Natural Environment Training, or NET, is a branch on the ABA tree. NET is all about naturalistic “learning through play” or learning in the natural setting. Natural setting means that teaching isn't just occurring at a desk or table located in a therapy room, but in a variety of environments and locations.

 Unlike more structured ABA teaching methods such as Discrete Trial Training (DTT), NET focuses on: 

*        Intrinsically motivating items and materials- Reinforcement is embedded into the task: The child learns to say "juice" and gets a sip of juice.

*        Teaching in natural contexts/settings- Teaching occurs in the grocery store, at the bank, during breakfast…the setting is directly related to the skill.

*        The child’s immediate interests- Look for “teachable moments” when the child displays interest and excitement about a particular person, item, or object.

From the child’s perspective NET isn’t teaching at all…it’s just playing or interacting with the environment. 

One common critique against ABA is that the children don’t generalize the information they have learned, or they don’t “use” the skill. That would look something like a child who can make and hold appropriate eye contact during therapy, but on the playground at school he stares down at his shoes when speaking to peers. Parents will sometimes ask me questions about generalization such as, “When will he/she be able to perform this skill outside of the therapy room?” The simple answer to that question is that ABA cannot occur in a vacuum. If the child is only asked their telephone number while sitting at a table across from a therapist, that skill wont just magically pop-up in other places (response or stimuli generalization does sometimes occur without intentional training, but not often). 
Parents have a large responsibility to encourage generalization of what their child is learning during ABA therapy, as the therapists cannot be with your child 24/7. Any quality therapist should include maintenance and generalization during their therapy sessions, but are you as a parent reinforcing what your child is learning?
For example:

1.    If your child can throw a ball underhand, do you practice tossing dirty clothes into the laundry basket?

2.    If your child knows how to return greetings, do you ask visitors to your home to walk up to your child and say Hello?

3.    If your child can identify the color red, do you stop at stoplights and ask “What color is that?”

4.    If your child can count objects, do you have them count leaves at the park?

A great thing I like about NET is that its so easy for parents to implement with their own children. Many parents whose children receive ABA therapy are curious about how to get involved with therapy, and how to continue teaching their children when the therapists leave. Since NET is less structured and intensive than a typical ABA session, its easy for parents to grab moments throughout the day to reinforce skills with their child. 

NET sessions should be noisy, boisterous, full of language, with movement all over the home/outside the home. I train so many therapists who think if they are not at the therapy table, then they must be doing NET. Simply changing location does not mean you are doing NET.
The NET activity should fit the skill you are targeting, capture the child’s interest and motivation, and be full of language….either language from the child or from the therapist/parent/teacher. If you are working with a nonverbal child, then the therapist should be doing something I call “Narrating”. Narrate everything the child does, even if they don't respond. This waterfall of language that you surround the child with can eventually lead to vocal imitation, receptive language skills, or the child responding to your language with words or even full sentences. Narration would sound something like this:

“Let’s go outside and swing! Okay, go get your coat. (Child gets coat and then drops it) Oops!  Uh-oh, you dropped it. Pick it up, please. (Child picks it up) Thank you. Put your coat on. (Child doesn’t comply) Put your coat on like this (therapist uses modeling to show the child what to do. Child begins putting coat on). You got it! Put in this arm, and then that arm…all done! You put your coat on, good job. Should we bring the bubbles outside? (Child doesn’t respond. Therapist places bubbles right in front of child’s face) Bubbles outside? (Child pushes bubbles away) Oh okay, that’s a no. (Therapist prompts child to shake head no) That’s how we say no. Okay, let’s go outside!”

See how the therapist had a full conversation with the child, even though it was one sided? That’s what NET should sound like. As the child becomes more verbal, the exchanges will become fun and lively as the child joins the conversation.
NET should have a loose structure, and be driven by what the child wants to do. The therapist should prepare for an NET session but also be open to changing that plan if need be. The therapist may set up a board game in the living room to work on turn-taking during NET, but while walking to the living room the child might decide to veer into the kitchen and mand for “cookie”. Instead of forcing the child to go play the board game they clearly have no interest in at that moment, take advantage of this teachable moment.

If your scheduled NET session changes before or during the activity, that’s okay! Remember, it’s about what the child wants to do. Stay flexible and think on your feet, and you'll be fine.

**Quick Note: NET does require some planning and preparation, even though you are following the child's motivation. The reason why is because if the child goes into the kitchen and wants to play with spoons, do you know how to turn that into a teachable moment? What can you teach using those spoons? 

 When I was a newbie ABA Therapist, what worked really well for me was creating a NET ideas box. Get a small index-card sized file box, some index cards, and a few colored highlighters. You can also get some small section dividers, but it’s not necessary. On one side of the cards write:

1. Skill

2. Date Mastered

3. Description

Write the name of the skill, such as “large peg puzzle”. Put the original date that the child mastered the skill. For the description, describe the skill in plain language so that anyone could read the card and know what to do, such as “Janice can independently complete a large peg puzzle with no more than 5 pieces”. On the back of the card, write a few brief ideas for how to teach the skill in a natural setting. The highlighters are used to color code the cards, according to domain. Puzzles are in the Visual Performance domain. So all the cards where the skill is highlighted in green are visual performance tasks. Place the cards in the box in random order, which the highlighting will help you to do quickly. When you are ready to do a NET session with the child, grab a few cards randomly, being sure to grab cards with different highlighter colors. When you finish NET and are putting the cards away, place them in the back of the file box to ensure that you are rotating through all of the cards.

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Tameika Meadows, BCBA

"We must accept finite disappointment, but never lose infinite hope."  
Dr. Martin Luther King, Jr. 

Parents, have high expectations of your children with Autism and remain hopeful. Progress is rarely achieved without first being hopeful that the situation can improve.

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Tameika Meadows, BCBA

First you will need some tights…

Oops, wrong post.

So you want to be an ABA Therapist! It’s almost like being a superhero, except we have better hours, better super- powers, and working on weekends is optional.

I’ve been getting a lot of emails recently from people interested in entering the field of ABA, but not sure exactly how to do so. I’m excited to be waving the flag for ABA, and hopefully motivating people to enter the field.  The main reason I started this blog was to reveal to people what ABA really is (because there are many myths out there) and if that causes people to want to become an ABA Therapist, I think that’s great!

I talked briefly in my FAQ post about how to get started in this field, but this post will go much more in depth and provide details.

I can’t give a specific "How To" guide, because much of this information will vary from state to state. Also, for my international readers I don’t have much information about how people outside of the US can get into the field of ABA. This post is more of a guideline of general tips. To anyone with an interest in pursuing ABA as a career I recommend doing research for your particular area and networking with people currently in the field.

How do I become an ABA Therapist?

-     What exactly is an ABA Therapist?:

      It's important to distinguish between an ABA Therapist and a Behavior Analyst. BA’s supervise, manage,  and run ABA programs as Consultants. ABA Therapists are the lifeblood of the ABA program, as they are the ones who work with the child day after day to teach skills. As an ABA Therapist you are usually responsible for teaching very specific skills, and implementing a behavior plan.  ABA therapists can also work with a variety of clients, not just kids with Autism.  There’s a growing demand from schools who want ABA services for typically developing children who have behavioral issues. So ABA Therapists really can work with anyone who is in need of behavioral services.

-    What’s it like being an ABA Therapist:

      The clients you work with will take you from joy to frustration in 0.2 seconds. On Monday your client could be excited to see you and give you a huge hug, and then on Thursday they might try to bite you. Even if you only work with one client, every day won't be the same. That's whats so great about this job: if you have a bad session you get to hit "reset" and start over again the next day. If you are a person who loves sameness, routine, and predictability, you might not enjoy this type of work. The field changes all of the time, parent expectations can change, the behavior plan can change, the programs change....did I mention you must like change??

-    What kind of person would be a good fit for this job?:

      Anyone who is PASSIONATE about special needs, detail oriented, energetic, and loves to learn. Parents often feed off of the enthusiasm of the ABA Therapist, and feel encouraged by it. It’s important that as an ABA professional you enjoy learning, because you never stop learning and growing when this is your job. Research and technology change all the time and so does this field. You have to be open to receiving supervision and correction, even if you have been doing this for years. If you aren’t a person who can take constructive criticism then this likely isn’t the job for you!

-    I’ve heard some horror stories; do ABA Therapists really get bruised and injured at work?:

      Short answer? Yes. :-) Here's the scoop: as an ABA professional you usually have control over who you work with. You could choose to only work with cognitively impaired adults, or only work with high functioning teens. The majority of my work experience has been skill acquisition with young children. So I haven't been in situations where big, strong teens or adults have attacked me, thrown desks at me, groped me, shoved me against a wall, bent my fingers back, etc. Do all of those things actually happen? YES. That would be called a severe behavior client.  The good news is you shouldn't be thrown into situations like that unprepared. Your employer should provide physical management training, there should be a behavior plan in place, and if applicable a crisis plan. So I suppose my answer is, it is possible you could really get injured depending on the clientele you work with and the training you are given.

-     What are the hours like? :

      There’s a lot of variability as far as scheduling, but if you work inside homes with young children  then you'll probably have early morning hours. If you work with school age children you'll have evening hours unless you see the child at school. If you work for an agency, you will likely have a jam packed schedule of various days and times, sometimes with really unpleasant huge gaps in your schedule. You know the kind...not enough time to go home, but too much time to just sit in your car. Working weekends should not be mandatory. If you burn yourself out with a hectic caseload then what do you have left to give to your clients?

-     Where can I find ABA jobs? :

      This can be a bit tricky. It’s always easier to find an ABA job when you already have one, because families will refer you to other families. If you are looking to break into the field I’d recommend working for an agency first. You will get more clients and supervision than you would with an individual family. Research the ABA providers in your area, and contact them to see if they need ABA Therapists. If they don’t hire inexperienced therapists, see if they have volunteer positions so you can gain experience. You can also try your local or state organizations for ABA, as they often allow members to post job openings on their website.  If you are currently a college student, often the heads of the Education or Psychology departments will have leads on ABA jobs/practicum sites.

RESOURCES:

If you are interested in becoming an ABA Therapist, here are some resources to locating work. Its pretty easy to gain Autism experience due to the steadily increasing diagnosis rates. I'd recommend taking an intern or volunteer position first to make sure this is something you want to do before committing to a paid job. This field isn't for everyone, and thats okay. This is high energy, stressful work, often with frustrating or aggressive individuals....it may not be your cup of tea.

GA Parent to Parent Network -Georgia statewide agency for parent support, has a database of companies and providers.

http://p2pga.org/

Craigs List - Agencies often post ABA jobs here under the education section.
Craigs List

This article has some really creative suggestions for locating ABA work.

Behavior Analyst Associations - Look up the Behavior Analyst association in your state. These websites usually post career opportunities, or if not, you can contact members directly to see if they have job leads. For GA, the state association is GABA.

www.Google.com- Google “Autism treatment” or "ABA therapy" and the name of your city, and see what comes up.

AIBA- Association of International Behavior Analysts (has a job directory).

http://www.abainternational.org/aba.asp

Autism Speaks- Leading Autism information website, has a provider database.

http://www.autismspeaks.org/family-services/resource-guide

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Tameika Meadows, BCBA

“I can’t even talk on the phone/take a shower/ visit with guests because my child gets into everything.”

“She spends all day moving from toy to toy, and I’m constantly cleaning the house and picking up.”

“She doesn’t have any hobbies.”

“I can’t sit down/watch TV/talk to my spouse, because I have to entertain my child.”

“How do I stop my son from hitting and annoying his siblings all day long.”

“His teacher says he’s fine at school, but here at home he is just climbing the walls!”

These are just a few of the questions/comments I hear from parents who have no routine inside of their home. I personally feel this is bigger than an ABA issue and is really just an organization issue. I think most parents could benefit from incorporating structure into the household, but especially parents raising children with Autism.

Many parents raising children with Autism see that there is order and routine inside of their child’s classroom, but for some reason don’t see a need to generalize this same type of structure into the home environment. Any teacher of special needs children can tell you that without a schedule and routine, chaos would ensue.

Households without structure and order tend to have all kinds of problems:

*        Transitioning issues

*        Compliance issues

*        The children don’t initiate activities (if bored, they just bother their parents instead of finding something to do)

*        The kids fight and aggravate each other all day

*        The house is hard to keep clean; toys, puzzles, games are scattered everywhere

*        Keeping the kids entertained is placed on Mom and Dads shoulders

A red flag for me is when I am meeting with parents and we can’t hold a conversation because they keep stopping every few seconds to tell their child to get down…to be quiet….to stop hitting their sister…..to put the cat down…..to get off the table….or my favorite:  to “Go Play” (the words “Go Play” mean nothing to a child with no play skills).

If your household sounds anything like this, then you and your family could benefit from creating a schedule to put structure and routine into your home.

So where do you start?

1.      Write out the schedule for your home divided up by time increments, starting with what already happens everyday (such as dinner). Be sure to add in structured activities for your child, such as Water Play, Fine Motor Activities, or Art.

2.      Decide how you want your child to transition through the activities. Do you want to use timers? Sound cues, such as playing a specific song? Giving the child a directive, such as “Its time for Art”? Each activity needs a clear start and stop, so the child can easily transition.

3.      Modify your home to accommodate the schedule. For example, you may need to set up areas of the home for different activities, section off large rooms so multiple activities can happen in that room, put items and objects away in cabinets or drawers when they aren’t needed for an activity, and label areas so the child knows where to go to do the activity. If the schedule says your son is to do homework everyday after school, then there should be 1 designated homework area, and any needed supplies (paper, pens, calculator, etc.) should be kept nearby.

4.      Create a visual schedule, or write out the schedule and display it in a central location in the home.

5.      Explain the new schedule and routine to your child in simple language he/she can understand.

6.      Teach your child to follow the schedule. This is a step many families skip. It isn’t enough to make a routine and hang it up in the living room. The routine must be taught, and will take your child time to learn. Be firm, use lots of prompts and reminders, and do not allow your child to deviate from the schedule. If the schedule says its time for Reading & Vocabulary, then it doesn't matter if the washing machine breaks, the cat gets sick, or the new neighbors drop by unexpectedly: stick to the schedule.

Creating a schedule for the home will bring order, quiet, and structure into your household. Parents have consistently told me that they have more free time after implementing a schedule. The reason why is simple: when the children are appropriately engaged, it is no longer up to Mom and Dad to constantly put out behavioral fires or keep the kids entertained. 

 Below is a sample schedule for the home:

SAMPLE DAILY SCHEDULE

6:00 Wake up, Morning routine, Get dressed

6:30 Morning chores: Make bed, Feed dog

7:00 Breakfast

7:30 Leave for School

3:30 Arrive at home, Afternoon chores: Take out trash, Put book bag away, Take out homework

3:50 Snack time

4:00 Homework

4:30 Outside Play

5:00 Quiet Reading

5:30 Computer Time      

6:00 Cooperative play with siblings

6:30 Prepare for dinner, Wash hands, Help set table

7:00 Dinner

7:30 Bathtime, Brush teeth, Put pajamas on

8:00 Bedtime routine

8:15 Bedtime, Goodnight!

** Quick Tip: I really like this YouTube video posted by a Mom showing how she made her entire house ABA-Friendly. Click here to watch the video.

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Tameika Meadows, BCBA

                                                                                 Photo source: www.slate.com

Disclaimer: Conducting an FBA is a very individualized process that must consider the setting, the learner's environment, and who will carry out the intervention. The following post contains suggestions to guide the process, and is not intended to be applicable for every learner or every situation. It’s also important to note that the usefulness of an FBA extends beyond individuals with Autism.

For my original post explaining how to conduct a FBA, click here: http://www.iloveaba.com/2012/02/everyday-fba.html

This post is for caregivers (parents, teachers, therapists, etc.) who have conducted a FBA to determine the function of a challenging behavior and it is:  Automatic Reinforcement.

Challenging behaviors that have a function of automatic reinforcement are also called Self- Stimulatory behavior, or you may hear the word "stim" used.
These behaviors are not dependent upon social interaction or receiving a tangible item…the behavior itself is reinforcing to the learner. Just think about when you get a mosquito bite and it begins to itch. You don't need someone to give you a sip of juice, or to clap and say "Yay!", in order to enjoy the scratching. Scratching the bite serves as its own reinforcement. So in the future if you get bit by a bug again, you are likely to scratch again.

That means:

The child will engage in the behavior if they are alone.

The child will engage in the behavior if you put NO demands on them.

The child will engage in the behavior if they lose rewards, privileges, or reinforcers.

One thing I notice is that a sensory function is very overused. What I usually hear is "he/she can't help themselves, they have unmet sensory needs!". I would point out that its hard to imagine a part of your day when you are not receiving sensory input, and have to process it/deal with it.
For example, as I type this post I am in a room by myself. BUT, I am sitting on a not so comfortable office chair, I am feeling a few loose keyboard buttons under my fingertips, and I am a bit thirsty. I am processing all of these internal states as I type up this post. So to simply make a blanket statement like "he/she just has too many sensory issues going on today!" is a super over-generalization and wont help you to create an effective behavioral intervention.

What do automatically maintained behaviors look like?

For parents and teachers: If the child/student will engage in the challenging behavior when they are alone and under no demand, then it’s likely an automatically reinforced behavior.

For ABA professionals: If the results of your FBA or FA are inconclusive or the data has no clear pattern, then it’s likely an automatically reinforced behavior.

Common automatically reinforced behaviors can include: 
Hand flapping, rocking, inappropriate jumping/climbing, repetitive or extended vocal sounds, fingers in ears, toe walking, pica, saliva play or holding spit in mouth, stuffing cheeks with food, mouthing, chewing on fingers or clothing, screaming, smearing/playing with feces, licking objects, rumination (vomiting), immediate or delayed echolalia, and self-injurious behaviors such as eye poking, head-banging, or pulling hair.

Why do children engage in automatically reinforced behaviors?

These behaviors serve as their own reinforcement, so the short answer would be "Because they want to". :-) Especially for self harming behaviors, there is the possibility that the individual may process the pain differently than you or I might. 

How do I handle automatically reinforced behaviors?

Once you determine the function of a behavior, you need to do 2 things in order to reduce the behavior: stop reinforcing (feeding) the inappropriate behavior, and teach the child what to do instead.

It can be difficult to do a true extinction (extinction means to disconnect the reinforcement from the behavior) with automatically reinforced behaviors. The reason for this is typically some type of protective equipment is involved. For example, an extinction technique with a child who head bangs would require placing a helmet on the child. It has been my experience that most families do not want to use protective gear in the home or out in the community, or even know where to purchase these types of items. In severe situations, this is why inpatient facilities are often recommended.

Automatically maintained behaviors are often managed by combining response blocking with a functionally equivalent (and as possible, topographically similar) replacement behavior. So if a child bangs a table because they enjoy the sound that is produced, giving the child a puzzle to play with is not functionally equivalent. Something like giving the child a drum to bang would be functionally equivalent, and a more acceptable behavior than banging on a table repeatedly.

Remember: When creating a behavior intervention for automatically reinforcing behaviors you are competing with a highly preferred, free, & easily accessible activity. If the child bites their arm to receive automatic reinforcement, then you are competing with an always available arm that requires minimal effort to bite into it.  Trying to teach the child to come find you and request a teething toy will not be effective because that requires much more work than simply biting ones arm.

Recommended Resources:

Chandler, L., & Dahlquist, C. (2006) Functional Assessment: Strategies to prevent and remediate challenging behavior in school settings.

Does Sensory Integration work?

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Tameika Meadows, BCBA