Tag Archives: ABA

You say “toMAYto” and I say “toMAHto”

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May is Better Hearing and Speech Month.  Speech and Language Pathologists like to use this month to educate and teach others more about what we do and how to better ourselves as clinicians.  As an SLP, we work with many therapists OT, PT and BCBAs. Many of us use the same vocabulary and many terms can differ. As an SLP working in a team with BCBAs it is vital to know what we are all talking about! I could say “toMAYto” and a BCBA could say, “toMAHto,” but we really just want to get along and understand each other! We came together and created a vocabulary list to better understand each other.
Here are some of the common terms we both use and how we really are meaning the same thing!
Some of the common speech terms that overlap with BCBA terminology is listed. The Speech term is first then the ABA term:  Requesting-Manding, Labeling-Tacting, Imitation- Echoic, and Fill in- intra-verbal. Knowing these basic terms will help the SLP and BCBA and ABA therapist to understand each other. We may speak different languages but we are all trying to come together and work as a team to get the same result.
— Hannah Trahan, MS CCC-SLP & Nicole LeMaster, MA BCBA

SLP Term Translation
Label Tact
Request Mand
Imitation Echoic
Fill in Intraverbal Fill in
Open ended question Intraverbals
Non-verbal Non-vocal
Code switch a different means of interacting with people based on your learning history with them. Ex: the way you talk with friends vs. the way you talk with co-workers
Motor planning being able to complete the steps necessary to do an activity. Being able to move your body to get the job done.
Articulation Speech sounds
Executive functioning Problem solving
Therapy of mind Perspective taking
Central coherence ability to focus on details as well as the whole picture
AAC Alternative Augmentative Communication
Fluency smooth, rhythmic, effortless speech
Dysfluency stuttering
Syntax grammar
Semantics word meaning
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Why Changing a Child’s Team is a GOOD thing

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Throughout the course of a child’s treatment with any ABA provider, one thing should be a constant: therapist changes happen. Frequently.

And understandably, this tends to be a difficult adjustment for both our kiddos and their families! In order to continuing developing the best team possible, there are occasionally team changes as a result of professional growth and career advancement, however, it’s important to recognize that team changes do not solely occur because staffing dictates; as an ABA provider, our ultimate goal is to ensure that your child receives the absolute best quality treatment, and one element of providing a well-rounded ABA program is therapist change.

Why?

There are a multitude of benefits to changing therapists, however, we’re going to focus on two: generalization of skills and functional relationship building.

Requiring a learner to be able to respond to new therapists is an important, often under-utilized form of teaching generalization. While learning a new skill with a specific therapist is an amazing accomplishment for a child, it is equally important to ensure that skills taught aren’t just generalized across different environments, but across different people as well.  For instance, a child may return a greeting daily to the therapists that have been teaching them this skill for 6 months, but that doesn’t necessarily mean that, if a novel persons says ‘Hi,’ the response they’ve learned with their typical therapist will generalize.

In addition to generalization, building relationships with and responding to novel people regularly will help set up your child for success in the future. In school, work, or other standard day-to-day activities, we are expected to be able to form and cultivate relationships with new people. Whether it’s a new teacher, a new boss, a new neighbor, a new babysitter or family member, being able to and confident in responding to new faces is always beneficial to a child.

In the end, we understand that therapist changes can be a difficult adjustment for everyone involved, but the benefits of regular team changes will only help children to meet their goals.

Topics in ABA: Experience Trumps Credentials

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Over the past 10 years the number of BCBA’s has grown from approximately 2,500 in 2005, to close to 20,000 in 2015.  This growth is partially due to the increase in availability of certification programs in the field of behavior analysis. Although there is a growing need for behavior analysts, many students have been entering degree programs with little or no experience working in the field of ABA and a limited knowledge of what a behavior analyst actually does.

As professionals who have supervised and taught in certification programs our experience has been that the most successful students are those that have a background in ABA and have had the opportunity to demonstrate those principles in the natural environment (for our sake, with kids with autism). We have unfortunately witnessed unsuccessful students and a common denominator is typically jumping into a certification program without truly understanding the roles and responsibilities of a BCBA.

As a behavior analyst you have the ability to change behavior! We can make a huge difference in the life of a child with autism and their family; this is something that should not be taken lightly. This is why we are dedicated to not hire or promote individuals because of their credentials, but instead due to their experience and proven ability to be effective at what they do.

Chrissy Barosky M.Ed BCBA, & Danielle Pelz, MS BCBA

Topics in ABA: The Missing ‘A’ in ABA

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What truly sets us apart from most other providers is much simpler than one would expect- that is, a developed team of Behavior Analysts whose sole, full-time responsibility is to ensure clinical programs are designed to the highest quality.

The increased rate of autism diagnosis has led to a concurrent increase in providers claiming to provide efficacious treatment.  One way of keeping up with demand has been by creating a model of provision in which application can be easily replicated, from one client to the next.

The model looks something like this: 1) Assessment (typically a behavior analytic assessment such as the VB-MAPP); 2) Language and behavior programming 3) Application of the program through therapy and 4) Data collection.  What results is a set of rules, and providers develop only the skills necessary to follow those rules. Unfortunately, throughout this process, and particularly after data collection, not much “analysis” is done at all.  What is lost when services take on these characteristics is the 2nd “A” in ABA, …the most important part of what makes ABA effective in first place.

Within the community of behavior analysts, we identify these services as “Applied Behavior”.  And most providers do not even realize they are doing it.

In our October newsletter, we discussed the movement within our organization towards a more systematic and thorough system of measurement.  Measurement is the key to effective behavior analysis, as it allows our BCBA’s to identify patterns of behavior change, or trends, and to make decisions about our kids learning.  Through these data sets, and the patterns identified, Consultants and BCBA’s learn from their clients, and the analysis and effectiveness of programming grows exponentially.

We are taking this focus on Analysis a step further.  Our entire team will receive will receive extensive training in the upcoming year on how to analyze data and behavior as it occurs throughout a session.  This includes everyone from the Consultants to the Therapists. We will be trained to analyze client’s learning, minute by minute, and make decisions about what to do differently to ensure that learning does not have to “sit and wait” for our consultants to see change is needed.  All therapists will receive intense training on their own decision-making, and data will show that our therapist’s decisions are in line with our highest skilled BCBA’s.  We look forward to striving to be the BEST!

Laura and Liz 

May is Better Hearing and Speech Month

May is Better Hearing and Speech Month, a time to raise awareness about communication disorders and the Speech-Language Pathologists and Audiologists who provide treatment.

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A Speech-Language Pathologist (a.k.a. Speech Therapist) is a professional who evaluates and treats children and adults with speech and language delays or disorders. On the hearing side of things, an Audiologist is a person who provides diagnosis and rehabilitation of hearing loss.

I have worked as a pediatric Speech-Language Pathologist (SLP) for nearly 12 years now. I learned a lot in school to help me with my profession, but my real education has come from everyday experiences in working with children and their families. These invaluable experiences have molded me into the therapist I am today. One important topic comes up frequently when talking to parents: most wish they had more knowledge and awareness of speech/language development so they knew sooner that their child’s development was delayed.

The two main areas of communication development are Language and Speech. Language is the rule-based system that we use to communicate, including what words mean, how they can be put together, and how to make new words. It is made up of Expressive Language (what is said) and Receptive Language (what is understood). Speech is the actual verbal communication and includes fluency, voice, and articulation. SLPs also work on Pragmatics, the social use of language, and aural rehabilitation, after children receive hearing aids or cochlear implants. The American Speech-Language Hearing Association (ASHA) has fantastic resources on speech/language development that can be accessed here: http://www.asha.org/public/speech/development/chart/.

There is little information on the incidence of communication disorders and delays in the United States. In the 2005-2006 school year, 1.1 million students were classified in schools as having a “speech and language impairment”. This number is certainly higher to account for children who receive therapy in outpatient clinics, non-public schools, and in the home. Beyond these numbers are the numbers of children diagnosed with Autism. It is now estimated that 1 in 68 children are on the Autism Spectrum. 1 in 68. What this means for SLPs is that our caseloads are being made up more and more of children who have a diagnosis of Autism. Not all children with autism have speech/language challenges, many need help learning to follow directions, take turns talking, greeting others, saying words, signing, and imitating gestures and actions. The list goes on and on. A lack of or delay in communication is often the first sign parents have that something is going on with their child’s development and so it is so important to understand typical development.

All of that is the technical information about what I do. It is very important that parents, families, and the public understand what speech and language is and when to recognize a delay or disorder. But, I can tell you that there is so much more to what we do. This is a job that my fellow SLPS and myself are extremely passionate about. We LOVE helping children learn to communicate! There is nothing more rewarding than the first time a child says a sound, word, or their first sentence. THAT is why we do what we do every day.

Kristin Kouka, MA, CCC-SLP

Speech-Language Pathologist

Kouka Kids Speech Therapy, LLC

Is my ABA provider effective?

Applied Behavior Analysis (ABA) therapy for children with autism has been proven to work over a period of time. However, as a parent you may not have the necessary experience or background to determine if the level of expertise of a practitioner is meeting your child’s goals and needs.

Beyond the obvious signs of whether or not your child is making progress, there are some other factors when assessing a provider that you can use to evaluate their potential effectiveness.  Here’s a tool-kit that you can use.

Didactic Children Therapy

How many children are on your BCBA/ BCaBA’s caseload?  Of course, you might also want to check if the individual overseeing your child’s program is credentialed (Board Certified).  The best way to find out is to ask directly.  If that doesn’t work then you can approximate this by comparing the total number of children in the program with the total number of BCBAs/ BCaBAs.  There is no ‘correct’ number of children per BCBA/ BCaBA (it depends on the complexity of each program, the experience of the staff, number of assistants etc).  In our experience a good approximation is no more than 10.  You can also think about it this way – if your BCBA/ BCaBA has, for example, 15 kids, then assuming they spend about 2 hours a week with each child, that adds up to 30 hours (assuming no travel time from one location to another).  Now each child’s care also involves programming time (writing reports, collecting data training with staff etc).  Conservatively allocating around 1 hour per child for programming time totals 15 additional hours for a total of 45 hours. Add in usual administrative time for meetings, emails and other non-clinical weekly activities and very soon you’re above 50 hours/ week.  This is not an effective setting for providing quality of care and leads to compromises and shortcuts.

How many individuals are assigned to your child’s team? An effective model involves more than just the BCBA/ BCaBA overseeing a child’s program – such as such as trainers, program managers (or people assisting BCBA/ BCaBAs etc).  Additional team members should be assisting with some of the tasks mentioned above.

Is your child’s team trained?  How effective a provider’s training program is can have a direct correlation with how good your child’s program will be.  You should inquire about your provider’s training program and methodology to ensure adequate attention is devoted to this.

Is parent training offered?  For a child’s program to be successful – you should be able to ask for and receive training to implement some of the principles at home that are being used with your child everyday.

Is the child actually receiving one on one therapy? – Or are multiple children overseen by a therapist?  For ABA services to be most beneficial – your child should be one on one with a therapist.  Your child’s therapist should not be paired with multiple kids at once.  This is important not only for the quality of care – but also for how billing is done (if services are being accessed through health insurance)

Are you allowed free and open access to your child’s team and to his/ her sessions?  If not, that is a red flag… it is your child, after all and you should be able to observe your child’s sessions.  (Incidentally this is also a good way to check the above points about one on one therapy).

Are you able to interact with your child’s team on a regular basis and develop a good working relationship?  The level of communication and involvement that you have with your child’s team is a good measure of how vested the provider is in your child’s program.

What is the general vibe and environment like at the place of service?  Schedule a visit or request and observation. You can tell a lot by observing and interacting with the team.

Does your child’s staff take proper data and clinical note? You should be able to get a summary of your child’s sessions – either upon request or as a regular part of the process.  This is a good way for you to stay up to speed with your child’s progress.

Creative Children Therapy

Since time is your most valuable resource, especially when your child’s progress is concerned – it is crucial to have a toolkit to assess the effectiveness of your provider. These questions should serve as a starting point for you.

Further reading: http://www.bacb.com/Downloadfiles/ABA_Guidelines_for_ASD.pdf

7 tips to help kids with Autism prepare for Fireworks

fireworks

The Fourth of July is a day that often involves, fireworks, barbecues and, at least around here, lots of crowds. For families that have children with autism, everything about the holiday can be a recipe for a meltdown. These seven tips were compiled for families that would like to see the show together. The key is to know your child’s limits and have an escape plan in case he or she needs a break.

Prepare for the Show 

Letting your child know in advance what might happen in advance will give your child some sense of control and help reduce his level of anxiety. Talk about exactly what you will be doing: getting in the car, taking a picnic, eating, watching fireworks, walking back to the car, waiting in traffic and any other details you can think of. The more your child knows what to expect, the better he will be able to handle the situation.

Preview the Show

Sparklers may not have much sound, but they look like mini fireworks. You can also watch videos of fireworks displays online. Fireworks Blast-Off  is an app ($.99) that lets the user control the colors and size of fireworks on the screen. Programs like this are great at simulating actual sound but not at the intense level you would find at a real fireworks display but they can serve as a good introduction.

Watch from far away

Your best option may be a nearby parking lot, or the side of the road with the windows rolled up may provide a comfortable and safe distance for your kiddo to experience the show.

Have a solid Plan B

When you make the decision to try a live fireworks display, be prepared to leave if your child becomes overwhelmed. Despite the fact that you have spent time preparing your child and have a pair of headphones available, things may not work out as planned. Keep this in mind when parking the car so you can have an easy route out

Take comfort items

Be sure to pack items that help to calm your child, such as a weighted vest, blankets, snacks, iPad or fidget toy.

Create a Social Story

A social story may work to prepare your kiddo for any event that might be stressful throughout the evening. A great social story is up for free download here.

Headphones

If you haven’t already, invest in a good pair of noise canceling headphones or construction grade earplugs. You may be able to prepare your child for the crowds and change of surroundings, but they may be over stimulated by the noise! You can even play soothing or patriotic music through them.

Indy with Kids has laid out Fireworks in the Indianapolis Area here.

Fort Wayne area Firework displays are listed here.

Greater Boston area Fireworks are listed here.

Have fun!