How to Entertain A Child with Autism and Provide Ideal Learning Environment During School Closure

by Dov Breuer | Mar 19, 2020 | ABA Therapy, Parent

By : Gabrille Galto, MS, BCBA, NYS LBA

It is official. We are living through a pandemic and in a state of emergency. Most of us have never experienced anything like this before and are feeling overwhelmed. Many school districts have recently announced closures, some even for an indefinite amount of time to reduce any further exposure and spread of COVID-19. 

During this time many families are faced with a number of difficulties and challenges. For families with a child or children with Autism, school closures mean a reduction in additional support services received. How can you continue to provide a therapeutic learning environment? How can you maintain skills previously learned? And how can you entertain your child with autism?  

The answers to the questions above will be further discussed below with some ideas on various activities and strategies you can use at home to keep your child with autism entertained during this time. 

Please note: What is described below is not an exhaustive list and would not replace a current behavior intervention plan, or effective strategies already used within your home. I highly advise parents who currently have a Board Certified Behavior Analyst® (BCBA®) working with their child to reach out for additional support, request the most updated copy of their child’s treatment plan and behavior intervention plan (BIP), and request services via Telehealth if available. If strategies within your BIP cannot be implemented for any reason (e.g., lack of materials), consult your BCBA® before attempting new techniques or strategies. 

Activity Schedules

Due to school closures children are home, some for an indefinite amount of time. How do you create structure and routines throughout the day to keep your child stimulated? 

Start by setting up an activity program for your child with autism. This can be done in a number of different ways, from simply writing a list of tasks/ activities on a piece of paper to printing pictures for your child as a visual aid. Present the activities clearly in a way that your child can understand that this will be his/her activity program. 

For children who have never used a visual schedule, you may have to prompt them through each activity and that is okay! The main goal is to have a clear picture of what to expect. Once an activity is completed either check off the task, cross it out, or remove the picture to indicate the activity is over. Point to the next activity, say exactly what is next (e.g., “Story time!”), then guide them or instruct them to the activity.  

What a scheduled day should include is routine regular times for bathing, eating, school/learning activities, and socialization. Maintaining a set time for sleep and bed time that you child is used to is highly recommended. Make sure to include required activities at predictable set times and room for flexibility for additional tasks and kid chosen activities. 

Materials you’ll need:

1. White Board, chalk board, or a piece of paper
2. Dry erase markers, chalk, pen or pencil, etc. 
3. More crafty people can search for pictures of items/activities to print, and laminate and use Velcro to put onto a grid (see example below)! 

How to Set Up an Activity Schedule: 

1. Write numbers 1 through 5 or number of activities desired (remember you can always create more than one schedule throughout the day). 
2. Choose activities for the schedule: 
3. • Write the activity, draw a picture, or use a picture to indicate the task/ activity on the schedule. 
   • Determine required tasks (e.g., school work, bathing, etc.).  
   • Include your child by having them choose an activity or choose the order of activities! Great way to gain some compliance! 
4. Go over the schedule in easy language for your child.
5. Start the activity.

Activity Ideas

Keeping kids busy is honestly a tough job in and of itself! How to entertain a child with autism is an even greater challenge. It is even harder when you have more than one child at home, especially that are different ages or do not get along, or if you have a child who does not have the skills to just play with his or her siblings. Either way all of the scenarios have their difficulties, and, of course, if you have kids that play, get along well, and keep themselves occupied, great! Amazing! But it is still important to ensure that there is a sense of structure within the day, learning is encountered, and skills continue to maintain and develop. 

As I noted earlier make sure to reach out to your BCBA® (if you have one) to discuss goals to target. I also suggest that if you have not received any school work from your child’s teacher to reach out regarding homeschooling. Both may be helpful in providing you with games, sensory projects, and other activities to keep your child with autism child busy and entertained while developing important skills.  

It may be tempting to simply hand over the iPad or put the T.V. on during the day, however children with Autism can have a difficult time once demands are then placed on them or told to turn off the device. This can become a very difficult issue, and working on a schedule at your own pace can help during this tough time. Maintaining expectations throughout the day will require your child to follow demands, work on transitioning, and engage in activities both parent lead and child lead. You want to balance the day with tasks that are less preferred with those that are preferred, gaining cooperation and creating learning opportunities within your child’s day to day schedule. 

Arts and Crafts Activities

1. Playdough: Set up a playdough activity at a table with different shape cutters, plastic utensils, plastic containers, or other play-doh activities sets already in the home. Try a DIY playdough recipe if you do not have playdough in the home!   Your day’s activity can also include “Making Play-doh”! Both creating and playing with playdough are great sensory activities for children with autism. 
2. Printable Arts and Crafts: Print out or create blank templates for kids to fill in with drawings or paint to keep your kids busy while expanding their imagination! Here are some fantastic printable art activities. 
3. Finger Painting: If you have paint already, have an art and craft finger painting day! Make fun designs, allow for your child’s creativity, and encourage exploration with mixing colors together! Allow for kids to make handprints by painting their hands! This can also be a great sensory activity for those kids who love the texture of paint!
4. Cut and Paste Activities: Take some colored paper and cut out easy shapes and designs for your child to paste and make different shapes or a picture scene. I provided some ideas below – you may want to get some more exciting ideas online! 
   • Butterfly – cut out the wings, body, antennas.
   • Snowman – 3 circles, triangle nose, circle eyes, buttons, hat.
   • Flower – long stem, circle, and flower petals.
   • House – square, rectangle, and triangle.   
5. Water Fun: Place water toys or water-safe toys into the tub or large bin! Add some containers or plastic cups to pour with and if you have food coloring at home play around with making the water change colors by adding purple and blue or red and yellowing together! 

Turn Taking Activities:

1. Find all your board games and bring them out for turn-taking with your child! Pick a game to play each day or every other day to include the whole family! 
2. Play Charades with your child or children! Have them either help create different subjects or make it fun by teaming up and having them act out a card together! 
3. Play I SPY by presenting clues to your child until the child either says the correct answer, points to, or even gives you the item you were providing clues for. If your child can give clues, have them take a turn! 

Pretend Play

Play pretend with your child to encourage imaginary play with and without others objects! Below are some ideas you can try, but adding additional ideas based on your child’s interests (such as acting out a scene from their favorite movie or game) will further motivate them. 

1. Dress up as an explorer, hide a treasure somewhere in the home to find, and create a map to follow as you search for the missing treasure. 
2. Pretend you are a dinosaur looking for food and roaring!
3. Use blocks to create buildings and drive around the “city”, maybe incorporating directions to go to different stores and working on listener skills with prepositions! 
4. Make an animal hospital and take all the stuffed animals or animal toys to help heal them from an injury or sickness. 
5. Make a pretend restaurant! If you have pretend food and/or a play kitchen, create a restaurant, maybe make a menu to order from (some more arts and craft ideas), and have your child pretend to be a waiter and Chef! You can also make pretend money and have a price for different food items. At the end add up the total as a way to incorporate using everyday math! 

Go Outside

Yup, I said it! If you are not in quarantine because you have been told to do so due to testing positive or being in contact with anyone who has tested positive, making time to go outside is important for your child’s daily health. If you live in an area of concern please take the necessary precautions as needed. If you are in an area with less people outside in the streets or have a yard to play in, take time to go outside. Some things to do outside:

1. Take a 5 – 15 minute walk! Whatever is appropriate for you and your family, but getting outside and staying active is important for our mental physical health. 
2. Play catch with your child for a couple minutes, maybe bouncing the ball or kicking back and forth. 
3. Simon Says – Go play outside!

Learning Opportunities

Lastly, below are some ideas and activities to include your child in that you may typically have not in the past or some simple learning activities to include as scheduled activity lessons. 

1. Cooking: Include your child with a chosen meal or making brownies. This can include a child reading the instructions to physically prompting a child to pour in an ingredient with your help! I believe this can be individualized across many individuals and even can include an independent task such as write a list of what you need to make a sandwich then complete each step to working on having your child get ingredients when instructed! 
2. Sorting: Sorting can be done with MANY things and within MANY activities. Maybe make a sorting activity with colored cotton balls, the Legos or all those hot wheel cars laying around. Sorting can be done if you have bins to sort toys into specific bins; for example, animals, cars, blocks and pretend food items. You can also include your child in sorting socks after the laundry is completed, as a sorting activity. 
3. Table work: This can include working with your child one on one, or the child completing a worksheet or independent tasks. 
   1. Ask your BCBA® and/or teacher for a list of goals or materials to work on that is appropriate for your child. 
   2. For example: Work on sorting picture cards at the table, identifying pictures by selecting the corresponding card when given the function (i.e., what do you drink – selects water), and labeling items. These are simple examples of what you may consider but remember, you want to work on what is best for your child and their level of learning!
4. Story Time: Select books to read to your child during the day and ask questions during or following the story.
   1. For early learners: Books with pictures you can have your child point to items s/he sees, have them label items and characters in the book, and respond to simple questions. 
   2. Next Level: For learners who may still be reading picture books but need to work on comprehension work on asking them questions such as what do you think will happen next? You can also try asking why questions. 
   3. Advanced: Have your learner read to you or if able to read on their own have then provide a summary of what happened in the book, who was in the story, etc. 
   4. Idea to consider – Put on an audiobook or story read on Youtube! Search #OperationStoryTime on Youtube for many of your favorite books read by the authors themselves! 
5. Have a Dance Party: For learners who like to get up and move have set times for music and movement by putting on their favorite song and breaking out your best dance moves! Or you can also look into music and movement videos to dance along to with them!  
6. Make an Obstacle Course: Place a pillow on the floor to jump over, a pretend balance beam using tape on the floor, have your child walk or move like an animal, toss a ball into a bin or basket to work on those motor skills!  Here are some more ideas:
   1. Hop like a frog
   2. Slither like a snake 
   3. Crab walk 
   4. Bear crawl
   5. Prance or gallop like a horse 
7. Go to the Museum: Yes, you read that right! There are 12 museums that you can take a virtual tour of from your home! 

Here are some additional resources and materials you can use to entertain your child with autism child in a meaningful way: 

• Free Homeschooling Resources For Families Affected By School Closures
• Funbrain Games, Videos and Books
• ABCya Learning Games
• Little Twisters Yoga & Emotional Wellness 
• Holidays and Autism
• Minecraft

Note: Attentive Behavior Care takes no responsibility for the information contained within these links.

If you are interested in learning more about Attentive Behavior Care or how we can help, please contact us today!

Autism and Technology

by admin | Feb 27, 2020 | ABA Therapy, Parent

By: Amy Black, MS, BCBA®, LBA

Technology is used in almost all areas of life to simplify tasks, save time and improve convenience. But perhaps one of the most valuable uses of technology is when it is used to help individuals with Autism Spectrum Disorder (ASD).

Individuals with ASD struggle in many areas and ABA therapy can be used to teach them the skills they are missing to help them attain a happy and independent life. However, many times, therapy sessions alone are not enough. Many individuals need more permanent assistance to help them reach their goals of integrating into the community and accessing all that they need. Here is where technology enters the picture. There are many forms of technology that can be used to help individuals access the skills they are lacking, and when we use technology alongside ABA therapy, we can accomplish so much more.

Technology to Assist with Communication

Communication deficits are one of the core and primary symptoms of ASD. According to recent research, approximately 1 in 59 children are diagnosed with ASD and approximately one third of those children are non-verbal (Autism Speaks, 2020). Assistive and augmentative communication (AAC) devices started being commonly used in the 1980’s to help individuals communicate with others without the use of vocal speech. These devices have evolved over time and with the advancements of technology have become increasingly complex in capability and simpler to use. With electronic devices becoming more readily available, many individuals don’t require a dedicated, costly, and intrusive AAC device anymore. There is a large amount of assistive communication apps available that can be downloaded and used on any personal device. So if an individual already has personal device that is used throughout the day (e.g., smartphone, tablet, PDA), instead of carrying around an additional AAC device, the individual can simply use his existing device to communicate with others.

Communication Apps

Knowing which communication app to choose is important since every person is unique and has specific needs and capabilities. A speech language pathologist and/or BCBA® can assist in determining which app would suit an individual best.

A commonly used assistive communication app is one where the individual can select one word pictures or icons, create sentences out of pictures, or use a keyboard to type. The words or sentences selected by the individual are vocally spoken out by the app allowing the individual to have a method of communication that is audible and easily understood by others. These apps are extremely customizable and can be set up for both early learners and advanced communicators.

There are also other communication apps that use gestures instead of selections. Instead of the individual selecting the specific word or picture, a gesture is made on the screen (e.g., swipe up, double tap) which then causes the app to speak out the word or phrase that is paired with that gesture.

Lastly, for individuals with severely limited motor movement, eye gaze AAC devices can be used. This device tracks the individual’s eye gaze and the individual can select words, pictures, phrases or type using a keyboard.

Collaboration between the BCBA® and speech therapist is key when teaching an individual to communicate using any of the above options.

Technology to Assist with Task Completion

Many individuals with ASD benefit from having a clear schedule of tasks or activities to complete. This can be for leisure purposes or work purposes and is helpful in increasing independence. However, when teaching individuals with ASD to complete tasks that contain multiple steps, for some, prompts can be difficult to fade out and true independence is difficult to achieve. To assist with this, there are many apps that can be used to provide built in prompts, reminders or checklists.

Visual schedule apps can help the individual stay on task and progress from one activity to the next. Some apps just have a list of activities or steps of activities that the individual can check off as they complete. Others have more detailed instructions within each step coaching the individual on how to complete that step or activity. These instructions can be set up via pictures, text or videos. Additionally, some apps have a time component in which the individual is reminded to move on to the next task/step after a specified amount of time has passed. The timer can be visual, auditory, or a combination of both. All of these apps can be crucial in helping individuals who are prompt dependent enjoy a more self-sufficient life by being able to carry out both leisure and required activities on their own.

Technology to Assist with Social Skills Training

Social skills deficits are another core and primary deficit of ASD that are worked on during ABA therapy. With all skills taught during ABA therapy, repetition is key in ensuring acquisition of the skill. Additionally, role modeling is strategy commonly used with teaching social skills. When working on interpersonal skills, having a peer accurately role play the scenario multiple times can be challenging. Therefore, the use of a simple video camera can be very helpful in contriving multiple practice opportunities. In addition to using a video camera to create role play opportunities, it can also be a powerful tool when used to video the individual himself in a social situation so that the individual can watch a playback of the scenario and point out what should have been done and what shouldn’t have been done.

Another interesting use for videos to assist with social skills training is for behavioral prompts. For some individuals, it is difficult for them to remember how to act in difficult or unexpected situations. What can then happen, is that the individual becomes dependent on someone else to coach them on how to react and what to do every time a situation arises. To address this issue, short coaching videos can be created, labeled by type of situation and stored on any device that the individual uses. Then, if a situation comes up and the individual is unsure how to react, instead of requiring a live person’s coaching, the individual can find the relevant video on their device and get coached independently.

Technology as a Reinforcer and Leisure Activity

Technology is often a strong attraction to individuals with ASD and can be channeled into a leisure activity. There are hundreds of educational apps that can be used for constructive leisure purposes and furthermore, these leisure activities can be used as motivators and reinforcers during ABA therapy. The more the individual enjoys the activity, the stronger and more potent of a reinforcer it can become. When it functions as a strong reinforcer, it can then help the individual acquire skills in all areas being targeted.

Using Technology with Caution

The key goal of ABA therapy is to increase the individual’s social interaction and social communication skills so that they can access social reinforcement in their lives. Therefore, when choosing goals to target in therapy and types of assistive technology to use, one must always make sure that they are socially significant to the individual. The goals and tools being used need to be easily used in daily life and help the individual attain a happy, productive and independent life.

Source:

Autism Speaks. (2020). Autism facts and figures. Retrieved from (https://www.autismspeaks.org/autism-facts-and-figures)

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

Preparing Children with ASD for a Brighter Future

by admin | Feb 20, 2020 | ABA Therapy, Parent

By: Catherine Witanowski, M.A., BCBA, LBA

Your child has been receiving ABA therapy since he was two years old. He wasn’t talking, now he is, he’s gained a bunch of new and useful skills, but what is the big picture? When your child is first diagnosed, you’re encouraged by your doctor to research ABA therapy, start early intervention services, etc. As the years go by, you start to wonder, “Well, now what?” Is my kid going to go to college, get a job, or both? Okay. Short term. What about kindergarten? Has ABA therapy prepared my child for the “real world?”

First Things First, Let’s Talk Kindergarten

How does ABA therapy prepare your child for kindergarten? Good question! This a huge transition for all kids; neurotypical kids and for kids on the ASD spectrum. The structure is going to be so different from anything else that they have experienced thus far. Therefore, anything that can help kids cope with the transition and become better at adjusting to change is going to be major. Most times, someone at the school your child is going to attend will be trained in ABA and working with your child. If that is the case, then these routines previously learned during private ABA therapy carryover more naturally and make school feel a lot safer and more comfortable.
 As far as social interactions, this is also considered one of the biggest transitions in any child’s life because they are going to be around so many novel people and the set of expectations is so different from being at home. Essentially, this means all the social skills and rules that they have learned either from their ABA therapist or just from simply observing now have to be relearned and generalized for a new setting. The more adaptable a child is to learn new behaviors as well as decrease behaviors that are maladaptive or inappropriate, the more successful they are going to be in school with academics and peers.

I interviewed a Special Education kindergarten teacher and she said, “The hardest thing for me transitioning kids into kindergarten is the fact that most have never been in a structured school or setting and just the expectations and rules are totally foreign. On top of learning how to be around so many other people, they also have to deal with the input from teachers constantly expecting them to follow one million directions. In my experience, kids who have previously received and/or are continuing to receive ABA therapy help make this transition smoother in general. Kids on the spectrum who have familiarity with learning how to adjust their behavior and maintain their emotional regulation in other contexts have a much easier time with the transition.”

All of the above does not only pertain to kindergarten, but the following grades as well. Once individuals are able to continue within the school setting, their skills will continue to grow with the right care and intervention. ABA therapy is not a cookie cutter treatment, it is a completely individualized process. As your kiddo grows, the trajectory of their ABA therapy will grow too!

How Will ABA Therapy Help Your Child be Successful in the Workplace?

Be consistent, stick to a schedule, and reinforce appropriate behavior. What do these things mean? When I go to work, I wake up at about the same time every day, work a similar set of hours, and every two weeks, I get reinforcement. This structure helps me be efficient. Schedules help us be proficient, reduce the need to plan, save time, and build confidence in our daily lives. ABA therapy provides a similar system every day to individuals with autism. Starting with early intervention, kiddos are encouraged to explore their likes and determine their strengths and weaknesses. Throughout receiving ABA therapy, these children are being prepared for a bigger picture – school, work, and socialization.

Think about when you interact with any kid and you ask them the question, “What do you want to be when you grow up?” This question encourages little ones to use their imagination and creates a fun topic of conversation. Growing up and becoming a part of a workplace creates a sense of belonging. ABA therapy techniques are often used as a part of vocational training as your child grows up. Vocational training is conducting ABA therapy with specificities to the individual’s job interest. This could include but is not limited to following a work schedule, teaching appropriate workplace communication, self-regulation in response to a wide range of emotions one may experience in a work environment, etc. These skills are extremely beneficial when navigating any workplace.

General Socialization With Peers

Let’s touch on the myth that ABA therapy is only about intensive structure and table time goals or skills. As discussed earlier, ABA therapy is a very individualized type of therapy. If your kiddo is in need of learning how to sit at a table, and everyone agrees that is a socially significant goal, then yes, it will be worked on. If your child needs to learn how to play functionally, independently, with peers, etc., then that will be worked on during their ABA therapy. Teaching functional play skills including pretend play is extremely beneficial to a child’s social development. The more socially developed an individual is, the more successful relationships they will have. In an article by Dr. Rachel E. White, she discusses how play supports children in regulating their own behavior, lays the foundations for future academic learning, assists in figuring out the complexities of social relationships, and helps develop problem solving and executive functioning skills. It is important for adults to assist in directing children’s play to facilitate significant growth. That is where ABA therapy comes in. The therapists working with your child have the resources to consistently contrive different learning opportunities reflecting all of the above.

Final Thoughts

Everyone wants the best for their kid. Raising a child involves a ton of decisions and sometimes those decisions can be very stressful. When thinking about your child’s future, you want to feel confident in the choices you make whether it is the school they go to, the friends they have, or the food they eat. All in all, every parent hopes their child has a promising future ahead of them filled with happiness and success.

Referencing the topics throughout this post, the purpose of them is to help you organize the steps you will take to prepare your child with ASD for tomorrow. Therefore, the important takeaway here is not only does ABA therapy help your child prepare for kindergarten, the work place, and teach them social skills, it also serves the purpose of helping prepare your child for a better, brighter, and more successful future.

References:

• White, R. E. (n.d.). THE POWER OF PLAY: A Research Summary on Play and Learning.
• In Minnesota Children’s Museum. Retrieved from https://www.childrensmuseums.org/images/MCMResearchSummary.pdf

If you are interested in learning more about Attentive Behavior Care or how we can help, please contact us today!

Considering ABA Therapy? (A Helpful Guide)

by admin | Jan 30, 2020 | ABA Therapy, Parent

You have heard about Applied Behavior Analysis (ABA) therapy and may be considering whether it is appropriate for your child.

What is ABA Therapy?

Applied Behavior Analysis is an evidence-based treatment that is founded on the science of learning. It is a scientific approach to understanding behavior and systemically applies behavioral laws to change socially significant behavior that improves the lives of individuals.

Decades of research has established that ABA is the most effective treatment for individuals with Autism Spectrum Disorder (ASD), and has been endorsed by the United States Surgeon General, David Satcher, MD, PhD, who recommended intensive behavioral intervention for individuals with autism, stating, “Thirty years of research demonstrated the efficacy of applied behavioral methods in reducing inappropriate behavior and in increasing communication, learning, and appropriate social behavior.”


Numerous organizations have endorsed the efficacy of ABA including: American Academy of Pediatrics, American Academy of Occupational Therapy Association, 
American Psychological Association, American Speech-Language Hearing Association, 
Society for Developmental and Behavioral Pediatrics, Autism Society of America 
and the National Institute of Child Health & Human Development.



Bringing Out the Best

ABA has been effective in teaching language and improving communication, developing social skills, teaching life skills, working on academics, increasing attending skills, deceasing maladaptive behaviors such as aggression, noncompliance, self-harm and restrictive and repetitive behaviors, and in teaching individuals coping strategies and replacement behaviors. ABA therapy also trains caregivers to teach their child important skills, and to manage their behavior.

For more information about ABA therapy or how we can help your child, contact Attentive Behavior Care today.

In-Home ABA Therapy

by admin | Jan 16, 2020 | ABA Therapy, Parent

By: Pranali Hoyle, MA, BCBA

How to Create an Appropriate Instructional Environment

In-home ABA therapy is now an approved service that is covered by many insurance companies. Parents, therapists, and BCBAs® each play a role in how an effective session can be conducted. Each person is crucial in carrying out a session that may lead to positive outcomes for the learner. Some standards that have been developed are based on benchmarks of best practices. These can be used as guidelines when a session is conducted within the home.

Setting Up the Environment in Your Home for Success

As behavior analysts, we are trained to work in many different settings including homes, clinics, schools, community, and even employment settings. When providing services in the home, It is important that an area of the home be designated for therapy sessions. This can limit distractions from other family activities and provide a successful interaction between the therapist and the child. When the child is not in a session, materials that are pertinent to therapy can be kept in this space. It is encouraged that the child does not have free access to the space or the materials. This will limit the loss of materials that need to be readily available for the therapist during sessions. Your BCBA® supervisor can be an asset to determining the space. This also does not need to be a large room full of furniture and wall decorations, it can be a simple corner with a desk, chair and perhaps a shelf.

Limiting Attention and Access to Items

When a learner first begins his/her therapy, the session may not look as fluid as what most of us tend to observe in schools or clinics. This could be due to the fact that the child is not accustomed to receiving therapy in home, they have unlimited attention and access to toys without having to engage in specific responses. It is important to build a relationship with both the learner and the family. While parents are present during these sessions, it is best if boundaries are established from the start. This will help the learner establish a rapport with the therapist and limit escape-maintained behaviors that can be inadvertently reinforced. Parents should keep certain items that can be used as reinforcers during session time, this will allow the therapist to easily pair with the learner. It will also help the learner correlate session time with fun rather than work.

Use Your BCBA® as a Resource

Even though BCBAs® are accustomed to different situations, especially when it comes to learners. Each learner and family will bring along their own set of unique characteristics. It is important to communicate with your BCBA® what the expectations are for you and your family. The BCBA® in return should also review the policies and procedures for sessions to avoid any confusion in the future. The BCBA® is also a source of information and should be available to answer questions post session for parents. This will help to clarify what goals may be pertinent and how to achieve them. Parent training time therefore is essential and can be useful in determining aspects of therapy that are crucial for the family on a day to day basis.

If you are interested in learning more about Attentive Behavior Care or how we can help please contact us today!

Navigating Transitions for Young Adults and Adults With Autism

by admin | Jan 2, 2020 | ABA Therapy, Parent

By: Lauren Fernandez, B.A.

Life transitions can be scary; especially for those diagnosed with Autism Spectrum Disorder (ASD). Transitioning out of adolescence and into the adult word is a crucial time for an individual with ASD. During this time, support is needed by family members/caregivers to help maximize the opportunities for the individual to participate fully in society (Thompson, Bölte, Falkmer, Girdler, 2018).

Some important life changes that are inevitable to occur may include transitioning to a new school, entering college, starting a job, or even living independently. Coming up with a transition plan and preparing for the transition in advance are two strategies that may be beneficial to help make any transition easier for the individual and their family (Autism Speaks, 2019). Government law, Individuals with Disabilities Education Act (IDEA), mandates students diagnosed with ASD have the right to a comprehensive transition service during high school. This was implemented to ensure that while in high school the student has access to resources and supports needed to meet their desired goals to the best of their ability upon graduation. Even though a majority of planning the specifics regarding continuing education or employment occurs during the teen/high school age, it is best to start preparing early.

For example, Daily Living Skills are skills that the individual is going to need through life, so starting young may be beneficial to help ease future life transitions. With advocacy for Autism becoming more and more popular, there are many colleges, universities, and employers that welcome those with ASD. Some establishments even partner with ABA providers to ensure the individual is fully prepared for their journey into their new chapter of life.

Some Autism Focused Colleges

• Syracuse University: Syracuse University houses the Lawrence B. Taishoff Center for Inclusive Higher Learning. It is an institute that serves students with any intellectual or developmental disability. Syracuse has a separate program specifically for students with ASD, “InclusionU.” It is a program where students with ASD can participate fully in the college experience with supports in place.
• The University of Alabama: The University of Alabama offers “UA-ACTS”, which is a platform that helps students move from the high school environment into college living. UA-ACTS also advocates for and facilitates a campus that is ASD friendly.
• Rutgers University:  Rutgers is home to the Douglass Developmental Disabilities Center (DDDC), an ABA program which serves the needs of those diagnosed with ASD. The center offers a College Support Program (CSP) that guides students both academically and personally. Social groups, parent workshops, weekly meetings, and academic counselling are just a few of the services that are available through CSP.

Some Autism Friendly Employers

• Ford Motors: In 2015 Ford Motors announced their pilot program, “FordInclusionWorks” specifically designed for those with ASD to gain work experience through Ford. Ford collaborated with Autism Alliance of Michigan to offer on-site job training specifically tailored to each worker with ASD.
• Walgreens: Since 2012 Walgreen has partnered with Turning Pointe Autism Foundation to support the employment of those with ASD. Walgreens hosts “Walgreen Career College” that trains individuals in various areas of retail prior to entering the workplace. The Walgreen Career College in Illinois even has a mock Walgreen retail store for students to practice in!
• Home Depot/CVS Pharmacy/Fairway/Boscov’s (Part of “Kens Krew”): Kens Krew is a nonprofit organization that teaches vocational training skills and offers job placement services to young adults with ASD.

Like all individuals, those with ASD need support and encouragement to achieve their ambitions and goals. While facilitating an individual, it is important to remember this is their transition that needs to include independence and self-advocacy. Luckily, there are resources to help the individual navigate their transition, as well as their family.

ASD Transition Tool Kits

Below you will find a “Transition Tool Kit” that was put together by Autism Speaks for those living in New Jersey and New York:

• https://www.autismspeaks.org/sites/default/files/2018-10/new-jersey-ttk.pdf
• https://www.autismspeaks.org/sites/default/files/2018-10/new-york-ttk.pdf

More can be found at https://www.autismspeaks.org/tool-kit/transition-tool-kit.

Sources

• Autism Speaks, 2019
• Thompson C, Bölte S, Falkmer T, Girdler S (2018) To be understood: transitioning to adult life for people with autism spectrum disorder. PLoS One 13:e0194758
• U.S. Department of Education Office for Civil Rights. (March 2011). Transition of Students With Disabilities to Postsecondary Education: A Guide for High School Educators.

If you are interested in learning more about Attentive Behavior Care or how we can help please visit contact us today!

Holidays and Autism

by admin | Nov 21, 2019 | ABA Therapy, Parent

It is slowly becoming that time of year again. Leaves are already starting to change here in Michigan. The days are getting shorter and the temperatures are mercifully dropping from the scorching summer heat.

That means it is time for the holiday season to begin. Was that a collective shudder? Great, so it wasn’t just me! The holidays can be stressful even during the best of times. Throwing in a family member with specific needs only adds to the difficulty. So, to help potentially reduce some of the stress here are a few tips and tricks.

1. Stick to your routines: Trying to stay on a schedule during the holidays is… challenging? What is halfway between difficult and impossible? (Anyone else have this struggle or is it just me?) However, structure is critical to success for any child not just someone with ASD. Keep bedtimes and other routines as close to normal as possible. It may make things more complicated during the holiday, but the transition back to “normal” life will be far smoother.
2. Have realistic expectations: You know your child’s limits in the best and worst of times. Expecting perfection or trying to push their boundaries is likely to just set yourself up for additional stress and pressure. Set realistic expectations for how long to spend at events and what level of engagement you want to see.
3. Make sure everyone is on the same page: Nothing is more frustrating than when you noticed great aunt Susan slipping your child candy because “it will keep him/her quiet” as soon as they start to cry. What started as a well meaning gesture is now going to be a significant hurdle you have to overcome. The holidays are a time to be lax, but make sure that everyone is aware of what to do in case problem behavior occurs so you don’t run the risk of undoing any work you have done.
4. Have an escape route/safe space: This is just as much for your child’s benefit as it is for you. Have a specified space away from everyone that is the “safe space.” This is a room where the lights are dimmed, maybe some calming music, and a preferred activity. If you notice your child getting a little overstimulated take them to the safe space. Give them some time to decompress and relax. If your child is able to reliably request things, show it to them before hand and show them how to request it. This is a great way to not only help your child through a difficult time, but teaching a valuable life skill at the same time: it’s ok to say I need a break.
5. Have a visual schedule: Having a visual schedule of activities can be incredibly helpful, particularly if visual schedules work well for your child in other settings. These types of schedules are excellent if telling time or the abstract concepts of time management are beyond your child’s skills at the moment. That way there is an easy to access way to see what is coming up and when.
6. Social stories: Creating a social story about what to expect during the day can be helpful. Describe the activities in detail and go over what to expect.
7. Come prepared: Make sure you have everything you will need to be successful. Things like charging cables, preferred snacks and comfort objects can be great reinforcers in a pinch.
8. Don’t forget your ABA: Remember to reinforce behavior you want to see. Catch your child being good and make sure you are telling them what they are doing right. It may seem like a small thing, but these can go a long way.

Unfortunately, we can’t make the holidays less stressful. However, we can do things to ease them a bit so they are less difficult. Making sure that we stick to routines and prepare ahead of time will mean a smoother transition and hopefully fewer headaches.

If you are interested in learning more about ABA therapy or how we can help please visit contact us today!

“I Think it’s Time for ABA Therapy…”

by admin | Nov 14, 2019 | ABA Therapy, Parent

By: Jonelle Lupero, M.Ed., BCBA, LBA (NY) 

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

“My name is Susan and I have an eight-year-old son John who is diagnosed with Autism Spectrum Disorder. I received John’s diagnosis when he was 3 years old; at the time John’s autism seemed “mild” to me and I never sought outside help. Recently he has been displaying more severe behaviors and I’m not sure I can manage them; I think it might be time for ABA therapy but I’m still not certain. When is it time for my child to receive ABA therapy?”

Susan is a common example of many parents today who do not know if their child would benefit from ABA therapy. Let’s explore this subject further…

What is Applied Behavior Analysis (ABA)?

Applied Behavior Analysis (ABA) is a therapy based on the science of learning and behavior. Behavior analysis helps us to understand: how behavior works, how behavior is affected by the environment, and how learning takes place.

ABA therapy applies our understanding of how behavior works to real situations. The goal is to increase behaviors that are beneficial and decrease behaviors that are harmful or affect learning. ABA therapy programs can help: increase language and communication skills, improve attention, focus, social skills, memory, and decrease problem behaviors.

The methods of behavior analysis have been used and studied for decades. They have helped many kinds of learners gain different skills – from healthier lifestyles to learning a new language. Therapists have used ABA to help children with autism and related developmental disorders since the 1960s. (cited from autismspeaks.com)

Why ABA Therapy?

ABA is considered an evidence-based best practice treatment 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 includes many different techniques.  All of these techniques focus on antecedents (what happens before a behavior occurs) and on consequences (what happens after the behavior).

More than 20 studies have established that intensive and long-term therapy using ABA principles improves outcomes for many but not all children with autism. “Intensive” and “long term” refer to programs that provide 25 to 40 hours a week of therapy for 1 to 3 years. These studies show gains in intellectual functioning, language development, daily living skills and social functioning. Studies with adults, though fewer in number, show similar benefits. (cited from autismspeaks.com)

When Should Your Child Start ABA?

There is a large body of research that underscores the critical importance of early intervention services for children with autism. The right age for a child to begin working with an ABA therapist is as soon as he or she shows signs of autism or is diagnosed with a developmental disorder. According to the well-renowned source, “Autism Speaks,” in a study with toddlers, intensive behavioral intervention helped all ages, but those who started before age 2 were most likely to make dramatic gains.

This All Sounds Wonderful But…

As we know it is most beneficial to start ABA as early as possible but it doesn’t always happen like that for many reasons; to name a few, many families don’t receive an autism diagnosis right away, sometimes they will receive it later in the child’s life, 3-4 years old. Furthermore, many families are not aware of ABA therapy, and finally many families think that they have the “situation under control” and they don’t require outside support.

But Guess What …

Just like ‘Susan’ many families start to see signs and/or behaviors that indicate their child might need ABA Therapy however they are still not certain; Here is a list of some scenarios (using Susan’s son John as an example) to help parents know “It’s time for ABA therapy….”

It’s time for ABA therapy when…

1. My child’s behaviors are starting to interfere with our family’s normal day to day routine. For example, John’s mother is not able to take him into the supermarket because John has a temper tantrum every time he needs to leave the car and enter a store.
2. John’s Mom is noticing that he has been lining up his toys in a specific way and has a very hard time coping if the order is not the way that he prefers it to be.
3. School reports; John’s family is receiving feedback from his teachers that John’s aggressive behaviors are starting to interfere with his learning and are preventing him from learning and establishing relationships with his peers.
4. John isn’t able to tell his parents his wants and needs on a daily basis and as a result there has been an increase in problem behaviors including aggression and noncompliance in the home.
5. John’s language is not developing as a typical child’s would; for example, he is not able to engage in a normal back and forth conversation with a peer.
6. John’s Mom is seeing that John does not make eye contact with other people.
7. John has been having a hard time when his parents tell him “no” and as a result is exhibiting aggressive behaviors both in the home and in the public.
8. John is fixated on his routine during the day and is displaying noncompliant and aggressive behaviors if his routine is changed.
9. John is having difficulty sleeping throughout the night and it is affecting his family’s routine/well-being.
10. His mother notices John is not interested in making friends and prefers to be by himself; he rarely initiates any social interaction…
11. John has a very hard time tolerating loud sounds and is putting his hands over his ears when he goes into a public place that is “noisy.”

This is a list of some typical scenarios, however there can be plenty more reasons why it’s time for ABA therapy.

References:

• Cooper, J., Heron, T., & Heward, W. (2007) Applied Behavior Analysis, Second Edition. Upper Saddle River, NJ: Pearson Prentice Hall.
• American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed. Arlington, VA: American Psychiatric Association; 2013.
• https://www.autismspeaks.com

Top Characteristics of an ABA Therapy Provider

by admin | Oct 31, 2019 | ABA Therapy, Parent

By: Alyssa Joyce, MS, BCBA and Lauren Fernandez, BA

Applied Behavior Analysis (ABA) is an evidence-based therapy that is deemed a treatment for individuals diagnosed with Autism by the US Surgeon General and by the American Psychological Association. Due to the data driven backing of ABA therapy, it is important to find an ABA provider that is both a great fit for your child and family, as well as a provider that truly understands the science of learning and behavior (Baer, D. M., Wolf, M. M., & Risley, T. R.1968). It is crucial to remember that quality of service is directly linked to the quality of the provider. Unfortunately, finding the “perfect” provider can be difficult. Below are several key factors and/or skills that caregivers should be on the lookout for when choosing a provider.

What an ABA Therapy Provider Should Have Clinically

When it comes to your child, “good” is not good enough. That is why, clinically, a provider should have four strong essential qualities; Credentials, Training, Staffing and Scope of Practice. The very first key ingredient that is necessary to outstanding ABA service is the credentials of the agency as a whole. Caregivers should seek a provider that abides by the Behavior Analyst Certification Board’s Professional Ethical Compliance Code and Guidelines for Responsible Conduct (Carr, J. E., & Nosik, M. R.2017). It is also imperative for the agency to comply with all local, state, and federal laws with regards to the provision of services. Another, highly sought after, achievement that professional providers should hold is the Behavioral Health Center of Excellence® Accreditation (BHCOE®). The BHCOE international accreditation is awarded to agencies, like Attentive Behavior Care, that display and have met an assortment of clinical and administrative standards according to a qualified third-party evaluator.

Like stated earlier, training and staffing are two ingredients that go hand and hand when choosing an ABA provider. Apart from the agency as a whole, individuals who are administering direct care and supervision for ABA services must have their own individual credentials. Team members working with your child must include a Board Certified Behavior Analyst (BCBA®), Behavior technician (some states require a Registered Behavior Technician certification), and usually includes a case coordinator. In order to practice as a BCBA®, the individual has to obtain a master’s degree from an accredited institution completing specific coursework related to the field of Applied Behavior Analysis, have a minimum number of 1500 hours of supervision from a BCBA®, as well as sit and pass the BCBA® national examination. But because credentials only show that a BCBA® has passed an exam, it is important to question their personal experience and ask about the agency’s training program/continuing education programs. Reputable agencies, like Attentive Behavior, have a department that is dedicated to come up with and implement rigorous training programs for its staff to meet the standards of the agency.

These training programs ensure that both BCBAs® and Behavior Technicians are well rounded in all areas of ABA and are fully prepared to handle a wide variety of unique cases. ABA is an ever-changing field with new advancements made constantly, which is why continuing education programs (CUs) are also vital. Agencies that promote and support their staff attending CU conferences, meetings and events are what every parent should be looking for when it comes to who will be serving their children. Lastly, a fundamental piece to choosing the correct provider for your child has to do with scope of practice. Scope of practice refers to the techniques, procedures and protocols that BCBAs® are extensively trained in. Your child’s BCBA®, Behavior Therapist, must follow strict guidelines to ensure that your child is getting the highest quality of service possible.

What an ABA Therapy Provider Should Have Executively

Your child’s diagnosis with Autism can be scary. A provider that has both a strong Clinical team and Executive team is essential to best help you, your family and your child overcome what can be viewed as a stressful process. First, it is of most importance the agency you are interested in accepts your health insurance. Before researching which ABA provider is a best fit for your child, you must know what type of health benefit you have. Luckily, due to much advocacy, all fifty states have taken action to require some sort of ABA coverage. Some plans are “full coverage” meaning the state implements benefit regulations while others are “self-funded,” which is regulated by federal law. There are other options for families effected by Autism as well; Medicare, Marketplace Health Insurance, TRICARE, and Federal Employees Health Benefits (FEHB) Program (TRICARE, 2006). Reputable ABA agencies usually have an intake department where parents can verify health benefits, discuss co-pays, ask questions, and receive plenty of information with respect to health coverage.

Most ABA agencies are home based, which data has proven to be an effective treatment for those diagnosed with Autism (Lovaas, Koegel, Simmons, & Long.,1973) But providers that truly are well rounded offer more than one location for their services. For example, Attentive Behavior offers in home ABA therapy, clinic-based therapy, group socialization sessions, and community outings. One study by Dixon, Burns, Granpeesheh, Amarasinghe, Powell, and Linstead (2014) has actually shown that individuals receiving center-based services over home-based services demonstrated higher rates of learning during treatment. This alone can demonstrate providers who offer many service locations truly know the benefits of a wide variety of service delivery forms. It is also important to ask what other evolving programs the agency coordinates; summer camps, day-programs, Early intervention programs, transition programs, etc. It is imperative to find this information about a provider early on so as your child grows there is no need to find a new agency that can support their progression.

Finding a “perfect fit” ABA agency for your child can be tough and stressful. The above traits and characteristics are great points of reference to help caregivers find an agency that provider unparalleled services. The hope for this blog was to shed light and help the decision-making process easier to meet your child and family’s needs.

References:

• A Program Evaluation of Home and Center-Based Treatment for Autism Spectrum Disorder. Behav Anal Pract. 2016;10(3):307–312. Published 2016 Oct 25. doi:10.1007/s40617-016-0155-7
• American Psychiatric Association (2013). Diagnostic and statistical manual of mental disorders: DSM-5. Arlington, Va: American Psychiatric Association.Dixon DR, Burns CO, Granpeesheh D, Amarasinghe R, Powell A, Linstead E.
• Baer, D. M., Wolf, M. M., & Risley, T. R. (1968). Some current dimensions of applied behavior analysis. Journal of Applied Behavior Analysis, 1, 91-97. doi:10.1901/jaba.1968.1-91
• Behavior Analyst Certification Board. (2016). Professional and ethical compliance code for behavior analysts. Retrieved from http://bacb.com/ethics-code
• Carr, J. E., & Nosik, M. R. (2017). Professional Credentialing of Practicing Behavior Analysts. Policy Insights from the Behavioral and Brain Sciences, 4(1), 3–8.8© 2019 Behavioral Health Center of Excellence (2015). Retrieved from https://bhcoe.org
• Lovaas OI, Koegel R, Simmons JQ, Long JS. Some generalization and follow-up measures on autistic children in behavior therapy. J Appl Behav Anal. 1973;6(1):131–165. doi:10.1901/jaba.1973.6-131
• TRICARE. (2016). Autism care demonstration. Retrieved from http://tricare.mil/Plans/SpecialPrograms/ACD

For more information about ABA therapy or how we can help your child, contact Attentive Behavior Care today.

Being a Savvy Consumer

by admin | Oct 17, 2019 | ABA Therapy, Parent

By: Jacob Papazian MS, BCBA – Regional Clinical Director

Receiving an autism diagnosis for your child or loved one is an overwhelming process that brings a flood of emotions: relief that there is finally an answer, fear of the unknown, trepidation for battles to come. The list is endless, and they all come crashing in waves that relentlessly beat at you with no warning. I am writing this blog post not only as a Board Certified Behavior Analyst (BCBA®), but also the parent of a child on the autism spectrum.

Personally, it was the uncertainty that shook me to the core: what will my loved one’s life be like in the future? Will he be happy? Will he require support his entire life? What will happen when my partner and I are gone and he is alone? The relentless search for interventions began creating a whirlwind of confusion that still plagues us to this day.

A simple Google search for “treatment for autism” brings a plethora of interventions: ABA, Floor Time, Equestrian, Speech, Occupational Therapy, Recreational Therapy, SonRise, Music Therapy, and the list simply continues to grow. How do you choose the “right” one? What is the “best” option? How do you, as the parent, make an informed decision that minimizes your resources (i.e. time, money, travel, etc.) while maintaining progress.

How Do I Become a Savvy Consumer?

The first step to being a savvy consumer is to do your research and determine which are going to be the most effective. With so many options to choose from as far as interventions are concerned, it can be completely overwhelming. A quick Internet search can provide a plethora of information regarding efficacy, side effects, and testimonials for and against. Although these data are helpful¸ they are not evidence. Testimonials are simply expressions of an experience and not necessarily reflective of the true nature of that treatment. More importantly, the individuals expressing these opinions may not necessarily be experts in that intervention and may not be able to speak fully to all aspects of the treatment or not provide a full or impartial depiction of each component.

The most important thing to do is to find the empirical evidence that supports the intervention of choice. You will find many interventions that are not based on scientific data or those in which only very weak forms of evidence exist. It is strongly recommended that these types of interventions are not implemented simply because they take up resources that could be used for those that are evidence based and have a long history of effectiveness.

So I Chose an Evidence Based Service. Now What?

The second major step to being a savvy consumer is to advocate for what your loved one needs. You will be encouraged to try things that seem strange in any intervention (see our ABC blog about the strange things we do in ABA and why we do them!)

But if something does not seem right or just plain wrong, voice your concern. If your loved one is not receiving the services they require or the provider is not following through with what they prescribed or recommended, speak up. Any professional worth their copay is going to listen to your concerns. They may continue to recommend services in a manner that is confusing or difficult to attain in its entirety, but those that simply dismiss your concerns are not worthy of your time or resources.

The third major step: look at the qualifications of the professionals working with your loved one. What type of credentialing do they hold? Does your state have a license for their intervention and if so, are they licensed and in good standing? Is there a national credential or certificate that is recognized by insurance companies? Remember that licensing and certifications provide standards for education and experience and screening. Don’t be shy to ask about their educational background and their current licensing. Transparency about history and experience is a critical feature of effective and ethical service delivery. Ensuring that person delivering services is either certified/licensed or supervised by someone that is can dramatically improve the quality of services delivered.

The final step to being a savvy consumer: constantly evaluate progress. If you are spending your time, energy, and effort to engage in a treatment or therapy, it is important that it is effective. If the professional you are working with is not actively monitoring progress or keeping you involved in changes to the overall plan, it may be time to discuss your concerns with them. In order to ensure that effective decisions are being made, BCBAs® routinely review data collected in session and make decisions.

Being a Savvy ABA Consumer

Up to this point we have discussed being a savvy consumer of any type of service. However, Applied Behavior Analysis programs have their own specific accreditation and intervention styles that require specific consideration to see if they are a good fit for your family. Not all programs are created equal and each BCBA® is going to approach your child’s treatment differently based on their experience, training, and clinical style. Here are things to look for when trying to find a quality ABA provider.

Look for a program that meets your family’s needs.

ABA programs can be offered in a plethora of settings but are most commonly in home or in a center/clinic for outpatient treatment. If you know that scheduling will be difficult or the drive to the program is going to be a barrier to treatment, home based services may be a viable alternative. Perhaps home is going to be incredibly distracting for your child or there simply is not a private enough area to complete treatment for the day. A center based program may be more appropriate to promote learning and progress. If you are concerned about leaving your child at a center based program, ask to observe a session. You may be asked to observe from an observation room or similar to protect the privacy of other consumers in the clinic, but a quality program encourages participation in treatment. (Attentive Behavior Care offers both home and clinic based program in most of its locations!)

Ask about accreditation.

Ask if the program is accredited. Although not required for insurance reimbursement, accreditation demonstrates that program administration has gone through the process of evaluating their systems for quality control, clinical excellence, and consumer satisfaction with services delivered. Remember that all accredited programs have pain points and problems and that non-accredited programs can be fantastic and provide incredible services. This is simply a way for you to gather more information about the program. (Attentive Behavior Care is a 2-year Accredited Behavioral Health Center of Excellence – BHCOE)

For more information about ABA therapy or how we can help your child, contact Attentive Behavior Care today.

What to Look for in a High-Quality ABA Therapy Program

by admin | Oct 10, 2019 | ABA Therapy, Parent

By: Gabrielle Galto, MS, BCBA, NYS LBA

Autism Spectrum Disorder (ASD) presents us with unique and challenging symptoms across a number of areas including, but not limited to engaging in problem behavior, limited communication skills, decreased social interactions, and abnormal play and/or leisure abilities. These challenges can impact any individual’s daily life functioning and well-being.

This leads to some important questions when looking into Applied Behavior Analysis (ABA) programs for your child with ASD;

1.  What does a high-quality ABA program look like?
2.  How can I tell if my child has an effective ABA program?
3.  What are the key indicators?

I will go into all three of these questions as best I can to illustrate what a well-rounded ABA program should look like and present those key indicators to identify for families already enrolled or address at the onset of services.

ABA involves many techniques for understanding and creating behavioral change that will lead to socially significant outcomes. In order to ensure you are obtaining high-quality care it is important that treatment is supervised by a Board-Certified Behavior Analyst (BCBA®). The BCBA® would oversee, supervise and train the behavior therapist or registered behavior technician (RBT). The therapist will then work directly with your child on goals outlined by the BCBA®. If you hear someone simply say they “do ABA,” that probably means they are not a qualified provider or have quality training.

Assessment

First off, an ABA program is not a “one size fits all” treatment modality, meaning it should be individualized to your child. I am sure you have heard the saying, “If you’ve met one person with autism, you have met one person with autism.” Even with common features of ASD, there is also great variability between individuals. This is why you want to make sure treatment is developed for the individual, not just the ASD since that can lend itself to ineffective treatment. Okay, so now that we got that out of the way, what is next?

Prior to the onset of treatment, a comprehensive assessment is needed to develop an individualized treatment plan. The assessment should include a thorough evaluation utilizing a variety of measures such as indirect and direct assessment of the child’s skills and functioning level. The assessment tools can vary depending on functioning level, for example some individuals may require a more language-based assessment (i.e., VB-MAPP), others social (i.e., Socially Savvy), or functional skills (i.e., Essential for Living). Regardless of what type of assessment tool is used (multiple may also be used), a main goal will include teaching and increasing independence of skills.

Next, a well-rounded treatment plan and recommendations should be based upon the assessment results that target the core deficits of autism spectrum disorder. Another factor to look out for is the inclusion of caregivers within the treatment process to provide for the most comprehensive treatment package. Some useful questions for caregivers can include: 1) How will care be coordinated across providers and teachers? 2) Is involvement with caregivers and/or siblings required? 3) How are the therapists trained? 4) How will you manage problem behavior? and 5) How do you plan on evaluating progress?

Programming

What does an effective ABA program look like, you ask? The treatment plan should include goals across the core deficits of autism, reduce any barriers to learning, and increase independence across environments (i.e., home, school, community). When looking at a treatment plan it is important that there are clear, concise objective goals that are building upon your child’s strengths. Next, goals should be taught systematically through the use of evidenced based practices emphasizing reinforcement systems. If services are not building upon a child’s strengths or do not have a reinforcement system in place, this could be a red flag. In contrast, if punishment systems are in place without any alternative reinforcement system, that is a big red flag.

Programing should be consistently monitored by a BCBA®, where if progress is not demonstrated this should be discuss with the provider(s). I always stress to my providers that if the child is not showing progress that is a signal for us that we are doing something wrong. A key indicator for quality care includes consistent oversight of the BCBA®, specifically when progress is not demonstrated assessment should be conducted and appropriate changes made to further facilitate behavior change. The BCBA® should schedule regular direct oversight supervising the client’s treatment plan and implementation. The number of hours can vary from case to case that typically will correspond with the amount of direct treatment hours provided. High-quality ABA should include consistent oversight of the client’s progress, technician’s implementation of behavior analytic techniques, and communication with the family.

Program goals can look immensely different across each person, which makes me a little resistant on describing what exactly an ABA program should look like. Again, with what I have described prior make sure that goals are targeting those core deficits of ASD; communication skills, social skills, and restrictive-repetitive behavior (including maladaptive behavior). It is important that goals are balanced across each of these areas, however programing may need to first focus upon reducing restrictive behavior prior to other areas to ensure success across additional domains. Important areas that indicate a quality ABA treatment plan include goals that target barriers to learning such as, compliance to tasks, weak or limited communication such as ability to request for wants and needs, problem behavior, self-stimulatory behavior, and/or obsessive-compulsive tendencies to name a few.

Instructional methods can include very structured teaching techniques to facilitate learning, but teaching should be further incorporated within multiple areas and environments. When teaching skills, it is important to see not only structured training sessions, but once mastered, a systematic plan for assessing and training within a more naturalistic approach. Therefore, some ABA programs can look very much like play to mimic how a natural environment may be set up for a child. When looking at a program targeting natural environment teaching some goals could include increasing appropriate play, language, and social skills. The therapist may start with a game or preferred play activity to work on turn taking, waiting, and may even refrain or hold back from giving the child an item to encourage communication. All the skills just mentioned often can occur on a day to day basis for a family and are required across a lifespan. These are the type of goals you want to see your child learning! Things that will continue throughout life, lead to other social interactions, and an overall happy healthy life!

Lastly, it is important that caregivers are able to replicate mastered skills to ensure that a child is able to demonstrate generalization, meaning they are able to exhibit skills learned with one person across a novel person (such as a parent). The BCBA® should plan on targeting this process and create a plan to ensure that success is observed with others. It won’t be socially significant if a child is only able to comply to a demand or communicate their needs in the presence of the therapist and not a caregiver. The treatment modality described is called parent training, which targets generalization and maintenance of skills. During these sessions other skills could be further targeted that may only be a concern when in the home or community with the parents or other caregivers. It is important that this part is included to ensure effective treatment is provided as this will further lead to the most progress for a family’s overall daily living.

References:

• American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: Author.
• Bailey, J. S., & Burch, M. R. (2005). Ethics for behavior analysts: A practical guide to the Behavior Analyst Certification Board guidelines for responsible conduct. Mahwah, N.J: Lawrence Erlbaum Associates, Publishers.
• Ellis, J.T., & Almeida, C. (2014), Socially Savvy: An assessment and curriculum guide for young children. New York, NY: Different Roads to Learning Inc.
• McGreevy, P., Fry, T., & Cornwall, C. (2012). Essential for Living. Winter Park, FL: Patrick McGreevy.
• National Autism Center (2009). National Standards Report. Randolph, MA.
• Sundberg, M. L. (2008). VB-MAPP: Verbal Behavior Milestones Assessment and Placement Program. Concord, CA: AVB Press.

For more information about ABA therapy or how we can help your child, contact Attentive Behavior Care today.

7 Dimensions of Applied Behavior Analysis

by admin | Oct 3, 2019 | ABA Therapy, Parent

When Should My Child Stop ABA Therapy?

by admin | Sep 26, 2019 | ABA Therapy, Parent

By: Nahoma Presberg, MS BCBA

ABA therapy is highly individualized and very personal. From the decision to seek this therapy for your child, to finding the right practitioners, to when to discontinue services, there are no concrete rules.

In this article, we will discuss the factors that should be considered when thinking about discontinuing ABA therapy including progress on treatment goals and assessments, socially significant progress, availability, support system and resources, and funding. We will then discuss some tips for appropriate titration, or reduction in services, and ultimately, a successful discharge.

Progress on Treatment Goals and Assessments

Let’s consider this scenario: Your child has been enrolled in ABA therapy for some time and you think that it might be time to consider terminating. What are the thoughts that are going through your head?

The first thing you might think about is what progress your child has demonstrated, or what have been the outcomes of his or her therapy so far. Your child’s ABA therapy provider should be supplying you with a regular progress report, usually every 6-months or so. This should include two things: a description of your child’s progress on the treatment goals worked on during the period and a description of your child’s progress utilizing some regularly administered assessment tool.

First let’s discuss how you might analyze progress on treatment goals. Each goal should display your child’s level of performance prior to the start of treatment, or baseline data, and then display your child’s current level of performance. With the help of your BCBA®, you should be able to analyze your child’s rate of progress. If you find that your child is regularly not making progress on his or her treatment goals, and that these goals are not being updated in order to meet his or her needs, this might be a time to consider either changing ABA providers, or, seeking additional resources. Alternatively, if you see that your child’s rate of progress is very good and that they are mastering treatment goals in baseline or very quickly, this might also be a time to consider reducing or terminating ABA therapy.

Next, you should also look at your child’s progress on the assessment tools your ABA provider is utilizing. This might be something like the Vineland, VB-MAPP, Essential for Living, or something else. The results should inform you of your child’s level of performance before they started treatment and his or her current level of performance. The results may also compare your child’s scores to other children his or her age, or provide some other indicators of progress. It is best to analyze these results with your BCBA®, but the results of these assessments can be a good indicator of when it might be appropriate to discontinue ABA therapy.

Socially Significant Progress

Now that we’ve talked about the progress measured by your ABA provider, let’s talk about the most important thing: progress measured by your family. In ABA, we refer to this as “social significance.” Think about what you were hoping to get out of ABA when you first entered treatment. What was the original reason that you reached out for support? Has your family’s life significantly improved as a result of the progress your child has made with ABA therapy? One of the biggest indicators that it may be time to move on is if you’ve met your goals. For example, you may have requested ABA because your child was struggling with his or her morning routine. Maybe it was a battle to get your child up and ready for school every day. Is that still an issue? If your child has made progress in those goals then you might be ready to move on. If they haven’t, there could be an issue in the treatment plan itself and it might be time to consult with your BCBA® about making program modifications to better support these goals, but it is also probably a sign that you would benefit from continued services. However, once you’ve met the goals that you’ve set out to accomplish, it is worth having a conversation about whether there are additional skills that should be worked on within the context of ABA therapy or if it is a natural time to discontinue or begin to decrease the number of hours of therapy.

Availability

ABA therapy isn’t like taking a pill. It takes a lot of time and energy on the part of both the parents and the child. One of the considerations when determining how many hours of ABA your child should have, is thinking about what other things they would be doing with that time if they weren’t in therapy. Sometimes, parents may choose to prioritize other kinds of opportunities such as sports or camps or other kinds of activities that may be important for a child’s social skills development. If your child needs the support that ABA can provide, then it is worth the investment of time and effort to work on the skill development that they will learn in ABA. However, it is important to identify clear goals and priorities and make sure that time is being spent working towards those goals.

Support System & Resources

When considering a discontinuation of any treatment, it is important to consider what additional supports and resources are available to pick-up where that treatment left off. Although your child may have made significant progress on his or her treatment goals and assessments, your family’s life has improved dramatically as a result of the improvement in your child’s behavior, and you’ve made plans for your child’s schedule to be full of new and exciting extra-curricular activities in lieu of ABA therapy, it is important to take a step back and consider what might be left behind. Does your family have adequate training to implement the techniques that were successful in getting your child to this point? Do you have an appropriate transition plan that will guide you into the next phase of your child’s life? Are there any major changes coming up that might result in the continued need for therapy, such as a change in schools, a new sibling, changes to medication, puberty, or a move to a new town? Discuss all of these with your ABA provider so that they can support you through this transition so that your child will continue on the path for success. In addition, be sure you know how to contact your ABA provider in order to resume services should the need arise, or if you need any additional support throughout the transition.

Funding

Finally, another reason you may choose to stop ABA therapy might be financial.

ABA therapy is intensive and requires a team of highly skilled professionals who work closely on creating an individualized approach for your child. This often comes with an expense that can place a large burden on families and take away from other needs. Currently, all fifty states have coverage requirements for autism treatment. This can significantly improve access and reduce the cost of treatment. That being said, this does not always apply to all individuals. If you are considering stopping ABA therapy due to high costs, reach out to your ABA therapy provider to see if they can provide you with financial support. There are also organizations that provide grants and other support options for families in need.

Alternatively, funding sources may attempt to dictate when ABA therapy should stop based on variables that are not in line with the recommendations of the ABA provider or the family. If this is the case, your ABA provider should be able to give you resources to appeal these decisions and, if necessary, file appropriate reports for wrongful action on behalf of the funder.

The most important take-away from this section is that although ABA is an expensive treatment, if it is medically deemed necessary, and your child is benefiting from therapy, there are many options for funding and financial support that could allow therapy to continue.

Titration and Discharge

Typically, ABA services aren’t simply discontinued. Once your child begins to master goals, it is common to slowly decrease the number of hours of therapy until it is time to stop completely. Decreasing these hours slowly is a way to make sure that the skills maintain outside of the context of ABA and also that additional issues don’t unexpectedly arise. Slowly decreasing the number of hours helps to ease the transition both for the child but also for the family as a whole.

Another consideration is whether you can involve your child in the decision-making process. ABA is often something that a parent decides for their child, However, if it is possible, involve your child in the decision-making. They know themselves better than anyone. While sometimes it may not be possible and each circumstance is different, talking to your child about their goals and priorities can sometimes provide a huge amount of insight about what is best for them.

Lastly, as a parent, this is not something that you have to decide for yourself. The process of reducing and then discontinuing ABA services is something that should be an ongoing conversation between the family and your team of providers. Make sure that you are advocating for the needs of your child and encouraging these conversations on a regular basis so that you can plan for any upcoming transitions that your child or your family will face. The goal of ABA therapy is to teach skills that improve the quality of life. This means that there is always room to make the adjustments that you need so that ABA works for you.

For more information about ABA therapy or how we can help your child, contact Attentive Behavior Care today.

When Should My Child Start ABA Therapy?

by admin | Sep 19, 2019 | ABA Therapy, Parent

By: Tobey Lass M. Ed., BCBA, NY LBA

The time after a child receives a diagnosis can be filled with many unknowns. There are many decisions that families must make for their children and there is no crystal ball that can instruct a family towards what services will provide a favorable outcome.

There is only one course of treatment that all special education experts agree will set a child up for future successes: beginning therapy as early as possible.

Early intervention is a national program for children 3 years old and under geared towards allowing families and children access to therapies such as ABA starting as young as infancy. A child’s early experiences play a critical role in brain development. Receiving therapy from a young age can have a significant impact on a child’s ability to learn new skills and overcome challenges and can increase success in school and life (CDC, 2019). According to the Institute of Child Health and Human Development there are significant negative effects of delaying early access to therapies such as ABA. “It takes four times as long to intervene in fourth grade as it does in late kindergarten because of brain development and because of the increase in content for students to learn as they grow older”. Children can avoid future learning challenges by receiving Early ABA therapy. Teaching children targeted, individualized skills when they are young increases their potential for success since It is easier for a child to acquire skills when a child is younger because of the brains plasticity to learn new things.

The Research

Research shows that a child that starts ABA therapy in childhood has the potential to make significant improvements but emphasizes that ABA therapy is most effective the earlier it is begun. One of the original studies of the benefits of early ABA therapy found that children who began ABA therapy before turning 5 had better outcomes that children who started ABA therapy after 5 years old (Fenske, Zalenski, Krantz, & McClannahan,1985). Subsequent studies demonstrated that children who began ABA therapy as early as 2 and 3 years old led to significant cognitive and adaptive skills. Access to inclusive educational settings in a mainstream classroom is among the significant long term gains made by children who received early access to ABA therapy.

Using ABA as early as possible to address the deficits of Autism can address and decrease many situations frequently experienced in autism families. Deficits in skills associated with an autism diagnosis, such as not being able to communicate their wants and needs effectively, can often result in problem behavior (Koegel, Koegel, Ashbaugh, Bradshaw, 2014). A child might also engage in behaviors such as screaming and tantrum to gain access to an item if they lack functional communication. Behaviors become a form of communication because parents often respond to these behaviors by giving a child what they want when they exhibit the maladaptive behavior to try and stop the behavior from occurring. What parents don’t realize is by engaging in the cycle in the short term stops the behavior from occurring, but in the long term causes the behavior to happen more frequently because the child learns that they will get what they want by engaging in the behavior. The longer a child engages in these behaviors, the more resistant the behavior becomes to change.

Why Start ABA Therapy Early?

Starting ABA therapy early and as close to the onset of behaviors will teach critical skills to both the child and the family to decrease any maladaptive behaviors. ABA therapy can teach a child skill such as functional communication training to replace maladaptive behaviors and parents learn how to respond when their child is engaging in maladaptive behaviors in a way that reinforces the replacement skill not the behavior. These supports have been shown to help both family members and the child gain skills that enable the child’s needs to be better met.

There are so many reasons why families do not start ABA therapy early. Parent’s did not know about it. They did not think their child’s deficits were permanent, they thought their child would “grow out of it”. Parent’s did not want to label their child and stigmatize them too early. The list of reasons for not starting ABA therapy as early as possible is endless. By delaying early access to ABA therapy it is likely that there will be significant negative consequences for children with ASD (National Research Council, 2001). This is why it is crucial for families to speak with their pediatrician if they suspect their child has any developmental delays.

I have never worked with a family who has regretted starting ABA therapy early, I have only heard regrets from families who didn’t start soon enough.

To any family who is at the beginning of navigating their child’s delays or autism diagnosis- don’t delay. Find out how your child can begin receiving ABA therapy as soon as possible in your local area.

To any seasoned autism families who have not yet started ABA therapy, it’s never too late to get your child the help they need.

For more information on the benefits of early intervention and ABA please reference:

• https://www.autismspeaks.org/tool-kit/100-day-kit-young-children
• https://www.researchgate.net/publication/323767830_Early_Intervention_ABA_for_Toddlers_with_ASD_Effect_of_Age_and_Amount
• https://pediatrics.aappublications.org/content/136/Supplement_1/S60
• https://www.ncbi.nlm.nih.gov/pubmed/19948568
• https://www.ncbi.nlm.nih.gov/pubmed/10832778

For more information about ABA therapy or how we can help your child, contact Attentive Behavior Care today.

Why is an ASD Diagnosis so Important?

by admin | Sep 12, 2019 | ABA Therapy, Parent

By: Gabrielle Galto, BCBA, NYS LBA

The following information provided is not meant to diagnose or treat and should not be taken in replacement of a medical professional or behavioral consultation.

Speaking on behalf of this question, I remind myself of how difficult and overwhelming it can be to hear that your child has Autism Spectrum Disorder (ASD). Receiving an ASD diagnosis, as a parent or caregiver, can result in shock and is a really hard pill to swallow. However, an accurate diagnosis can provide some relief since it can help lead to receiving appropriate treatment and services.

An ASD diagnosis comes with many concerns and questions. That said, what I would like to focus on is what follows a diagnosis for a child or other individual with Autism Spectrum Disorder.

Difficulties Without a Diagnosis

In this case, ignorance is not bliss. Without a diagnosis, it could be really difficult to obtain appropriate care and treatment. This could also come with many hardships both emotionally, physically, and financially for families. Individuals, no matter how young or old, without a diagnosis can encounter many difficulties in life that can result in maladaptive behaviors or outbursts, social isolation, and negatively affect their educational abilities. Once diagnosed, the deficits and hardships encountered can be worked on through evidenced based treatment packages designed to help diagnosed individuals reach their full potential. A young child can then start to engage in more appropriate ways to support social development, build friendships, and can be taught skills for independence or even job placements.

Early Diagnosis

Furthermore, early diagnosis is just as important because it provides treatment at such a critical juncture. During this time, treatment can be provided to assess and teach skills to help a child catch up to their peers, providing for a comprehensive intervention package promoting growth across domains. According to the Center for Disease Control and Prevention (2019), ASD can sometimes be detected as early as 18 months but many children may not receive an ASD diagnosis until much later. Developmental screening tests provide an assessment on learning basic skills to determine if a child has delays, and screenings for ASD should be routinely checked. With early detection comes early treatment. However, autism is a spectrum disorder, which means symptoms are presented across a wide range of differences within type and severity.

Therefore, an accurate autism diagnosis is important so that appropriate therapeutic services are provided. Autism spectrum disorder is an extremely complex condition and there has yet to be a single cause for the disorder, which makes it far more difficult to diagnose. ASD affects many areas of functioning including social interactions, communication, idiosyncratic behavior and interests in children and adult alike. Signs of ASD can be presented very differently between each individual, which can make identifying and diagnosing more difficult.

Additional Benefits

An ASD diagnosis can also provide additional resources such as necessary benefits or disability living allowances, and a delayed diagnosis would only further prolong access to these benefits. Furthermore, one  can obtain a diagnosis no matter what age. This diagnosis would provide eligibility for supports, services, and protection under the Americans with Disabilities Act (ADA), which details specific rights and accommodations at work and school for individuals with disabilities. There are also services that provide support with vocational placements and rehabilitation programs such as counseling and job placement services.

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

How Will ABA Help My Child?

by admin | Sep 5, 2019 | ABA Therapy, Parent

By: Megan Miller, MSEd, BCBA, NYS LBA

ABA Therapy

“Applied behavior analysis is the science in which the principles of analysis are applied systematically to improve socially significant behavior and experimentation is used to identify the variables responsible for behavior change” (Cooper, Heron, & Heward, 2007). In simpler terms, ABA makes changes to the environment in order to replace current behaviors with more appropriate behaviors. Keep in mind that “behavior” refers to anything a person does.

What ABA is Not

There are often several misconceptions regarding what ABA actually is. Let’s clarify that by telling you exactly what ABA is not. ABA is not, bribery, doesn’t turn kids into robots, it is not a “one size fits all” approach, it is not only for individuals with autism, it doesn’t only involve discrete trial training, it is not boot camp style, and lastly, it is not just a theory.

Who Can Provide ABA Therapy?

In most cases, a therapist, or registered behavior technicians (RBTs) will provide direct therapy to your child. Therapists and RBTs are trained and supervised by a Board Certified Behavior Analyst (BCBA®). A BCBA® holds a Master’s Degree or PhD in psychology or behavior analysis, is required to pass national board certification exam, and holds a state license (in some states). The primary role of a BCBA® is to assess the child and develop an individualized intervention plan for them which will be implemented by the therapist and overseen by the professional behavior analyst. In most cases, the BCBA® will attend sessions weekly to supervise the therapist and will also provide a parent training session to the family.

Although you may only see your BCBA® on a weekly basis, there are a lot of things that they are responsible for behind the scenes. The BCBA® will also review records, interview parents and caregivers, conduct assessments, develop behavior intervention plans to decrease maladaptive behaviors, develop treatment intervention plans based on the individual’s strengths and weaknesses, develop written procedures, train behavior technicians, caregivers, and others, provide ongoing supervision and monitoring of interventionists, provide ongoing, frequent direct observation and measurement of target behaviors and review and analysis of graphed data, adjusts protocols and targets based on the data, train interventionists to implement the revised protocols, review progress with the client, caregivers, and intervention team, provide coordination of care with other providers (e.g. medical doctors, school teachers), and write up reassessment reports.

What Does ABA Look Like?

It varies based upon the child’s individual needs, but most ABA programs will incorporate various teaching strategies throughout a single therapy session. Below are a few of the most common teaching strategies.

Discrete Trial Training (DTT)

• 1:1 teaching method
• Involves intensive learning of specific behaviors
• Big learning tasks are broken down into smaller steps

Natural Environment Teaching (NET)

• Teaches skills in settings where your child will naturally use them
• Uses the child’s natural motivation in the moment to provide meaningful learning opportunities

Individualized Treatment Plan

Most treatment plans will work on increasing skills in a wide variety of areas such as, communication, social skills, play and leisure skills, and daily living skills. The skills being taught must be socially significant to the individual. Typically skills that impede most on the individual’s ability to learn and function independently are targeted for intervention. When receiving ABA therapy services for insurance funded programs all skills that are taught must directly be related to the core deficits of autism spectrum disorder, which are deficits in social communication, social interaction, and restricted, repetitive patterns of behavior, interests, or activities.

Data Collection

Data on your child’s performance will be recorded throughout each therapy session. Continuous data collection and analysis of this data, allows treatment protocols to be constantly assessed and tailored to meet the needs of a specific individual. The BCBA® overseeing your case will review records, provide ongoing supervision and monitoring of interventionists, provide ongoing, frequent, direct observation and measurement of target behaviors, review and analyze all graphed data, adjust protocols and targets based on the data, and train the therapist to implement the revised protocols.

Skill Acquisition

Individuals will be taught more appropriate skills to replace problem behaviors. Positive behaviors will be targeted for increase, while interfering behaviors will be targeted for reduction. Skills are chosen based on the individual’s specific needs and can be provided in a one to one or group setting. ABA therapy can be provided in a variety of settings such as, home, school, and within the community.

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 materials, people, and settings. Some individuals may require more explicit training in order to generalize skills that are taught during therapy sessions. 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.

Behavior Reduction

All behaviors serve a function and are likely occurring for one of the following reasons, escape, attention, access to a tangible, and/or self-stimulation. Once we determine the function of a behavior, then we can teach a more appropriate behavior to help the individual get what they want.

Parent/Caregiver Training

Parent/caregiver training is provided to families whose children are receiving ABA services. The purpose of family training is to support the family by providing them with strategies and tools to better help support their child outside of therapy sessions. Families will also learn how to interact with their children in a way that teaches them how to reinforce and help generalize skills that are targeted during therapy sessions.

Effectiveness of ABA

ABA is a research-based science that has data to back it up. The United States Surgeon General (1998) concluded, “Thirty years of research demonstrated the efficacy of applied behavioral methods, in reducing inappropriate behaviors and increasing communication, learning and appropriate social behavior.” Continuous data collection and ongoing analysis of this data allows treatment protocols to be constantly assessed and tailored to meet the needs of a specific individual.

When Will I See Results?

There is no set timeline for how fast or slow an individual will learn. Interventions are constantly being monitored and adjusted to account for maximum progress. Some individuals are better in some skill areas than other areas, which means faster progress in some skill areas and slower progress in other skill areas. Consistency across people and settings will help skills to be generalized. It is also very important to stick to your recommended number of treatment hours in order to receive the best outcome from therapy.

References:

• American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed. Arlington, VA: American Psychiatric Association; 2013.
• Cooper, J. O., Heron, T. E., & Heward, W. L. (2007). Applied behavior analysis (2nd ed.). Columbus, OH: Merrill Prentice Hall.
• Kanchwala, A. (n.d.). ABA 101. http://theautismhelper.com/wp-content/uploads/ 2015/09/ABA-101-Handouts-The-Autism-Helper.pdf.
• United States Surgeon General (1998). Mental health: A report of the Surgeon General. Washington, DC: Author.

For more information about ABA therapy or how we can help your child, contact Attentive Behavior Care today.

Back to School: 7 Tips and Tricks to Ease Your Child’s Transition

by admin | Aug 29, 2019 | ABA Therapy, Parent

Can anyone believe it is back to school time? To many families, back to school means a time of stress and frustration. It can be incredibly difficult to transition from the free flowing days of summer to the structure and rigor of the classroom.

Getting into the routine may be met with some interesting behavior. It’s important to remember that no transition is going to be completely smooth, but there definitely ways to make it a bit less challenging.

Here are 7 tips and tricks to help ease the transition back to school.

1. Keeping a routine is key: If you have not started already, it might be helpful to start getting a consistent bed time and wake up time similar to what it will be like in the school year. This will help not only set the expectation for when school begins, but also get your child’s biological clock on the right schedule. If you’re interested check out this cool resource on how to reset your circadian rhythm. #science!
2. Calendar marking down the days: Some individuals may find it helpful to have a visual of when their vacation is over and school begins. Take time each day to cross the current day off with your child and remind them that the school year is starting soon. Creating a concrete picture of when “freedom” ends and the work begins can help some individuals.
3. Take a trip to the school: If your child lives by the motto “I’ll believe it when I see it” set a time to go by the school and walk up to the front doors. Perhaps show them where they will enter each day or where the bus will drop them off. Practice walking from your home to the bus stop. Any combination of these types of activities can reduce problem behavior by simply exposing your child to the routine.
4. Create a visual schedule or social story for the school year: By now you probably have some idea of who your child’s teacher may be or what classroom they may be in. If you have that information, write a social story about what the first day may be like. Focus on the positive aspects of starting a new school year: new friends to meet, a new teacher, learning really cool stuff and new school supplies!
5. Prepare the night before: Nothing can be worse than scrambling the night before a big event. The night before school starts, make sure everything is in order: backpacks are made, lunches are ready to go, and breakfast is ready to be made in the morning. It’s quite a bit of extra work but the morning will likely flow better and the transition will be a bit smoother.
6. Drop off and pick up place: As annoying or redundant as this may sound, having a specific place to put a jacket, backpack, and shoes can be an incredibly helpful way to establish a routine. Anyone ever watch Karate Kid with the jacket? It’s kind of like that. It not only provides a consistent routine, it provides a level of independence. Eventually you can say to your child “go get your shoes and backpack” and continue about your morning routine.
7. Get into routines: Once the school year starts the transition does not fully end. Establish a few nightly routines to help keep things going strong. Have time set aside for relaxation time, homework, meals and extracurricular activities. Make sure that these times are consistent, but be flexible. You may have a homework-light night or just want to watch a movie as a family.

Unfortunately, there is no one simple way to help your child transition from summer vacation to school without any problems. With some planning and preparation the transition can be less difficult.

If you are interested in learning more about Behavior Analysis, join us for our Parent Engagement webinars!

Is ABA Therapy Really an Effective Treatment for Autism?

by admin | Aug 29, 2019 | ABA Therapy, Parent

By: Tobey Lass M. Ed., BCBA, NY LBA

There are many therapies marketed towards treating autism all claiming to be effective. According to Autism Speaks, ABA therapy is one of the most popular therapies used to treat autism. Despite it’s popularity, most of the articles I found about ABA present information subjectively. Selecting what treatment to pursue for treating autism spectrum disorder can be an overwhelming task. What information do parent’s need to know to objectively determine if ABA is an effective treatment for autism?

What is ABA?

Applied Behavior Analysis (ABA) is the science of human behavior. ABA focuses on improving specific behaviors through a system of rewards and consequences. The principals of ABA were founded on B.F. Skinner’s research which measured the effects of consequences in teaching behaviors to animals.

How did ABA go from animals to autism?

ABA remained laboratory based until the 1970’s when Dr. Oscar Lovaas developed a method of teaching children who have autism using B.F. Skinner’s theories of behavior. The effectiveness of his method was validated by Dr. Lovaas’ research. The data showed that the children who received daily, intensive instruction demonstrated significant improvements in their symptoms with almost half being classified as having “normal intellectual and educational functioning”. Dr. Lovaas method became known as ABA therapy and has been used as a treatment for children who have autism for over 40 years.

Ok, but Lovaas’ article was only one study. How did it become the model for modern ABA therapy?

Since ABA is a data driven therapy its methods can be replicated evaluated using the scientific method. Being able to replicate data ensures that behavior change is direct result of ABA therapy. ABA studies have been peer reviewed, which means that the methods were deemed effective after being evaluated by an outside group of researchers.

Don’t other therapies have research to support their effectiveness?

Many therapies claim to be effective treatments for autism. The difference between ABA therapy and the other therapies is science. ABA is the only therapy whose methods have been validated through the scientific method. ABA’s roots in science is the reason that ABA has been endorsed by state and federal agencies, such as the US Surgeon General. It is also the reason why doctors deem ABA therapy medically necessary and why is covered by health insurance.

I’m a parent, not a scientist! How can parents determine if ABA is an effective treatment for autism?

Effectiveness of ABA therapy is easy to evaluate as a parent as well. ABA is one of the few therapies covered by insurance that provides parents with parent training hours. These hours are to be used for collaboration between the BCBA® and the parents and caregivers to discuss the child’s progress, answer parents’ questions, and provide training to carry over effective methods outside of therapy sessions. The role of data is extremely important for determining if ABA is an effective treatment. BCBAs® choose goals and instructional procedures based on data from studies in ABA journals. Progress is evaluated by analyzing data collected during instruction and indicates what changes should be made in a student’s program to ensure that learning is occurring. For a parent, data is an objective way to evaluate progress which enables parents to make informed decisions about how their child is doing in ABA therapy instead of relying on anecdotes.

But you’re a BCBA®! You’re biased. How can you objectively consider other therapies?

Unbeknownst to the families I work with, I was not always a believer in ABA. In college I was introduced to complementary and alternative therapies used to treat Autism. They all made so much sense to me. Each therapy had multiple clinicians and parents raving about the life changing effects of these therapies. I spent hours and hours studying the theory behind each therapy. Outside of my classes I sought out further training from the top practitioners in different therapies to improve my practice. In my first jobs working with individuals who have autism I used these methods to teach my students. I believed that complementary and alternative therapies were the effective methods of treating autism.

Until my Intro to ABA class.

I first heard about ABA from a high school teacher after I told her I wanted to teach individuals who have autism. I watched the videos and read articles and I was not impressed. I viewed ABA therapy was outdated, cold and rigid, basically the opposite of the educator I wanted to be.

I came into the class ready to challenge everything the professor said, armed with years of knowledge from studying complementary and alternative methods for treating autism.

I tried over and over again to disprove what we were learning with examples of other methods that could be used to achieve the same goal. Any evidence I used to support my beliefs was quickly refuted by my professor. I found myself unable to challenge his responses- his beliefs supported by data unlike mine which were derived from anecdotes. In a few weeks my beliefs about what therapies were effective for treating autism completely changed; ABA replaced complementary and alternative therapies as the most effective treatment for autism.

I’m a BCBA® because I believe ABA is an effective therapy for autism.

So, is ABA an effective therapy for treating autism?

As the only scientifically proven, data driven, and objective therapy for treating autism: my answer is ABSOLUTELY YES.

Still not convinced?

For more information about ABA therapy or how to determine effective treatments options for autism contact Attentive Behavior Care today.

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

by admin | Aug 22, 2019 | ABA Therapy, Parent

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.

• https://www.healthyplace.com/parenting/parenting-skills/reinforcing-positive-behavior-at-home
• https://positivepsychology.com/parenting-positive-reinforcement/
• https://www.care.com/c/stories/3467/6-positive-reinforcement-examples-to-try-with/

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

What to Expect From ABA Therapy

by admin | Aug 8, 2019 | ABA Therapy, Parent