I Love ABA!

Welcome to my blog all about Applied Behavior Analysis!

This blog is about my experiences, thoughts, and opinions on ABA. My career as an ABA provider is definitely a passion and a joy, and I love what I do.

This is a personal blog: The views and opinions expressed here represent my own and not those of the people, institutions, or organizations that I may be affiliated with.

Wednesday, February 6, 2013

FAQ Part III!- Letters To The Editor

First there was FAQ Part 1

  Then came the sequel, FAQ Part 2

And now it’s a trilogy!

I decided to compile some of the questions I’ve received from readers of my blog, in the hopes that it could help other people going through similar situations. ABA is such an enigma (quite similar to Autism) in that it is very simple and very complex at the same time. When I explain ABA to teachers or parents they often say something like “Oh that’s what ABA is?? But that’s so simple! I already tried that”.
 Yes, on the surface ABA can seem very easy because at its core it is simply Operant conditioning. It is the application of ABA that can be quite complex. It is knowing which technique to choose, how to implement it, when to modify it, and what to do when it isn’t working that trips many people up. For this reason there are many people out there who think they are “doing ABA” but they really aren’t.

Many people who read my blog send me comments or feedback about posts they liked --or didn’t like-- or things they’d like to see on the blog. I also get lots of questions from professionals and parents. From the types of questions I receive it’s clear that there are many, many people out there dealing with difficult behavioral problems in their homes or classrooms.

The purpose of this blog is to share ABA with people and provide a place for encouragement and resources. I didn’t expect this blog to be read by so many people, and I have learned a lot about what ABA and Autism look like in different countries just from hearing from my readers.
 I greatly appreciate everyone who takes the time to comment, email me, or purchase one of my books. I really do read all of the emails I receive, and I am touched by many of them.

Q- “My son wont stop banging his head on the living room floor/My daughter screams if you turn the TV off/ How do I get my child to stop doing ______?”
A- I get a lot of questions of this variety, with the same theme of “What do I do about XYZ” behavior. Behavior reduction is not that simple, and it’s not that cut and dry. When trying to intervene on a problem behavior it’s important to complete the FBA process, create a behavior plan, and then implement the plan. A professional can’t know with confidence what to do about a specific behavior just from hearing a few details about it. We need information to provide us a clear snapshot of the behavior so we can formulate an idea of why the behavior is happening, and what to do about it.

Q- “My son has Autism, and he is 8. The school wants to place him in a self contained classroom but I really want him to be in an inclusion classroom. Which one is better?”
A- The decision on whether to place a special needs child in a self contained classroom or a typical classroom will vary from child to child. Does every child with Autism automatically need to be in the “Autism classroom”? No. I have seen situations where my clients should have been transitioned out of their self contained classroom a LONG time ago, and I have also seen situations where my client was drowning trying to make it in a typical classroom. While it is important that children with special needs do not spend all of their time around other children with special needs, it is also unfair to the child to place them in a classroom setting that is far too advanced for them. Ask yourself: Is the child benefiting from being placed in a self contained classroom? Will a classroom aide be available, who is properly trained on Autism and ABA? Does the child exhibit problem behaviors that would cause social stigma in a typical classroom? Can the child learn in a variety of settings, or are they only at the point to learn from 1:1 instruction? If the child is in a self contained classroom, can they do a pull- out for any part of the day and go into a typical classroom? Questions like these will help to make educational placement decisions.

Q- “My son is working on a Waiting program in his ABA therapy. He talks to me during the program and likes to play with the timer. Is that okay? What is he supposed to do as he waits?”
A- It isn’t uncommon that vocal (verbal) children will talk to the therapist during a waiting program, ask questions, or try to gain the attention of the therapist. It really depends on why the child is talking. If the child is attempting to plead or bargain for the item they are waiting for, then no you shouldn’t respond to that. However, some kiddos like to narrate what they’re doing, such as saying “I’m waiting” or they may engage in some vocal stimming while waiting. I don’t see anything wrong with that. The child definitely should not be allowed to play with or hold the timer. In the natural setting, if the child is told to “wait” the expectation is they will wait calmly and appropriately without trying to reach for or touch the item they are waiting for (such as waiting in line, waiting to start playing a game, waiting for a cup of juice, etc). Teach the skill of waiting correctly during tablework, and it should generalize well to natural environments.

Q- “Why do I need a BCBA/What does a BCBA do?”
A- A Board Certified Behavior Analyst, or BCBA, is a person who is qualified to manage, oversee, and supervise direct staff (ABA therapists). BCBA’s are trained in analyzing behavior, conducting behavioral assessments, behavioral theory, data collection, and much more. The ABA therapist is the person who works with the child directly, usually in a 1:1 format (a BCBA can work as a direct therapist, they just usually don’t). Typically there will be at least 1 person over the ABA therapist acting as a supervisor. The reason it is preferable that this person be a BCBA is because of the knowledge and expertise necessary to supervise an ABA program. Many professionals without BCBA certification are not equipped to modify, manage, and intervene on behavior. For example, the ABA therapist may be knowledgeable about parent training and teaching skills, but they may not have understanding of why to avoid punishment techniques, or how to conduct a FBA.

Q- “I was able to secure some funding for ABA, but there are no providers in my area”.
A- This isn’t an unusual problem. Depending on where you live, there may be ABA agencies falling out of the sky. Or there might be one agency with a 2 year long waiting list or ridiculously high rates. You have two options depending on the requirements of the funding source. You could find laypersons and get them trained, such as teachers, paraprofessionals, the babysitter, etc. With proper training and supervision any of these individuals could be used as an ABA therapist. However, some funding sources specify that they will only pay for ABA services performed by a BCBA. If that’s the case, you could hire a BCBA who does not live in your area. They could provide long distance consultation, in addition to traveling to your home for in-person trainings or visits. The BACB website has an international directory of Board Certified professionals.

Q- "I enjoy reading your blog 'iloveaba.com' because I find it resourceful and informative. I have been doing ABA for slightly over a year and I really love it. Although, there are times I am stressful and worried especially during team meetings. I am quite a shy person thus team meetings with other therapists, consultant, and the parents is a little too overwhelming for me. As each of the therapists have to do a short session with our boy, I find myself getting anxious and jittery whenever it's my turn. I tried to ignore their presence in the room but I still feel so anxious that I end up making mistakes and not being able to perform well. I sense that the boy knows my emotions because most of the time when it's my turn, he will have tantrums or refuse to comply.
Does this happens often to ABA therapists? Could you share how I could overcome this problem? Like you, I am passionate about ABA but I don't seem to know how to overcome this fear and shyness in front of so many people."
A- I can SO relate to what you describe! I have definitely been in that situation. My very first client in this field used to have these huge training meetings that combined the home staff and school staff and we would have to take turns working with the child...while also being videotaped. It was incredibly stressful and I used to hate those meetings :-)  Looking back on it, what changed the situation for me is when my confidence grew. I used to feel timid, uncomfortable, and panicked doing therapy in front of everyone because I was scared I would make a mistake, or do something wrong. But to learn in ABA, you have to make mistakes! That's how learning happens. I know how scary it is to perform therapy while people watch, but its a valuable learning tool and it will make you a better ABA therapist. The only thing that can build your confidence (besides time) is really striving to become better. Watch ABA training DVD's, read books, read research articles, ask questions of the consultant, and I also recommend taping your own therapy sessions. Kind of like how football coaches review tapes of great games, as an ABA therapist it can be very helpful to view tapes of your own sessions and critique your performance.  
As your confidence grows, the fear will go away. Also the child is very likely responding to your timidness and lack of confidence by testing you. That's why he starts to act up. You have to show him that you are not going to allow that behavior no matter who is watching. Over time he will realize that you aren't kidding around, and he will stop.

Q-“I was told that my child is too high-functioning to use Applied Behavior Analysis (ABA) because she is verbal and relates to other people. Is it true that ABA is best used with children who are lower functioning?”
 A- I have heard this myth before that ABA is only for young kids or low functioning kids. However, that simply isn’t true. I have worked with children all over the Spectrum, who varied from low functioning to high functioning. ABA can be successful for older kids as well as adults. It all depends on what the goals are. ABA therapy with a teen may focus on more cognitively advanced skills that the child has deficits in, such as dating, employment, joke telling, puberty issues, etc. Progress is possible when using ABA with an individual of any age. Some funding sources severely minimize or cut off funding for children over a certain age (usually 8), because of the belief that “recovery” is no longer possible so there’s no point to therapy. This does not mean that ABA can’t help a teen or adult, it just may be difficult to find a funding source to pay for it.

Q- “When I started working with my student (26 months now), he did not speak and had many communication difficulties.  Now he is speaking (not in sentences yet) and repeating everything he hears! However, socially, he is still not making as much progress as I would like him to be making.  We just had him enrolled in a toddler class for 2-hours/week, which his mother and I will be attending with him.  He does not play with other children and does not want to participate in any activities.  These isolating behaviors are worrying his family and I would like to be able to help him with this.”  
 A- The social issues you describe need to be taught. It sounds like a skill deficit, so putting him in a social setting wont be very successful because he lacks the ability to know what to do and how to engage. You can’t generalize a skill that doesn’t exist yet. Even if he can socialize with you or with Mom, that may not automatically transfer to being able to generalize socializing with children. I would suggest writing 2-3 social skill programs and also setting up more playdate situations where it is just you, the child, and a peer. In the play date you would be targeting appropriate social interactions such as eye contact, sharing, and conflict resolution.

Q- "I was just hired as a middle school teacher with 8 students who have autism.  I'm reaching out to you to ask advice as to how to approach my students on my first day.”
 A- The suggestions I have for you are the same ones I would give to a therapist going to work with a new client. You want to start off by building and establishing rapport, taking baseline data, and observing/analyzing behaviors. I know it’s a bit different for you because you have many students, not one child you are working with. I would suggest creating time blocks in the day where you are interacting with or observing/taking data on specific students. So maybe during Circle Time you observe and collect data on 2 students, and then during recess you interact with 2 different students. Just keep rotating through until you have the information you need on all students. This information will be invaluable to you once you start teaching, and it will help you to differentiate instruction among the students (which I believe should happen in every classroom).

Q- My son is 9, and we have been struggling with severe problem behaviors for quite some time. A while ago we were given one technique to deal with his cursing. That was that every single time he cursed, I was to send him to his room. Being an untrained parent, I dutifully obeyed. If we were at the park and he cursed, we came home and he went to his room. If we were eating dinner and he cursed, he was sent to his room. If we were food shopping, we immediately left the store and he went to his room. His base time was for 5 minutes. As he was going to his room, I was to add a minute for every curse uttered.  He grew to love this, and the cursing only increased. When I mentioned to the case manager that his cursing was increasing and he was smiling while cursing, she just said that I wasn't following through with the timeout!”
 A- Based on the information you have shared, it does sound like his cursing is a way of being sent to Time Out so he can escape a situation. Typically with escape maintained behaviors the intervention is to not allow escape no matter what. Unfortunately, Time Out is one of the most misused behavioral strategies that I come across. “Time Out” is actually short for Time Out from Reinforcing Activities. In other words, if the child is engaged in something reinforcing then Time Out is likely to be effective. If they are doing something they really don’t want to do and you place them in Time Out, what just happened? They got to escape a dreadfully boring task. So in the future when they want to leave a store, stop doing a task, or get out of a demand, they will act up in order to be sent to Time Out.

Q- “I'm thinking about working for an autism organization as a line therapist this summer and am wondering if you have any advice for me. Do you like your job? How difficult or consuming is it to be a line therapist?”
A- I get many questions like this. Being an ABA therapist is definitely not a job for everyone. I love what I do, but I have seen therapists get hired and very quickly quit. It depends. Not all companies are created equally, so sometimes you can work for a company that is unprofessional, treats staff badly, and pays very little. So that could cause someone to leave the field because they think all companies are like that. How difficult the job is will depend on the training provided to you, and how much support the company gives you. Also the more you learn and as your experience grows, you will become more confident in your abilities which will also make you like the job more. Here is a helpful post for anyone interested in entering the field of ABA.

Q- “I have a 6 year old son who has high functioning autism. He is potty trained fully for the day time but we are having a difficult time taking him out of the pull-ups at night. I've google searched for social stories regarding this issue but have not found any. Do you have any stories you can share or any links you can give me?”
A- If you can’t find the kind of social story you are looking for, you can always write your own. It’s not difficult. Go to Carol Gray's website and view the information about how to make a social story and what content it needs. Include photos of your child, use language that is at his level of understanding, and start teaching him using the story. Here is a link to writing your own social stories. Good luck!

Q- “I have a heart for people, especially kids with Autism. I want to go to school but am having a hard time choosing a degree. I am creative and systematic, very much a puzzle solver and I get bored quick the same old routine everyday. Would behavioral analyst/specialist/consultant be a good career choice?”
A- If you want to become an Autism Consultant, which is a BCBA, then the BACB website lists the specific degrees required to obtain certification. In addition to a degree, you need specific coursework (which may or may not have been part of your degree program), you need to be supervised by a BCBA while you gain ABA experience, and you must pass a rigorous exam.
Oh, and if you decide to become a BCBA don’t worry about being bored. There is so much variability to the field! You can decide where you want to work, with what ages, and the daily duties change based on who your clients are. It’s definitely not a typical 9-5 job, which is what I love about it!

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