Saturday, May 30, 2015

Program: Play Dates


Photo source: www.Sheknows.com, www.Parentmap.com



*Recommended post: Teaching children with autism to play

Play skills in general are often taught to clients across the age span (for older individuals, these programs may be called “leisure activities”) as well as functioning abilities. Play skills/Play interaction is an important social skill that shouldn’t be neglected as part of an ABA treatment plan. 
For professionals who typically work in home settings, you can sometimes be at a disadvantage when trying to teach play skills because you see your clients 1:1. Not every client has a sibling you can pull into the session, and sometimes even if they do the sibling isn’t an appropriate peer model. It’s also important to use a variety of peers, as this is a generalization issue. So bringing in the 5 year old sister each week isnt helping your client generalize.
 If my client only ever plays Monopoly with me, or with me and their sister, can I truly say they have mastered the skill of Board Game Play? No, I cannot. I need to observe the client play a variety of board games, across a variety of people.

In situations where socio-emotional skills are lacking and I don’t consistently have peers available to incorporate in therapy, I will often add a Play Date program for my clients.
A Play Date is just bringing together your client with a peer to target specific skills in a structured/intentional manner. How structured will vary depending on the setting and the needs of the client. 

It’s important to consider a few things before introducing Play Dates, and to make sure the learner is truly ready for this skill. Here’s some helpful tips:
  •    Is the learner ready for a Play Date? I see parents do this all the time----the ABA team tells the parents that the learner has social skill deficits, so the parent begins putting together Play Dates on their own. Just putting the client with other kids in a room, is not a Play Date. There should be specific goals, based on the treatment plan, and both the peers and setting need to be appropriate as well. Where will the Play Date be held? If at the client’s home, is the client okay with peers being in their space or touching their belongings? If not, the Play Date likely won’t go well. Does the client exhibit frequent aggression or vocal stims? If so, that may scare a peer off, or stigmatize the client. These things need to be considered before introducing Play Dates.
  • So what exactly is an appropriate peer model? An ideal peer is compliant, they do not themselves have lots of poblem behaviors, they are patient, they are neither bossy or timid, and they aren't easily "spooked". If the client gets upset and has a brief screaming fit, the type of peer you want is one who will happily play alone for a few minutes, not who will demand to go home.
  •   When selecting Play Date goals, I recommend first observing the learner with peers, both in structured and non-structured settings. It can also be very helpful to speak to the parents/caregivers about the social and play issues they regularly see. Just because a learner can play appropriately with peers on a Play Place at Chick-fil-A, that doesn’t mean they can sit down and play a card game with a peer. Or vice versa. If you don’t have any specific goals you are targeting during Play Dates, then how exactly are you tracking progress?
  •    Speaking of progress, someone should be collecting data during Play Dates, and this data needs to be regularly reviewed to evaluate the effectiveness of the intervention. This could be done by the ABA therapist, the BCBA, the parent, etc. It just depends on who is facilitating the Play Date. A common mistake I see parents make is to set up a Play Date, the peer(s) arrive, and the kids just go off and play. That doesn’t look very therapeutic to me….if the learner was capable of engaging in appropriate play independently then they wouldn’t need a Play Date program. So unsupervised Play Dates are a no-no. 
  •    The level of adult facilitation will vary depending on the needs of the client. I have participated in Play Dates where I laid out ground rules at the start, and then faded into the background to observe from a distance and prompt if needed. I have also participated in Play Dates where my client needed much more intrusive assistance, I came up with the activities, I transitioned the children as necessary, and sat directly behind my client. It just depends on your client’s ability to play appropriately (with both objects and people).

Appropriate play skills include much more than just being able to share a toy, or to stay in the same room as the peer(s). Other skills I often target during Play Dates include:

-          Keeping your hands to yourself (not excessively touching, rubbing, or leaning on the peer), Greetings (both initiating and responding), Social eye contact, Asking spontaneous questions, Responding to spontaneous questions, Maintaining a conversation (includes staying on topic), Imitating the peer (following the peer’s lead), Displaying appropriate social manners (if peer is upset or crying, asking “whats wrong?”), Demonstrating assertiveness (speaking up if peer is being rude or mean), Resolving conflict or Problem solving with peers


Lastly, I often have the benefit of being able to combine clients (or to “borrow” siblings of clients) to use as peers during Play Dates. Many of the parents I serve don’t have this luxury, and it can be pretty difficult to locate kids that can be regularly incorporated into Play Dates, especially if the client is older.
 I like the tips presented in this article for helping parents set up Play Dates, feel free to share it with the families you serve.



Sunday, May 24, 2015

Quote of The Day


Words. Have. Power.

That is the truth. The impact of the words that we choose to speak to others can hurt, inspire, discourage, or build someone up.

A personal pet peeve of mine, is when people talk negatively about one one of my clients directly in front of my client. That really bothers me. It happens with clients of all functioning abilities, but I see it the most with my nonverbal, more early learner type of clients. I think people look at them and set low expectations: "Well, Joshua doesn't talk and he stims alot, so he can't be smart", "Well, Joshua isn't even listening to what I'm saying anyway, he's busy jumping all over the room".

Make it a habit to choose carefully the words you speak around, or to, your child or your client. Remind others who try to talk negatively about the child in frot of them, to speak with you privately, or to write it down.
When I am supervising my staff and we need to discuss the client's behavior, we write notes to each other. The last thing I want to do is say in front of the child how badly the child is doing in their therapy session.

I choose to speak encouragement to the children I work with, even if I don't know how much they understand. It doesn't matter. I would rather assume the best of them and be wrong, than to assume the worst of them.
Wednesday, May 20, 2015

Transfer of Learning



Photo source: mmedu.net, businessinsider.com.au, popsugar.com




*Recommended Post: Teaching Loosely





I have talked about the need for teaching with intentional generalization on my blog before, but as a refresher here is a definition for Generalization:

The act or process whereby a learned response is made to a stimulus similar to but not identical with the conditioned stimulus

I see the pitfalls and learning errors from a failure to teach to generalization all the time, so this is something that’s definitely need-to-know information for ABA therapists/instructors. This post is specifically about generalization across environments---home to school, school to work, and especially self-contained classroom to inclusion classroom.
 If you have a client or student who can only perform a specific skill this way, in this room, with those flashcards, then can they really perform the skill? The answer would be: No….they cannot.

I think about this issue a lot when I’m traveling. I travel often for work, and find myself in unfamiliar airports. Inevitably, at some point I have to do some problem solving to locate a bathroom, or to find my luggage, or to get to my gate. Fun fact: I don’t like to stop people and ask them for help. So how do I problem solve in an unfamiliar setting? Well, I combine what I know with cues from my environment. If everyone gets off the plane and starts veering to the left, I should probably veer to the left too. If I see a blue sign with a suitcase symbol on it, then I can reasonably expect that we are all walking towards baggage claim. 
So I am able to build upon existing knowledge of airports I am familiar with, and transfer those skills appropriately based on the new setting. I often wonder, “Could any of my clients do that? If they were dropped off in a new setting, and unable/unwilling to communicate with others, could they find their way?”

There are SO many different ways inability to transfer skills can exhibit itself in learning situations. A big one I see often is learners who have spent months or years only receiving 1:1 intervention (either early intervention, ABA therapy, or maybe a school shadow in a special education classroom), and then must transition to a general education classroom. What happens to the kid who has been in the “Autism” classroom for 2 years, once he is plopped into a typical classroom?

Planning for generalization is really about planning for Transition.
There is always a next step, a next goal, and a next challenge in the lives of the individuals you serve as an ABA professional. To fail to plan for generalization is almost like saying “This individuals life won’t change, vary, or improve at any point so I don’t need to prepare him/her for that”.

For most ABA professionals, we know to ask ourselves “can the learner perform this skill to fluency”, “can the learner perform this skill with me and with mom/dad”, and “can the learner perform this skill when I vary the materials”. Go beyond these questions, to ask yourself if the learner could perform the same matching task they do at the DTT table, inside of a Wendy’s restaurant. Or if they are learning to brush their teeth at home, can they brush their teeth inside a school restroom? If they are learning to follow a bedtime routine at home, can they also follow that routine at a hotel when the family goes on vacation?

There are many ways to help ensure that the individuals you serve don’t just learn skills, but that they can transfer those skills from familiar to non-familiar environments. Successful teaching doesn’t occur in a bubble; it spreads and pops up spontaneously in new settings.

Tips for Promoting Generalization
1.       Plan for it – Well, this seems like an obvious tip. Do you intentionally plan for generalization when selecting skills to teach? How? There should be a clear and measurable system for ensuring generalization is embedded into teaching, and all the staff who work with the learner need to know what the system is. There are no specific rules here, just think about the scenarios in which the learner may need to perform the skill. Let that guide you. For example, if you are teaching labeling colors what about labeling colors of objects? Labeling colors of animals? Labeling colors outside at the park? Labeling colors when the stimuli varies (knowing that “pink” can be light or dark)? Labeling colors while standing in the checkout line at the grocery store? If you have taught a few colors during DTT using some flashcards, you definitely are not done until generalization has been planned for.
2.       Vary where you teach- Sometimes providing ABA in the home environment can cause a disadvantage in this area because often you are teaching skills the learner needs to perform in their home. Working in school and center environments automatically helps promote generalization because teaching can occur outside of the setting where the skill must be exhibited. As much as possible, vary where you teach. Run trials outside, in different rooms, at public settings, and plan trips into the community. I regularly plan “Fun Days” with my clients where we go out and do things, and on the surface I’m sure it can seem leisure motivated and just about a good time. But in reality, when we ride in a car, cross a public street, walk through a store, or enter a Burger King, multiple skills are being targeted and generalized to new settings.
3.       Talk to the parents/caregivers- In order to successfully embed generalization, you need to know where your learner is going. Are they transitioning into a new school? Transitioning out of intensive, in home ABA? Transitioning out of the use of a school shadow? Each transition can benefit from intentional generalization. I mainly work with early intervention kiddos, and before they start school I talk to the parents about helping the learner adjust to learning in a typical classroom environment. My instruction needs to mirror classroom instruction more and more, as that learner gets closer and closer to their transition into school. Otherwise, the HUGE differences between 1:1 ABA and learning in a classroom could trip my learner up and cause him/her to regress.
4.       Think about the Experience each setting offers- This is similar to point #3, but the generalization lightlbulb came on for me when I started putting myself in my clients shoes, by thinking about how the experience of setting A differs from the experience of setting B. Let’s compare learning play skills at an ABA clinic environment to learning play skills at a park. At a clinic, most likely staff won’t exceed 5-10 people, reinforcement is immediate and visible, there’s air conditioning, the space is relatively quiet, and the children sit and play on carpeted floors. Now let’s look at a typical park/playground: there are multiple adults and multiple kids present, reinforcement may be discreetly tucked away/hidden or even back at home (“You can have ____ after we leave the park”), its hot outside, there’s planes flying overhead and cars driving by, and the children sit on sand or dirt. Just examining the environmental changes, gives so many clues as to why all of a sudden the learner cannot perform a skill at the park that they readily perform during ABA therapy. Add to this possible issues with sensory processing, and it makes even more sense.


This is one of those teaching distinctions that can help consumers differentiate between a low quality ABA provider, and a high quality one. How is the provider you are working with planning for generalization? How are skills intentionally transferred across environments/settings? Generalization is a part of mastery, so a skill can’t be truly mastered until the learner can appropriately generalize.

For example if the learner is learning to wash hands, can they perform this skill at home, at school, and inside the bathroom at Red Lobster? Are they readily able to use a towel, automatic air dryer, and paper towels to dry their hands (as the materials in the bathroom usually vary from location to location)?
 If not, then that’s an error in teaching, and not to be blamed on the learner.