What is Applied Behavior Analysis (ABA)?

What is ABA?

Applied Behavior Analysis (ABA) is the science of behavior which focuses on the application of behavioral principles in real-world settings such as clinics, schools, and the work place with the aim of improving socially significant behaviors such as behavior problems and learning (Baer, Wolf, & Risley, 1968).

Socially significant behaviors can include:Applied Behavior Analysis

  • Functional communication
  • Receptive and expressive identification
  • Imitation
  • Gross and fine motor skills
  • Activities of daily living
  • Social skills
  • Play skills
  • Reducing/eliminating problem behaviors

How can ABA therapy help my child?

If you are a parent of a child with learning and/or behavioral concerns, ABA can help address and treat these concerns. After an initial assessment of your child, an individualized treatment program will be developed with goals tailored to your child’s specific needs. Progress towards these goals will be constantly monitored, and data will be collected daily for each goal. ABA sessions can take place in your home, in the school, or in a clinic setting.

ABA sessions vary by the child, but typically consist of a combination of table work to work on skill development and natural environment training to generalize those skills to real life situations. Behavior plans are also implemented during ABA sessions to address any behavioral concerns.  ABA sessions that take place in the home can also have a parent training component which allow the parents to learn effective strategies to address their child’s problem behaviors.

What are the qualifications of an ABA therapist?

ABA therapy differs from other disciplines like speech and occupational therapy in that there are usually at least two or more therapists that are part of your child’s treatment team.

A board certified behavior analyst (BCBA), who holds at least a Master’s degree and has attained board certification by the Behavior Analysis Certification Board (BACB), conducts the initial assessments, designs and oversees the individualized therapy program, and monitors progress.  A behavior therapist, who has a Bachelor’s or Master’s degree carries out the direct one-on-one therapy sessions with the child. Often times a child may have 2-3 behavior therapists that they work with each week. This is actually very beneficial to the child, as it ensures skills are being generalized across various people.

Misconceptions of ABA

Over the years, there have been many misconceptions about ABA which may cause parents to be hesitant about beginning ABA therapy for their child.

Common misconceptions include:

    • ABA uses punishment and/or aversive items to decrease problem behaviors: Physical punishment is never used in any reputable ABA program. Reinforcement-based strategies are always preferred and utilized over any type of punishment procedure. If punishment is used, it is never used to injure or harm the child. Common punishments include time-out from reinforcement or the loss of a privilege.
    • ABA uses bribery: Bribes are never used in ABA as they are not an effective behavioral strategy. Bribery is ineffective because it used after a negative behavior has already occurred (i.e., If you stop crying, I will give you a cookie). ABA teaches individuals that rewards are contingent on appropriate behaviors (i.e., if I do what my mom says, I will get rewarded).
    • ABA is like animal training for people: This misconception is most likely due to the fact that many therapists use edibles when conducting ABA therapy, especially early on in treatment. Edibles are used due to the fact that food is a very powerful reinforcer. However, the goal is to always to fade out the use of edibles over time and use more natural reinforcers like social praise.
    • ABA is all table work: Yes, most ABA sessions take place at a table, for at least a part of the session. This is because for optimal learning to occur, the individual needs to be focused and attending to what they are learning, and the table is the best place for this. Just as students sit at desks in school, for learning, the same applies during ABA therapy. However, natural environment training, which takes place away from the table, is also a crucial aspect of ABA and should be incorporated into each session.
    • ABA can only be used for children with autism: While ABA is very commonly used for children with autism, it can be used with a wide variety of individuals with or without a diagnosis, in various settings.

NSPT offers Applied Behavior Analysis (ABA) services in BucktownEvanstonHighland ParkLincolnwoodGlenview and Des Plaines. If you have questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140 and speak to one of our Family Child Advocates today!

References:

Baer, D., Wolf, M., & Risley, T. (1968). Some current dimensions of applied behavior analysis. Journal of Applied Behavior Analysis, 1, 91-97.

Autism graphic

Intervention For Autism Spectrum Disorder

After a child has been diagnosed with Autism Spectrum Disorder, parents are often at a loss as to where to go or what to do next.  It is important that parents are informed about treatment choices and utilize empirically supported interventions in order to provide the child with the best possible outcome. Applied Behavior Analysis (ABA) therapy is a research-supported approach to intervention that focuses on improving positive behaviors while extinguishing negative behaviors.

Autism graphicThere has been bad press regarding ABA therapy such as that the focus of the therapy is solely on punishment.  In reality, ABA therapy focuses on positive reinforcement of behaviors with a minimal use of punishment.  Punishment of any kind should only be implemented in specific situations in which the child is in danger of hurting himself for someone else. The amount of ABA therapy varies and is completely dependent upon the child’s needs.

Therapy is often implemented in the home, school, and clinic settings. Oftentimes children with a diagnosis of Autism Spectrum Disorder present with language concerns; either expressive language (ability to express themselves) and/or pragmatic language (which is their social language).  These children often benefit from speech and language therapy in order to develop these skill sets. It is also quite common for children with a diagnosis of Autism Spectrum Disorder to present sensory concerns; either they avoid certain sensory modalities or actively seek out various sensory inputs.  Occupational Therapy can often help provide strategies for children, parents, and academic staff as to how to better deal and cope with these sensory concerns.

The treatment of Autism Spectrum Disorder cannot be done in isolation.  The majority of children with such a diagnosis would require a multidisciplinary treatment approach.  It is vital that all care providers are on the same page and meet routinely to ensure that the child is making progress.

Child being told to be quiet

Working With Parents Regarding Behaviors at Home

One of the major stressors that parents have to deal with on a daily basis is negative behaviors.  Negative behaviors can take the form of  non-compliance, physical aggression, and/or verbal aggression.  Behavioral management focuses on increasing on-task behaviors (e.g. behaviors parents want the child to engage in) while extinguishing off-task behaviors (the negative behavior).   Below are some bullet points that are important for parents to realize about behavioral management.

  • Child being told to be quietNegative behaviors always increase in intensity when being modified or extinguished.
  • Focus should almost always be on positive reinforcement of appropriate behaviors
  • Punishment only utilized when behavior is dangerous to the child or others
  • Reasons for failure of reinforcement systems

o   Too confusing; if we as adults do not understand them, then the child of course will not

o   The wrong behavior is being addressed

  • Goals need to be attainable

o   Child and parent have to see that the system will work

o   Slowly increase demands

  • Never take away a reinforcement that a child earned
  • The reinforcer will constantly change

o   What is rewarding today for the child will likely be different in the near future

Behavior almost always can be modified.  It is important for parents and professionals that are working with the child to understand that, in order for a behavioral reinforcement system to work, there needs to be consistency with the approach.   The idea is to set realistic and measurable goals and constantly identify how much improvement is exhibited.

Child misbehaving in school

Behavior In The Classroom

Many times children with behavioral concerns, attention issues, emotional concerns, or learning disorders will exhibit negative behaviors within the classroom setting.  Behaviors, by nature, are reasonable and driven by some factor.  The majority of the time, there is a purpose and a reason as to why a child engages in a negative behavior. What this indicates is that it is vital to figure out what the driving force of the behavior was as well as what the consequences of the behavior are.

If a parent or teacher has significant concerns about a child’s behavior, it is truly important to figure out what is going on.  Many times in these situations a Functional Behavioral Analysis (FBA) is required.  An FBAis when some behavioral specialist with the school will go and observe the child over several days and several times during the days.  The individual will first identify the percentage of time the child is off task in comparison to a few peers.  It is always important to have the percentage of off task behavior with several other children in the classroom.  This way there is anecdotal data indicating that child ‘X’ was off task xx% while the other children on average were off task only xx% which could indicate that the child in question actually is off task more than peers.

Child misbehaving in schoolOnce off-task time is established the focus is then on identifying the antecedents and consequences of the behaviors at hand.  There almost always is a driving force (the antecedent) which causes the behavior.  In addition, there usually is a reaction, either positive or negative (consequence), which results in increasing the likelihood of the behavior in the future.

Once the FBA has concluded and information has been disseminated to the team, the next step is to create an action plan to decrease negative behaviors while increasing positive, on-task behaviors.  This is when a functional intervention plan is created.  This plan utilizes the data created by the FBA to set up reinforcement of on-task behaviors, identify triggers and situations that might increase the negative behavior, and set up manageable goals.  A goal must be manageable and attainable.  For example, if a child is off task on average 80% of the day, a goal of being off task 10% of the day would be unrealistic.  What might be established is that with reinforcement and behavioral management, the goal for the first few weeks would be that the child is off task only 70% of the day, then slowly decrease it until the goal is consistent with the amount of time that the rest of the class is off task.

The take home message about behavior in school is that in order to change behavior we have to first identify what the behavior we want to change is, how often it occurs, and why it occurs (what triggers it and what does the child get out of it).

Boy having a temper tantrum

1-2-3 Magic Behavioral Principles: Harder Than We Think?

The popular discipline program, 1-2-3 Magic, is based on the basic behavioral principles of reinforcing positive behavior and reducing negative.  Simple, right?  Not necessarily, especially if you are parenting a child with a difficult temperament or developmental delays.  The difficulty lies not in the conceptual understanding of the program, but in the execution.  With practice and guidance it can be done and is well worth the effort.

The two most common pitfalls are 1) inconsistency in counting and following through with time-out and 2) unintentional reinforcement during time-out (e.g., talking and expressing emotion).  Every parent will fall victim to one or the other at the beginning.  The goal is to be aware of these traps, catch yourself when you are committing them, and work to avoid them next time.

Here is how to get started:

Step 1: Getting noncompliance and other negative behaviors under control.  The idea is to consistently send the message to your child that these behaviors are not ok.  How do we do that?  We consistently set limits on what is not acceptable by using a counting system.  This gives your child up to two opportunities to change their behavior before a consequence is handed down.  When your child does not comply after number 2, immediately go to number 3 and that’s it.  They will soon catch on that you are serious.  There is a learning curve, and not without its emotional meltdowns along the way, but children learn very well if consistency is in place.

Step 2: Get more of the good behaviors.  This is the fun part.  Spend time with your child one-on-one, have fun with them, listen, and be a model for appropriate ways to cope with situations.

With practice, it becomes easier.  Feel confident in your ability to create change in your home and enjoy the rewards!

 

Phelan, Thomas. (2010). 1-2-3 Magic: Effective discipline for children 2-12. Glen Ellyn, IL: ParentMagic, Inc.





What is Co-Treating?

You may have heard your therapist say, “I think a co-treat would be a great option for your child!” But what does that really entail? Will your child still be getting a full treatment session? Will his current and most important goals be worked on? Will he benefit as much as a one-on-one session? When a co-treatment session is appropriate, the answer to all of those questions is…YES!

What is a co-treatment session?

Co-treatment sessions are when two therapists from different disciplines (Speech Therapy (SLP), Occupational Therapy (OT), Physical Therapy (PT), etc.) work together with your child to maximize therapeutic goals and progress.

When is a co-treatment session appropriate?

When the two disciplines share complimentary or similar goals.

EXAMPLE: Maintaining attention to task, executive functioning, pragmatics, etc. Playing a game where the child needs to interact with and attend to multiple people while sitting on a stability ball for balance. [all disciplines]
*When children have difficulty sustaining attention and arousal needed to participate in back-to-back therapy sessions.
EXAMPLE: Working on endurance/strength/coordination while simultaneously addressing language skills. Obstacle courses through the gym while working on verbal sequencing and following directions. [SLP + PT or OT]
*When activities within the co-treatment session can address goals of both disciplines.
EXAMPLE: Art projects can address fine motor functioning as well as language tasks like sequencing, verbal reasoning, and categorizing.
*When a child needs motivations or distractions. [OT + SLP]
EXAMPLE: Research has shown that physical activity increases expressive output. Playing catch while naming items in category or earning “tickets” for the swing by practicing speech sounds.  [PT or OT + SLP]
EXAMPLE: PT’s need distraction for some of their little clients who are working on standing or walking and working on language through play during these activities works well. [PT + SLP]

Why co-treat?

  • Allows therapists to create cohesive treatment plans that work towards both discipline’s goal in a shorter amount of time.
  • Allows for therapists to use similar strategies to encourage participation and good behavior in their one-on-one sessions with the child.
  • Allows for therapists to collaborate and discuss the child’s goals, treatment, and progress throughout the therapy process. Together, they can consistently update and generate plans and goals as the child succeeds.
  • Aids in generalization of skills to different environments, contexts, and communication partners.
  • Allows for problem-solving to take place in the moment. For example, an extra set of hands to teach or demonstrate a skill or utilizing a strategy to address a negative behavior.

Co-treatments sessions can be extremely beneficial for a child. There are endless ways therapists can work together to promote progress and success towards a child’s therapeutic goals.. However, co-treatments may not always be appropriate and are only done when the decision to do so is made collaboratively with the therapists and the parents.

Contact us for more information on the benefits of co-treating in therapy sessions.

AAC: Speech Devices for Autism

For a child with autism, communication can be a challenging and difficult hurdle to manage. For some children, verbal communication may simply be an impossible or ineffective means of communicating. For these circumstances, an augmentative/alternative communication device (AAC) may be an answer.

What is AAC?

AAC is an acronym for Augmentative Alternative Communication and describes a communication tool that is substituted for traditional expressive speech to allow a child to communicate. These tools can be low-tech like PECs or an eye gaze board or they can be high-tech speech generating devices. Many insurance companies will cover AAC devices with the proper paperwork.

Use of AAC with Autism

AAC devices can be used at any age and across many settings. Research has been shown to support growth in attention, communicative initiation, expressive and receptive language and pragmatic skill development through use of an AAC.

Many children with autism acquire language early in life and regress quite suddenly. Other children with autism simply develop very few words, if any. With proper intervention, children with autism can explore a variety of options and find better ways to gain speech and language skills. Some research suggest that, when used in intervention, speech devices have resulted in faster progress in therapy.

Use of AAC with the Verbal Child

AAC devices can be used for children with verbal skills as well. One characteristic of autism is echolalia, or the repetition of heard speech. For children who script or repeat in conversation, an AAC device can assist is helping them to formulate novel utterances and to participate in more meaningful conversational turns. More importantly, use of an AAC device will not prevent your child from using and increasing their verbal skills.

Is AAC Right for My Child?

A speech-language pathologist with a concentration in AAC devices can assist you and your child in determining the appropriate device based on individual needs and skills.

To read about common misconceptions about augmentative and alternative communications, click here.

For more information and resources of AAC devices for autism, check out The Center for AAC and Autism’s website.

What is a Pediatric Neuropsychologist?

Pediatric neuropsychologists are clinical psychologists who focus on completing comprehensive evaluations to ascertain the most appropriate diagnosis in order to lead to the most effective treatment outcome. All neuropsychologists have their Ph.D. or Psy.D. in Clinical Psychology and also have several years of training with brain based behaviors, neurodevelopmental conditions, as well as effective interventions and accommodations.

The typical questions that parents will bring forth in a neuropsychology clinic are related to the child’s academic performance, behavioral regulation, social interaction, and/or emotional functioning. It is the goal of the neuropsychologist to help identify what is causing the negative behavior and what would be an effective course of action.

Conditions and diagnoses that pediatric neuropsychologists often work with include the following:

Often, it is found that a child may have multiple conditions. One of the goals of the neuropsychologist is to help determine what the main condition(s) to address are and the most effective interventions.

The interventions that are determined by a pediatric neuropsychologist are often found in the following places:

8 Great Apps for Kids with Autism

Parents often ask me if I have suggestions for applications to download on their iPads, iPhones or other devices for their children.  I do!  I have TONS of apps that I use in my work with children with Autism daily.

My 8 favorite apps to use with kids diagnosed with Autism for iPhone/iPad users are the following:

  1. 123 Token Me– This app is a visual token board that can be used for one child (free version) or unlimited children and unlimited behaviors ($9.99).  This app gives you the versatility to choose background color, various token choices, and graphs and visually displays data for you. This is the most motivating token board I have used with my kids because it is interactive.  Also, one of the token options shows a picture of the child, which they all love!
  2. First Then Visual Schedule HD– This app is 2 applications put into one; it is both a visual schedule and a choice board.  It allows you to show the child “first ___, then ____.” with the ability to make choices from a visual field.  It also allows you to make more complex, multiple-step, visual schedules.  It is a bit on the pricey side at $14.99 but totally worth it if your child struggles to make choices verbally or would benefit from a visual schedule.  It is much easier to carry around than a paper schedule or choice board, because you can update it on the fly using the camera function or Google images.
  3. Duck Duck Moose, Inc.- (includes Wheels on the Bus, The Itsy Bitsy Spider, Old MacDonald and many more).  All of the Duck Duck Moose apps are a big hit with all the kiddos I work with as they are interactive, the characters move, jump and dance, and they all play familiar kid’s songs.  The apps range in price from free versions up to $3.99 each. Read more

How to Teach Your Child about Bullying

The beginning of the school year is a great time for parents and guardians to talk with kids about bullying.  Bullying is a problem which affects millions of children and teenagers.  It takes place in many forms: physical, verbal, psychological/social and through means of social media.  Read on for several tips for talking to kids of any age about bullying.

Tips for talking to kids about bullying:

  1. Teach assertiveness.  Model and teach your child peaceful ways to solve problems.
  2. Teach empathy.  Talk to your child about helping others and taking action if she observes someone being hurt or hurting themselves. This is only if the situation is safe to do so.  Help build empathy in your child by talking about examples from television, movies and books.  Ask your child how she thinks others must feel in the various scenarios.
  3. Hold children accountable.  Teach your child that if she is watching someone being bullied, then she has a responsibility to tell someone; otherwise this hurts the victim also.
  4. Get to know your child’s friends.  Encourage your child to invite her friends over.
  5. Be a good role model.  Model these skills whenever appropriate.

For more bullying resources, click here to watch our Bullying Webinar or click here to read about including bullying in your child’s IEP.

Reference: http://www.ncpc.org/topics/bullying/teaching-kids-about-bullying/what-to-teach-kids-about-bullying