have (at NSPT we will check benefits and provide a summary explanation as a courtesy to all of our families). Families are then able to determine if it is going to be financially feasible to begin services with the provider.

ABA therapy requires consistent communication and collaboration between provider and family, so above all, it is vital you find a provider who you are comfortable talking, sharing, and brainstorming with!

NSPT offers services in Bucktown, Evanston, Deerfield, Lincolnwood, Glenview, Lake Bluff, Des Plaines, and Hinsdale! If you have any questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140!

The Difference Between Positive and Negative Reinforcement

Trying to figure out different ways to approach behavior can be overwhelming and frustrating. One thing to always remember is to try and focus on reinforcing the behavior you want to see moreBlog-Reinforcement-Main-Landscape
than punishing the behavior you are wanting to decrease. Using positive and negative reinforcement can both help achieve the same goal of increasing the behavior you would like to see more of.

The difference between positive and negative reinforcement is simple. The use of positive reinforcement is adding something (typically something that is liked) to the environment after a behavior occurs that will increase the future instance of that behavior. The use of negative reinforcement is taking away something (typically something that is not liked) from the environment after a behavior occurs that will increase future instances of that behavior.

 Examples of positive reinforcement include:

  • Giving a praise after a specific appropriate behavior occurs and then that behavior continues to increase.
  • Earning a special treat after a specific appropriate behavior occurs and then that behavior continues to increase.
  • Getting a 5 minute 1:1 time with parent after a specific appropriate behavior occurs and then that behavior continues to increase.

Examples of negative reinforcement include:

  • Removing a chore from the chore list from the schedule after a specific appropriate behavior occurs and then that behavior continues to increase.
  • Taking away a specific school related task after appropriate behavior occurs and then that behavior continues to increase.

The key to making sure either type of reinforcement is working is to measure and track the behavior and see if that behavior is increasing over time!

NSPT offers services in Bucktown, Evanston, Deerfield, Lincolnwood, Glenview, Lake Bluff, Des Plaines, Hinsdale and Mequon! If you have any questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140.

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Help! My Child is Wetting the Bed

Wetting the bed is a very common issue that occurs with many children. Below are some preventative and reactive strategies to help decrease bed wetting from occurring. Blog-Wetting the Bed-Main-Portrait

Preventative Strategies for Wetting the Bed

Liquid Intake

It is important for children to drink liquid throughout the day to stay hydrated, but it is best to stop drinking liquids before bed time. This may prevent the bladder from having to be emptied while the child is asleep.

Bathroom Schedule

Scheduled bathroom breaks help empty the bladder when it may need to be emptied. Many times when children are engaged in a preferred activity they choose to not use the bathroom when it is needed. Bathroom breaks/schedules throughout the day can prevent other issues like infection or wetting pants during other parts of the day. Using the bathroom multiple times or at least one time right before bed may help the child from needing to empty the bladder while he or she is sleeping. Parents can also wake their children up when they are getting ready for bed and have them use the restroom one more time.

Reactive Strategies for Wetting the Bed

Waterproof bedding

When a child does wet the bed, use waterproof bedding, blankets, and padding to prevent any damage to mattress. Clean up will also be easier.

Alarms

Sometimes children are in such a deep sleep that the signal of wetting the bed does not wake them up. There are alarms that can be bought to help signal/wake the child when he or she needs to use the bathroom in the middle of the night.

Open Communication

It is important to not embarrass your children or make them feel bad when they wet the bed. This can be a sensitive topic and it is important for open communication and to make you child feel comfortable when it happens.

NSPT offers services in Bucktown, Evanston, Lincolnwood, Glenview, Lake Bluff, Des Plaines, Hinsdale and Milwaukee! If you have questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140.

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Help for Defiance

Life can already be busy enough making sure your child gets through all of the tasks he or she needs each day. The last thing you need is your child refusing to follow directions. Here are some proactive and reactive strategies for when you need help with defiance. Blog-Defiance-Help-Main-Portrait

Preventative Strategies for Defiance

Clear Directions/Expectations

When asking your child to complete a task, make sure you are crystal clear with the directions. For example, if you ask your child to clean their room, your child may go pick up their clothes off of the floor and then say they are all done. When you go to check the room you say, “Your room is not clean.” This may cause an argument/conflict. To your child, a clean room means there are no clothes on the ground. To you, a clean room is a made bed, clothes folded and put away, and a clean desk. Clearly state your expectations to leave no room for confusion and make success more achievable for your child.

Offer Choices

Sometimes, your child may get overwhelmed and become defiant if they have numerous tasks to complete. Giving them the option to choose what tasks they need to complete each day may make them more compliant and successful. For example, give your child the option of making the bed or cleaning the clothes off the ground. Another example is giving your child the option of which homework assignment they would like to complete first.

Shortening Tasks

I know many teachers who use this tip when working with students who refuse to do their work. For example, they might give a student a math worksheet of 20 problems and ask them to complete 15. Another way to use this tip is asking them to work on one problem or one part of the task and then increasing the number of problems/parts of the task over time. Following strategies like this may feel like you are giving in to them, but in the end they are still completing part of the task, as opposed to refusing to address it at all.

Offer Rewards

Many children are motivated by rewards. When stating your expectations, ask them what they would like to earn after they complete the task or give them options of what they can earn. You want to make sure you do this while stating the expectations. If you do not, and your child engages in defiant behavior and you then offer the reward, it becomes a bribe. Bribes are dangerous for growth because they teach children that if they refuse to do something at first, they will eventually get something extra. We want them to learn that they get a reward by complying with the task.  For example, “What do you want to earn when you complete your chores? You can get 15 minutes on the iPad or a candy bar.” Make sure the rewards are activities or items that your child enjoys and will motivate them. If earning a reward is not enough, you can also present the consequences of what will happen if they refuse to do the task.

Reactive Strategies for Defiance

Reassess Motivation

After the child decides what they want to earn, they still may not complete the task. Their behavior shows that the reward may not be motivating enough for them. You can offer new choices or remind them what they are earning if they complete the task.

Stay Calm

When your child is engaging in defiant behaviors you want to stay calm. Use a neutral tone when you speak to them and make sure your facial expressions stay neutral, too.

Stay Consistent and Follow Through on Expectations

If you offer your child a reward after they complete a task, make sure you give it to them immediately. If you do not, your child may not be motivated by rewards because they will become skeptical. Additionally, you can’t give them the reward at a later time if they do not complete the task.

Deliver Verbal Praise for Appropriate Behaviors

When your child is being compliant instead of showing defiance, please deliver verbal praise!

NSPT offers services in Bucktown, Evanston, Highland Park, Lincolnwood, Glenview, Lake Bluff, Des Plaines, Hinsdale and Milwaukee! If you have questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140.

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