Thursday, April 30, 2015

Let’s teach our kids how to be happy

I recently overheard one teacher’s assistant say “They don’t know how to be happy”, after one of her students responded in a grumpy way for no clear reason. Interesting statement, I thought, why I don’t write a blog about it.

Happiness, being happy, is a subjective state. What is “happy” for one person might not be for another one. But for the sake of this discussion I think we can agree that when we are happy we feel good, we are more in control of our behaviors, and we enjoy ourselves. Most people know how to be happy for the most part because they know what makes them happy. An activity they enjoy doing, a favorite restaurant, time with loved ones, success at work, the satisfaction of fulfilling responsibilities, etc. In behavioral terms, most people know how to meet natural contingencies of reinforcement, or how to obtain rewards. 

For kids with special needs this doesn’t come naturally. They often live in a state of confusion and anxiety.  Not only is it difficult for them to understand what’s going on around, they don’t know how to meet natural contingencies of reinforcement. In plain English, they don’t know how to achieve positive experiences. The chaotic organization of their behaviors can make them feel in a constant state of discontent.  This can cause frustration, anger, disappointment to the people around them who then react with aversive methods of discipline. Which then feeds the cycle.

Therefore, it is our job as teachers and parents to rescue them. We need to teach them how to be happy. In the process, we can also manage their behaviors.
How do we do this?

As explained in my blog post titled “What’s your talent?” we do so by exposing them to experiences where they can feel a sense of success and achievement:

1.      Contrived rewards and praise have to be built into their daily schedule of activities, at home and at school. Instead of waiting for them to fail to reprimand them, let’s create the environment and provide them with the necessary support to succeed.

2.      Catch them being good. Even during challenging situations make an effort to praise them for something. Do not focus exclusively on the “bad.”

3.      As we discussed in a previous blog (See “Fun can change behaviors”), something as simple as fun is the easiest way to change people’s behavior for the better. For example, if a child is resisting brushing teeth, going into the bathroom together and singing a funny song may be motivation enough. If getting dressed is a struggle, initiate a game of tickle, act silly and turn getting dressed into something fun.  Instead of demanding that a child clean up the toys, turn on some music, dance around and turn it into a game.  Make it fun and you will make it easier.

4.      Another way to help them be happy is to teach the child a more effective and appropriate way to get her needs met. If your child is having a hard time doing homework, for example, teach her to ask for breaks, or help.

Disciplining our kids is part of our job description as a parents and teachers. I know I’m doing my job right when I make them laugh/smile. I do that best when I’m enjoying my time with them. You need to have “fun” in your toolbox because fun is one of the most powerful tools of discipline.
Daniel Adatto, BCBA

Tuesday, April 14, 2015

Family involvement

We always say that when parents and other caregivers get involved in the interventions, their children show the most gains and progress. Parents become the therapist and thus, the intervention is in place 24-7.

The question is what it means to be involved. Here are my recommendations regarding the necessary steps of family involvement:

Phase 1: Look, listen, and learn

·       This is the introductory phase where the parent observes the behaviorist working one to one with the child. The parent will observe different segments in a variety of domains including independent living skills, functional communication, play, and behavior. Verbal instruction as well as modeling will be used throughout this phase to familiarize the family with common strategies and techniques.  

·       20 - 25% of the session will be devoted to observation. 

Phase 2: Working together

·       The parent has now observed all of the segments and is given a choice of what segment they would like to work on. During this step the parent and provider are both actively involved in the segment. The parent begins to give instructions, redirect inappropriate behavior, and use reinforcement contingencies.

·       The behaviorist is collecting data on the consumer’s interactions with the parent as well as with herself/himself.

·       20 – 25% of the session the parent and behaviorist will work together on achieving the consumer’s goals.

Phase 3: Parent lead

·       The parent is now leading the segment with the support of the provider. Instructions, redirections, and opportunities are all directed by the parent.

·       The behaviorist is taking data on the interaction and is only stepping in when necessary to give feedback to the parent.

·       25 – 30% of the session will be parent lead.

Phase 4: Independence

·       In the fourth and final step the parent is working with the consumer one to one and the provider has been completely faded. The parent is responsible for handling difficult behaviors, following through with demands, and employing environmental modifications.

·       The parent and behaviorist are both taking data that will be compared during the debriefing session to check for reliability.

·       25 – 30% of the session will include parent participation.

All this take and investment in terms of work and commitment. But it is worth it because you are investing in your family quality of life.
Daniel Adatto, BCBA

Tuesday, April 7, 2015

The First 3 Months of Early Intervention

Numerous research studies show that the earlier the better when it comes to early intervention using applied behavior analysis in the treatment of autism.  What is not so often written about, is how exactly to begin an early intervention program and what are the critical first steps to take when a Behavior Analyst begins working with a child with autism.
At a recent ABAI conference an expert from Poland held a session on why the first 3 months of an early intervention ABA program are so critical. The presentation focused on quality of services and building a strong foundation, reminding us not to jump ahead too quickly, not to target all deficits but to prioritize deficits and skills to ensure quality. The presenter emphasized how important it was to develop a positive relationship with the client in the first month in order to obtain optimum results. This information probably seems intuitive to most Behavior Analysts yet so many of us go about our first treatment sessions the wrong way.
When a typical ABA program begins, a Behavior Analyst will gather information on problematic behavior and details surround that behavior - the frequency, where it occurs, when it occurs, etc. The Behavior Analyst will meet with important people in your child's life, such as friends, babysitters, teachers, and relatives to get an understanding of how they behave within a variety of relationships. Also, they will schedule a time to observe your child to personally witness the problematic behavior. Once they have gathered enough information, the Behavior Analyst will complete an entire behavioral assessment on your child's behavior and then begin to implement the plan in your child’s natural setting such as the home or classroom. A Behavior Therapist will typically show up with a bag of tricks (toys, games, motivators) and get to work. This is where, according to the presenter, some of us may be going wrong.
What she recommended was to use the first month to build motivation in the child by establishing a playful rapport. Do whatever it takes to win him over – jump on the couch, do fun activities or just be silly.  If a child knows that every time his therapist comes he/she will need to work, then a feeling of dread comes over the child when the therapist arrives. But if the first month is used to establish a positive foundation, the child will look forward to the arrival of his therapist and be more motivated to work.
Another recommendation was to take a step back in the beginning to identify the motivating factors that are already in the child’s home. If all the therapist uses to motivate the child are his special toys in the bag of tricks, it will be very difficult for the parents to replicate once the therapist leaves. If there are things in the household that motivate the child – special  DVD’s, one-on-one attention, preferred games – use these motivators rather than the toys that come and go with the therapist.      
And as we always say, consistency in the implementation of the treatment plan across people and time is paramount in the success of the intervention.
We at Total Education Solutions are committed to being at the forefront of the behavioral health services industry. We strive to keep up to date with all the latest research and trends in the industry. It is always our pleasure to pass along to our readers and clients the valuable information we learn.
Daniel Adatto