Sunday, July 20, 2014

The Easy Way vs. The Hard Way





I will often explain ABA to new clients/families by saying ABA therapy isn’t easy to do, but it doesn’t have to be difficult. What I am very careful not to say is that ABA isn’t hard.
It is hard.
 It can be very hard.

Many strategies and techniques we use as ABA professionals have taken us graduate level coursework, years of experience, and a super thick skin to implement correctly. The average busy and multitasking parent isn’t quite ready for what ABA can fully entail, and the changes that will be necessary for their whole household.

When I say ABA doesn’t have to be difficult, I mean that an experienced and quality BCBA/Consultant/Supervisor will have the skills to present complicated concepts to a parent or teacher in a lively way, thoroughly define and explain strategies, and reinforce effort to promote learning. The right professional should make you feel supported and encouraged, and when they need to correct or modify your behavior they do so tactfully with a great deal of patience.

When I say ABA isn’t easy, I mean just that. ABA is often the opposite of “taking the easy road”. Many times as you are on the ABA therapy journey you will have the choice to do what feels easy or “right” or to do what feels difficult or “wrong”.
As a professional I face that same choice.  Am I going to roll up my sleeves and do the work necessary to help my client be successful, or am I going to shrug and say “Well, that’s close enough”.

I think much of discipline or behavior change in general requires changing your mind about what you as the parent or teacher are capable of, what the child is capable of, what behaviors you are willing to accept, and what behaviors you are NOT willing to accept. What can initially seem like a fairly easy way out of a tricky behavioral situation, can cost you much more effort, pain, or frustration in the long run.  It’s similar to eating fast food: in the moment it’s cheap, quick, and easy. But over time, it has an impact on your health and your waistline.

So the next time you are facing behavioral challenges in your child and have various choices of how to respond running through your head, pay attention to the ones that seem the most challenging, time consuming, or difficult. Those choices are likely what an ABA professional would recommend you do. Think about it like this: Autism is not simple or easy, so why would the treatment be simple or easy?

Here are a few examples I see fairly often, of being faced with that Hard or Easy Choice.

BEHAVIOR
EASY CHOICE
HARD CHOICE
Child is screaming at you that they hate you and calling you names
Yell back at the child  that they can’t talk to you that way
Once the child is calm, talk to them about why they feel that way
Child is refusing to stay seated at the dinner table
Promise the child they can have the Ipad for the rest of the night if they will come back and sit down
Get up and bring the child back to the dinner table. Hugely reinforce every 20-30 seconds of appropriate sitting
On a long car trip, the child is engaging in repetitive “junk” talk about boobs and butts
Crank the radio up super loud to drown out the “junk” talk
Pay no attention to the inappropriate conversation, and give high fives to the other children who are talking nicely
At a family function your toddler begins to cry and tantrum. You aren’t sure how best to respond, but people are beginning to stare.
Quickly grab your child and leave the family function
Wait, and do not attend to the behavior. If you don’t know how to respond then do nothing. Quietly wait for calm, as you decide how best to intervene





Friday, July 11, 2014

Quote of the Day

"The rat is always right" B.F. Skinner 
(Father of Operant Conditioning, Author, Researcher, and just all around amazing person)


"The rat is always right" is a classic Skinner saying that alllll ABA people should have stitched onto a pillow somewhere in their home.

What Skinner meant with this statement is that if something is not going right with your experiment, the rat is not to blame. The rat isn't being lazy, stupid, or stubborn. The rat is doing what you have trained the rat to do. Rats can only be rats.

I'm sure you see where I'm going with this.......

When your client just "isn't getting it" after intensive teaching, switching up reinforcement, and changing your materials/stimuli, do you blame the client? Do you assume they cant learn, or are just being noncompliant? 

For parents, when the team of therapists leave your home and all of a sudden the child stops manding and problem behaviors begin, do you think the ABA just "isn't working"? Do you blame the therapists or supervisor that you cant get your child to complete tasks?

To put it simply: the child will do what you have the environment set up for them to do. So blame the environment, not the child.



Tuesday, July 1, 2014

Behavior Plans Made E-Z




Suggested Reading: Creating a Behavior Plan


I have mentioned before on my blog that the extensive behavior plans/interventions ABA professionals create are typically handed to someone else to implement. That may be a parent, teacher, ST, OT, etc. It can be difficult getting someone else to follow your recommendations, and to commit to sticking with the behavior plan especially if an Extinction Burst initially occurs.

I have seen some wonderfully bright and talented BCBAs falter in this area. I like to look at it as Knowing your Audience. A typical busy parent of 2 children really doesn’t want me to hand them a 4 page document with Behavior Plan typed on the first page. That wasn’t what they had in mind when they asked for help with behavioral issues. 


However as a professional, that’s all some us have been taught…..how to conduct FBAs, how to generate hypotheses, and how to form a plan based on results of evaluation.
 What about taking all of this amazing knowledge and expertise, and transforming it into something that’s easy to digest? Now that takes skill! :-)
 

Something I like to do with my clients is create “Cheat Sheets” for behavior plans, that I strongly recommend the family post in visible locations. That could be on the fridge, on the child’s bedroom wall, and making a laminated card to carry out in public. In order for a family to implement my behavior plan, they must know what it says.
 Simply reading and reviewing the plan with a family may not be that helpful. Often after reviewing a 5 page intensive behavior plan, the parents are too intimidated to ask any questions. Or they are in a daze, or feeling extremely overwhelmed ... I actually had a parent start crying once in the middle of a treatment plan meeting. That’s not the reaction you want the client to have!

Creating a small, portable cheat sheet does a few things: it makes the behavior plan seem less scary and unattainable, it serves as a visual prompt for what to do in the moment, it is helpful for family members who work outside of the home and maybe aren’t always available during supervision sessions, and as we all know out of sight, out of mind….simply having the cheat sheet posted in the house helps everyone in the family stay alert to how they are managing problem behavior, or how they may be contributing to problem behavior. Putting my photo on the cheat sheet can be helpful for that too (I’m so joking).



A few tips for making a great cheat sheet for your clients:

  • Leave the jargon at the door:  It’s great that you can easily use terms like Schedules of Reinforcement and Partial Interval Data Collection, but the cheat sheet is supposed to be NON- intimidating. So use simple, everyday language.
  • Visuals can be helpful!:  Picture icons can be added to the schedule for ease of use, they catch the eye, and if there are siblings in the home adding photos to the cheat sheet makes it more kid friendly.  Use of bright colors, highlighters, stickers, etc., is also suggested. We want little sister or big brother to know how to implement the behavior plan too.
  • Use positive language that is non-judgmental: Keep statements like “Don’t do this”, or “Stop saying this” minimal, and focus on what you want the family to DO or SAY to manage problem behaviors.
  • Provide practice or role play opportunities for the family: Sometimes during supervision sessions my clients experience what I like to call Mechanic Syndrome. Similar to how when you take your car to the mechanic because it is making a noise, and then the mechanic swears they don’t hear anything. Then as you drive away, you immediately hear the noise again. Sometimes even with triggers present, my kiddos won’t engage in the problem behavior when I’m at the home. So I do a role play with Mom or Dad. Using the cheat sheet as our guide, I have them pretend to be their child engaging in a problem behavior. Then I pretend to be them, and show them how they would react. This can be a SUPER helpful exercise because inevitably when I give parents a behavior plan they will say “But Tameika what about when he_______”, “What about if she does _______”, “This plan doesn’t cover if he suddenly ________”. So role play scenarios are good for troubleshooting all those What If situations.


*Resource: Here is an example of a Behavior Plan Cheat Sheet