Preparing For In Home ABA Therapy

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ABA Therapy hours were approved and you are ready to get started, YEY!! 🎉 You are probably asking yourself what you may need to do to get your home ready for sessions. Below you'll find a simple guide to setting up your home for success with in-home ABA therapy services.

1. House Rules: Let us know what your house rules are so that we may all may follow them (i.e. any cultural practices, no shoes inside the house, noise levels, etc).

   1. Access to your home: Letting your team know any areas that they can have access to. We love to teach in the child's natural environment and sometimes this may look like playing in the room with their favorite doll house, playing with chalk outside and teaching new skills like riding a bike around the neighborhood!

   1. YOU! We love when our parents are a part of our sessions. We love to teach in the moment when implementing any techniques or protocols and want to make sure you feel confident in them when we walk out.

      • Also note: You know your child best! If you notice your child may be doing something different than usual or may be having an "off day" (i.e. may be getting sick, didn't sleep well), let us know so that we may modify our activities for the day to best help them.

   2. Your child's favorite toys: We love incorporating your child's favorite items within our sessions and teach through play (see Natural Environment Teaching)!

   3. Table and chairs: Sometimes we will complete activities that require a table and chair (i.e. homework activities, teaching trials that require a flat surface, messy items like kinetic sand or slime that we'd like to keep in a contained area and not on your floor (you're welcome 😉)) (see Discrete Trial Teaching).

   4. Distracting Items and/or Activities: Blenders, vacuum cleaners, dump trucks, TV's & siblings! We love teaching in the home because we are able to work through some of the most common distractions however, there may be some that are TOO distracting and should be kept to a minimum when our therapist arrives. Our team will review these items with you and how we can work together to minimize or bring these into sessions.

   5. Code of Ethics: All therapists in an ABA therapy team have a Code of Ethics to abide by. We always recommend that our parents review this Code of Ethics and ask any questions to their child's case manager if any areas are violated. Parents are able to report any violations to the Behavior Analyst Certification Board.

      1. RBT Ethics Code

      2. BCaBA/BCBA Ethics Code

We encourage our families to observe our sessions and ask any questions you may have in the moment. Communication and commitment to our families are part of our values at AMA Behavioral Consulting and we want to ensure we share our knowledge in each step of the way.

We hope this list was helpful and if these services seem like a great fit for you, make sure to fill our contact form here.

Can ABA Help My Child with ADHD?

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Can ABA help your child with ADHD?

Research shows that ABA therapy is evidence-based therapy that can help other diagnoses including ADHD. Research shows that a combination of ABA therapy and medication can make significant changes in a child’s behavior. 

Oftentimes, we’ve worked with children who engage in behaviors that may seem “impulsive”, “off-task” and “disruptive” to others in their environment. From our experience, some of these behaviors typically have a reasoning as to why they're occurring. Sometimes the learner may be engaging in these behaviors because they cannot communicate their wants and needs. Sometimes these learners cannot concentrate on their tasks because they are distracted by something in their environment. Sometimes these learners don’t realize they are being disruptive with their actions to others around them. 

Step right up Applied Behavior Analysis (ABA)! What do we do in these types of situations? One of our primary goals in ABA is to provide our learners with the tools to help them advocate for themselves. We teach our learners to request for needs and wants appropriately instead of being impulsive and grabbing whatever they may need (be it materials or someone's attention).

We observe the learner in their natural environment and analyze the patterns of their behaviors. We conduct in depth analysis of their environment to determine what could be distracting them in times that they are off-task. We add tools to help them cope in environments that may be overstimulating to them. 

We provide our learners with tools to teach them recognize the behaviors they are engaging in and then help them correct this behavior (should it need to be corrected). One of our learners had a very challenging time completing tasks that involved more than 1 step (i.e. homework). We created a visual support to help with the completion of these steps. We then taught him self-management strategies to keep himself on track and complete these tasks from start to finish. An example of this program can be found below. We also taught this learner to track his “on-task” behavior using a vibrating timer at every 3 minute interval. When the timer went off, he had to evaluate his current actions and label if he was on or off task. Depending on the current action, he would either continue working OR redirect himself to the task he was supposed to be engaging in. This strategy was taken from Finn et al in 2014. 

In summary, ABA can be of immense help in helping your child with ADHD. Board Certified Behavior Analyst will evaluate your child’s current skill set, help create programs to help them develop the skills they need to communicate and teach any replacement or self-management behaviors to help them in the most challenging times of their day. Give us a call to learn more about how we can help! 

Resource: 

Finn, Lisa & Ramasamy, Rangasamy & Dukes, Charles & Scott, John. (2014). Using WatchMinder to Increase the On-Task Behavior of Students with Autism Spectrum Disorder. Journal of autism and developmental disorders. 45. 10.1007/s10803-014-2300-x. 

Teaching Your Child/Adult to Tolerate Wearing a Mask

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For some of our children/adults, clothing in general may present discomfort. With the pandemic we are facing today, it may be necessary for your child or adult to wear a mask while out in public. In this article we will teach you 5 steps to help your child/adult tolerate wearing a mask while out in public. 

1. Allow the child/adult to become familiar with the mask by playing with it, modeling how it is used on a favorite stuffed animal or on yourself. We want our child/adult to know that there is nothing scary about the mask! 

2. As part of the teaching process, we can use a social story if the child/adult understands the concept. We would not solely suggest this as the only method but it may be helpful if the child/adult understands the information being provided. A link to a social story about wearing masks can be found here: Wearing a Mask Social Story

3. When the child/adult has become more familiar with the mask, begin requiring that the child/adult wear the mask and time how long they are able to tolerate it. This will be our starting point! If the child/adult takes it off after 1 minute, we may need to start at 45 seconds and provide praise and lots of reinforcement once you hit 45 seconds when you practice. 

4. We will then start increasing the time required to wear the mask. If we had 3 successful times of tolerating the mask at 45 seconds, we can then move onto 1 minute, then 3 minutes, then 5 minutes, then 10 minutes and so on while doing other things at the same time (i.e. reading a book, playing with blocks, going for a walk). Our mission is to increase the time gradually and successfully while making the process for the child/adult less aversive. This is a procedure we call shaping. Think of it as creating the shape of a clay bowl: we must work on the small steps over and over again until we can achieve our biggest goal.  

5. The next step will be to test in the natural environment. Take your child/adult to a place where a mask may be required (i.e. grocery store). Remind the child/adult of the expectations before arriving and remind them of what was practiced at home. If the child/adult does not tolerate the mask in a public place, we may need to take a few steps back and test again to see where we need to work on and try again. 

Additional COVID-19 social stories: Autism Little Learners

We hope these steps are useful to you in these times! If you have any questions, please email me at amarilys@amabehavioralconsulting.com

Preparing for a Visit to the Dentist

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Who likes going to dentist? The dentist for me up is not my favorite place to be. When one of our parents asked for tips on how to make this process a bit easier for our learner, I immediately jumped into action. Here are some of the things we did to get ready for our big trip:

1. Created a social story on the steps that would take place for our visit. I contacted the dentist office and asked about each step and the expectations of the child. I took pictures from their page and created a social story with visuals of what the office and equipment the child would come in contact with would look like.  See the video of our social story below!

2. Practice! During our sessions we practiced by playing with similar items so that the child could become familiar with some of the steps. We used Play-Doh dentist set as well as took our own set of X-Rays using the X-Ray Scanner Teeth App to portray the steps that needed to be taken in a visit. 

3. Last but not least, during our one on one direct therapy sessions, we practiced different instructions like “Open your mouth” “Stick your tongue out” and even “Stand as still as a soldier” to prepare the child with some of the instructions they may hear as well as the expected behaviors. If the child did not know what behavior was expected, I showed him how to do it and we practiced together! 

4. During these steps, our learner was provided with lots of praise and positive experiences so that the transition to the actual office would be as flawless as possible. 

Playdoh Dentist Set

Although our learner had difficulty with some of the steps in the actual office visit, he was able to complete the cleaning and we are calling it a success! The visual schedule truly helped with the process of knowing what was coming next and he was able to see the tools we played with in real life. I would love to thank the staff at Happy Family Dental Group in Brandon, Florida for their patience, understanding and their willingness to provide materials and information before our visit! 

Top 10 Questions to ask your ABA Provider…. ANSWERED!!

1. What kind of oversight will the direct staff have? All direct care staff (RBT’s, BCaBA’s and BCBA’s) will be overseen on a weekly basis to ensure treatment fidelity of programming and continued learner success.

2. Do you have team meetings? Yes, we have monthly team meetings in which we review our learners successes and difficulties, learn new concepts/review research in the field and work on team building activities! 

3. How is data collected and graphed? Our data is collected and graphed on a daily basis via our online platform: Central Reach. The lead analyst reviews this data on a weekly basis to ensure that our learners do not need additional modifications and continue to make significant progress. 

4. What kind of parent support is offered? What will this look like? Parent support is an extremely important portion of our therapy! We believe that all skills worked on should be generalized to the natural environment and with the caregivers involved with our learners. Parent support is offered with the lead analyst and usually follows the behavior skills training model: Instructions are presented, the analyst performs the skill, the analyst and caregiver rehearse the skill and then the caregiver receives feedback implementing the skill. Instructions are modified per family structure. We will always make accommodations on what works best for your family! 

5. Can we do community outings? ABSOLUTELY! We go where you may need us the most. Community outings lets us put the skills we are working on to the test in the natural environment. 

6. Do you coordinate with other service providers (e.g., school, OT, speech)? Collaboration is KEY! We love to collaborate with other service providers to incorporate whatever skills they want us to incorporate and vice versa. 

7. What kind of teaching will be involved in my child’s program? We incorporate both Discrete Trial Instruction and Natural Environment Teaching. Click on the links for additional information. 

8. How are the goals developed? Goals are developed using various methods. We will conduct an initial assessment to test the learner’s skillset, observe them in the natural environment and conduct a series of interviews with caregivers. Based on these results, we will develop goals for our learners to meet in the next 6 months. We will review with caregivers to ensure they are in accordance with these goals. 

9. What will be in my child’s behavior intervention plan? We will include antecedent manipulations, consequences and replacement behaviors for maladaptive behaviors. 

10. What services are available to my child? We offer one-on-one direct intervention, parent support services, school consultation, behavior based feeding therapy, and toilet training. 

11. Ok so there was 11: Do you have social skills groups? At the moment, we do not. BUT stay tuned for future planning!

Teaching Your Child To Be More Independent

Read Time: 5 minutes

Teaching activities of daily living are one of my favorite areas to teach as a behavior analyst. With each daily living skill I teach, I am able to provide each learner with a skill that they will be able to perform for the rest of their lives. We are able to teach a range of daily living skills from riding a bike, to getting dressed, to learning how to dial a caregivers phone number to making food for themselves.

As behavior analyst, we individualize our teaching procedures for each of our learners. We will talk about the three primary ways we teach a long list of steps like teaching activities of daily living. 

Selecting a teaching technique varies greatly by the learner. It is important to consider the following: 

1. How many steps does the learner already know?

2. Will the child need to access to reinforcement quickly (i.e. a break, praise, etc)?

3. How strong are the child’s motor skills (as this will influence how much prompting will be required)?

The first technique is forward chaining. In forward chaining, we teach each learner to complete the very first step of the task and help them through the rest of the steps in the task. Once the first step has been acquired, the second step is taught. When the second step is acquired, the third step is taught and so on. For example, when teaching a child to comb their hair, the first step would be to teach him/her to pick up the hair brush and prompt through the rest of the steps. Once the child has acquired picking up the hair brush on their own, we would then require the learner to pick up the brush (step 1) and place the brush on their head (step 2) and so on until we are able to require them to complete the entire task. 

The second technique is backward chaining. In backward chaining we only require the learner to complete the final step of the task. Similar to forward chaining the learner is taught one step at a time and then required to complete the acquired step and the previous step in the routine. When teaching shoe tying, the learner would be helped through the entire task and then required to complete the last step (i.e. pulling the loops to complete the tie). Once this final step is mastered, the learner would be required to make the loops and also pull the loops to complete the tie. The same sequence would continue until the learner knows all of the steps.

The final technique used is called total task chaining. In this technique the learner is taught the entire task receiving assistance as needed. This technique is great to use if the learner already knows some of the steps and may only need a little assistance. When teaching to make a PB and J sandwich, the learner may know how to gather the ingredients to make the sandwich but may need assistance with spreading the peanut butter and jelly and putting the ingredients away. In this example, the person assisting would refrain from prompting the learner in the areas they know and assist in the steps the learner has not yet acquired. 

Our learner in this video, learned to complete his shoe tying task using forward chaining in which we taught the first steps of the chain and continued to add on to the task as he acquired the steps. In a very short period of time, our lovely guy was asking for the rest of the steps to complete the task on his own! We are so proud of him! You may also be able to hear his brother providing him with positive reinforcement by cheering him on!

Graphed through Central Reach