Better Understanding Your Job as a Board Certified Behavior Analyst

Better Understanding Your Job as a Board Certified Behavior Analyst

By: Maria Pantelides, MA, BCBA, LBA (CT, MA, MD, NY)

You have finished your coursework, you’ve completed all of your supervision hours and passed the BACB Exam, CONGRATULATIONS!

Behavior analysis is the science of behavior. Behavior is a product of its circumstances, particularly the event that immediately follow the behavior. (The Board Certified Behavior Analyst® (BCBA®), 2019).

In the role as a behavior analyst, you study behavior and how that behavior affects motivation. Our goal as behavior analysts is to improve the lives of the individuals and those who care for those individuals. Applied Behavior Analysis (ABA) “is a scientific approach for discovering environmental variable that reliably influence socially significant behavior and for developing a technology of behavior change that takes practical advantage of those discoveries” (Cooper et. al, 2007).

By utilizing the principles of ABA our goal is to provide the highest quality services possible to our clients, and increase socially important behaviors. There are various environments you can work as a behavior analyst (e.g., schools, homes, clinics, hospitals); regardless of the environment you are working it is important that every client has an effective treatment that is rooted in the evidence-based literature of ABA.

Often times, as a behavior analyst you spend an extensive amount of time working with other professionals (e.g., technicians, parent/caregivers). These individuals also work with the client and implement treatment that you have created. It is your responsibility to analyze the data, and be present as a BCBA in the client’s program and ensure that you are providing an effective treatment. We are constantly communicating with parents and other team members of our clients and in your role as a behavior analyst, it is important to remember that collaboration and consistency is critical to the success of your client.

As a behavior analyst you must be able to provide services that are within your scope of practice and area of expertise. You must abide by Behavior Analyst Certification Board’s Professional Ethical Compliance Code and Guidelines for Responsible Conduct (BACB, 2014) as well as all local, state, and federal laws with regards to the provision of services.

A behavior analyst plays a huge role in an individual’s team and can help decrease the challenges faced, enhance the lives of individuals, and increase an individual’s quality of life as well as their families. The field of ABA is constantly growing and there is always new research being conducted on how to improve our client’s socially significant behavior. There is no better job or field than that!

References

  • Applied Behavior Analysis Treatment of Autism Spectrum Disorder: Practice Guidelines for Healthcare Funders and Managers (2014, Behavior Analyst Certification Board Inc.(“BACB) Ver 2.0). Retrieved from http://bacb.com/wp-content/uploads/2016/08/ABA_Guidelines_for_ASD.pdf
  • Behavior Analyst Certification Board Professional and Ethical Compliance Code for Behavior Analysts(2014,
  • Behavior Analyst Certification Board, Inc. “BACB”). Retrieved from http://bacb.com/wp-content/uploads/2016/03/160321-compliance-code-english.pdf
  • Cooper, J.O., Heron, T.E., & Heward W.L.,(2007). Applied behavior analysis (2nd ed.).
    Columbus. OH: Merrill Prentice Hall.

Are you interested in joining the Attentive Behavior Care team? Apply today!

My Child Was Just Diagnosed…Now What?

My Child Was Just Diagnosed…Now What?

It can be difficult when your child gets an autism diagnosis. It is normal to have a conflict of feelings – relief at the clarity and direction the diagnosis gives you, mourning over the loss of the dreams of typical development you may have had for your child, denial that the diagnostician really understood your child, and of course, confusion over what to do next.

First of all, there are a few things that are so important to keep in mind when initially dealing with the diagnosis and to continue to remember as you raise your child.

Your child’s diagnosis and conditions are not your fault. There is nothing to be ashamed or embarrassed of at having a child that is not exactly like every other kid his age. In fact, there are no kids that are exactly like every other kid their age!

Don’t let the diagnosis of autism take over who your child is. Your child is not just someone with autism. He is still your child with his unique personality, interests and strengths. Recognize him and celebrate him always!

And of course, remember that autism is not a death sentence. There is so much that you can do to help a child with autism, and research is constantly enhancing and augmenting the interventions available. Reach out to see how you can help your child and dare to dream of her successes even when you may be facing regressions and challenges.

Don’t forget yourself either. Find support through a support group or from friends with children on the spectrum. Share your successes and challenges.

For information on how Attentive Behavior Care can help your child, please contact us today.

Why ABA Therapy is the Right Way to Go

Why ABA Therapy is the Right Way to Go

By: Heyde A Ramirez, MA, BCBA, NYS LBA

Perhaps you had concerns for a while or maybe this is all brand new to you. Either way, here you are, now faced with the reality that your child has an Autism Spectrum Disorder (ASD) diagnosis. What happens now? What do you do?

For starters, take a moment. This can be a lot to digest. Breathe. Be kind to yourself. Remember, your job as a parent hasn’t changed. You are still going to be an advocate and do what whatever it takes to help your child have the best chance at the best life. Just remember you don’t have to do it alone. Your child has a team filled with doctors, teachers and therapy providers.

Has your doctor approached you about the possible treatment choices out there? Have you heard about applied behavior analysis (ABA)? I am here to tell you that ABA therapy is the right way to go! If your child can benefit from a therapy that can target the core deficits of ASD and increase his quality of life, then choose ABA. Ask for it, demand it, and make sure it’s provided by highly trained and qualified professionals.

What is ABA Therapy and How Will it Help Your Child?

ABA uses thoroughly researched strategies and procedures to change behaviors worth changing. Does your child demonstrate difficulties with communication? If your child cannot make requests for his wants and needs despite being vocal, we can use what we know about motivation and reinforcement among other behavioral principals to help your child communicate with you and the people in his environment.

Perhaps your child isn’t vocal at all and you are at a loss as to how to help your child even begin to communicate. We can use a behavioral approach to assess what, if any, alternative methods of communication may be appropriate. On the flip side, what if your child is most definitely vocal, and he engages in one-sided language or repeating words or phrases (i.e., echolalia)? We can create a treatment plan based on evidence based practices to help with these and other communication concerns.

ABA therapy also targets those social deficits that many individuals with ASD have. Whether it’s difficulties with eye contact, play skills, joint attention, understanding and using nonverbal cues, or any other social deficit, ABA can pinpoint the skills needed to alleviate these deficits. ABA employs a structured and systematic approach to targeting these skills.

ABA therapy can also be used to increase tolerance to changes, being told “No,” being asked to wait, among other important situations. ABA therapy can also be used as a way to increase the use of functional communication. After all, if your child is able to communicate with you and the others in his environment what he wants and needs in a safe appropriate manner, he will have less motivation to communicate with you by screaming, hitting, or otherwise engaging in behaviors that are unsafe, destructive and/or socially isolating.

What About Other Therapies?

As a parent, I am sure you want what’s best for your child. Perhaps you’ve searched Google or asked other parents what they have done. Maybe you’ve had a parent tell you that when they implemented a certain diet change or put their child on a certain vitamin regimen, they saw changes in their child’s behavior. Whether those changes really made a difference or were responsible for those changes cannot be determined without data and research.

The data and research supporting ABA therapy as a treatment for ASD is there, and it continues to build every day. I do caution you against treatments that have not been researched. These “fad” treatments have the potential of not only wasting valuable treatment time, but also can at times cause harm. The Bleach treatment for ASD definitely carried a risk for harm to the client, but when a treatment promises to be a cure-all, we can understand the allure. Equine therapy seems safer, and potentially even fun, but it is not a therapy that is able to target the core deficits of ASD and utilize evidence based practices in order to effect long lasting sustainable change that can be generalized across settings and people.

ABA therapy is a commitment, and hard work, for your child and the family and the team as a whole. The work put in has a great pay off; the benefits most definitely outweigh the costs. Choose ABA for your child when discussing the treatment that will be put in place. Ensure that the therapy is provided by trained professionals who have your child’s interests in mind and will provide treatment in an ethical evidence based manner.

For more information about Attentive Behavior Care and how we can help your child, please contact us today.

When Your Child Won’t Stop Acting Out

When Your Child Won’t Stop Acting Out

By: Catherine Tsiris, Ph.D., BCBA-D, LBA

You’re Not Alone

Every parent of a child with autism knows about challenging behavior. Whether it is perseveration on a preferred topic, inflexible adherence to routines, difficulty with transitions, challenges with new people, places, or activities, to tantrums, aggression and self-harm, raising a child with ASD often comes with managing a variety of challenging behaviors. It’s so common in fact, that a Google search of “autism problem behavior” returns 45 million hits.

Parents often report that while their child works well with their ABA provider, following directions, waiting for their reinforcer, tolerating non-preferred tasks, etc., once the therapist leaves their child acts out. Why do some children respond well during treatment sessions, but act out when the therapist is not there? There could be several factors at play. Let’s look at a few of these.

Attention

During treatment sessions, your child has the undivided attention of the therapist, in addition to social reinforcement such as praise, smiles, high 5s, etc., and possibly other preferred rewards. Often, our kids act out for attention, regardless of whether the attention comes in the form of smiles and praise or corrections and scolding. While parents cannot provide undivided attention at all times, there are some strategies that can help.

Reward Positive Behavior

Catch your child being good. Rather than focusing on the negative behavior, and consequently providing attention to it, look for opportunities to celebrate and praise your child for good behavior. Whether she’s following directions, sitting quietly watching TV, doing homework, putting dirty clothes in the hamper, a plate in the sink, or anything else that you would like to see them do more often, take a moment and say “Good job putting your plate in the sink.” “Thanks for placing your clothes in the hamper.” “I love the way you are watching TV so quietly.” The opportunities are many and the more you praise specific behavior, smile, give thumbs up, hugs, etc., the more likely your child will be to engage in this type of “good behavior” in the future.

Avoid Rewarding Negative Behavior

At the same time, as much as possible and safety permitting, avoid attending to problem behavior. Practice the art of maintaining a neutral facial expression and tone of voice; parents often report that this is the hardest skill for them to master. If you need to attend to your child during problem behavior, do so without reacting. Focus on the child not the behavior. For example, avoid saying “Stop banging on the table.” Instead, redirect them quietly to another activity.

Avoid using negative words such as “no,” “stop,” “don’t,” “can’t,” etc. Instead of telling your child what they can’t do, tell them what they can do! For example, let’s say Jimmy is drawing on the wall, you can say “You can draw on paper or on the white board” presenting these options to the child.

Remember that whatever you are directing your attention to, is what you are going to get more of.

Choose Your Battles

During therapy sessions, your child may be working and behaving toward earning preferred activities or items. The ABA therapist will be using schedules, token boards, timers, breaks, functional communication training, and other techniques, to help your child succeed in learning new skills and earning those preferred reinforcers for their hard work. In contrast, it’s not always possible for parents to provide frequent rewards for following directions and good behavior to their child. There are however, a few tactics that can help.

If you do say “no,” you will need to follow through.

If we tell Jane to stop jumping on the couch, and she does not comply, we will need to go help her get off the couch (thereby inadvertently providing attention to the behavior). At the same time, Jane can escalate this into a tantrum. If we do not follow through and get her off the couch, we are essentially teaching Jane that when mommy or daddy tell her to do something, she doesn’t have to do it.

What if Timmy asks for his tablet during dinner and we say no, and he subsequently starts screaming (or engages in any other inappropriate behavior)? Do we give him the tablet when he escalates, thereby teaching him that he can get what he wants when he “turns it up?”

This “battle of wills” can easily turn into a constant stream of no’s, stop’s and don’ts, as the child engages in one maladaptive behavior after another to get attention, access to an item or activity, or to avoid doing a non-preferred task. Most significant is that the child, at best, learns that these negative words don’t mean anything, or worse, that their behavior is garnering attention from the parent, albeit negative. These words lose their value in the absence of follow up. Children quickly learn to tune it out or “turn it up.”

Therefore, it is recommended to choose your battles. If playing on his tablet during dinner is disrupting Timmy from eating his meal, or dinner is sacred family time, then by all means, no means no. However, if the parents themselves tend to check their phones during meals then perhaps this is not a battle worth putting your foot down for. In order to provide consistency to our children, we should consider which behaviors we will not accept, and are willing to follow through with, in order for the “No” to be meaningful to our child.

Antecedent Interventions

Antecedent-based interventions, commonly referred to as antecedent manipulations, are various evidence-based strategies that modify the environment in some way before the target behavior occurs. They tend to decrease the likelihood that problem behavior will occur and promote the opportunity for replacement or desired behavior to take place.

Effective antecedent interventions include utilizing functional communication training to help your child communicate effectively their needs and wants for items and activities, attention, help, or when they need a break, as opposed to engaging in maladaptive behavior; providing your child with choices regarding what they will do and when they will do it; using pre-teaching which entails providing reminders to your child that an event is coming up to ease with transitions from preferred to less preferred activities as well as changes in routines; using reward charts and token boards to encourage good behavior; implementing a behavioral contract with your child; using picture or written schedules, and utilizing visual count-down timers.

These several tips are not meant to be exhaustive. There are many evidence-based strategies that can be utilized to decrease problem behavior. Work with your BCBA® to determine your child’s triggers and the consequences maintaining his or her problem behaviors and consistently implement the behavioral interventions they recommend to decrease maladaptive behaviors and increase replacement behaviors.

For more information or to discuss how Attentive Behavior Care can help your child, contact us today.

Your Child Has Autism: How to Handle the News

Your Child Has Autism: How to Handle the News

By: Nahoma Presberg, MS BCBA

When I was asked to write to parents about having a child with autism and how it can be a blessing, I was excited. This initially sounded like an easy task. Of course it can be a blessing. Children are always a blessing. Why would a child with autism be any different? But then I thought about it some more. How could I write about an experience that I’ve never had. I’m not a parent of a child with autism. I’m not even a parent. How could I communicate this message that I wholeheartedly believe in without stepping on anyone’s toes or making broad sweeping statements about something that I really know nothing about?

The long and the short of it is, I can’t. What I can do though, is talk about my own experiences. I can talk about working with individuals with autism and their families. I can discuss the life lessons that I have learned from people who think differently from myself. I can talk about how diversity has brought richness to my life, and how neurodiversity is a critical piece of the diversity puzzle.

I want to share with you something that my mom reminded me of years ago when we were in the kitchen preparing dinner. We were talking about jobs, college majors, and what I should do after high school. She told me that I have often talked about wanting to work with the people that most view as “difficult.” I have always been interested by the ways our systems are designed to work for particular kinds of people and those who don’t fit that mold are often labelled as being “lesser” for needing different kinds of support. She was right. This was something I had naturally gravitated to long before I knew what it meant. What I’m trying to get at is that when someone is struggling to fit in, it’s because the system made it that way and not because who they are is “wrong.”

Getting a Diagnosis

Getting a diagnosis can be really scary. Hearing that your child has autims can feel devastating. Individuals who need different support than society is used to providing automatically go through life with new and different challenges, and it can be exhausting to be constantly fighting the system to get you and your child what you both need. Due to this, working with this community has taught me a tremendous amount, both about myself as well as the human experience.

My first piece of advice is to take a step back and pause before reacting. It can be easy to have a strong initial reaction to big news and to let our brains spiral to all of the worst case scenarios. But pause. Look at your child. Remember that he or she is the same amazing, lovable kid that he or she has always been. The only difference is now you have an extra tool to help you understand them and to understand how they might experience the world.

Also, remember that autism means something very different for each person. Saying that your child has an “autism diagnosis” actually means remarkably little. It doesn’t tell you anything about what their skills are or what they can bring to the table. It just means that they fit within a class of people that meet the diagnostic criteria for autism. Autism doesn’t mean that there are suddenly all sorts of things that they can’t do. It just means that there may be ways that you will need to adjust your current way of looking at the world in order to help meet their needs in specific ways.

Become an Advocate for Your Child

Put on your boxing gloves, and get ready to fight. Remember that it’s not your child’s fault that he or she needs support that the world doesn’t know how to give him or her. Advocate for your child. Tune in to what they need, and fight to get them just that. Find a community that can give you emotional support. Seek out parents who are going through similar experiences. They can serve as a critical support team if the system fails you or when you have a really rough day. They can also help you navigate the advocacy work by sharing experiences and learning together.

Don’t forget to give yourself a break. Advocacy can be all consuming, but you can’t pour from an empty cup. Give yourself time and space to just take care of yourself. And do that often. You deserve it.

For more information or to discuss how Attentive Behavior Care can help your child, contact us today.

Our ASAT Partnership

Our ASAT Partnership

By: J. M. Coimbra, MS, BCBA, LBA

The Association for Science in Autism Treatment (ASAT) is a not-for-profit organization aimed to improve the lives of people with autism by providing a reliable source of easily-digestible, empirical and science-based information on the current best-practices for the most effective and ethical treatment, education, and care for individuals with autism.

What Does ASAT Do?

ASAT offers guidance to all audiences, from parents of newly-diagnosed children, educators, behavior analysts, paraprofessionals, members of the media, and even to medical professionals, who may deliver those initial diagnoses. Since its start in 1998, ASAT has produced and distributed a quarterly newsletter that reaches over 10,000 consumers in 95 countries and in 6 languages, published monthly blogs, participated in several professional events (e.g., Association for Behavior Analysis International (ABAI) Convention or New York State Applied Behavior Analysis (NYSABA) Conference) and parent conferences, broadcast dozens of interviews, and built relations with several organizations in the form of sponsorships.

Additionally, over the last decade, ASAT has served as an advocate for the use of scientific methods, opposed to fad-treatments, “miracle cures,” and other pseudoscientific therapies. ASAT combated inaccurate newscasts by letters and posts and recently doubled the size of their database to promote science-based autism treatment to students. The need to promote evidence-based, scientific practices may never have been more critical than as in the present.

Pseudoscientific and inaccurate information about autism easily and quickly spreads and contributes to negative outcomes (e.g., an increase in the number of children who do not receive vaccinations, Burgess, Burgess, & Leask, 2006; Hill, Elam-Evans, Yankey, Singleton, & Kang, 2018). Strategic partnerships establish a united front to advocate science-based treatment and illustrate the positive effects of those treatments (e.g. skill acquisition and behavior reduction through methods rooted in the science of applied behavior analysis, ABA).

Attentive Behavior Care & ASAT

Attentive Behavior Care (ABC) is an agency, whose goals align with ASAT. Each individualized treatment program is designed by a competent behavior analyst, who endeavors to improve the lives of children diagnosed with autism, while upholding all of ABC’s core values: delivering effective treatment rooted in evidence-based practices of ABA, shaping new, meaningful skills of social significance, making specific, clear interventions implemented with high fidelity, increasing opportunities for meaningful and rewarding activities and relationships, maintaining ethical conduct congruent with the best-practices outlined in the behavioral treatment and considering requirements determined by other professionals (e.g. other medical needs), and maintaining training and continued education for updated best-practices.

With integrity, ASAT has been a pioneer for other organizations serving to help those affected by autism and their networks of family members, caregivers, educators, etc. The work done by ASAT has had an immeasurable impact on the community. Given our aligned values and goals and with reverence, Attentive Behavior Care (ABC) supports ASAT as benefactor sponsor.

Together, ASAT and ABC tackle several shared objectives: improve lives, increase awareness of accurate, scientific, evidence-based methods of treating autism, present as beacons for information and support to families, professionals, and paraprofessionals alike by blogging, attending professional events, and hosting events for parents, foster collaborative relations among organizations in our united front against misinformation and harm, service diverse communities, and expand the scope of ABA and treatment of autism to meet the ongoing and dynamic needs of individuals from first-day diagnosed to first-day at a job.

References:

  • ASAT Website: www.asatonline.org.
  • Burgess, D. C., Burgess, M. A., & Leask, J. (2006). The MMR vaccination and autism controversy in United Kingdom 1998–2005: Inevitable community outrage or a failure of risk communication? Vaccine, 24, 3912–3928.
  • Hill, H. A., Elam-Evans, L. D,. Yankey, D., Singleton, J. A., & Kang, Y. (2018). Vaccination coverage among children aged 19-35 months – United States, 2017. Morbidity and Mortality Weekly Report, 60(40), 1123-1128. doi: http://dx.doi.org/10.15585/mmwr.mm6740a4External.

For more information about Attentive Behavior Care and how we can help your child, please contact us today.

The Importance of Caregivers in ABA Therapy

The Importance of Caregivers in ABA Therapy

By: Paige Sands BS, ABA Graduate Student, and Maria Pantelides, MA, BCBA, LBA (CT, MA, MD, NY)

Caregivers have one of the hardest jobs in the world. Whether you are a parent, grandparent, aunt, uncle or other form of primary caregiver, you know how big of a responsibility it is to be in charge a little life twenty-four seven.

When your child has special needs, additional challenges can arise. It’s around this time that you may begin to look for outside support. This is an important first step! So, you find an agency and begin your ABA journey. Your family has been assigned a BCBA® and supporting technicians…now what?

Your team will work to get your child on the right path, but we cannot do it alone! ABA therapy requires a team effort. We are only one link in the chain. In order for what we bring to the table to stick, we need caregiver support. BCBA’s® and technicians need parents to be part of their child’s treatment during every step of the process so results can have maximum impact.

Why Be Involved?

Your provider will be working very hard on their programming to ensure your child is able to apply skills learned, which can be translated across multiple environments and people. As your child begins to approach mastery criteria with their technicians, your treatment team will start to move toward handing the new skill or behavior reduction techniques off to you as a caregiver.

This can really happen during almost any point in the process, but most of the time occurs once your child is used to the expectation. Caregiver training allows you to spend time learning how your technician has been approaching teaching your child to set you both up for long-term success. Bennett (2012) outlines that when caregivers are not involved, then a disconnect between treatment and everyday life can occur making it more difficult for skills to generalize.

How Can You Be Involved?

It is one thing for us to say we want you to be an involved caregiver, however you may be thinking; “How do I do that?”

The easiest and quickest answer is to be willing to participate in caregiver training, but there is a lot you can do. Communication with your treatment team is huge. If you notice changes in your child’s behavior when the treatment team is not around or if a previous learned skill is not being shown, tell your team. Your team will work with you to find what may be contributing to this. Additionally, if there is a specific skill you want worked on, let your BCBA® know and they will work with you to add it to your child’s goals.

Long Term Benefits

Look at ABA therapy as an investment. It’s an investment for your child and for yourself. The goal for your provider is to teach themselves out of your need for them, to give you control back. Grindle et al (2009) showed that 86% of female caregivers and 52% percent of male caregivers saw practical benefits for themselves after introducing ABA into their lives.

More importantly, both parties saw 100% improvement in their child. Other research shows that “parental involvement is the one invariable factor and an integral part of the success of early intervention programs for children with autism” (Ozonoff & Cathcart, 1998). Take the time, make the investment and be an active part of your child’s success in ABA!

References:

  • Bennett, A. (2012) “Parental Involvement in Early Intervention Programs for Children with
    Autism” Master of Social Work Clinical Research Papers.
  • Grindle, C., Kovshoff, H., Hastings, R., & Remington, B. (2009). Parents’ experiences of home-based applied behavior analysis programs for young children with autism. Journal of Autism and Developmental Disorders, 39(1), 42-56. doi:10.1007/s10803-008-0597-z.
  • Ozonoff, S., & Cathcart, K. (1998). Effectiveness of a home program Intervention for young children with autism. Journal of Autism and Developmental Disorders, (1), 25-32.

For more information about Attentive Behavior Care and how we can help your child, please contact us today.

Why I Love Working at Attentive Behavior Care

Why I Love Working at Attentive Behavior Care

By: Jessica Basir, M.S., BCBA, LBA (NY, CT)

If you are reading this post, chances are you are pursuing an ABA therapy job. You may have a lot of experience working in the field, or you even have your BCBA®. Maybe you are just beginning your journey in this field and have no experience at all. Either way, deciding on a job in the field of ABA therapy can be overwhelming since there are a multitude of options out there.

So, how do you choose?

You already made the first step by checking out our website and doing some research!

First and foremost, many individuals who work for Attentive Behavior Care (ABC) grew their careers within the company. Current full-time BCBA’s® began their careers working part-time with ABC as technicians on one or two cases.

As their interest grew in the field, they began pursuing their education in ABA, obtaining their degrees, and becoming Board Certified Behavior Analysts®. From there, they pursued their career goals with the help of the clinical team and obtained full-time positions as supervisors overseeing a multitude of cases. ABC helps grow professionals and fosters long-term professional goals.

Working at ABC

ABC has been recognized as a Behavioral Health Center of Excellence since 2016 and was recently awarded a two-year re-accreditation from the BHCOE. This award recognizes the company’s integrity and the effectiveness of the services they provide. Working for a company that achieves substantial recognition in our field provides a great sense of pride and admiration from the employees who work within it. At ABC, you can be proud of where you work.

Working within ABC you will also have access to top-of-the-line data collection systems and virtual clinics. Rather than completing data on paper, fussing with clipboards, and managing a multitude of program sheets, all data is stored in a virtual database allowing for easy access of all programs, targets, and data collection procedures. You do not have to worry about forgetting anything because it is all at your fingertips! ABC also provides all staff with their own personal company tablets, and an on-site training team to assist with any difficulties you may have.

ABC’s Support Teams

Another great asset of ABC is their support teams. Whether you are a technician starting your first case, or a BCBA® who has been in the field for years, the science of ABA therapy requires an extensive amount of collaboration. ABC provides each case with a case coordinator, an individual assigned to help maintain schedules, consents, and communication between families and their staff. In addition to the coordination staff, the offices consist of a clinical director who is assigned to help collaborate and respond to clinical questions concerning your specific cases.

ABC also offers part-time and full-time opportunities, in multiple states. Schedules are tailored to your preference in location, times, and skill level. Similarly, the company fosters an environment that allows individuals to grow and pursue their long-term career goals from start to finish.

Whether you are just beginning your journey or are a seasoned professional in the field of ABA therapy, ABC will support you on your journey to growing your skills and offer you experiences that will last a lifetime.

That is why I love working at ABC!

Are you interested in joining the Attentive Behavior Care team? Apply today!

Q & A With Miriam Newmark, Our Clinical Director

Q & A With Miriam Newmark, Our Clinical Director

This interview first appeared in the Voice of Lakewood on November 22, 2018.

Q: Tell us About Attentive Behavior Care.

A: We provide ABA therapy for individuals on the autism spectrum; we work with children aged 18 months and up and adults. ABA is a science-based method that has been proven to work in addressing the core deficits of autistic children: social, communication, and behavior reduction. Because autism is a spectrum disorder, a wide range of children fall along the spectrum. Some are nonverbal and need to learn how to communicate their needs, while others need social skills training and group practice to bring them up to par. Examples of skills that we target include social skills, toilet training, independent dressing, safety skills, communication, and hygiene — all essential skills which enhance the quality of life of the child.

At Attentive Behavior Care, we believe in a team approach; we work closely with parents, professionals, and other peers to ensure that skills learned are being maintained in the child’s natural environment. I frequently tell parents, “If your child only behaves while with me in my office, I was not successful.”

Q: Please share some thoughts about your clients.

A: There is a saying, “When you meet one child with autism, you have met one child with autism.” Each autistic child has individual needs, and I see each child as a puzzle with unique strengths and weaknesses. Our job is to figure out what is causing their behaviors, which skills are lacking, and what motivates them to learn new skills. Then, we work to build additional skills in a fun and meaningful way.

Q: Why did you choose ABA Therapy as a career?

A: I have worked in this field for almost 11 years. I’ve always enjoyed children and teaching, and even spent a number of years fostering autistic children. Working with these children really intrigued me. Some don’t have obvious disabilities, but something is holding them back from progressing academically and socially. It pained me to watch them suffer, and I wanted to help them and teach them to advocate for themselves and better fit in with their peers. I had a master’s degree in special education, and I began taking courses in Applied Behavior Analysis, eventually becoming a certified BCBA®. It’s not easy to teach social skills and communication to children who don’t pick them up naturally, but I was, and am, driven to help these children. Now, as a BCBA®, I always keep up-to-date on the newest research. My motto is “The more I know, the more I will be able to help children.”

Q: Tell us about some memorable experiences.

A: I once worked with a nonverbal two-year-old whose mother was told her son would never speak. Of course, she was devastated. At the initial assessment, he made noises, but didn’t actually form any words; he cried and used aggression to have his needs met. After around three weeks, he was able to say “pizza,” his favorite food. His mother called everyone to share her excitement… and a year later this boy is speaking in full sentences! The most satisfying type of phone call I receive is when a child cancels their social group because they were invited to a play-date with a friend instead. Then I know we have accomplished our goal.

Q: What is unique about Attentive Behavior Care?

A: It’s easy to teach a skill; it’s harder for children to apply the skills in real life situations. At Attentive Behavior Care, we plan for generalization in two ways: Number one, we involve the parents in the therapy; by giving parents hands-on training, we enable them to achieve success with their child at home. We also offer great social groups, or “clubs,” where the child practices their skills in a natural environment, with the therapist present. Children bake, play sports, create crafts, or play games in order to practice skills such as conversation, reading social cues and gestures, losing a game gracefully, problem-solving, following directions, compromising, adjusting to changes in routine, sharing, and taking turns.

We also have a special program that we all our “Attentive Day Center.” We have our own classrooms and play areas, and we provide a full-day therapy program for preschool-aged children, focusing on communication, play, and social and independent skills. Recently, we have expanded our services in these Day Centers to include Speech-Language Pathology (SLP) and Occupational Therapy (OT). This allows the children to receive an intense therapy focused on skill-building in a fun and engaging way at this critical time in their lives – all under one roof!

Q: What do you tell a parent who’s child needs therapy?

A: Early intervention is always the key. Sometimes parents are hopeful that their child’s symptoms will lessen and they will “catch up” to their peers. Unfortunately, many times the gap only widens, and we then have to make up for lost time. It is also important for the therapy to take place where the issues are happening. If a child misbehaves at home, the therapy should take place at home as well. Having a child with special needs is difficult. These suggestions can help:

Having a child with special needs is difficult. These suggestions can help:

  1. Have clear expectations and rules. These children often have “black and white” thinking and have trouble understanding words like “later,” “we’ll see,” and “maybe.”
  2. Focus on the good; praise your child as much as possible.
  3. Spend a few minutes of quality time with your child daily, with no interruptions.

Q: How can a parent ensure that they get the most out of therapy?

A: Parents need to be open about their child’s struggles; understanding all the dynamics in your child’s life will allow us to provide much more effective help. Remember, we are here to help, not to judge. When I come to people’s homes at busy times, I tell them, “We all have families of our own. We don’t expect a clean or perfectly calm house.”

If you would like more information on how Attentive Behavior Care can help your child, contact us today!

An Interview With Trish Rollins of Autism Speaks

An Interview With Trish Rollins of Autism Speaks

Patricia Rollins (left) and Kaitlin Causin (right)

About Trish

Patricia “Trish” Rollins is the NYC Field Development Manager for Autism Speaks. Trish originally got involved with Autism Speaks in 2007 as a volunteer. She has a brother on the spectrum, and wanted to do something bigger and outside of her family, so she volunteered with Autism Speaks.

She participated in her first walk in 2008, and very quickly decided that this was something she really wanted to get involved with in a meaningful way. She joined up with the NYC walk committee to have a deeper involvement in the cause, and when the Staten Island walk committee was formed in 2012, she joined up with that committee as well. A temporary position with Autism Speaks opened in 2014, and of course she took it, and later a permanent position in 2015, which she continues to hold today.

Trish has an organic connection to the organization. She has a unique perspective on Autism Speaks having been involved as a family member, a volunteer, a committee member, and a finally as a full-time employee. She has seen the walks as a volunteer and participant, and lends that perspective to the planning of the walks.

Trish sees herself as an Autism Speaks lifer. It is a rarity these days, but she is one of the lucky few who wakes up every day and genuinely loves going to work. She feels a strong connection to the families that she works with and speaks with on a daily basis. This is especially true at walks and events where she gets to meet the people that she helps face-to-face and to hug the kids and see them having a good time.

Autism Speaks: Mission and Vision

Autism Speaks’ mission and vision is undergoing a shift from autism awareness to autism understanding and acceptance. Awareness is important, but even more important is developing a better understanding and acceptance of autism and those affected by autism because that is what leads to individualized treatment and specialized care.

World Autism Awareness Day & World Autism Month

Autism Speaks put autism on the map, and World Autism Awareness Day and World Autism Month are key awareness drivers.

The 12th annual World Autism Awareness Day is April 2, 2019, and is one of seven health related UN world days. Joined by the international community, hundreds of thousands of landmarks, buildings, homes and communities around the world will “light it up blue on April 2” in recognition of people living with autism.

Individuals who want to “Light it Up Blue” can get involved in the following ways:

  • Wear blue: Wear something blue on April 2 in support of understanding and acceptance for people with autism. You can get official #LightItUpBlue gear at the Autism Speaks e-store. Many schools and businesses participate in dress down days where students/faculty/employees wear blue.
  • Light blue: Get BLUE Philips light bulbs at Home Depot, or visit rosco.com/LIUB to get blue light filters. A portion of sales goes to Autism Speaks, and you have an easy way to light your house up blue!

In addition, there are many ways to show your support and spread the word on social media. Click here to learn how to Share Blue, Spread Blue, and Support Blue on World Autism Day, and throughout April, which is World Autism Month.

World Autism Month features autism-friendly events and educational activities designed to increase understanding and acceptance and foster worldwide support.

We asked Trish what makes World Autism Month so special and she shared that it is a time when Autism Speaks hears from a lot of the families. It’s a time for everyone to share their own personal stories. There is a mosaic on the website where families can share pictures and stories about themselves and their children. It provides these families and individuals a great opportunity to share their stories in one big space and to truly see and understand that there is a community out there.

Visit https://www.autismspeaks.org/world-autism-month for events and resources, and to learn how you can get involved.

History of Autism Speaks and the Walks

The organization was started in 2005 by Suzanne and Bob Wright who were inspired by their grandson who was diagnosed with autism. The Wrights helped raise funding for research, advocacy and extensive family services. They also led initiatives that affected change in insurance reform, began a public service campaign, started World Autism Awareness Day, and Mrs. Wright also helped launch the iconic blue puzzle-piece logo now recognized around the world.

Trish Rollins of Autism Speaks ABA Therapy

Patricia Rollins of Autism Speaks

Recalling the time that she first met Mrs. Wright, Trish remembered her as a force to be reckoned with who did not take no for an answer:

“Suzanne set the bar of the parent advocate. I think she would be proud to see where we are going now.”

Suzanne and Bob Wright are the ones who started the first walk in Palm Beach, Florida. Now, it is always the first walk of the year. Today, there are over 70 walks that take place throughout the country. Organizations can reach out to the Field Development Team at Autism Speaks to express interest in starting a walk in their own community.

Fundraising is the #1 goal of all of the walks, but a close second according to Trish is that the walks provide families with an opportunity for face-to-face interaction with Autism Speaks staff, service providers, and other families in their local community. People are uplifted after seeing all of the other families. They are provided with a feeling of community, making personal one-to-one connections that develop into sounding boards and even support groups.
Trish’s favorite part of the walk is right at the start. She loves to get a great vantage point where she can see the people holding signs and waving and cheering. It’s like a giant parade and she can and feel the amazing energy that is created by the group.

Resources

Trish feels that the most important resource Autism Speaks offers for parents or individuals is the Autism Response Team (ART) – they are the “boots on the ground” and are there to help answer questions and connect people with autism, their families and caregivers to a wealth of information, tools, and resources.

Aside from the ART team, there are over 40 free downloadable tool kits available on the Autism Speaks website that can be filtered by audience, age range, level of support, and resource type, so you can easily find the specific resource you need. If you would like to check them out, visit the online resource guide with 10,000+ resources – search by zip code and find local resources.

Autism Speaks Walk 2019

Don’t forget: the 2019 NYC Autism Speaks Walk is on Sunday, September 15th at the South Street Seaport Pier 15. Please come down if you are in New York City and experience the walk for yourself! And don’t forget to look for us at our Attentive Behavior Care tent!

If you would like more information on how Attentive Behavior Care can help your child, contact us today!

Attentive Behavior Care Earns 2-Year BHCOE Reaccreditation

Attentive Behavior Care Earns 2-Year BHCOE Reaccreditation

BHCOE Accreditation is the only ABA-specific accreditation. It provides feedback regarding clinical best practices, staff satisfaction and turnover, and consumer protection.

Acting as a third-party, BHCOE systematically measures and reports on existing quality criteria in the behavior analysis community using standardized methods and practices, and accredits only those service agencies that meet these standards.

What is the BHCOE Accreditation?

Attentive Behavior Care BHCOEThe BHCOE Accreditation is a trusted source that recognizes behavioral health organizations committed to continuous quality improvement. BHCOE offers a third-party measurement system that differentiates and provides independent feedback on clinical quality indicators. The BHCOE criterion features standards that subject-matter experts developed to measure effective applied behavior analysis services.

Attentive Behavior Care is proud to report that we have received a two-year reaccreditation! BHCOE acknowledged us as a behavioral service provider dedicated to continuous improvement in Applied Behavior Analysis (ABA).

BHCOE Accreditation recognizes behavioral health providers that excel in the areas of clinical quality, staff qualifications, and consumer satisfaction. These areas are measured through a wide-ranging audit, including interviews with agency clinical leadership, in-depth on-site observation, a detailed staff qualification review, anonymous staff satisfaction survey, and anonymous consumer satisfaction survey.

“At Attentive Behavior Care, we are proud to receive BHCOE Reaccreditation because it reflects our commitment to continual growth and improvement. We are thankful for our highly qualified team that makes our reaccreditation possible and aids our clients in making positive behavioral changes,” said Chief Clinical Officer, Kaitlin Causin, M.A., BCBA, LBA (AZ, CT, MA, MD, NY), “We look forward to continuing to provide comprehensive behavior analysis services of the highest quality in New York, New Jersey, Maryland and beyond, for years to come.”

Our Mission Statement

We are very proud to be comprised of behavior technicians, supervisors (e.g., Board Certified Behavior Analysts® (BCBAs®), Licensed Behavior Analysts (LBAs), and a strong administrative team who work together to provide ABA services for individuals with Autism Spectrum Disorders (ASD).

We specialize in providing intensive, individualized, treatment rooted in the principles of ABA in order to meet our patients’ needs. Our treatment plans focus on increasing skills that will lead to increased opportunities, involvement, and independence while simultaneously decreasing problem behavior and other barriers to learning.

It is our mission to decrease the challenges faced and enhance the lives of individuals with ASD and their families by providing one-to-one instruction, group treatment, education, training, guidance, and resources.

Our Core Values

Our practices hinge on the following core values:
1 – Every patient has the right to effective treatment that is rooted in the evidence-based literature of the science of ABA. Treatment must consist of an in-depth assessment to select goals and objectives which target socially significant behavior.
2 – Every patient has the potential to learn new skills and the right to acquire meaningful repertoires measured by a consistent data collection system and systematic review.
3 – Every patient has the right to programming and treatment which increases access to reinforcers, opportunities for rewarding personal relationships, well-being, productivity, independence, and community involvement while decreasing barriers to learning.
4 – Every patient has the right to treatment that is provided within the context of what is legal, ethical, and best practice.
5 – Parents/caregivers have the right to be involved throughout every facet of the assessment, treatment, transition, and discharge process through effective communication and active participation.
6 – Every patient has the right to a treatment team of qualified, highly trained professionals.

For more information about Attentive Behavior Care and how we can help your child, please contact us today.

The #1 Question Everyone in ABA Therapy Should Know How to Answer

The #1 Question Everyone in ABA Therapy Should Know How to Answer

By: Heyde Ramirez, MA, BCBA, LBA

Am I Making a Difference?

Congratulations! You are officially a Board Certified Behavior Analyst® (BCBA®). The day has finally come, and you’ve been handed your first case. You are excited! After all, imagine all of the possibilities. All of the potential behaviors to shape, increase, and decrease. You have trained for this and you can’t wait. You want above all else to make a difference!

You go and meet your client and their family for the first time. You are professional and courteous. You conduct a skills assessment and go home and develop goals. You are giving this case your all, as you should, and you find yourself devouring the research, ensuring that all of your treatment techniques align with what we know to be evidenced based practice. You create the data sheets. You gather your materials. You feel good, right? A sense of accomplishment that comes with knowing that you are about to change someone’s life envelopes you. You are the team captain, and you have gathered the finest crew available. You have plans to provide ongoing training to the behavior technicians and to your client’s family. You know exactly what to do and where to go as you make plans to lead your team on an expedition that will no doubt take your client on a journey towards independence and a higher quality of life. But are you REALLY making a difference? How do you even begin to answer that question?

Find Out From Others

Well, it’s not the kind of question you can or should answer on your own. Talk to the team, remember, while you may be the BCBA® on this case, you are just one part of this team. Sure, you’ve trained for this and you believe you know what your client needs most, but ultimately you are there to provide a service to your client. Is your client and their family going to be happy with the service rendered? Families have sought out ABA therapy in most instances in order to see the life of their loved ones improved. They want to see a difference. So how do you make that difference? You may have a treatment plan with beautifully written long and short term goals, but are they socially valid?

Social Validity is Everything!

What is social validity? Well plainly put, does anyone care about what you are teaching your client to do? Is it going to better their quality of life? Is the family on board with the goals in the treatment plan and how you plan to achieve those goals? Were the results noteworthy? If social validity is low…well… let’s just say… you may not be making that difference in people’s lives that you strive to make. Social validity is like that secret ingredient of that dish you love so much, and without it, no one is really going to want to go back for seconds.

As a BCBA®, you are in an amazing position, armed with powerful behavior altering tools, and within reason there is probably nothing you can’t train. Be sure to never stop asking yourself if you are making a difference. Be the BCBA® who stops and truly listens for that answer. Whenever possible, ask your client what they want to work on, and when that isn’t possible, rely on trusted caregivers to give you as much information as possible. Use evidence based practices and ensure buy-in from the team.

Remember, treatment plans should be individualized to the client and that includes the treatment techniques used during treatment. Be the BCBA® who spends the time training the entire team to teach the client relevant and functional skills that will make a difference in their lives. Be the BCBA® whose entire team can confidently say, Yes! This is making a great difference in the client’s life!

Are you interested in becoming a BCBA® with Attentive Behavior Care? Apply today!

Autism: Debunking the Myths

Autism: Debunking the Myths

By: Jonelle Lupero, BCBA, LBA (NY)

Unfortunately, some commonly held beliefs about Autism, which we know to be untrue, still continue. This lack of understanding can make it difficult for people on the autism spectrum to have their condition recognized and to access the support they need, in addition to compounding the worries of the average parent.

The following is a list of 12 myths about autism which aims to expand autism awareness as well as put an and end to any misconceptions.

1. Myth: Autism is Just a Mental Health Disorder

The truth: Autism is a neurodevelopmental disorder that impairs an individual’s ability to communicate and interact with others. There is more than one type of autism caused by different genetic combinations and environmental factors. In children with autism, the brain develops differently to typically developing children, affecting many areas of development.

2. Myth: Autism Only Affects Male Children

The truth: Children with autism grow up to become adults with autism. Boys are much more likely to be diagnosed with autism than girls, with ratios ranging from four boys diagnosed to every one girl (http://autismspeaks.org). Girls with autism are more likely to have stronger social skills than boys with autism at the same level of cognitive functioning, and they are more likely to have stronger social interests. “Being aware of these key differences in boys and girls with higher functioning ASD can help in awareness and identification of girls with ASD” (Audrey Carson, Ph.D., assistant professor of pediatrics-psychology at Baylor).

3. Myth: People With Autism Don’t Experience the Full Range of Emotions

The truth: People with autism may have difficulty expressing emotions, or may express them in a different way. Children with autism experience the full range of emotions. It is common for people with autism to have difficulty identifying and understanding the emotions of others which can lead to misinterpretations.

Children with autism can build skills and learn to respond to other people in ways that are more typical or expected. Children with autism can and do show physical affection but often on their own terms. For some children, typical means of showing affection are more difficult, such as maintaining eye contact and physical contact.

4. Myth: People With Autism Don’t Want Friends

The truth: Most people with Autism do want to have friends, but have difficulty engaging socially with others, which may make it difficult to interact with peers. The social skills required to form friendships often need to be taught clearly to children with Autism.

In contrast to the previously dominant idea that they prefer social isolation, recent studies have demonstrated that most people with ASD want to form relationships with others. (Brownlow, Rosqvist, & O’Dell, 2015)

5. Myth: People With Autism Don’t Have Other Disorders or Conditions

The truth: Although many people with Autism do not have other conditions, many do. Research has shown that people with autism also have co-occurring conditions such as Intellectual Disability, Epilepsy, gastro-intestinal disorders, food sensitivities, allergies, and Fragile X Syndrome.

6. Myth: All People With Autism Have an Outstanding “Savant” Skill

The truth: There’s an iconic moment in Rain Man, in which Dustin Hoffman’s autistic character counts in an instant the exact number of cocktail sticks dropped on the floor by the waitress. In other scenes he demonstrates incredible powers of memory and calendar calculation. The success of this film has helped spread the incorrect idea that all or most people with autism are savants.

Although many people with autism have amazing “savant” abilities such as extraordinary math or musical skills, the reality is that approximately 10% of the autistic population has an extreme talent or genius level gift (according to the Autism Research Institute), the majority do not.

Children with autism have a wide range of IQ scores and skill sets, and every child is different. 31% of children with ASD have an intellectual disability (intelligence quotient [IQ] <70), 25% are in the borderline range (IQ 71–85), and 44% have IQ scores in the average to above average range (i.e., IQ >85).

7. Myth: Vaccinations Cause Autism

The truth: There is no reliable scientific evidence that childhood vaccinations cause Autism. There is evidence that not vaccinating children has led to an increase in preventable diseases.

In 1998 the British pediatrician Andrew Wakefield and his colleagues published a small story in the respected Lancet medical journal that implied that the MMR (measles-mumps-rubella) vaccine plays a causal role in autism. The Lancet paper was withdrawn in 2010, judged to be flawed and untrue. The same year Wakefield was struck off the doctor’s register after being found guilty of dishonesty and professional misconduct. Several large-scale studies have since examined the possibility of a link between MMR and Autism and have found no evidence to support the link.

According to the Autism Society, no single cause (https//www.autism-society.org/what-is/causes) triggers autism.
Studies (https//www.cdc.gov/ncbddd/autism.data.html) also show that genetics and other chromosomal disabilities tend to be linked to autism.

8. Myth: Children With Autism Don’t Speak

The truth: Although some children with Autism may have delayed speech or may not use words to communicate, many have very well-developed speech. In fact, some children may speak earlier than typically developing peers, but may have an unusual style of communication, such as overly formal speech or a strong preference to talk about particular subjects. There is a very wide range of skills and abilities among children with autism in relation to speech.

9. Myth: Children With Autism Are More Aggressive

The truth: As with other children there are those with autism who may shout or hit when they are distressed, but this is certainly not the case for all children with autism. When problem behavior occurs, it is often related to a lack or deficit of alternative skills or difficulties coping in the sensory environment, regulating emotions or communicating needs.

According to the Autism Society (http://www/autism-society.org) people with ASD are more likely to be victims of violence than to perpetrate it.

Challenging behaviors are often a communication of last resort. It is rare for a child with autism to intentionally cause harm to another person.

10. Myth: Autism is Caused by Bad Parenting Style

The truth: In the 1950’s, a theory called the “refrigerator mother hypothesis” arose suggesting that autism was caused by mothers who lacked emotional warmth. Even though we do not yet know the exact causes of Autism, the research that has been conducted supports the view that parenting style does not cause autism.

Because of difficulties with sensory processing and communication, some children with Autism respond negatively to some typical parenting behaviors, such as touch and hugs, and may require direct communication in order to understand others. When parents adapt their behavior to respond to their child’s needs it may appear unusual to others, but it is important not to assume that the parenting style is causing the child’s difficulties.

There is no known single cause for autism spectrum disorder, but it is generally accepted that it is caused by abnormalities in brain structure or function. Brain scans show differences in the shape and structure of the brain in children with autism compared to in neurotypical children. (autism-society.org)

11. Myth: We Are in the Midst of an Autism Epidemic

The truth: Prevalence in the United States is estimated at 1 in 59 births. (CDC, 2018,) Prevalence of autism in U.S. children increased by 119.4 percent from 2000 (1 in 150) to 2010 (1 in 68). (CDC, 2014)

While it is true that autism diagnoses are on the rise, it doesn’t necessarily mean that there are more cases of autism than there have been in the past. The increase is better explained by a broader definition of autism and more efficient diagnostic methods.

Before 1980, autism wasn’t considered a diagnosis, but a trait of schizophrenia. Over time, the Diagnostic and Statistical Manual for Mental Disorders (DSM) has expanded its description of autism, and it has reduced the number of traits that doctors need to identify in patients in order to diagnose them as autistic.

An autism diagnosis has been expanded to include all spectrum disorders which covers a wide variety of symptoms, severities, and conditions.

In addition, since the late 1980’s and early 1990’s, awareness has also increased over time; more paents, pediatricians, and educators are learning to recognize the early signs of autism and are more likely to seek an Autism evaluation.

12. Myth: Autism Can be Cured With Medicine

The truth: Autism is a life-long disorder; it cannot be cured with medicine. While there is no known cure for autism, there are treatment and education approaches that can address some of the challenges associated with the condition. Intervention can help to lessen disruptive behaviors, and education can teach self-help skills for greater independence. But just as there is no one symptom or behavior that identifies people with autism, there is no single treatment that will be effective for everyone on the spectrum. Individuals can use the positive aspects of their condition to their benefit, but treatment must begin as early as possible and focus on the individual’s unique strengths, weaknesses and needs. (autism-society.org)

According to Autism Speaks (https//www.autismspeaks.org), “We do know that significant improvement in autism symptoms is most often reported in connection with intensive early intervention.

On the other hand, medication can be used to deal with gastrointestinal disorders or problem behaviors that are caused due to autism.

References:

For more information or to discuss how Attentive Behavior Care can help your child, contact us today!

Does My Child Have Autism?

Does My Child Have Autism?

Do you sometimes wonder if your child falls on the autism spectrum? Is your child developing at a different rate than his peers or does he have unusual ways of keeping himself occupied?

There are a number of indicators that a child may be on the autism spectrum, otherwise known as ASD (Autism Spectrum Disorder). Remember that each child is unique and develops at his own pace. It is normal for each child to have his own quirks and behaviors. However, if you can identify with a number of the symptoms below, you may want to seek a professional opinion and an evaluation. Although it may be hard to face a diagnosis, the sooner a child with ASD starts getting intervention, the better his outcome can be.

Communication

Does your child have a hard time communicating at an appropriate age level? A younger child with ASD may have a hard time indicating or requesting his needs, while an older child may point or make gestures instead of using language to communicate. Does he have a hard time describing things, getting stuck on unimportant details instead of focusing on the bigger picture? Does he have a hard time making eye contact or engaging in a back and forth conversation? Do you notice that he often gives answers that have little to do with the question being asked? Language deficits, such as non-verbal communication, failure to make back and forth conversation, and not making eye contact can be associated with ASD.

Social Behavior

Does your child choose to play on his own instead of joining the group activity, whether in class or with a group of friends or siblings? Does he have a hard time engaging in appropriate turn taking during play? Can he play out a pretend story like driving a car to his grandma’s house, getting to grandma’s house and giving her a kiss or does he get stuck in the car driving? Does he have the same way of playing with toys each time he uses them, like lining them up or watching the car wheels spin?

Transitions and Rigidity

Does your child have a hard time with transitions, going from one activity to the next, like stopping to play and getting ready to go to school? Does he have a hard time when there is a change in schedule or plans? Does he get fixated on certain topics that are of interest to him, but not necessarily to anyone else around him? Does he engage in repetitive motor movements or constantly repeat certain phrases? Children with ASD often engage in repetitive stereotypical behavior, inflexible with routines, rigid thinking, and hyper focused on specific topics.

Sensory Processing

Does your child have extreme reactions to noises or textures that others don’t even notice? Does he react adversely to loud noises or regular background noise? Do you find that he is very picky about what he will wear or what texture foods he will eat? Does he seek constant touch or activity? Does he shrink from the touch of others? Perhaps he doesn’t seem to hear or feel what everyone around him is aware of. It is common for children with ASD to have unusual reactions, either overreacting or under-reacting, to noise, textures, lights, smells and tastes.

What Do I Do Next?

If you do think your child fits into a number of the above criteria, discuss your concerns with your child’s doctor. Ask for a referral to a specialist who can give your child a full evaluation If your child does have a diagnosis of ASD, remember that there is help! Behavioral therapy, otherwise known as ABA therapy, can help your child by addressing the negative behaviors he may engage in and developing the skills he needs to function and become the best he can be.

For more information or to discuss how Attentive Behavior Care can help your child, contact us today.

The Definitive Guide to ABA Therapy and How it Can Help Your Child

The Definitive Guide to ABA Therapy and How it Can Help Your Child

By: Jessica Basir and Nahoma Presberg

What is ABA?

ABA stands for Applied Behavior Analysis. ABA is currently the leading treatment which has been scientifically proven to treat the symptoms of Autism Spectrum Disorder.

Let’s discuss what ABA is, and why it actually works.

The technical definition of ABA is: “The science in which tactics derived from the principles of behavior are applied to improve socially significant behavior and experimentation is used to identify the variables responsible for the improvement in behavior” (*Cooper, Heron & Heward, 2007, p. 20).

Let’s break down the key components Cooper is trying to say. Firstly, we address socially significant behaviors. Hold onto that, we’ll come back to it later.

Second, we’re talking about using a scientific process to analyze the contingencies that motivate and act on behavior. By understanding the reasons why behaviors are occurring, we can increase all that good stuff we want to see more of, and decrease the things causing challenges for your child and your family.

What is Social Validity?

Coming back to social validity: Social validity is a huge component of ABA therapy and is what the Board Certified Behavior Analyst® (BCBA®) working on your child’s case will take into account for every program they design. So what is social validity?

Social validity refers to the satisfaction and acceptability of the interventions and procedures effecting behavior change, based on the opinions of the individuals who receive services and implement them. Simply put, this means that YOUR opinion matters and so does YOUR CHILD’s.

Yes, you are under the care of highly trained professionals who have done the research and received the training necessary to implement effective strategies and identify behaviors that need to be increased or decreased, but the science is also founded on the opinions of the individuals on the receiving end.

Social validity also changes based on factors specific to the individuals receiving services. Cultural, religious, and environmental variables may alter what is socially valid in certain families and certain parts of the world.

The main take away from this is that your child’s program is tailored for who he or she is, what he or she needs, and what will make a difference in his or her life. Your child is unique and so are his or her circumstances.

The science of ABA understands this and tailors programming to match these needs, ensuring programs and interventions are effective for each and every individual.

 

 

Now that we’ve learned a little bit about what ABA therapy is, and how it relates to you and your child, let’s talk about some of the specific ways that behavioral interventions are effective. We are going to discuss: functional communication training, antecedent manipulations, generalization, parent training, task analyses, and reinforcement.

Functional Communication Training

Functional communication training (FCT) will most likely be a large part of your child’s ABA program. As we know, one symptom of Autism is difficulty with communication and/or language delays. Functional communication training focuses on increasing functional language. Functional in this sense means communication that has a purpose and is practical.

For example, if your child hits his or her sibling every time he or she wants to play, or cries each time he or she wants you to pick him or her up, he or she is trying to ask for attention, but in a non-functional way. Crying and hitting are behaviors that ABA would want to target for decrease, while teaching your child a functional response as a replacement.

For hitting and crying, we may teach the child to sign the word “play,” to tap their sibling on the shoulder, or verbally say, “Can you play with me.” FCT teaches words, signs or gestures that your child may not currently have, allowing him or her to communicate effectively with you and their environment.

Antecedent Manipulations

Antecedent manipulations refer to changing aspects of an environment in order to either reduce or increase the frequency of a behavior. Many management strategies for problem behavior are focused on how we are reacting to behavior. We refer to this as consequence interventions.

However, antecedent interventions are a proactive approach. When it comes to problem behavior, it is often helpful to utilize antecedent strategies to reduce the behavior in order to allow for an opportunity to increase alternative skills.

We can use antecedent manipulations to increase functional behaviors. For example, if you give a child a bowl of ice cream but no spoon, they might ask you for a spoon so they can eat the ice cream. However, if you gave them the spoon along with the bowl of ice cream, you would have lost the opportunity to practice functional communication.

Creating a lot of situations like this can support a child in the acquisition of functional language because you start with things that they are highly motivated for, and then you can expand to a broader range of language.

Antecedent strategies are also common in behavior intervention plans to reduce problem behavior you want to decrease. For example, if a child tends to engage in problem behavior in order to seek attention from a caregiver, you could provide a lot of attention to the child that is not contingent on engaging in problem behavior.

By increasing the amount of attention they are receiving, you are reducing their motivation to engage in the problem behavior and it is likely to decrease. With a reduction in the rate of problem behavior, there are more opportunities to teach skills to support that child’s ability to get what they want using appropriate methods.

You can teach them to request your attention using a gentle tap on the shoulder and then start ignoring the attention-seeking problem behavior. This combination of interventions results in a “treatment package” that in combination will have lasting results on behavior.

Generalization

Have you ever noticed that your child is able to do something in one environment, but not in another environment? Or maybe they know how to do something with a therapist or babysitter, but have trouble engaging in the same behavior with their teacher or parent?

There are a lot of reasons why a child’s behavior may differ across people or environments. One of the ways that this problem can be addressed is through teaching generalization. Generalization means that a behavior is taught in multiple settings or with multiple people in order to help the child utilize the skills in more functional ways.

Generalization doesn’t just refer to behaviors in different environments or with different people. It also means that you don’t have to teach every single thing a person encounters in their environment. If you teach a child the word for horse using a picture of a horse, and then they see a horse in real life, they should be able to generalize that instruction to know that the real horse is also called a horse.

Many children with autism have trouble generalizing things that they learn to new contexts/people/situations. This can mean that it takes a lot longer to learn because a lot more direct instruction is required. Behavior therapy addresses this by including explicit programming for generalization. A therapist will work with a child on a new skill in multiple environments, with multiple people, and with multiple different examples so generalization can emerge.

Parent Training

Maybe you’ve noticed that your child comes home from school every day with a glowing report from the teacher, but the minute he or she arrives home, all of the problem behavior that you know so well comes right back.

It can be difficult to understand why your child’s behavior can be so different at home than in other environments. Parent training is a critical component of behavior therapy. It ensures that the child is learning consistently across all environments and can support parents in understanding how to respond to difficult situations.

Additionally, working with a professional can be helpful in understanding contingencies in the environment that you might not be able to see if you live it every day. Parent training can also support the acquisition of skills that happen outside of therapy time.

It is not uncommon for parents to experience challenges with daily routines like getting ready for school, getting ready for bed, mealtimes, and hygiene routines. Parent training allows for a parent or caregiver to work closely with a BCBA® to identify specific challenges in those routines and collaborate on solutions for making everyday situations more manageable.

Task Analyses

Task analyses are terrific teaching tools and highly effective teaching procedures that break down a task into smaller components. Think recipes.

A good chef would not throw you into a kitchen and say, “bake chocolate chip scones” without providing you with a recipe or the steps to do so. Task analyses focus on the same method; breaking down one large task into smaller steps that you can learn independently in order to learn the entire task over time.

Some examples of skills where a task analysis may be used could include:

  • Tooth brushing
  • Shoe tying
  • Making a sandwich
  • Doing laundry
  • Hand washing
  • Cleaning a room

The possibilities are endless. How do we know these are effective? It allows specific teaching to occur for one or multiple steps that a learner may be struggling with, and ensure all the smaller skills needed to complete a task have been learned and are efficient.

Back to our baking example: if you didn’t know how to measure flour or roll out dough, how could you make a scone? These steps would need to be taught before you were expected to follow the scone recipe, and this is where a task analysis (or recipe) would come into play.

Task analyses can also help to break down a task that may seem very overwhelming to start. It can be difficult to approach a whole new skill, but if you break it down, then you might find that it isn’t as complicated as you first thought.

Reinforcement

Reinforcement is the most basic principle of ABA therapy and of behavior in general. Reinforcement is the reward for doing a behavior and will increase how much you do that behavior in the future.

Let’s use the example of going to work. You wake up, go to work, come home, and repeat this every day and 5 days per week. Why? Odds are it’s because you are getting paid. Each time your paycheck hits your account, you are reinforced for the behavior of showing up to work, so you continue to do it.

We encounter reinforcement every day and so do your children. ABA understands the principles of reinforcement and uses them to target specific behaviors that should occur more often. Reinforcement can be used to increase all types of behavior. Some examples include:

  • Verbal speech
  • Functional communication
  • Appropriate meal time behavior
  • Appropriate voice volume
  • Independent dressing
  • Safety skills
  • Attending skills
  • Play skills
  • Social skills

The list goes on and on. Reinforcement has been proven to shape appropriate, functional behaviors and is an essential part of every ABA program.

ABA therapy is unique in that it uses scientific principles to analyze specific behaviors and the specific contingencies that surround those behaviors. Other therapies seek to address significant challenges in an individual’s life, but may lack the analytic power to understand those challenges in the same ways. These techniques are the core of many behavioral interventions.

However, every child receives an individualized plan based on their unique needs. This means, that you can be sure that your child is being supported in the exact way he or she needs. It also means that there’s lots of room for parent and family involvement.

 

Behavioral therapy can help, and we can help show you how! Contact Attentive Behavior care today for more information.

 

* Cooper, John O., Heron, Timothy E. Heward, William L.. (2007). Applied behavior analysis. Upper Saddle River, N.J.: Pearson/Merrill-Prentice Hall.

Confronting the Challenges of ASD

Confronting the Challenges of ASD

By: Catherine Tsiris

Let’s Get Personal

I got into this field to help people. I wanted to make a difference, to help make a positive impact on people’s lives. And a day doesn’t go by that I am not reminded in some way that I made the right decision.

When a mom calls me Monday morning to tell me they had a tantrum free weekend, or when I get a text that Johnny let dad brush his teeth, when the child that used to throw herself on the floor when her tablet was removed even briefly independently goes to the work area when the therapist arrives ready to do work, when parents convey to me that their child’s teachers are noticing a positive change, when the child that had a single word in his repertoire a year ago now has over a hundred words and growing, and when week after week I see our children mastering goal after goal, I know I made the right decision.

ABA Therapy Works. Period.

I know ABA is an effective therapy. I have lived and breathed it for over 16 years, but it’s when the parents I work with tell me they see the positive changes ABA therapy made in their child’s behavior and skills, and in their family’s life, I know I made the right decision.

It’s not an easy job and it’s certainly not a glamorous job, but it is immensely rewarding. However, it is also a job where we, the professionals are often isolated. Where the treatment team consists of the child (our client), his or her parents/caregivers, the therapist and the supervisor. At least this is the model I have encountered in many organizations that provide ABA services to children with ASD and their families.

A Different Model

It wasn’t until I started working for Attentive Behavior Care that I encountered a different model. Where the child, their family, and their ABA providers are part of a greater family. An organization that cares about them, and about their child’s progress. They care about helping them overcome their challenges and celebrates their successes.

From the case coordinators who work tirelessly to match families with providers and ensure that each child is receiving top notch ABA services, to recruiters who carefully vet providers, to the clinical team that oversees treatment, to all the folks behind the scenes, every single person in our organization has one purpose in sight. To provide the best possible ABA therapy to each and every child.

I’ve lost count how many times parents tell me how happy they are that the case coordinator checked in with them, making sure they were happy with their services, and how many parents have told me how much they appreciate that their treatment providers go above and beyond for their child.

I think it’s best summed up by something one of my moms said to me:

“I can’t imagine life without ABA now. I can’t imagine going back to how things were. I can get my hair done now! I can take a nap or watch a little TV. ABA has changed my life, and thank God for my neighbor who told me about Attentive Behavior Care.”

Do you think your loved one could also benefit from ABA therapy? Enroll today or contact us for more information.

Behavioral Therapy Techniques That Actually Work

Behavioral Therapy Techniques That Actually Work

By: Heyde Ramirez MA, BCBA, NYS LBA & Frank Kou MSEd, BCBA, NYS LBA

When a family receives ABA therapy, oftentimes parents wonder: “What is happening?” and “What is this person doing to my child that is helping?” The most important question they ask is, “Will this work?”

To help concerned parents wondering if ABA is the right therapy for their child, here are five behavioral therapy techniques that actually work to help reduce problem behavior.

1 – Differential Reinforcement of Alternative Behavior (DRA)

Using this technique, a problem behavior is reduced by reinforcing a different behavior. For example, John hits his peers to get their attention. During ABA therapy, John gets lots of attention and praise for using his words instead of hitting others to gain attention. John learns to use his words because he can earn the attention he seeks without hurting others. The DRA in this example is getting attention for “using words” instead of “hitting.”

2 – Differential Reinforcement of Incompatible Behavior (DRI)

Using this behavioral therapy technique, a problem behavior is reduced by reinforcing the complete opposite behavior. For example, John always gets up from his seat in class, which gets him attention when the teacher yells at him. During ABA therapy, John gets attention and praise for being in his seat, which he likes. John learns to remain in his seat in class. The DRI in this example is getting attention and praise for being in his seat rather than getting up from his seat.

3 – Differential Reinforcement of Other Behavior (DRO)

Using this technique, a problem behavior is reduced by delivering reinforcement when that problem behavior does not occur during specific times. For example, John likes to pull strands of his hair when he does his work. During ABA therapy, a 5-minute timer will be set and John will get rewarded for not pulling his hair during the 5 minutes. When he pulls his hair, the timer is reset. The DRO in this example is being rewarded for not pulling his hair.

4 – Premack Principal

Using this behavioral therapy technique, an ABA technician will encourage a child to complete a non-preferred activity by following the activity with the opportunity to complete a highly preferred activity. Think of this like Grandma’s Rule: “First eat your broccoli and then you can have desert.” This increases the probability that the child will complete the non-preferred activity. For example, John does not want to complete his math homework because it is hard and boring. During ABA therapy, John gets to watch his favorite cartoon only after he completes his math homework.

5 – Token Economy

Using this technique, a child learns how to earn tokens for engaging in positive behavior. These tokens can then be exchanged for a variety of preferred items and activities. Think of this like an allowance: “If you clean your room, you will earn $2 towards your video game.” Not only can this technique be effective for teaching new skills, but it also helps teach children how to tolerate instruction for increased periods of time and respond to more natural conditions of reinforcement (e.g., earning money to buy something vs. earning the item itself). For example, John’s teacher notices that he is not participating in class. During ABA therapy, John is given a token every time he raises his hand to participate in class. At the end of class he exchanges his tokens for time to play his favorite iPad game.

These are just a few of the many ABA techniques that can be used to increase desirable behavior and decrease non-desired behavior. Remember, ABA is a toolbox where the data guides the treatment, so techniques should always be tailored to the individual needs of the child, guided by the data, and overseen by a qualified professional such as a BCBA® or Licensed Behavior Analyst.

For more information on how Attentive Behavior Care can help your child, contact us today.

What is ABA Therapy?

What is ABA Therapy?

ABA stands for Applied Behavior Analysis. ABA is an evidence-based approach to treating individuals with Autism Spectrum Disorder (ASD). ABA is backed by decades of research and has helped countless children diagnosed with autism learn new skills and gain greater independence.

The goal of ABA therapy is to improve meaningful behavior in real world, every day settings using techniques that are based upon the principles of behavior. ABA therapy applies an understanding of behavior to affect real life situations. The goal of ABA therapy is to increase helpful behavior in your child and reduce behaviors that are harmful or negatively affect learning.

Research has shown that ABA therapy is one of the most effective treatments for individuals with ASD. ABA therapy can help your child learn new skills and gain greater independence. It can also help to reduce problematic behavior. It can teach critical life skills—including language skills, communication skills, social skills, and daily living skills—which are the building blocks of success.

ABA therapy increases your child’s opportunities for meaningful personal relationships and involvement in the community. It can also help him or her manage throughout the day and become successful in school and at home, all while decreasing difficulties to learning.

How Does ABA Therapy Work?

ABA is a recognized and effective treatment for children with Autism when performed in a high-quality and intensive manner. ABA often utilizes positive reinforcement to increase desirable behaviors and advance the skills of the child. ABA therapy utilizes a research-based approach based on the principles of behavior. ABA programs are driven by data, so success can be measured and programming can be adjusted if the treatment is not effective.

A Board Certified Behavior Analyst (BCBA) is the primary provider of ABA therapy services. BCBAs establish concrete ways to measure behavioral changes and improvements and identify whether behavior modification is appropriate or not. A BCBA must have a master’s degree or doctorate degree in behavior analysis or psychology and must take and pass a certification exam that recognizes specific training in the principles of applied behavior analysis. Some states require an additional license for the BCBA as well.

ABA therapy programs also involve ABA therapists – sometimes referred to as Paraprofessionals or Registered Behavior Technicians (RBTs). Therapists are trained and supervised by a BCBA. They interact directly with patients and work toward the specific and individualized goals written by the BCBA, typically in a 1:1 setting. It is common for more than one ABA therapist to work with a child.

ABA therapy programs are highly individualized, and each treatment program will differ from one child to the next. Your child will be guided through an assessment process and a treatment plan with appropriate goals will be developed. Your child’s plan will then be implemented through regularly scheduled sessions either in your home or at a location of your choosing.

For more information about ABA therapy and how it can work for your child, please contact us today.