Tag Archives: autistic child

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.

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What does an early intervention program look like?

Early intervention programs can range from 25-40 hours per week depending on the child’s need.  If the goal of an intensive and early intervention program is to close the gap between the child and typically developing peers, programs can range from 30-40 hours per week.  Early intervention programs can increase language skills, play skills, social skills, academic skills, self-help skills and help to reduce problem behavior.  Programs should be very “play based” and fun for the child.

Because each child is different, the specific curriculum for an intensive intervention program can very dramatically according to each child’s specific skill strengths and deficits.  For example, one student could be working on things such as fine motor or gross motor imitation as well as developing a communication system through the use of vocals, ASL signs, or PECS and being taught through discrete trial format.  Another student could be working on social skills or group responding skills to prepare the child for the classroom environment through more incidental teaching techniques and teaching in the natural environment.  While each child’s curriculum and the way skills are taught may be different, it all still falls under the umbrella of Applied Behavior Analysis. mom-and-toddler-playing-with-blocks

Key Points to Look for When Selecting an Early Intervention Program

Early detection of autism is essential.  As soon as a diagnosis is made, families should be provided with accurate, up to date information about science-based intervention options.  Often, once a diagnosis is obtained, precious months are wasted as families negotiate the maze of intervention alternatives.  It is important for doctors to direct families to services that are research-based and proven to be effective. Unfortunately, there are many fad treatments, which are also available and claim to be beneficial to children with autism, but have no research to actually support their effectiveness.  In fact, some of these therapies can actually cause more harm than good.

Here are some key things to look for when choosing an appropriate program.

  • There should be plenty of research supporting the effectiveness of the intervention.  Claims and parent testimonials alone does not qualify as research.
  • Therapy should be “data driven” in order to monitor progress and see if an intervention is working.
  • The National Research Council (2001) published recommendations for educating children with autism. They recommend that a child receive intensive behavioral intervention for a minimum of 25 hours per week in a low student-teacher ratio, focusing on a variety of functional skills as well as targeting decreasing challenging behaviors.
  • Parents should be heavily involved in their child’s treatment and receive appropriate parent training.
  • Staff should be well trained and the intervention is directed by a qualified and experienced professional.
  • Pick a provider who has a good reputation within your community

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Early intervention services are available for children under the age of 3 and  research indicates that the earlier the child gains access to quality behavioral treatment, the more likely they are to have a better long term outcome.  Check out the latest findings and summaries from the National Autism Center for comparing the effectiveness of different treatments for autism.

http://www.nationalautismcenter.org/pdf/NAC%20Standards%20Report.pdf

Focus on what is most important first!

I have been working as a consultant in the field of ABA for 9 years and have worked with dozens of different children. When talking about goals, I often find myself saying one important phrase to the families I work with. “Let’s focus on what is most important first”.

When I meet with clients for the first time, I assess a child’s abilities in many different areas such as language skills, social skill, appropriate play skills, cooperation skills etc. I get a chance to interact with the children myself, talk to the families, and prepare a report, which outlines the basic direction in which a child’s therapy program should be designed. I often have many children that need improvement in a lot of different areas depending on the severity of the autism.

It is vital for a child’s success that families understand you can’t work on every single problem all at once. We need to pick what is most important and beneficial to the child to begin learning and focus on teaching these things first. Developing skill sets are like building blocks. Once you teach a new skill, you can use it to help you develop another and so on. As a Behavior Analysist, I am able to break down a goal into small steps and my job is to train therapists and families where to start and how to see results so that we can continue working towards the overall goal.

For example, a child with absolutely no communication skills, who never follows directions, and engages in many different forms of disruptive behavior is not going to be able to sit at a table right away so we cannot begin teaching him to begin academic work at a table. This is where I ask families, “What do you think would benefit your child the most right now?” My main goal would be to first help this child how to communicate effectively with his family and help him ask for a drink when he is thirsty, a cookie or cracker when he is hungry, or a favorite toy. Could you imagine what it would be like if you were not able to ask for the things you want the most? Next, it would be important to start working on developing cooperation skills because you can’t teach a child anything if they are not willing and ready to follow directions. If you try to teach a child to learn any type of new skills under these conditions, you will be turning it into a struggle and teaching the child that learning is not fun.

Once a child is cooperative and enjoys learning, we can continue expanding on learned skills and begin teaching other possible skills such as labeling objects, playing appropriately with toys, increasing eye contact, and basic social skills. At this point, academics may be a little way down the road, but if you follow developmentally appropriate goals, and continue to work towards the next step, you can eventually get to the point where children are ready to sit at a desk and learn academics in a school environment.

It takes patience, dedication, and time, but I have worked with children that have experienced this type of success through ABA therapy.

Myths Regarding Negative Reinforcement

Negative reinforcement is often misunderstood as a term that is associated with punishment. Because the word “negative” is used, people often think this term means something “bad”. However, this is far from true. Don’t let the “negative” part fool you. Reinforcement is actually a good thing.

In “technical terms” a reinforcer is the process in which a stimulus is added following a behavior and it increases the likelihood that behavior will occur again in the future. In “simple terms”, it means you do something and because something pleasant becomes of it, you are more likely to do it again. Reinforcers are also defined by their effect they have on behavior. Therefore, it has to increase the likelihood you are going to behave that way again in future. A person engages in negative reinforcement if they do something that helps remove or avoid something unpleasant. An example would be teaching a child to say “stop” instead of hitting a peer in an attempt to block the peer from taking a toy away. If the child begins to say “stop” in a similar situation this would show the behavior of saying “stop” increased.

Another reason negative reinforcement has become a term associated as meaning something “bad” is because we often don’t realize that we are using negative reinforcement when we shouldn’t. Using negative reinforcement to stop problem behavior can cause problem behavior to increase. Giving a child a piece of candy to make him stop crying would be considered negative reinforcement if you find yourself doing this a lot more in order to make the crying stop. Even though it makes the child stop crying in that moment, it also teaches the child crying results in something favorable. Therefore they will be more likely keep crying often and I am sure that is not the desired result 😉 In a situation like this, it is best problem behavior is never rewarded.

By understanding how the principle of negative reinforcement works, you can learn to use so it helps you instead of having it work against you.

Continuing research on autism and brain size

Interesting article in the wall street journal on continuing research on brain size and autism. They are working toward being able to diagnose earlier.

http://online.wsj.com/article/SB10001424052748704436004576299371343861618.html

Replacement Behavior

As a general rule, if you want to reduce a problem behavior, you have to teach an appropriate replacement behavior that produces the same outcome. Too often, strategies to decrease problem behavior focus primarily on punishing the behavior in order to make it go away. However, simply punishing a behavior is not enough, and quite honestly, not fair.

A good consultant will focus on teaching an appropriate replacement behavior that produces the same outcome. Remember the example of the little boy I mentioned that went to the bathroom in his pants while hiding during a game of hide and go seek? He really didn’t know he could stop the game to take a bathroom break. It would have been unfair to punish him for having an accident in his pants by reprimanding him or giving him a time-out if he didn’t know there was an alternative. Instead, a replacement behavior was taught first, which in this case, was enough to solve the problem.

A few days ago, I was working with new family and their 5 year-old non-verbal son in their home. I was training his mother on how to teach her son to request using sign language, when his father walked into the room. The little boy was excited to see his father come home and went right over to him and started hitting his legs and laughing. His dad asked me how to get his son to stop doing this.

For this little guy, a great replacement behavior would be to teach a more appropriate “high five” instead of hitting his dad in excitement. This was a great start. I also began teaching his dad how to teach other positive interactions with his son, such as picking him up and spinning him around. The little boy quickly began to enjoy this activity. Because he liked it so much, we also began teaching him to sign “spin” in order to continue building on teaching important replacement behaviors that would help him learn to communicate effectively with others.