SEARCH RESULTS

In light of many recent events within our field, I think a bit of explanation is in order to reaffirm values and ideals within our agency, as well as I believe any ABA agency that is providing ethical services. ABA is such a valuable addition to any therapy program and has some pretty amazing benefits and results, with children often rapidly gaining skills and eliminating many dangerous behaviors within 1-2 years. Over the next few weeks, I will be highlighting some common complaints/ misconceptions about ABA and focusing on a few key points to address my thoughts on these. ABA Professionals are “Know it All's”. This one hits home so hard, but as professionals in any field know, you can not do it all. We need and thrive when we work with a collaborative, multidisciplinary team. Agencies need to be kind to others in their field, and practice within their scope. ABA is not the only answer, but rather is one piece of a giant puzzle of PTs, OTs, SLPs, Feeding Therapists, caregivers, teachers and other professionals in a child’s life. Finding a BCBA who can manage this will save you precious time and allow for maximal progress as usually we can teach other providers what we know only if they are interested in learning from us, and frankly, who wants to learn from someone who does not know how to be humble? "ABA creates robotic responding". This is absolutely true, that if done poorly without planning for generalization, children may start responding automatically with the same 2-3 responses regardless of what is being asked of them. However, with effective therapy and proper supervision, typically this “phase” is short lived as we increase more responses in their repertoire and they learn that repeating the same word over and over does not lead to access to any item but rather to that one specific item they are requesting. In the same way, children may walk around clapping or touching their head because this was a skill targeted through sessions, but they should grasp shortly that nothing happens when they clap or touch their head if no one has asked them to. If you are seeing this type of response for more than a few weeks, programming should be changed to address this, as this is never the intention of a provider.

ABA therapy utilizes many teaching techniques for learners to gain new skills. Prompting is one technique which is frequently included within programming and is often very successful. Prompting refers to the therapist providing something which aids in the learner completing the correct response (such as selecting the correct answer, pumping soap into their hands during hand washing, or answering correctly when we ask “What is your name?” Without prompting, many learners would either not engage in the correct response (i.e. they would continue to rub their hands under water without getting the soap) or they may answer incorrectly (such as when a learner repeats the question we are asking instead of giving the answer). Prompting can take many forms, verbal (where we are saying the whole or part of the answer), physical (where we might place our hands over the learner to guide them to the soap), gestural (where we may point to a correct answer), or a stimulus prompt (where we provide something to prompt them within their environment, such as a highlighted line for a paper, or a sign that says “Stop” when we want the learner to stop doing an action. Prompting has 2 main methodologies, least to most and most to least. When we prompt the learner immediately with a “large” prompt (such as physical guidance), this is commonly referred to as errorless teaching. When we prompt using a “small” prompt such as a gesture or a small sound (like the first sound in a word) we refer to that as least to most prompting Both of these methods are helpful for different reasons and as such there is no one size fits all approach to designing skill acquisition programs. All programs should be individualized to the learner to ensure that adequate progress is made and adjustments should be made regularly if this is not occuring. To expand more on how these decisions are made and how individuals may benefit from one method over another , explore them both in more detail. Errorless teaching prevents mistakes or errors from occurring. If errors do not occur, learners become frustrated and may exhibit challenging behaviors such as hitting, kicking, screaming or trying to throw teaching materials. This makes sense because they are not getting the answers correct and are not getting access to reinforcers. Errorless teaching is also beneficial because by eliminating errors we are making it more likely for correct responding to continue to occur. If errors and mistakes happen frequently, we are more likely to repeat these errors or mistakes instead of the correct answer. In contrast, least to most prompting is successful because it often allows great independence in skills to be gained at a rapid rate. This means a child or adult that often “waits for someone to do it for them” may learn with this method that the prompt is not coming quickly and may complete the task themselves.

Despite its serious name, a behavior contract is a great tool that can be used at home or in school to help kids reach their goals. Similar to how adults have a job contract and description, a behavior contract outlines goals and behaviors that we want to improve and sets up criteria for reinforcement. Both the child and caregivers work together to make this contract, so it has input from everyone involved. As the caregiver identifies goals, the child is able to identify reinforcers and incentives that will motivate them. Once all parties are satisfied with the contract, it can be “signed” and enacted! Here is an example of what a behavioral contract may look like, and there are great examples online as well! Keep in mind that when creating a behavioral contract, there are a few key items that should always be addressed! WHO is participating in the contract - this includes the child, yourself, or even any siblings or family members if they want to participate! WHAT is required of the child (the criteria) - written in very clear, precise language. For example “Will clean his room independently before 8:00 PM every Monday.” THE REWARD! What is the child working for? What prizes or reinforcers have they chosen to work for? When will they receive it? This is the part of the behavior contract where the caregiver follows through with their part of the deal. You can also make up great ways to keep track of your child’s progress! This could be a visual chart, a coin or marble jar, or even a calendar with smiley faces! Some behavior contracts even include consequences for when goals are not met, or inappropriate behaviors occur. These should also be discussed when drafting a behavior contract since your child should know about it as well. One of the best parts of a behavior contract is how it generalizes to the real-world. A behavior contract focuses on expanding a child’s executive functioning skills, which includes self-monitoring and even time management. These are all important skills that promote independence, whether it be at home, at school, or even at a job one day. Have you ever tried using a behavior contract at home or in sessions? Let us know your experiences! Credit goes to Kid Pointz for the amazing templates they provide online!

What is Functional Communication? Functional Communication focuses on teaching communication strategies to replace inappropriate behaviors. These communication responses or FCRs are based on the function or “reason” a behavior occurs. For example, if an individual throws their food on the floor when they are finished eating, we may teach them to say “all done” in order to have the food removed appropriately. In the same way, a child who screams every time their parent removes an item they like playing with may be taught “One more minute”or“More time” to request a small amount of additional time before the item is removed. Teaching these words or short phrases are much more effective at decreasing behaviors as they immediately target a problem the individual is having in their environment and opportunities to practice can be generalized with all caregivers quickly. ​Functional communication can occur via words, signs, PECS or a communication device. Regardless of their verbal skills, these responses are necessary as they aid in reducing behaviors that likely are significantly impacting the individual and their family. Often, when a client masters these (even with use of PECS or a communication device), their maladaptive behaviors are significantly decreased or even eliminated and families report higher levels of engagement in activities as a result of their improved communication skills.

Do you often wonder how we as Behavior Analysts figure out what strategies to use when reducing challenging behavior? If you struggle with understanding the “whys” of behavior and using this knowledge to know what to do when your child misbehaves please follow below to see if you can recognize the “function” of the behavior. There are 4 main functions of behavior: ​Attention, Escape, Tangible, and Sensory. Now think about your own child, do you see any of these root causes for any of their behaviors?

Parenting is a hard role to fill and parenting a child with a behavioral concern or developmental disability can be very challenging. However, participation in parent training on a regular basis can have amazing lasting effects and really enhance your child’s progress. Here are some key tips to getting the most out of your ABA therapy experience. Advocate for yourself: Ask your supervisor for parent training frequently. As a supervisor, I often get caught up in the supervision and program development aspect of a case and as a result may forget to ask families to set up time to review their own goals for learning and skills. Your success depends on getting these times scheduled, so please try to ensure that you have multiple options available and take advantage if the supervisor has openings! Set clear goals and be prepared to discuss. I like to ask families to choose 2-3 things that they would like to change within the next 6 months. Try to make these as specific as possible (goals such as, they will talk more will often fall flat because there are so many smaller parts to this). Think about your daily life and what would be most helpful for you. Ideas include, my child will play alone for at least 10 minutes, my child will be able to go to a playground for 15 minutes without attempting to run away, or my child will request items they want instead of crying or screaming. Be open. Come to training willing to try. Be prepared to answer lots of questions regarding the “ABCs” of behavior and to possibly be asked to try a strategy you may have used in the past (even if it didn’t work). Collect Data (and write it down to share). The best most effective parent training programs I have put together have focused on parents collecting data on progress and reviewing it every 1-2 weeks to ensure continued progress. This is what BCBAs are great at and is how we make programming decisions within programs, so if you can work on collecting this information and providing it to us, you are much more likely to be successful. If you don't understand, ask. Please don’t hesitate to ask “why” we are doing something this way. Our programming is based on the principles of behavior, so if you don’t understand why a particular technique is being used or why we are teaching a skill, please ask so we can explain it. Speak up if what we are asking for is too much. I would never expect a family to collect as much data as an RBT, or to spend hours each day implementing a program. Please let the supervisor know if you do not think you will be able to follow all the directions they are giving. We can work with you and break the skill up into smaller more attainable steps that will still get you to where you want to go! Be persistent. Stick with it! Behavior change will not happen overnight. Learning does not happen within 2 days. Please attempt to try all things we are implementing for the full 2 weeks before making a judgement on its effectiveness. We know it is hard, and we know you can do it!

ABA, or Applied Behavior Analysis, is a relatively new field with many different types of companies. Often BCBAs, or Board Certified Behavior Analysts, within each company have relatively different skill sets and competencies. Finding a provider that fits you and your child’s needs is of paramount importance because without this, achieving goals can be difficult. This brief list of talking points and questions to ask when searching for a provider may help! For you and your child, an individual or team of individuals that best fits your child’s needs can be extremely helpful. Questions to Ask When Searching for an ABA Provider What experience does the individual have in supervising my child’s program type? BCBAs must accrue a minimum of 1500 hours of supervision within the field before they sit for their exam. This number has changed and will probably continue to change as the program gains more insight. ​ Asking about the ages of clients they have worked with, the skills they have taught and the maladaptive behaviors they have programmed for may help you to gauge this experience level. How frequently will the supervisor be coming to my home? The BCBA must supervise an RBT, or Registered Behavior Technician, for at least 5% of their hours monthly. Broken down, this means that if your child receives 100 hours of therapy, the BCBA must be supervising this program for at least 5 hours out of every 100 hours. Ideally, the BCBA should be supervising 2-3 times monthly, breaking up those 5 hours over the course of the month. This allows your child and the RBT to be seen in a variety of moods and activities. These supervisions will aid in the professional development of the RBT working with your child and yield programming adjustments. It is the BCBA who determines if goals have been completed and provides new goals to be worked toward. Will you be providing parent training and if so, how does it work? Parent training provides the child a caregiver who can continue their ABA program outside of session times. All learned behaviors take time, patience, and continual work. When the parent and the teacher work together, the child benefits the most. Most insurers also require parent training as part of their willingness to provide coverage for ABA therapy. This means BCBAs should be discussing parent training with you and should be open to scheduling sessions to better the overall program through parent or caregiver involvement. What is your communication policy? Most ABA companies are overwhelmed with calls, and BCBAs typically supervise multiple cases. Even with this in mind, a family should be able to get a hold of someone working on their child's program within 2-3 days. If you are finding this is not possible, this may be a warning sign that the BCBA or the company itself is too full. Patience is always appreciated but you may need to address your concerns with them and discuss your expectations. Usually communication can help alleviate any concerns you may be having. When Can I Expect My Child's Goals to Be Completed? ABA therapy is flexible and provides many program styles for your child's care. It will take some time for the BCBA and RBT to develop a program thats perfect for your child's needs, as every child is quite different. Some children find certain goals, like counting, to be easier to accomplish than maybe verbal communications. Others may find brushing their teeth much easier than sitting still, and so on. Program efficiency will improve as the RBT and child spend more time together. Timeframe expectations can range, so communication about expectations is always helpful. Finding the quality ABA services for your family can be daunting and difficult. These questions will help you find the perfect provider and understand which ABA company you choose is best for your child's needs. Find other solutions to your child's needs at our resources page!

Antecedent strategies provide clinicians with a method of intervening which is unobtrusive and not restrictive to the individual. Antecedent strategies are most effectively used prior to a behavior occurring. If antecedent is effective, it can reduce the behaviors frequency, duration, or likelihood of the behavior happening at all. Using any of these strategies below can be effective when in combination with a solid ABA program model, and parent training. All three together can really increased opportunities for success with your child and their goals. Token Board I'm sure you've seen this in a teacher classroom or two! Token boards are a goal oriented system that therapists may use during session, with stars, stickers, checks etc. This board may have a space for 3 tokens, 10 tokens or even 30 tokens depending on your child and their specific program. The general idea is that a token is rewarded when good behaviors are present. Typically a certain number of tokens are hoped to be reached within a session. When all tokens have been earned, there is often an even bigger reward the child has earned, like time playing outside or other free play of the child's choice. If your child has a token board set up for their program, you can adapt it and use it for pretty much any goal. For example if your child has a difficult time using their fork at the table, try showing them the token board, and given them a token after each independent bite they take with the fork. Once they fill the board with the preferred amount of tokens, you can give them an item or activity in reward. A small dessert after a successful meal is often appreciated by most children. First, Then Strategy First, Then is a strategy you may hear quite a bit during your child's sessions. Often a therapist will say “First work, then break”. Basically, a non-preferred task is presented followed by a preferred task to increase the likelihood that an individual will complete and comply with the non-preferred task because there is a promise of a preferred task in the near future. This strategy is another one that works well for almost all non-preferred tasks or directions and can be molded to your child's goals. For example, if your child hates getting their nails cut, you may say “First nails, then YouTube” and show them that after they comply with nail trimming they can watch 5 minutes of YouTube videos. Timer Use of a timer can assist with many preferred and non-preferred activities. Many types of timers are visual as well as auditory and there a many great timer apps available for this type of strategy. Timer strategy works well for any activity which will come to an end, but needs to be continually worked for a set amount of time. For example, if you tell your child they may watch TV for 15 minutes, set your timer for 15 minutes. Prior to the end of the timer, give them a warning that it will be ending in 5 minutes, 2 mins, etc. This will help deflate any resistance when it the timer is up and the activity is finished. Visual Schedule A visual schedule strategy can help to get 2-4 tasks accomplished in a row, and helps the child see what is next. Typically, individuals will also develop more independence with this and will slowly need less verbal guidance as they understand their routine. They may even begin to make their own schedule after repeated practice! This strategy is great for any list of tasks you would like the child to complete. For example, each afternoon your child receives a window of free time, but a few things need to be done before they are ready for their free time play. Maybe your child must wash their hands, then eat their snack, and finally wash their dished before they can have their phone to play on. Each these steps would need to be individually written in order of desired completion The child could then put a check mark next to, or cross out each completed activity as they complete them. The reward (in this case phone time) should occur as the last activity on the schedule, and may possibly need a timer for this rewarded activity. As you can see, there are several ways to motivate and reward your child's good behavior, and we haven't even listed them all. More often than not, these strategies are used in combination to reach your child's goals efficiently. If you find yourself having struggles with these strategies, please contact us for professional help and possible ABA therapy for your child.

Applied Behavior Analysis, commonly known as ABA, is a type of therapy for autism spectrum disorders. This therapy focuses on improving specific behaviors in a way your child can understand. Behaviors to improve social skills, academia, and even self hygiene practices. ABA is fluid through all ages and all learning capabilities. It can even be helpful in understanding your loved one, as a parent or caregiver. A common reason applied behavior analysis can be so beneficial its for it's flexibility. Achieving Expectations understands that autism is different for each individual and each family, and value the unique qualities each family has. Since ASD is a neurobiological disorder, symptoms change throughout an individuals life. ABA allows the flexibility to learn in many different ways while still accomplishing age and ability related goals. Achieving Expectations really emphasizes the ability to teach for the learner, in a way that is as unique as they are. Early Detection Early detection is vital when considering a diagnosis on the spectrum. Though autism is difficult to diagnose before 24 months, it may be possible to see signs. The earlier treatment can begin in a child, the more they can learn along with their peer group. Through day to day learning in your child's regular environment, they can begin to harness particular social and motor skills. As they grow we can focus on other age appropriate skills like brushing their teeth and making their bed. Behavior Reduction Behavior reduction in ASD can be extremely important for problem behaviors. Achieving Expectations has treatment plans for those who may show more invasive actions. For example, if a child tends to hit their head with their fist or a toy when stressed and upset, this can be dangerous. Or maybe the child runs away and hides in loud public situations. Many behaviors can present themselves and be a cause for concern and immediate treatment. These behaviors can also cause major stress to the family and caregivers if not treated in a manageable way. Achieving Expectations is all about researching the problem and finding what causes the behavior in the first place. This helps us better understand our patient and how they interact with the world and those around them. From the data we gathered in observation, we can track what redirects or eliminates these bad behaviors for each individuals learning style. Parent Understanding Achieving expectations understands the pressures and confusions that can come with an ASD disorder. That's why we pride ourselves in offering parent teachings and explanations of what may or may not work for your child. We know it 'takes a village to raise a child' and that requires teamwork and communication. Another great source of knowledge for the family is our Resources page. Here we gathered all the helpful links South Florida and beyond has to offer for families of ASD. These core points are a great way to get to know what ABA is all about, and how it can help you and your loved ones. However, the journey definitely doesn't stop here. There is so much more to see and understand about how ABA works for each individual. If you are interested in finding our more or arranging a meeting please get in touch. We are happy to chat. AchievingExpectations@gmail.com