Thursday, August 30, 2012

When parents get involved in ABA the results are amazing!

There is so much research on the benefits of early intervention for children on the autism spectrum that we often forget that parents are really the first line of defense in the uphill battle. Parents can be the strongest influence in modifying a child's behavior when they understand the principles of behavior modification and implement them consistently. Extensive research shows that home-based therapies may be more beneficial to children with autism if therapists also provide parent support and parent training. Many parents reported that learning to use the ABA techniques not only helps their children but it helps them and the rest of the family.

But there are difficulties. As therapists that work with children with special needs we face the challenge of motivating parents and caregivers to implement the therapeutic advice we offer.  Learning the techniques and following through consistently takes a significant commitment on the part of parents, many of whom are already stressed and stretched to the limits. It helps if the therapist approaches the challenge of training parents with compassion and understanding while at the same time treating them professionally, as if they are the client, not just their child. Take into consideration that the same ABA principles and techniques we use in behavior plans for children work with parents also – rewarding desirable behaviors, consistency and persistency, effective instruction and environmental manipulations. 

Some tips on how to implement a parent-training program:

·       Parents need to be motivated. Praising them for their efforts and commitment is crucial. It helps to say “Good Job, mom”, or “You are doing a great job in taking care of your child and advocating on his behalf”. Keep in mind that we reinforce successive approximations towards the goal. We want to reward direction, not perfection.

·       Make it simple. Break complex concepts and techniques into small, more reachable units, and teach each unit until mastered. Provide sufficient modeling, examples and opportunities for turning the theory into practice. If necessary, go to the grocery store and show mom how to handle her child’s behaviors. Provide parents with audiovisual materials, such as research, articles, books, and videos. One thing is to understand the theory. It is another thing is to be able to apply that theory to real-life situations.

·       Consistency and Persistency: People do not learn overnight. Be patient. You will need to repeat the lesson several times. Do not get frustrated when parents reject your ideas and advice. They might need time to assimilate the new strategies. 

·       Environmental Manipulations: Parents are not able to implement a behavior plan if they have a full work schedule; if they are currently dealing with an emergency or a crisis, such as an illness or a divorce; if their lives are cluttered; or if they are extremely stressed. Helping them with time/stress management could be crucial in ensuring the success of the program. In some cases, we may need to suggest seeking professional help, taking time off work, changing jobs, getting help and support from family members and/or community sources.

When parents get “on board” the results are amazing. After all, what can be better than 24/7 therapy.

Daniel Adatto, BCBA


Tuesday, August 14, 2012

Behavior consultants: Who are they and how to find the right one?

There is confusion about this strange breed of professionals known as Behavior Consultants. They are not psychologists, but deal with behavior problems. They are not teachers, but teach socially significant and functional behaviors. They are not Speech Therapists, but teach communication. They are not Occupational Therapists, but deal with sensory deficits and excesses.

So, who are they? 

The California Association for Behavior Analysis presents an interesting article about this on its website:

The article was developed by representatives of three major professional organizations: the psychology division of the American Association on Mental Retardation, the MR/DD Division (Division 33) of the American Psychological Association, and the Association for Behavior Analysis.
As the article explains, board certified behavior consultants, or analysts (BCBA’s) are “professionals with documented graduate training and supervised, hands-on experience in Applied Behavior Analysis (ABA), and have passed a special examination in this area.” This program is managed by the Behavior Analyst Certification Board (please, see for more information, including a Certificant Registry).  
I especially like the following paragraph from the article:
“We suggest you do not use a behavior consultant who focused mainly and solely on reacting to the problem behavior unless a crisis or other particular circumstances warrant this focus. Focusing only on reacting to the problem behavior will not prevent it from happening in the future and does not represent current best practices. In crisis situations or in the case of an escalating behavior problem that requires immediate action, treatment should address both immediate concerns and preventing strategies, such as changing the environment and teaching appropriate alternative skills. In most other cases the main focus of behavior consultation should be on skills development.”   
Because of a shortage in trained and experienced behavior consultants, I recommend you look for programs directly supervised by BCBA’s. We will assess the meaning (function) of the problematic behavior and be able to determine an appropriate course of action. In other words, an experienced behavior consultant will be able to determine what the individual is telling us through his/her behaviors, what she/he needs. We will measure the current status (baseline) of the problem in quantifiable terms (numbers) and set goals accordingly. We will teach desired replacement behaviors so the individual can communicate his/her needs appropriately. We will measure each step of the process and compare it with the baseline and the goals in order to monitor the effectiveness of the program. We will make changes if those measurements show lack of progress. We will recommend consultations with other professionals when the problem goes beyond our scope of practice. And we will go to the natural environments and train all caregivers (parents, teachers, etc.) in the process so behavioral gains can be generalized across settings and maintained across time, even though when we are not there anymore. 
In summary, we are trained in behavior management and best practices on how to implement these programs. And we are ready to help you.

Daniel Adatto, BCBA