Photo Source: www.magnoliabehaviortherapy.com

As an ABA Therapist, sometimes it can be difficult getting the child you are working with engaged in the therapy session. You may arrive at the house and the child starts crying and runs away from you. Or, you work with the child at school and when you arrive the child begins to tantrum and throw things. Sometimes the child is fine when you arrive to their house/classroom, but the second you try to get them to start working/present demands the behaviors begin.

There will be good days and bad days, and its normal that your client won't be excited to see you every single day. However, if you are finding that every time you arrive at the home the child runs from you, begins exhibiting behaviors, or you have to struggle to get them to sit down at the work table then something is definitely wrong and you need to take action. You don't want to be consistently starting off a session with an angry, overstimulated, crying child who is only thinking of escape.
  
This is important for several reasons. Firstly, much of what we do as ABA therapists relies on a reinforcing or "paired" relationship with the child. If the child is consistently trying to escape work/the table/you, then pairing becomes very difficult and you will become aversive to the child. Secondly, it's unlikely that after you spend several minutes physically guiding or prompting the child to the work area, that you will then be able to get a great session out of that child. That is the equivalent of your boss waking you up in the middle of the night to go to the office and do some work. You just aren't at your best. We definitely want to work with these children when they are at their best, or as close to that as we can get.  Lastly, successfully getting your client ready for a session teaches transitioning skills. Moving from pre-work mode (whatever the child was doing before you arrived) into work mode is a big transition, and if you can teach the child to transition appropriately into a session then it should be easier to make small transitions during therapy.

Usually if a therapist is consistently having difficulty getting a client to the table its for one of the following reasons: the therapist isn't properly paired with the child, the parents aren't properly preparing the child for a session, or  the therapist isn't using reinforcement properly during a session. 

  • Issues with PairingRapport Building, aka Pairing is a critical part of instruction. Pairing is an applied strategy based on reinforcement where the therapist pairs with whatever the child finds reinforcing so that over time, the actual therapist can serve as a signal of reinforcement (translation: fun things happen when Ms Tameika shows up). Don't think of pairing as something that is done once, and then never again. Effective pairing should occur regularly, or even be embedded at the start of all instruction. How long does it take to play a quick game with the child, or watch a few minutes of their favorite video? Not long at all, and the benefits of starting off the session that way are very much worth it. Taking the time to pair properly will ensure more success once demands are placed, as well as higher motivation for the client to interact with you. I can typically tell when pairing has been successful if I arrive at a house for a session and the child displays excitement or interest in me. This can mean the child grabs my hand and tries to lead me to the work area, the child immediately goes and sits at the worktable, or the child runs to the door to greet me when I arrive. These are all signs of successful pairing. 
  • Issues with Preparing the Child for A Session- Therapists, you may need to help the family understand how to get their child ready for a session. You can be the most fun and exciting therapist around, but if right before you arrive at the house the child is jumping on the couch, watching cartoons, and eating a Snickers bar, that child will likely get pretty upset when they hear that doorbell ring and see you walk into the house. Depending on the child, at least 15-20 minutes before the session the parents need to begin making transition statements. Something like, "Its almost time to turn the TV off, because Ms Jane will be here soon". Give the child ample warning that it is almost time for work. Another way the parents can help you is by using a visual schedule and showing the child on the schedule that after TV time it is time for Ms Jane. Parents can also make sure the child is fed, clean, and has been to the toilet before each ABA session. The therapist should not have to try to motivate a hungry, thirsty, or wet child to participate in a therapy session.
  • Issues with Reinforcement-  I could write an entire post on reinforcement alone, so I will just discuss a few points here. Its important to always keep a balance between reinforcement and demand. If demand is too high, the child may start exhibiting behaviors or try to escape the table. If demand is too low, the child may tune out, withdraw, or become silly/giggly to entertain themselves. Try switching up your reinforcers and see if that will get the child to willingly come to the worktable. Arrive at the house with a bag of reinforcers and toys and let the child carry your "goody bag" into the therapy room. Once you get into the room, let the child select 1 toy to take over to the work area. This is a painless and simple way to do several things: get the child into the therapy room, get the child in a happy and calm mood, and transition the child from break to work. 


Below is some information about Pairing that I usually give to new therapists.
  • As the therapist, you should identify what is reinforcing to the child, and associate yourself with these items. This may occur by simply handing the items to the child, sitting next to the child while they access the items, or engaging in play with the item together with the child. Slowly ease in demands and language, as the child begins to trust you and be more accepting of your presence. As you hand the child a cookie say “cookie”, before giving it to them. Over time, you can require the child echo the word cookie after you. Another way to ease in demands is to place the reinforcer farther and farther away from the child, or to require language before they can access the reinforcer. Place the cookie in a container the child cant open independently, and when they come to you for help, have them say or sign “open” before you will open the container.  This way the child learns that the therapist has access to the things he/she loves, and the therapist becomes paired with fun, reinforcing things.  The use of reinforcers and pairing is the essential first step before any program can be implemented. Pairing is an important skill that may be necessary to come back to as time passes. If a child has been ill a long time, missed a few weeks of therapy due to vacation, or has a new therapist, then the therapist needs to go back to pairing before beginning work. At the start of a session a child should approach the therapist eager and ready to learn, and pairing is the tool that helps accomplish that. When the child is consistently approaching you, attempting to engage with you, wants you to join in play with them (particularly if they are on a break), or happily greets you when you arrive at the house, then you know that pairing has been successful.


    **Quick Tip: You can also use the Demand & A Promise technique to successfully transition a child to the worktable. 


I've discussed on my blog how to find ABA therapists for your in-home therapy program, and recommended a great resource for exactly how to do this ("Behavioral Intervention for Young Children with Autism" by Catherine Maurice).

 This post is for parents who have already found a pool of potential therapists and are ready to begin interviewing. If your child receives ABA services at school or through an agency then you typically don't get much say in who will be working with your child. The agency or school makes this decision and its probably based on availability of the therapists.
  However, even if you are dealing with a school or agency you can still ask to interview the ABA staff and to meet the therapist before they begin working with your child. 

I hope this information serves as a minimum standard of how to interview an ABA therapist.

 I've helped families locate and hire ABA staff and I've observed staff interviews. I have noticed many parents are uncomfortable being placed in the position of "Manager". As the parent, that is what you are. Even if you have a Lead Therapist supervising the ABA program, the parents are the ones who make hiring and firing decisions.

 It's important to treat the hiring process seriously. If you want competent and dedicated therapists then take the time to recruit carefully before hiring anyone. Avoid spending the interview laughing and chatting; the therapist isn't interviewing for a position as your buddy. Project the level of professionalism that you expect.



Here are a few tips regarding the interview process:


  1.  Decide before you meet with any potential therapist the job expectations, schedule, minimum and maximum pay rate, and create a short summary of daily job responsibilities. You may be hiring someone with little ABA therapy experience. This person may assume that if their last client paid $20 per hour then so will you.  On the other hand, you may find yourself interviewing a therapist that has many years of experience. Just because someone has worked with many families doesn't mean they are competent. Make all of the information about the position clear -put it in writing- and discuss it with the potential therapist. Explain what you expect regarding job performance (such as stating you will video record sessions). Dont let the ABA therapist be surprised when they begin working for you. If you expect them to stay 30 minutes after each session to go over notes and data with you, tell them that upfront.
  2. Parents often have the misconception that an ABA therapist is an all-in-one job title.....it's not. Most ABA therapists are only qualified to implement programs and run a session with your child. They may not be qualified to write programs, do assessments, or train teachers. I talk to so many parents who hire an ABA therapist and quickly realize the person has a limited skill set. The person who manages or supervises an ABA program is the Consultant. The person that implements programs is the ABA therapist.
  3. Schedule the interview for a time when your child will be home. Observe interaction between the potential therapist and your child. If you cant observe actual interaction, let the therapist view video clips of your child. Even experienced therapists may not be comfortable with ALL behaviors. Maybe your child has a saliva play stim, and the potential therapist seems disgusted by that. That would be something you want to find out before hiring that person. It is important that any potential therapist be comfortable working with your child on their best and worst days. Be honest during the interview. If your child becomes aggressive at times, say that upfront. Its better to scare someone off during an interview than to have a therapist abruptly quit on you after a bad session.
  4. I believe the most important characteristics when hiring anyone are: Attitude, Willingness to learn, and Energy. Any therapist you hire will need some training, even if its just learning about your child's personality. If the potential therapist doesn't respond well to feedback and doesn't seem passionate about their work then that shows a minimal willingness to learn. Regarding attitude, as anyone who works with special needs children knows there are great days and horrible days. If a potential therapist is cranky, argumentative, or rude during the interview process, imagine how that person will act after a bad session with your child. A positive and upbeat attitude is essential for anyone who wants to teach children with Autism. Moving on to energy,  I'm not saying that the person should arrive at your home and be bouncing off the walls. What you are looking for is a lack of energy. Does the person seem tired, overly quiet, or very soft spoken? Anyone working with young children should be able to "turn on" an upbeat, animated persona and leave their troubles at the door. If you are interviewing someone and cant picture them smiling, clapping, making goofy faces, or shouting "Hooray", then that is not an ideal ABA therapist.
  5. Most families tend to hire high school or college students with minimal experience as ABA therapists. This is usually due to low cost. When working with students you may want to consider including an employment clause where the individual agrees to a minimum length of employment, such as one year. There's a few reasons families choose to do this- 1) As stressful as high staff turnover is on the parents, imagine how stressful and confusing it is for the child to constantly have to get used to new people, 2) Students tend be transitory, so by placing an employment length commitment on them you are sending a message about the seriousness of committing to the job, and 3)Think of all the time and money you will spend on training a new therapist. You dont want a situation where you spend thousands of dollars training a new therapist, and he/she quits on you after 2 months of employment.
  6. Ask questions! So many times I have observed interviews and the parents just summarized the position and listed the pay. At no point did those families find out any information about the person they were interviewing, that wasn't clearly listed on a resume. Beyond the basic information  you need to get to know your potential staff. Here are a few questions to ask:  
  • Motivation for doing this kind of work?
  • What do you know about Autism? What do you know about ABA?
  • Do you believe a child with Autism can recover fully? Why or why not?
  •  What would you do if our child bites or hits you?
  • Describe your strengths.
  • Why should we hire you?
  •   What is your personal philosophy about special education?
  •   What was the last book you read about Autism?
  •   How do you feel about being videotaped?
  •   Have you changed a diaper? Have you changed a diaper on a child over the age of 5?
  •   How do you feel about bodily fluids getting on you, such as spit, vomit, urine, blood, etc?
  •   Willing to train new therapists in the future?
  •   Willing to attend training sessions, conferences etc.?
  •   What do you think the primary responsibilities of a therapist are?
  •   What type of activities would you do with a child of X age? 
  •  What do you do when a child totally frustrates you? 
  •   How do you handle temper tantrums? How do you handle meltdowns?
  •  What are your favorite children's books?
  •  What kind of relationship do you want with our family?
  •   What kind of boss do you work best with?
  •   What  important traits do you think a therapist should have?
  •    How would you describe your temperament?
  •    Do you plan to pursue Board Certification one day? Why or why not?

5.  You may have noticed I haven't listed requirements for experience, salary, or education. If you do a quick search online, you'll find tons of recommendations about education and experience requirements that ABA therapists should have. In my experience most families cannot find or afford a therapist who actually meets these standards. Sadly, the demand for experienced ABA professionals far exceeds the supply. You may need to recruit inexperienced individuals and spend time training them if you can't locate quality professionals in your area. In no way am I saying families should lower their expectations when hiring ABA staff. If you want an ABA therapist with 15 years experience and a Masters degree, then stick to what you want. However, know that it might be very difficult to find such an individual who has availability and is affordable. Most professionals who are degreed and experienced are in very high demand, or charge upwards of $40/hr. That is why I stress to parents to look beyond a potential therapists' experience and education and find out who the person is, how passionate they are about learning, and if they truly enjoy working with children. Those factors, along with time and training, can turn an inexperienced babysitter or family friend into an amazing ABA therapist.



*See below for a sample "Help Wanted" advertisement, to use when locating ABA therapists. Feel free to use it!:



Private family seeking fun and energetic behavior tutors!  No experience is needed. We are happy to train the right individual.

Position: We are seeking 1-3 behavior tutors to provide ABA therapy to our adorable 5 year old daughter, who has Autism. ABA stands for Applied Behavior Analysis, and is a behavioral treatment that has been successful for children with Autism. Your job will be to play with our daughter and to help her learn!

Availability: Afternoon (3:00 pm- 6:30 pm) and weekend availability is especially needed.

You Provide:
§        4 year degree in Psychology or Education is preferred
§        Must be willing to submit to a criminal background check, and/or fingerprinting
§        Ability to commit to a weekly schedule, and to show up for work on time
§        Reliable transportation is a must
§        Positive, can-do attitude!

We Provide:
§        A relaxed and caring work environment
§        Great starting salary ($11.50 per hr) with possibility for a raise after 6 mo. of employment
§        We will supply all necessary therapy materials and supplies
§        We work with a Consultant who will provide all training
§        An adorable and happy student for you to teach!


If interested, please send your resume along with a short introduction. Tell us about any related experience, what you know about Autism, and why you think you are a good candidate.



Behavioral Intervention for Young Children with Autism: A manual for parents and professionals by Catherine Maurice, Gina Green, and Stephen Luce.


 This is a very important topic thats close to my heart. I love working with families who are new to ABA therapy or Autism. I got my start in this field working with families in rural or international areas who knew very little about behavior therapy, or the diagnosis of Autism. It was challenging and at times frustrating, but I learned alot. Today with advances in technology, research, and with Autism seeming to be the current "It" word in the media, its much easier for parents of newly diagnosed children to know what to do. Even if you never knew anyone with Autism before your child was diagnosed, its likely that you have read a book or article, or seen someone on TV discussing Autism. Yet despite all of that parents have so many questions about treatment options. Just type the words "treatments for Autism" into a search engine and watch how much information you get back. This mass amount of information can be hugely intimidating and scary for parents who are new to Autism.

This post is targeted to families who want to start an in-home ABA program for their child with Autism. In order to be brief I will focus in on critical areas: After the Diagnosis, Why ABA, In-Home ABA, and Maintaining Balance.


  • After the Diagnosis- Once parents are hit with the diagnosis of Autism, it is completely normal to go through a series of tumultuous emotions and a time period of confusion and denial. Even if you may have suspected something or had suspicions, there is nothing like the actual moment when someone confirms to you "Yes, your child has Autism". While reeling from this emotional blow, parents also have to evaluate and determine plans of action,  tell family members, plan for the future, etc. For most families the weeks after the diagnosis are a blur. There are just so many decisions to make and no one can make these decisions for you. The doctor/psychologist/clinician who gave you the diagnosis cannot give you a "Recipe For Success" for Autism. There is no standard treatment plan. Many new parents ask me for one, but it doesn't exist. What you want to focus on is a therapeutic method that addresses your child's unique deficits and weaknesses. When working with special needs children the goal is to get them at their highest level of functioning. For some children that may mean they will always require significant care. For other children that may mean they will eventually be in regular education classes, and have hobbies and friends. The point is no one can tell you for certain.
  • Why ABA?- Once you have decided on pursuing treatment for your child now you have the decision of what therapeutic method to select. Just to name a few there are: Occupational Therapy, Speech Therapy, Incidental Teaching, Early Intervention Services, Bio-medical interventions, Floortime, Physical Therapy, etc. The list of treatments for Autism is ever growing, and ever changing. Certain treatment methods are dropped and labeled as "fads", and other methods change and morph into something else. What is most important when deciding on a treatment method is to look at your child's needs. What skills do they need in order to have a better quality of life? Determine your child's needs and then select a therapeutic method that will meet those needs. It is important to select a therapeutic method that has empirical data to support it, and has been proven to work with specifically with Autism. Its nice if a therapy works great for children with speech disorder, but how do you know it will work for your child who has Autism?. The treatment method should also have a method of showing progress and gains, which many treatment options out there are lacking. Without data how do you know the treatment is working? If you are spending hundreds of dollars on a treatment, don't you want evidence that it is working?  It is important if you are spending time and money on a treatment method that you are confident in its track record. 
  • In-Home ABA- If you have decided on ABA as a treatment, you have a few choices available. Your child's school can deliver ABA treatment to your child during the school day, you can contact an agency who will send therapists to your home, or you can run the in-home program yourself. Obviously, the last option is the most labor intensive on you, the parent. However not every school offers quality ABA services, and not every family lives near an agency. Often times even if you do, the agency has a year long waiting list. Waiting lists in this field are very, very common because the demand is so high. If you are considering running your child's in-home therapy program, then great for you! I love to encourage parents to take charge and not to wait around for a spot on a waiting list to come available. That may take months or even years, and that's valuable time that you could spend teaching your child. To get started you will need to assess your child's abilities, hire therapists, hire a Consultant/ BCBA, and gather supplies and materials. As far as resources and supplies, you need to know what programs you will be teaching in order to know what materials you need. A great resource on writing ABA programs is:   "Behavioral Interventions for Young Children with Autism" by Catherine Maurice.  This book is amazing, and I haven't come across a more parent friendly resource. I am also a fan of: "The Verbal Behavior Approach" by Mary Barbera, that focuses on Verbal Behavior.  Basically, Verbal Behavior is a form of ABA that focuses on communication and language being taught/increased behaviorally.  I recommend both books, but if you are a parent just getting started with ABA then you should start by reading the first book (I promise, its an easy read). The Catherine Maurice book is more of a comprehensive manual that explains in great detail how to start, manage, fund, and oversee an in home ABA program.
  • Maintaining Balance- Once you have your in-home program off the ground, you may find that your household has become an ever changing flow of therapists, schedule changes, meetings, and chaos. It can be a strange experience to get used to having therapists in your home several hours a day. If you have other children they may resent the fact that no therapists come to play with them.  Juggling therapies, hiring therapists, attending team meetings...it may all get to be just too much. Its important to remember to keep a balance and to stay organized. Running an ABA program is somewhat like owning a business. You need to stay on top of staff, keep up with progress, handle hiring and firing, make suggestions for performance improvement, etc. If you are organized it makes everything so much easier. Create a system that works for you and stick to it. As the in- home program is implemented and time begins to pass, consider hiring a BCBA. If you cannot afford to hire one to completely run the program, then you can ask the BCBA for their consultation rates. You can also ask if they have a sliding fee scale, or provide a discount if you sign up with other families in your area. I find that most families seek outside help when things start to go wrong or progress stalls. Or as I like to say, for "troubleshooting". I strongly recommend if you are having issues with your in- home program, to consult with a BCBA before you make any decisions. If you don't understand why you need a BCBA, I strongly recommend this amazing blog post, from Thinkingautismguide.com.

 Below is a list of resources for starting or running an in-home ABA program. I hope they are helpful.


BOOKS

Let Me Hear Your Voice – A Family’s Triumph over Autism, Catherine Maurice
Teaching Developmentally Disabled Children – The Me Book, O.Ivar Lovaas 
Behavioral Intervention for Young Children with Autism, Maurice, Green & Luce 
Teaching Children with Autism, Robert & Lynn Koegel 
Visual Strategies for Improving Communication, Linda Hodgdon
Treasure Chest of Behavior Strategies for Individuals with Autism, Beth Fouse



WEBSITES

These websites are a great resource for parent-therapists who do not have access to, or cannot afford to hire ABA professionals.

 http://www.maximumpotentialkids.com
 http://www.rethinkfirst.com
 http://www.autismabacurriculum.com





Motivating Operations (M.O.) is an important ABA concept that refers to the internal processes or desires of an individual that change or improve the value of a certain stimulus.  This change can improve the effectiveness or value of a certain reinforcer (E.O., or Establishing Operations), or it can reduce or lower the value of a certain reinforcer (A.O., or Abolishing Operations).

Basically when someone refers to M.O., they are describing Motivation.

So why is this an important concept for anyone who works with children with Autism to know? 

Well, one way that children with Autism may differ from NT children is a lack of motivation. It is that lack of motivation, or desire to please, that can cause a child with Autism not to exhibit behaviors many typical children do: point to objects excitedly (joint attention), make eye contact and smile, use communication effectively, display socially appropriate behaviors, etc. Children with Autism often need extra motivation to perform tasks or activities that typical children enjoy, or that typical children will perform to please someone else. 
For example, birthday parties are fun and exciting and the average child does not need extra motivation to attend one. But for a child with Autism birthday parties can be stressful, loud, chaotic, and overstimulating. So in order to get a child with Autism to go to the party it may be necessary to provide extra motivation. If you have a good understanding of M.O., it can be a powerful tool to make any stimulus  more motivating to your child or client.

Motivation is key within all aspects of life. Teachers often create highly motivating environments for their students using visuals supports within their classrooms, presentation of exciting curriculum units, and presentation of material using multimedia, such as showing a movie. Some students are intrinsically motivated to learn, and some are not. When you understand M.O. then you know how to take a non preferred item or activity, and make it preferred....even if only temporarily. Please see the example below:

You are trying to teach a 4 year old child with Autism to mand  for juice. So far you havent had much success getting many mands. You dont know if the child isnt manding because they dont like juice anymore, or because they dont want juice badly enough to use language. You are aware that manding needs to take place all throughout the day, so you offer juice to the child in the morning, afternoon, and evening, and you even vary the type of juice to see if that grabs the child's interest. Unfortunately none of these strategies seem to be increasing the frequency of mands.

Besides being an empirically supported behavioral tool, using M.O. correctly can save time and money. Instead of increasing time output by offering the child MORE juice, hoping that will get MORE mands, or increasing money output by buying apple juice, orange juice, and pineapple juice, try manipulating the M.O. 

Firstly, stop offering the child juice for a few days. Only allow them to drink water, milk, etc. This will make the juice more powerful when you bring it back because the child hasnt had it in a while. After a few days have passed wait until the child has an increased desire for juice. This could be after the child has been outside playing in the sun or after the child has eaten pretzels or salty snacks. Then offer juice to the child and try to get a mand. That is how you successfully use M.O. to manipulate the power, or desirability of a stimulus. ABA at its core is about manipulating the environment to bring about desired changes in behavior, and M.O. is an excellent tool to have in your arsenal. I use it all the time, and observe parents using it as well, even though they usually dont know what they just did has a technical name!
Trying to work with a child with Autism without understanding M.O. is like trying to ride a bike uphill vs. downhill- you are making your job harder. It would be much simpler to get the child to comply if you approach them with the knowledge of what their current M.O. is, and use that to your advantage.


Here are a few more examples of M.O.-


  1. "Fluid Loading" (providing free, unlimited, highly preferred fluids to drink) a child during potty training, to increase the likelihood they will have to urinate.
  2. Removing Skittles as a reinforcer because you notice the child just plays with the candy and doesnt eat it. Then bringing the Skittles back the next month, to increase the likelihood the child will want the candy.
  3. If you are trying to teach a child about automobiles, wait until they are playing with their Thomas the Tank Engine toy to have them learn the label "train".
  4. If you are working during a session with a child who is refusing to sit in their chair, go outside and have them jump, swing, run, hop, etc, and exert physical energy. Then take them back to the table, to increase the likelihood that they will want to sit down.
  5. Dont work on self help skills such as proper fork grip, and drinking from an open mouthed cup, at arbitrary times of the day. Work on these skills during mealtimes, so the child is more likely to want to want to use the skill so they can receive the reward (food).








This post is targeted to families  doing an initial or updated assessment on their own child (while targeted to families, this post could also be helpful for professionals who are new to assessing).
 It's always recommended for any in -home program that a qualified BCBA is in charge of writing programs, doing assessments, and generally overseeing the progress of the child. However, for many different reasons that isn't always possible. Many families cant afford to hire a BCBA or live in rural/international areas where BCBA's aren't readily available.

If you are a parent running your child's in home ABA program then you need to be very familiar with the ABLLS-R assessment tool. This is an educational assessment tool created by Drs. Sundberg and Partington. The ABLLS-R (pronounced "A-bulls") is a comprehensive and extremely useful way to assess a child's level of functioning in a multitude of domains, such as Visual Performance, Fine Motor Skills, Math Skills, etc. What distinguishes the most commonly used ABA assessments (ABBLS-R and VB-MAPP) from psychological tests or assessments is a focus on the core deficits of Autism: communication/language and social deficits.

 You might also be familiar with the VB-MAPP, which was created by Dr. Sundberg. Its a newer assessment, and more likely to be used by professionals than parents. I dont have much experience with the VB MAPP, but have been using the ABLLS for years.

For more information about these two assessment tools, please follow the links below:

VB MAPP

ABLLS-R


When I work with families who are new to the ABLLS they usually want to know if they should buy the whole kit or not. When you purchase the ABLLS assessment online, unless it specifies you are ordering a kit what you are really buying are the protocols. These are the manual, and the actual book that you use to score your child's responses to a very large amount of  tasks (the ABBLS has 25 skill areas and each area can contain anywhere from 20-40 questions). Sometimes families are upset to purchase the ABLLS online and then it arrives and its just 2 books.

If you do purchase the ABLLS kit, what you are buying is a large selection of items and materials that match up to specific ABLLS tasks. For example, puzzles, items to sort, items to count, picture cards, fine motor items, a doll with clothing that can be snapped/zipped/buttoned, etc. I have seen --and had to transport around-- this kit, and its a very large and bulky. Depending on your budget its also somewhat pricey. The average cost of the ABLLS kit is around $1500. Purchasing just the ABLLS books is around $70.

It does make sense to purchase the ABLLS kit if you are a therapist who assesses often, or if you work with an agency or school.  I know of some families who have combined as a group to buy a kit and then shared it amongst all their children. Another benefit of buying the complete kit is after the assessment is done you now have multiple items and materials to use to teach skills.

However, you can also use items around your home to complete the assessment. For certain tasks it may be necessary to make or purchase supplies, especially if the assessment is asking you to test a skill using multiple items (like 50 common objects).

Once you have the books and all the materials gathered, then you are ready to begin the assessment:

  • Each parent or caregiver should review the domains and see if any are not applicable. For example, many of the children I do an initial assessment on are very young/Early Learners so domains such as Syntax and Grammar, or Spelling Skills typically are not applicable to a child under 3. Look for domains that your child isnt ready for yet so you know to skip those areas (such as Intraverbals. If your child isnt verbal, you do not need to assess their intraverbal abilities). Read through the manual and answer as many questions as you can based on your knowledge of your child, and skills you have directly observed.
  •  Once you have eliminated domains that are N/A, and answered as many questions as you can, all that is left is direct testing. Particularly if your child is young, they may not be used to a testing scenario. You will need powerful and varied reinforcers to keep your child motivated, engaged, and willing to complete the assessment.  To your child, the assessment process will range from very easy  to very hard. Know this before you begin and have plenty of reinforcers, snacks, juice, etc., on hand.  Be prepared for the assessment process to take 2-6 hours, or maybe even days, depending on the child. 
  •  Complete the assessment making sure to accurately fill out the ABLLS protocol. Children need to be re-assessed roughly every 6 months or so, so if you don't fill out the protocol accurately and clearly you are creating more work for yourself when it is time to re-assess. Don't become upset or frustrated if your child tunes out, spaces out, attempts to leave the room, or dissolves into tears during the assessment process. Think of this as a huge pop quiz to your child. Do you like pop quizzes? Probably not. If the child refuses to respond, then score accordingly. It is okay to try to come back to items later, but don't ask your child the same item over and over. Its an assessment-- you aren't teaching yet.
  •  Once you have completed the assessment and given your child a much deserved break, score your protocol and review your notes. This is the point where you now have a snapshot of your child's current functioning level, and their strengths as well as weaknesses. The assessment guides the program writing process and should lead you directly into creating goals.

I found a blog a few months ago that gives practical ideas on how to create or find materials for programs that are written directly from an ABLLS assessment. The blog is: Practical ABLLS
It has lots of ideas on what to use for a program. It can sometimes be very difficult to know HOW to teach a program. The assessment will tell you what to teach, but it wont always tell you HOW. Many skills have prerequisites that need to be taught first, and there definitely is somewhat of a hierarchy regarding what to teach. If your child cannot request items they want or need, that is more important than teaching them to jump rope.

Assessment and program writing can be a  tedious and difficult process, but in no way is it impossible for a parent to do. Not all parents have the ability to hire a team of therapists or a BCBA. Read and research all you can, talk to other parents, see if you can find a BCBA who will train you to implement the assessment yourself, and lastly: believe that you are able to do this.

 Watch the videos below for a video tour of the ABLLS-R:



Video 1

Video 2




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