How Can I Help Reinforce at Home What My Child Learns in ABA Therapy?

How Can I Help Reinforce at Home What My Child Learns in ABA Therapy?

By: Megan Miller, MSED, BCBA, LBA

Perhaps this is your first experience with ABA therapy, or maybe your child has received services before. Either way, collaboration/caregiver involvement is key for maximum effectiveness when using applied behavior analysis as a treatment option. Think about it, your child may be receiving 10-20 hours a week of ABA therapy, and while that may seem like a lot and a therapist may be in your home working with your child every single day of the week, this also means that a therapist is not present for 148-158 hours of that week. When you think of it from this perspective, how can you ensure that your child still works on these crucial skills when they are not receiving direct therapy services?

Observation

The best place to start is simply observing your child’s session and becoming familiar with the programs that are being run on a daily basis. If you don’t understand something, ask questions! The therapist will be able to explain the skills that are being taught and can also model the teaching procedures for you. It is recommended that you learn a few of the programs that your child is working on and set aside a time to work on them at home using the same techniques as the therapist. The best skills to begin practicing at home are skills that your child is already doing well with so that they will be successful.

Reinforcement

One of the most often used strategies in ABA is reinforcement. The definition of positive reinforcement is “when a behavior is followed immediately by the presentation of a stimulus that increases the future frequency of the behavior” (Cooper, Heron, & Heward, 2007). It is important to keep in mind that just because the child might like something, it doesn’t mean that it will be an effective reinforcer. A true reinforcer will increase the likelihood of a desired behavior happening. When choosing reinforcers, it is important to ensure that the reward is worth the amount of work and effort that the child is expected to exert. Remember – if the desired behavior is not increasing, then your reinforcer might not be effective.

Tips for Reinforcement

Individualize rewards: Whatever your child is interested or motivated by in a particular moment can be used as a reward to reinforce the child for completing a task that was asked of them. This could be playing a game of chase, eating a favorite snack, or playing with a specific toy.

Make yourself the ultimate reinforcer: Teach your child that you are the giver of all good things. Let them know that all of the fun things they love will be available to them when they are working with you. This will motivate them further to want to work with you, as it indicates that good things are coming their way.

Be specific with your praise: Whenever you are rewarding your child for doing something well, be sure to indicate exactly what they did to receive that reward. For example, instead of just saying “Good job” you should say, “Great job matching the letter A!”

Reinforce immediately after the desired response: Ideally, you want to deliver your reward as quickly as possible after the child responds correctly. For example, if you ask your child to match the letter A and they do so correctly, you would want to say “Great job matching letter A” as you give them a piece of a cookie. Delaying reinforcement can inadvertently reinforce another response or behavior. For example, if you ask your child to match the letter A and they do so correctly, then they engage in yelling as you’re delivering reinforcement, they may think that they were just rewarded for the yelling as opposed to the matching. If this continues to happen, it is likely that the child will engage in yelling more often because they think they get rewarded for that behavior.

Behaviors

Many children may be receiving ABA because they have behaviors that interfere with learning or day to day functioning. Discuss the current targeted behaviors with your BCBA® and learn the strategies that are being used to help reduce these behaviors and increase replacement behaviors. Always keep the phrase “Catch them being good” in the back of your mind. What this means is that you should always being looking for opportunities to reinforce your child for doing appropriate things. For example, if you know that your child has a tendency to get up out of their seat often, but you notice that they are sitting nicely, use this an opportunity to reward them for doing the right thing. Remember – reinforcement increases the likelihood of a behavior happening again!

Communication

A lot of children on the spectrum have difficulty communicating their wants and needs with others. Every good ABA treatment program will include some type of goals to help the child to increase or expand upon their current level of communication. Whether your child is working on exchanging pictures, using sign language, a speech output device, single words, or complex sentences, the same expectations should be set across all people and settings. This means that if during ABA sessions, the therapist is having the child request items using a 3 word sentence, then everyone else should make sure that they are only giving that child them item for requesting it with 3 words. If the family provided requested items to the child when they only used a single word, the child would learn that ta single word is acceptable (at least when requesting from that particular person). This can potentially cause behavioral issues when the child tries to request an item from the therapist by using a single word and is then denied the item because the expectation is for them to use a 3 word phrase.

Parent Training

Parent training is part of every child’s treatment plan and is a crucial component. Parents will be provided with time where they can meet one on one with the BCBA® assigned to their case. During this time, parents will learn about ABA procedures and receive first hand training on how to implement their child’s programs appropriately. Parents may be asked to perform skills with their child while being guided by the BCBA®. Parents might also be taught how to record data in order to monitor their child’s progress.

Generalization

Generalization is a key component in any ABA treatment program. Generalization means that the learner can apply the skills that they have learned to outside the learning environment, across various people, materials, and settings. Any time a parent works on skills at home or within the community with their child, they are promoting generalization of skills. It is important to keep in mind that the ultimate goal is to have the child independently display the skills that they have been taught.

Resources for Parents:

The following resources will help you to learn how to use reinforcement to increase positive behavior at home.

 

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

What to Expect From ABA Therapy

What to Expect From ABA Therapy

By: Julie Bates, MA, BCBA, NYS LBA

Your child has a diagnosis of Autism Spectrum Disorder and is starting ABA therapy. Perhaps you are wondering what that entails? What is ABA exactly? What is the process to begin ABA therapy? What happens during an ABA therapy session? What should I expect?

 

What is ABA?

ABA (Applied Behavior Analysis) is considered an evidence-based best practice treatment for Autism Spectrum Disorder by the US Surgeon General and by the American Psychological Association. “Evidence based” means that ABA has passed scientific tests of its usefulness, quality, and effectiveness.

ABA therapy applies our understanding of how behavior works to real situations. The goal is to increase behaviors that are helpful, such as communicating with others, and decrease behaviors that are harmful or affect learning, such as aggression.

Positive reinforcement is one of the main strategies used in ABA. When a behavior is followed by something that is valued (a reward such as verbal praise, a tangible item or activity), a person is more likely to repeat that behavior. Over time, this encourages positive behavior change. Reinforcers vary for each individual child and may change from moment to moment.

 

It Starts With an Assessment

A Board-Certified Behavior Analyst (BCBA®) will assess your child to determine what goals will be beneficial to them. This assessment will very likely occur in your home. You will be asked questions about what your child is able to do and what areas are difficult for them. Based on the assessment, reviewed reports, and input from parents, the BCBA® will develop a treatment plan.

There will be goals selected to increase skills that we want your child to learn and goals to decrease any behaviors that may interfere with your child learning and functioning to the best of their ability. To decrease interfering behaviors, the behavior analyst will develop a behavior intervention plan for your child. After these goals are selected, the behavior analyst will select smaller objectives within each goal to begin.

These goals will include working on increasing language and communication skills, increasing play and social skills, and reducing behaviors that may be interfering with progress, such as leaving the work area or aggressive behaviors. Alternative, more appropriate skills will be taught to replace interfering behaviors. The individual treatment plan will continually be updated with new goals as your child acquires skills.

Your treatment team will consist of a BCBA® and one or more therapists. The therapist will provide much of the direct treatment hours and the BCBA® will monitor progress across your child’s goals. The BCBA® will provide direct supervision to the therapist based on the number of hours your child is receiving direct treatment.

 

A Typical Day of ABA Therapy

The BCBA® and therapist’s goal is to have your child be excited and looking forward to each session. An ABA therapy session in the child’s home will look a bit different for every child as it is unique and individualized for each learner. Therapy is usually for an hour to several hours at a time depending on each individual child. The first few sessions will be about fun and play rather than working on specific goals. The therapist will be “pairing” with your child. They will begin to develop a rapport with your child and will get to know what activities your child likes, such as games, toys, high fives, hugs, and snacks.

Once your child is more comfortable with the therapist and the therapy environment, the work can really begin. The therapist will keep demands to a minimum at first and then slowly begin to increase demands. Reinforcers, or rewards, will be used to increase learning and appropriate behavior. Reinforcers may include high fives, verbal praise, tangible items, snacks, tokens, and many other possibilities. A reinforcer is dependent on what your child prefers and is motivated by.

ABA therapy is conducted through Discrete Trial Training (DTT) and Natural Environment Training (NET).

Discrete Trial Training (DTT) is a method of teaching in simplified and structured steps. Instead of teaching an entire skill at once, the skill is broken down and then “built-up” using discrete trials that teach each step one at a time. It includes presenting an antecedent, the child’s response, and the therapist providing reinforcement for a correct answer or a correction for an error. Often, DTT will be done at a desk or a table like when your child is at school. Trials may be presented in blocks of ten or twenty consecutively, allowing for learner to have more opportunities to practice the skill. This is a very effective way to teach new skills quickly.

Here is an example of a discrete trial teaching for identifying foods (apple):

  • Therapist: presents a picture of apple and cookie and says “Point to apple”
  • Learner: points to the apple
  • Therapist: “Great pointing to apple. You did it!” (May give child a tangible reward).

Natural Environment Teaching (NET) is a method of teaching for when skills are taught or generalized within the natural environment. For example, during DDT you might teach a student to receptively and expressively label colors of items at the table. Then, during NET the student would get to practice the skill by labelling colors of crayons that you’re coloring with or asking for colors of Playdoh that you’re playing with. NET is also very useful in teaching play skills and social skills to a learner while prompting generalization of newly acquired skills.

This is an example of natural environment teaching (label colors).

  • Learner: is painting a picture at an easel.
  • Therapist: asks “What color?” and points to (the color) red on the paper.
  • Learner: responds “Red”.
  • Therapist: “Correct, that is red”.

A combination of DTT and NET will likely be used with your child during an ABA session. Each session the therapist will take data on your child’s progress for each target or goal. The BCBA® will review progress and intervene when necessary or add additional goals for your child as they master current goals. Again, ABA therapy is individualized for your child.

 

Caregiver Involvement

Caregiver and family involvement are a very important part of ABA therapy. Parent training is provided by the behavior analyst. This is very beneficial as it allows continuation of the treatment outside of therapy sessions and to other settings with the child’s family members. This may include parents, siblings, and other caregivers. It gives these family members the tools to maintain the child’s new skills, promote generalization in the natural setting, as well as techniques for managing behavior issues. Parents play an essential role in the child’s treatment plan because no one knows the child’s needs and personality better than the parent.

 

References:

Cooper, J., Heron, T., & Heward, W. (2007) Applied Behavior Analysis, Second Edition. Upper Saddle River, NJ: Pearson Prentice Hall.

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.

What Do We Do in ABA Therapy and Why?

What Do We Do in ABA Therapy and Why?

By: Jacob Papazian MS, BCBA – Regional Clinical Director, Michigan

Applied Behavior Analysis (ABA) has become an incredibly popular treatment for individuals diagnosed with Autism Spectrum Disorder and Developmental Disabilities (Foxx, 2008). ABA is a loaded acronym that includes a long list of skills and techniques all based on the basic science of behavior. Board Certified Behavior Analysts (BCBAs®) are trained to identify behaviors of interest, assess the reason(s) why they occur, and create plans to teach alternative behaviors that are more appropriate.

Those are all great things, but you may observe the BCBA® or technician working with your child and wonder “why are they doing that?” or “what on earth did I sign myself up for?” BCBAs® do things that seem counterintuitive or just plain strange. Our goal is to demystify some of the stranger practices in ABA and explain our backing in science.

Assessment

The first step in any treatment process is the assessment. Very little you will ever do in the ABA process is more important than this initial assessment. This is the first of many opportunities to ask questions, express concerns, and discuss your hopes and dreams for your child. The BCBA® likely asked numerous questions that were overwhelming. This is normal. A good treatment plan has an exhaustive record of medical, psychological, developmental, educational, and social history. After what probably felt like a grueling conversation, the BCBA starts working with your child pulling out toys, books, and enough laminated/velcroed pictures to cover your walls. The formal testing portion of the assessment is used as a “baseline” or starting point for treatment. This way, the BCBA® can gauge just how much progress was made over time.

Treatment Planning

Once the assessment was done, you likely received a formal treatment plan that looked more like a manuscript for a novel. This treatment plan, only partially written in plain English, is the document that provides your insurance company with information about what the plan is for the next six months. You will likely come across technical jargon that makes no sense. You may find things referencing “manding,” “tacting,” or “stimulus control.” Behavior Analysis, by definition, includes seven core dimensions: one of them focusing on using technological language that ensures continuity between providers, just in case another clinician needs to step in. it is also more efficient in the writing process. However, your BCBA® should make the time to answer any question(s) you have and translate the document from behavioranalyticease to English. Never be shy to question what you are reading and ask for clarification.

Intervention

BCBAs® do strange things when they are working with your child. Technicians will follow plans created by your BCBA® that just seem counter-intuitive. They will stretch their face like a cartoon character over the smallest things and repeat questions and activities over and over. Your BCBA® may ask you to take data about behaviors that might seem insignificant or to do and say things that seem strange. There is a reason for all of these things occurring.

First, and most importantly, behavior analysis thrives on the concept of reinforcement. Reinforcement, simply put, is providing some type of reward for engaging in the correct behavior. Think of this like your paycheck at work. You deserve to be compensated fairly for your time and effort. If you were not going to be paid, would you continue to work? Probably not! Behavior Analytic interventions operate on the same principle. Your child will be expected to complete tasks and engage with the technician, but will receive their own version of a paycheck in a variety of ways like games, music, snacks and other preferred activities and items.

Reinforcement has specific rules. It should only be given, in most cases, when the person has done something correctly. This is why BCBAs® start out small, sometimes with skills your child may already have. The BCBA® may have to teach your child that in order to get something, they have to do something. There is no easier way to teach that skill than having your child complete an activity they are able to do with minimal effort. Teaching procedures use a similar idea. Skills are broken down into small component pieces called “discrete trials” and repeated several times in a row. By breaking skills down they are less intimidating and easier to learn. Most often, these discrete trials are run consecutively five to ten times. Research has shown that when an individual practices the same skill in short bursts like this, sometimes called discrete trial training, the skill is learned faster (Lerman, Valentino, & LeBlanc, 2016).

You may have also noticed that your technician uses very short phrases when working with your child and rarely speaks in full sentences when giving instructions. This is actually incredibly important. Although it may seem odd to speak in short sentences, BCBAs® have found that the shorter the instruction the better the result (Dickenson & Wit, 2003). As the number of words increases, comprehension decreases significantly. By keeping sentences short and to the point, compliance from your child is likely to follow. As your child’s language grows, so will the length of your technician’s interactions. As for the teaching itself, there is lots of hands on practice. And by hands on practice, we mean the technician is guiding your child’s every step. This is something called “errorless learning.” Again, more research has shown that the more errors you make, the more likely you are to do them in the future (Mueller, Palkovic, & Maynard, 2007). By starting with lots of help and slowly cutting it back (fading) we may have better results.

Problem Behavior

If your child engages in problem behavior you will have likely heard your BCBA® say: “all behavior is communication.” Although true, it is not incredibly helpful at the very beginning. The clinician is likely to first start with asking you questions about what you do when the problem behavior occurs. This may feel invasive, but it is only intended to understand what you normally do in response to problem behavior. Nobody is perfect. More importantly, your BCBA® is not there to judge you for offering a candy bar to keep your child distracted while you go through the grocery store at a dead run. (The author of this blog having done that a few days previously!) In some cases the BCBA® may actually perform an experiment where they want you to give in to the problem behavior. They may ask you to take away the toy they are playing with, provide tons of attention for screaming, or tell them that they do not have to eat that broccoli. It is crazy to think that the BCBA® would be happy to see problem behavior occurring. But their job is to try and find a pattern and sometimes finding that pattern means giving in. We call that a Functional Analysis (Iwata et al., 1994). Once that pattern emerges, it’s time to roll up your sleeves and start intervening.

Then things can get even stranger. Charts start flying everywhere, dollar store stickers come pouring out of the BCBAs® bag, and you are now expected to play interventionists. Your BCBA® is probably looking at you with a wide smile and beaming with enthusiasm for the behavior plan they just created. As the parent, all you may see are ten new things to remember to do on top of the 30 other responsibilities you have. This is normal. You are allowed to be overwhelmed. BCBAs® are trained to not only be effective at changing behavior, but also how to work with families. Speak up and express your concerns if the behavior plan seems overwhelming or complicated.

Your BCBA® may ask you to do any number of ridiculous activities: tell your child maybe later, tell them to clap their hands, have them repeat nonsense syllables three times in a row. Just remember that there is a reason for every intervention. Recall those core dimensions of Behavior Analysis we mentioned earlier? One of them is “effective.” This means that BCBAs® only implement interventions that are proven to work based on research. And that research is peer reviewed, scrutinized, and validated several times over before it is accepted as a practice. Despite the evidence, you may feel like you are wasting your time or that it is not working. That is normal. BCBAs® expect there to be a bit of a lag between when the intervention starts and when progress is more noticeable. You can definitely teach new skills to your child, but it is going to take time. Your child will have to unlearn all of their usual ways to get what they need or what they want in order to make room for the new skills that you are trying to teach. Think about how long it takes you to pick up a new habit. It is the same way for your child.

We Made It!

From the day that you received a diagnosis of ASD for your child, you have been on a journey. That journey may have brought you to the field of ABA. Perhaps you are involved in a treatment regimen now. Maybe you are reading this blog trying to see if ABA would a good fit for you and your family. BCBAs® do a lot of strange things, but all in the name of helping your child grow and have the best developmental experience possible. Additionally, they are here to be a guide on the journey. Speaking as a BCBA®, I have had the honor and privilege of working with some of the most hard working and dedicated families. I have laughed and cried with them. I have joined them in celebrating the major milestones, and shared in their frustration over less than effective interventions. I have written my fair share of strange behavior plans and have had the look of utter bewilderment pass over my parents’ faces. Despite this, we were able to make effective change because we worked together as a team through the ups and downs. We may do strange things, but together they will become great things. In the words of Derice Bannock: “Cool runnings. Peace be the journey.”

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

 

References

  • Foxx, R.M. (2008). Applied behavior analysis treatment of autism: The state of the art. Child and Adolescent Psychiatric Clinics of North America, 17(4), 821-834.
  • Dickinson, A., & Wit, S.D. (2003). The interaction between discriminative stimuli and outcomes during instrumental learning. The Quarterly Journal of Experimental Psychology 56B(1), 127-130.
  • Iwata, B.A., Dorsey, M.F., Slifer, K.J., Bauman, K.E., & Richman, G.S. (1994). Toward a functional analysis of self-injury. Journal of Applied Behavior Analysis, 27(2), 197-209.
  • Lerman, D.C., Valentino, A.L., & LeBlanc, L.A. (2016). Discrete trial training. Early Intervention for Young Children with Autism Spectrum Disorder, 47-83.
  • Mueller, M.M., Palkovic, C.M., & Maynard, C.S. (2007). Errorless learning: review and practical application for teaching children with pervasive developmental disorders. Psychology in the Schools, 44(7), 691-700.
What Does a Behavior Analyst Do?

What Does a Behavior Analyst Do?

By: J M Coimbra, MS, BCBA, LBA

Scrolling through a list of occupations on an electronic document, I don’t see my title – behavior analyst. I’m forced to choose the closest option, but what is it? I’m left contemplating, “What does a behavior analyst do?

The short, first response to this question is “analyze behavior.” Seeking a better description, I reviewed the Behavior Analyst Certification Board’s (BACB) website to find a similar description, if not more ambiguous – behavior analysts are “practitioners who provide behavior-analytic services.”

Alright, so we do behavior analysis – what is that? Applied behavior analysis (ABA) by the definition found in my fundamental, graduate-program textbook, is “the science in which tactics derived from the principles of behavior are applied systematically to improve socially significant behavior and experimentation is used to identify the variables responsible for behavior change.”

Basically, the work of a behavior analyst is to make evidence based changed to an environment to affect behavior positively and systematically.

Also, check out this video, made by the BACB, which provides an overview of behavior analysis:

But how does it all translate to the more palatable occupation titles?

Advocate

Sooner or later it is the role of a behavior analyst to be an advocate – to fight for the rights of our clients. It is in the very definition of ABA that the science focuses on understanding and improving behaviors that are socially significant. That means, we change behaviors that are important to change that result in improved conditions. We fight to be ethical and fair to the client. This can take the form of teaching the client to stand up for himself or herself in unfair situations or even supporting the best interests of the client ourselves during attempts to coordinate care with others.

Consultant

As challenges arise, questions amount. Why is this happening? What do we do about this problem? Where did that action come from? It is the job of the behavior analyst to act as consultant for their clients, whether it be a family, a school, or organization. We are given a list of variables, we generally observe these variables, come up with solutions, and develop plans to realize those solutions. We may serve as a consultant for an isolated occurrence (e.g., a single assessment) or we may work for years with a client shaping continuous change and development.

Educator

One of the most generalized roles that a behavior analyst has is to educate. Yes, we can go in and cause behavior change in our presence. However, more often than not, the real concerns will not be addressed until members of the normal environment (parents, bosses, teachers, etc.) learn how to do some of the basic techniques of ABA (e.g., differential reinforcement, prompting, programming, etc.).

Engineer

Even though we teach technicians, caregivers, and other practitioners the basics of ABA, behind the scenes, we are engineering complex behavior change plans. One truism from my graduate program is ‘Behavior does not occur in a vacuum’. The solution to a behavior problem may be delivering a gummy bear at a specific time, but coming up with a contingency diagram and evaluating all variables in the setting to determine exactly when, how much, and by whom that gummy bear should be delivered requires true engineering.

Philosopher

If behavior analysis were to be considered a natural science (see the behaviourologists for the argument that it should be), it would seek to answer why behavior happens. Let’s also remember that just about everything an organism does is behavior. Crime and punishment, religion, ethics and values – all of these philosophical topics can be viewed through the lens of behavior analysis – and have been by Skinner (e.g., in About Behaviorism). Behavior analysts commonly work in micro-environments now, but the potential to produce meaningful change in communities and macro-environments exits using the laws of behavior, in which behavior analysts specialize.

Psychologist

Take Psychology 101 at any university and without question, you will come across the behaviorism section that focuses on some of the old scientists, like Pavlov and Watson. You will learn about how salivating can be shaped just like a phobia can be shaped. Behavior analysts shape processes that occur in the “mind” like any other psychologist may, but we do it using the principles of ABA. We consider reinforcement history and derived relations, for example. We look at a personality as a behavioral repertoire and we enhance that personality by teaching new skills and replacing undesirable behaviors with desirable ones.

Scientist

With clipboards, tablets, and/ or clickers in hand, you will see us behavior analysts, always collecting data. We use data to inform our decisions (inductive examination) so that we remain unbiased. We write our procedures using specific, technical, objective language, so clear that another behavior analyst, who is unfamiliar with the intervention could implement the program. Behavior analysts systematically evaluate behavior change variable by variable and determine interventions based on evidence taken for each individual.

Social Worker

Just like behavior does not occur in a vacuum, and organism does not exist independent of a network. It is the case for many behavior analysts working with individuals, that the social system in which the individual is enmeshed is also examined. Behavior analysts ensure the safety and well-being of their clients and are mandated reporters in cases of neglect and abuse. We try to help clients and their families or those in their networks cope with disability, disadvantage, trauma, and other social deficits or challenges.

Student

Proudly behavior analysts have a commitment to continuing their education. Not only are the attitudes of science drilled into us during our formal education, but the BACB requires all board certified behavior analysts to received approved continued education credits to ensure we are utilizing the most up-to-date, evidence based practices relevant to the populations we serve. Conferences are offered multiple times a year and the BACB has approved countless other resources (e.g., webinars, videos, seminars, etc.) that are available even from our own homes.

Supervisor

The Board Certified Behavior Analyst may have a formal role of supervising students, Registered Behavior Technicians, and those seeking board certification themselves. The role of supervisor requires preparing educational materials, delivering feedback, modeling procedures, testing skills, meeting regularly, and guiding supervisees through the ethical guidelines and practice of ABA. Furthermore, behavior analysts may be supervisors, who manage a clinic or manage other behavior analysts. Since it is less likely that a behavior analysts works alone for a client, we at a minimum supervise an intervention team for each client – whether it be a technician or a faculty.

Writer

Aside from writing the occasional blog, which may not be so common for the average behavior analyst, we write proposals, behavior change plans, behavior intervention plans, insurance-based progress reports, analyses of assessments, manuscripts, teaching procedures, recommendations, translations, books, tips, and anything else to help produce the results we seek.

So given all of these roles – what might a behavior analyst do in a typical day? Well, it varies greatly because of all of the roles and because of all of the fields in which a behavior analyst may be employed – autism & intellectual disorders, behavioral gerontology, behavioral pediatrics, clinical behavior analysis, education, health, fitness, & sports, organizational behavior management, intervention in child maltreatment, and sustainable practices. However, I can give a basic rundown of my typical day as a clinical supervisor in the field of autism and intellectual disorders.

A Day as a Behavior Analyst at Attentive Behavior Care

At 9:00, I begin my day doing some treatment planning so that I can slowly sip my coffee. I access the electronic data for a specific client and look at the data that have been collected over the last week or two, since my last treatment planning session. I look at the graphs to see if the interventions I have in place are effectively changing behavior (scientist). I input updated goals as some had been mastered and I write a teaching procedure for the technicians, who work with the client daily, so they know how to target that goal (writer).

By 10:00, I travel to a school, where I have a meeting with the school professionals, who are writing a new Individualized Education Plan for another one of my clients. Here I present data to support interventions that address my client’s needs best (advocate). I coordinate care with the teacher, when he asks me about a new problem behavior. We discuss the events that occasion the behavior, and I offer to conduct an observation the following week (consultant).

By 12:00 I begin traveling to a client’s home. En route, I turn on a podcast about feeding procedures that informs me for behaviors I plan to target in the next authorization period (student).

At 1:00 I arrive to the client’s house for parent training, and I help the parents practice following through with demands and giving reinforcement equal to their child’s effort in a given task. I prompt them and explain the rationale for more reinforcement or less in each trial (educator). Following the training, my client’s parents reveal to me that they are in need of additional support for respite services and seek guidance (social worker).

At 3:00 I am at clinic, where I take an hour to review a new client’s initial assessment. I review the qualitative data collected during observation and the quantitative data collected during formal assessment, and I create a plan for intervention (engineer). I see this client has stereotypical behavior and fixates on objects obsessively, and hypothesize other stimuli that I could use to expand his interests to vary his thoughts and interests for enrichment (psychologist).

When my next client is home at 4:00, I arrive to oversee the treatment fidelity of one of the technicians working with this client (supervisor). I provide feedback and instruction. She asks me a broad question about why a method is selected over another, and why it works, and if that method works then why does another exist and I tell her to email me or schedule a time to chat about it outside of session time (philosopher).

Each day will be different as a behavior analyst, but each day a behavior analyst will do his or her best to make meaningful change to improve lives – to achieve better living through behavior analysis.

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

Better Understanding the Principles of ABA

Better Understanding the Principles of ABA

By: Frank Kou, MSEd, BCBA, NYS LBA

What Are the Principles of ABA?

In order to learn and understand them, one must know what ABA is. Applied Behavior Analysis (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).

Three Terms of Applied Behavior Analysis (ABA)

1) Applied – In terms of ABA, it is the commitment to affecting improvements in behaviors that enhance and improve people’s lives. In addition, it is also to improve the relationships of the client with his/her environment including the interactions with those around him/her. Practitioners must select behaviors to change that are socially significant for the client that may include but not limited to social, language, academic, daily living, self-care, vocational, and/or recreation and leisure behaviors.

2) Behavioral – In terms of ABA, behaviors must meet three criteria. First, the behavior in question must be the behavior in need of improvement. It cannot be a similar behavior that serves as a proxy for the behavior of interest or another person’s description of the behavior. Second, the behavior must be observable and measurable. Behaviors have to show change over time. Third, when changes in the behavior do occur, it is necessary to ask whose behaviors have changed. Is it that of the clients or that of the practitioners? All behaviors of the both parties should be monitored if possible.

3) Analysis – In terms of ABA, analysis is analytic meaning that there was a demonstration of functional relation between the manipulated events and a reliable change in some measurable dimension of the targeted behavior. In other words, the practitioner can control the behavior from happening or not happening.

Applied Behavior Analysis Principles

By using ABA principles, practitioners can support individuals in multiple ways that may include the following:

  • Teach new skills that an individual previously did not have. For example, teaching an individual how to use utensils when eating when previously individual only used fingers to eat.
  • Increase positive and/or more socially acceptable behaviors. For example, having individual greet a peer or attend to a speaker.
  • Maintain behaviors. For example, having an individual continue with a conversation using skills that were previously learned.
  • Generalize or transfer behaviors from one environment and/or person to another environment and/or person. For example, having an individual put on his/her coat both at home, and at school.
  • Reduce interfering or challenging behaviors. For example, reducing an individual’s out of seat and wandering around the classroom behavior.

Using Applied Behavior Analysis in the Real World

Now that Applied Behavior Analysis and its principles have been discussed, how is ABA used in the real world? Practitioners use the ABC model in order to observe and change behaviors. ABC stands for antecedents, behaviors, and consequences. Each of the components will be discussed below.

a) Antecedents – Antecedents are situations or events that come before a behavior. Oftentimes they are described as the “trigger” for the behavior that follows. An antecedent can have many forms ranging from an event (i.e. loud phone ringing), to a person (i.e. regular teacher versus substitute teacher), or an object (i.e. stop sign) in the environment that cues a person to do something. An example of an antecedent is child having a tantrum because teacher said it was time to come in from recess {antecedent}.

b) Behaviors – Behaviors are any actions that can be observed, timed, or counted. Everything that a person does can be described as a behavior. In ABA, practitioners try to understand “why” or the function of the disruptive “problem” behavior in question in order to change it for the better. There are four main functions for behavior: 1) Escape or avoid a situation 2) Attention from other people 3) Tangible – to gain access to something he/she wants 4) Sensory – pleasing to the person “automatically rewarding.” When working with behaviors, it is important that the behaviors are described in specific details in order for all parities involved to observe and measure the same thing. For example “tantrum” is vague versus screaming in a loud voice and stomping a foot against a hard surface, which is a better description.

c) Consequences – Consequences is the term used to describe what happened immediately after the behavior occurred. It is also known as a response to the target behavior. Consequences can occur in two different ways. The first is natural in which they are the inevitable result of the person’s own action. For example, a person gets burned and hurt for touching an open flame. The second is logical in which they are imposed by another person, usually an authoritative figure. For example, a person receives a ticket by the police for speeding.

In the real world, practitioners use the ABC model to get a better understanding of the behavior in question. By manipulating the antecedents and/or consequences of the behavior, practitioners can increase a positive behavior, decrease a problem behavior, or maintain a behavior.

References:

  • Bearss, K., Johnson, C.R, Handen, B.L., et.al. (2018). Parent Training for Disruptive Behavior – The RUBI Autism Network. New York, NY: Oxford University Press.
  • Cooper, J., Heron, T., & Heward, W. (2007) Applied Behavior Analysis, Second Edition.  Upper Saddle River, NJ: Pearson Prentice Hall.
  • Lovaas, O. I. (1987). Behavioral treatment and normal educational and intellectual functioning in young autistic children. Journal of Consulting and Clinical Psychology, 55(1), 3-9.
  • https://www.behaviorbabe.com/
  • https://vcuautismcenter.org/resources/factsheets/printView.cfm/982

 

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

What Jobs Can You Get With a Behavioral Analysis Degree?

What Jobs Can You Get With a Behavioral Analysis Degree?

By: Jacob Papazian MS, BCBA – Regional Clinical Director, Michigan

Applied Behavior Analysis (ABA) is most commonly associated with intensive intervention for developmental disabilities. A quick search on Indeed.com in the Southeast Michigan area brought up 12 different companies asking for Board Certified Behavior Analysts to work with individuals diagnosed with Autism Spectrum Disorder (ASD) and one lecturer position for a university.

This is not terribly surprising considering that the highest proportion of the Behavior Analytic literature has focused on treating behavior disorders (Leblanc, Heinicke, & Baker, 2012).

What Jobs Can I Get With a Behavioral Analysis Degree?

Despite the popularity, there are a variety of career avenues available to Behavior Analysts that have nothing to do with developmental disabilities. In this post we’ll be discussing 7 fantastic jobs that you can get with your behavioral analysis degree.

1 – Clinical Behavior Analysis

Behavior Analysts have long been overlooked in the turf war that is psychotherapy. Psychologists, social workers and counselors are trained to shape verbal behavior in sessions to bring about changes with a heavy focus on emotions and internal events. Psychotherapy has evolved with manualized treatment that is behavioral in orientation. If you have the inclination to use self-reporting as a form of data collection and a thirst for Relational Frame Theory (Ruiz, 2018), then Clinical Behavior Analysis may be for you! Most states require a Ph.D. in Clinical Psychology or a similar terminal degree to perform and be reimbursed for psychotherapeutic services. However, several states allow Masters level clinicians to practice under the supervision of a Ph.D. Potential placements can include hospitals, schools, and private practices. Literature has been published in a variety of areas including personality disorders, depression/anxiety, psychosis spectrum, and obsessive compulsive disorders (formally under the umbrella of anxiety disorders).

2 – Clinical Research and Education

Are you a super nerd that has a passion for teaching?

Are you always reading the newest journal articles or dreaming of the next big research project for your clinical team?

If that is the case then you should consider a clinical research and teaching position with a local university. Many universities are offering coursework online and seek out Master’s level instructors. The advantage of having lecturers in their programs are twofold: they are typically less expensive than the core faculty and offer students an opportunity to learn from clinicians that are actively practicing. Research requirements are typically less intensive but offer resources most clinics do not have available.

3 – Comparative Animal Behavior

If you, like me, are a Disney fanatic and love animals, then there is the perfect job for you with the mouse! The Walt Disney Company hires Behavior Analysts that have experience with animal behavior. When new animals are introduced to the safari, they are taught to return to their night enclosures using conditional discrimination. Recreation specialists use phylogenically appropriate activities to keep the animals entertained and healthy. Most importantly, animal training occurs regularly for the wildlife shows throughout the parks to promote a message of conservation.

4 – Organizational Behavior Management

If working with neurotypical individuals is more your style, working in Organizational Behavior Management (OBM) might be a good fit for you. OBM practitioners typically work as independent contractors for companies to improve some aspect of performance through a variety of activities including functional assessments, interviews, and corporate trainings. Human Resources staff and recruiting also find that Behavior Analysts are great fits based on their understanding of motivation. Does helping the Olive Garden reduce food waste or increasing the average sale for a local pet supplies store sound interesting? How about helping managers become effective leaders? If so, OBM is a great option.

5 – Environmental Preservation

If the idea of protecting the planet is important to you then working in Environmental Preservation might be a good idea. Eco-friendly companies are always looking for specialists to not only market their products but to entice consumers to actually use them. Other organizations have been using Behavior Analysts in more traditional retail environments to increase use of biodegradable products. For example, researchers have recently been using extra stimulus prompts to reduce single-use plastics in restaurants with moderate success. For those that are interested in working in environmental policy this is a must consider.

6 – Theme/Amusement Park Safety and Security

Have you ever noticed that in theme and amusement parks, you feel relatively safe? So safe that you spend money on merchandise and food that you would normally never buy? There is an entire science behind keeping guests immersed and feeling safe to maximize spending. Behavior Analysts can provide valuable insight into the motivating operations to engage in target behaviors while in theme parks such as buying merchandise/food products and helping improve traffic flow to improve safety. Those that buy annual passes to their favorite attractions should look into these types of opportunities for free park admission and a paycheck!

7 – Health and Fitness

If you have been watching reality television shows lately, you may have noticed a small uptick in the realm of “life coaching.” Individuals are claiming to be “coaches” to improve quality of life. In most cases their goals center on health, fitness, and wellness. However, most of these individuals are not certified or licensed to be doing such work. Behavior Analysts are a logical fit to help consumers increase the frequency of engaging in healthy behaviors such as increasing cardiovascular exercise and reducing consumption of processed foods. Literature demonstrating the efficacy of basic behavior modification techniques to aid in weight loss is abundant. This specialization does warrants collaboration with other professionals such as dieticians, medical doctors and sports psychologists to ensure that clients are healthy enough for the activities and that they have an adequate caloric intake (Martin, 2015).

Regardless of the path that you take as a career, it is important to remember our ethical guidelines. As Behavior Analysts we stay within our competency. If you are interested in gaining more experience in an area, find a supervisor that can oversee your work and provide you additional support when needed.

What if I Like Developmental Disabilities?

If you have read up to this point and still are thinking “but I like what I do. I like working with Autism” then you are not alone. Working with ASD/DD is a lucrative option that has such a significant impact on the lives of those with which you work. As awareness increases, so do the opportunities for BCBAs ranging from direct care to clinical leadership. Attentive Behavior Care is one such organization that offers positions from technician to executive clinical leadership stressing clinical excellence.

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

 

References:

  • LeBlanc L. A., Heinicke M. R., Baker J. C. (2012). Expanding the consumer base for behavior-analytic services: meeting the needs of consumers in the 21st century. Behavior Analysis in Practice, 5, 4-14.
  • Martin, J. (2015). Behavior analysis sport and exercise psychology. Behavior Analysis: Research and Practice, 15(2), 148-151.
  • Ruiz, F. (2018). A multiple-baseline evaluation of a brief acceptance and commitment therapy protocol focused on repetitive negative thinking for moderate emotional disorders. Journal of Contextual Behavioral Science, 9, 1-14.
What Does it Mean to be an Advocate?

What Does it Mean to be an Advocate?

By Heyde Ramirez, MA, BCBA, NYS LBA and Maria Pantelides, MA, BCBA, LBA (CT, MA, MD, NY)

The definition of the word advocate is to speak, plead or argue in favor of. When you have a child with special needs, one of the biggest roles you will ever undertake is that of being your child’s advocate. You are vigorously fighting for your child. As an advocate, you are your child’s voice to make sure he/she is treated fairly, recognized, and afforded access to all the services and resources they need in order to reach their full potential. A child can have multiple advocates; for example a lawyer, another family member, etc.

Things You Should Know

It is most important that you know your child’s rights. The disability and mental health systems are complex. Each state has their own set of laws and regulations, so become familiar with those laws. It could be helpful to hire a lawyer to better assist you and educate you on the laws. Be prepared to present facts and documentation in support of what you are fighting for. It is important that you ask questions and listen to the answers closely.

Who Should Be On Your Team?

The people on your team should be the people that know your child best and have his/hers best interests in mind. Your child may have several existing team members already set up.

Medical Team

His/Her medical team may be composed of the pediatric practice where he/she receives yearly checkups and gets cared for when he/she gets a virus or the flu, the dental practice and possibly even an eye and ear doctor. The medical team may also branch out and include other medical professionals such as a neurologist or psychiatrist.

Depending on your child’s individual needs, his/her pediatrician will make the necessary referrals so that your child gets the best care possible. As an advocate for your child, express your concerns. Remember that your medical team relies on the information you report, and input as well. Your concerns may not always be apparent to others when they meet with your child, so it is up to you to let them know.

Have you ever experienced your child sitting perfectly still and following instructions at the doctor’s office, but at home, he/she starts to scream at the slightest demand. Mention it! As these professionals meet with your child, they will get to know him very well. They are great sources of information for you, but remember if you do not ask, you may not get the answers you are looking for.

School Team

Children spend a large portion of their lives learning, sharing meals, and socializing in school. It is no wonder that the teachers, teacher’s aides and other school staff will get to know your child on an individual and personal level. You will likely meet with the school team several times a year at parent teacher conferences and other meetings such as individualized education plan (IEP) meetings. These people know best about how your child is doing from an academic standpoint and what goals might be strived for in order to transition your child into a less restrictive setting. As an advocate for your child, demand the best possible education for your child. Laws have been enacted and your child is deserving of the best there is. If you feel that your child is not making progress or that the school is not meeting his needs, speak up! Never feel bad; you are representing your child’s interests.

Related Services Team

If your child has an IEP, there is a chance he has a team that extends beyond teachers and aides, and includes various therapists. Speech/language, occupational and physical therapist, just to name a few, are some of the people who may work with your child in order for him to meet his goals.

ABA Team

The BCBA supervisor can be an invaluable member of your team. The supervisor is someone who by default is constantly analyzing your child’s behavior and can give you a great idea of what techniques work and don’t work when it comes to teaching your child new skills and also when it comes to implementing behavior intervention plans. Your ABA team also consists of the behavior technician who will be working with your child directly. As an advocate, do not shy away from asking questions and demanding the best services available. ABA therapy is already the treatment of choice for ASD as it is an evidence-based practice. Be an advocate, incorporate yourself into those direct care and parent training sessions, and be sure that the services you receive are provided with the highest integrity so that your child can reap the most benefits!

All of these people come together and form a gigantic team that also includes the family and of course your child. As an advocate for your child, you cannot be a passive member of your child’s team. You want to be a leader, paving the way for the best life possible for your child. Take advantage of the education that is out there and available to you. Take advantage of the training opportunities your BCBA Supervisor can offer through parent training.

Additional Resources

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

Early Autism Detection and Prevention

Early Autism Detection and Prevention

By: Frank Kou MSed, BCBA, NYS LBA

In an ideal world, every child would grow up to be strong, healthy, and well adjusted. According to the Centers for Disease Control, one out of every 59 children has been diagnosed with an Autism Spectrum Disorder (ASD). Research has shown that early autism detection and prevention can benefit both children with ASD and their parents.

For the child with ASD, receiving early intervention can improve a child’s overall development by gaining essential social skills in order to react better in society, thus having the potential for a better life. For parents with children with ASD, early intervention may help parental relationships with their children especially through challenging behaviors and situations. In addition, early intervention may provide the parents the ability to prepare themselves both physically and mentally for the journey ahead.

During the child’s lifetime, vigilant parents can be on the look out for signs or red flags that may suggest that something may be wrong, and they should seek professional help depending on the child’s developmental stage.

 

For infants (0 months to 11 months), red flags may include:

  • Few or no smiles
  • Limited to no eye contact
  • Little or no back-and-forth interaction of sounds, smiles, or any other type of facial expressions

 

For toddlers (12 months to 36 months), red flags may include:

  • Limited to no babbling
  • Little or no back-and-forth gestures which may include pointing, waving, reaching
  • Limited or no response to name
  • Very few or no words
  • Very few or no meaningful, two-word phrases that are not imitated or repeated

 

For child (3 years old and older):

  • Delayed language development
  • Loss of previously acquired speech or social skills
  • Persistent preference to being alone
  • Avoidance of eye contact
  • Difficulty in understanding other people’s feelings
  • Constant repetition of words or phrases (echolalia)
  • Resistant to minor changes in routines or surroundings
  • Repetitive behaviors (flapping, spinning, rocking, etc)
  • Limited, restrictive interests
  • Intense and/or unusual reactions towards the senses (textures, sounds, smells, tastes, lights and/or colors)
  • Short attention span
  • Aggression
  • Meltdowns
  • Causing self injury
  • Unusual eating and/or sleeping habits

Currently there is no cure for autism, and prevention is a debatable topic among different groups of people. The best course of action to take is to do things that will benefit the child such as having pregnant mothers eat healthy diets, get plenty of exercise and rest, and avoid harmful chemicals and/or substances.

For the child, have regularly scheduled check-ups, proper diet and exercise, and if there is a risk “red flag” detected, seek help immediately instead of having a “wait and see” attitude.

Sources:

 

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

“What Next?” – When Your Treatment Plan Doesn’t Work

“What Next?” – When Your Treatment Plan Doesn’t Work

By: Jonelle Lupero, MsEd, BCBA, LBA (NY)

Note: The following is a fictional vignette created for the purposes of demonstrating common situations encountered by professionals in this field.

Every week, I meet with a fellow Board Certified Behavior Analyst (BCBA®), “Lauren,” my supervisee who has been working in the field as a BCBA® for almost one year, is currently earning her supervision hours and working towards licensure as a behavior analyst in New York State. We have weekly meetings where I give her feedback about specific clients, treatment plans, and anything else pertinent that she would like to speak about. Recently, we have been conversing about her patient, “Julie,” a non-vocal 7 year old girl with Autism Spectrum Disorder (ASD). Lauren supervises Julie’s home-based ABA therapy program. Recently, Lauren has been expressing frustration about the way treatment sessions have been going. This week the conversation went like this:

Me: “Hi Lauren! How have the sessions been going with Julie?”

Lauren: “Ugh. I am super frustrated; I feel like I have tried everything! Julie is not making progress on her treatment plan goals”

Me: “So let’s take a few steps back. What specifically is the major issue you are dealing with?”

Lauren: “After working for 30 minutes, Julie earns a break. Every single time she goes on her break, she has a severe temper tantrum.”

Me: “Is she requesting a break?”

Lauren: “No, she has a very limited mand repertoire. We are working on shaping her mands now.”

Me: “What are her reinforcers?”

Lauren: “M&M’s, IPAD, break.”

Me: “When did you conduct the last preference assessment? Did you conduct a reinforcer assessment?”

Lauren: “I haven’t.”

Me: “So how do you know that the “break” is a reinforcer for her?”

Lauren: “It states it in the initial assessment.”

Me: “What are the dates of the assessment?”

Lauren: “It’s from almost one year ago.”

Me: “So how do you know that the break is still a reinforcer for her?”

Lauren: “It states it in the report.”

Me: “Sometimes we need to reassess. Just because a break might have been reinforcing for her one year ago doesn’t mean that it is a reinforcer for her now.”

Lauren: “Do you think that is why she is having temper tantrums?”

Me: “It could be; perhaps she doesn’t want the break.”

Lauren: “So what are my next steps?”

Me: “First, you need to conduct a preference assessment to see what things might function as reinforcers for Julie.”

Lauren: “Okay.”

Me: “Then, I would test it out. Conduct a session using the suspected reinforcers that you identified during your preference assessment. This will help you determine if these “preferred” stimuli will actually function as reinforcers for Julie. In other words, does the presentation of these stimuli actually result in an increase in the future frequency of the behavior that preceded it?”

Lauren: “Okay.”

Me: “Let’s see how that goes first and then we will discuss the results the next time we meet.”
Lauren: “Okay. Thank you for your feedback.”

In ABA therapy, or any other type of therapy for that matter, it is true that sometimes treatment plans simply do not work out as planned. Problem behavior may increase, and the individual may not make progress with the specific treatment goals.

The great news for individuals receiving ABA therapy is that BCBAs® are perfectly equipped and trained to deal with this. ABA is a science, and because of that, the data guides our decision making. All of the data recorded during each session will be carefully analyzed on a regular basis so that the BCBA® can make immediate changes to the treatment plan when the outcomes aren’t what we expect.

Since data are recorded and analyzed constantly, an ineffective treatment plan will not stay in place for long. In fact, one of the 7 dimensions of ABA is that it is effective—therefore, if the treatment plan isn’t effective, it means that ABA is not being done correctly, and the treatment must be monitored and adjusted until there is a positive impact on the target behavior.

So, what can we do when this happens? The previous scenario is one example regarding what we can do when our treatment plan isn’t working the way it was planned: reach out to a colleague… (of course protecting PHI)

Here are some other recommendations:

  • Revisit the original assessment. When was it done? What are the behaviors targeted for increase? What are the behaviors targeted for decrease? Does it match the client’s deficits now?
  • Revisit the FBA/BIP. Does the FBA/BIP need to be updated? Do the interventions being implemented match the functions of the behaviors?
  • Is there treatment integrity? Is the treatment plan being implemented the way it was intended?
  • Are the patient’s reinforcers updated? When was the last preference assessment done? Was a reinforcer assessment conducted following a preference assessment?
  • Communication. Is everybody on the team communicating including parents, technicians, and the BCBA®?
  • Is parent training taking place? Have there been any significant changes in the individual’s life (e.g. moving, new sibling, change in school)?
  • Coordinate care. Did you coordinate care with other professionals who work with the individual? Is the individual on any medications? Are there any medical conditions or limitations you should account for? Are multiple treatments being implemented?
  • Collaborate with a fellow BCBA®. The field of ABA is very big and not one person knows everything!
  • Do the research! There is a vast amount of resources available to us including “ABAI”, Association for Applied Behavior Analysis International, “BACB”, Behavior Analyst Certification Board, JABA (Journal of Applied Behavior Analysis) and many more!
  • Consistency, Is the individual receiving the recommended frequency and duration of ABA therapy? Do adjustments need to be made to the schedule?

As a behavior analyst we have many options when our treatment plans are not working. I hope you found this information useful and can implement some of these recommendations.

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

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.