by Rachel Heese
In the past, some parents have asked me to suggest apps for use at home with students. During April for Autism awareness month there are some free educational apps available for download from kindergarten.com that address various language skills. You can search for these in the App Store under kindergarten.com or by typing in the term ABA. While the company name indicates that the apps are for younger students, some can be used with older students who have language delays. For example some of the apps target categorization skills, using descriptions and labeling emotions. Some however are for establishing early developing language skills. You can select the ones that you feel are appropriate for your child. One issue that arises is that children prefer to use the iPad for recreational purposes. If you have ios 6 on an iPad or iPhone, you can open an app and lock the home button so your child cannot exit the app without a password. This is done by going to settings - general - accessibility and then turning guided access on. This feature also allows you to lock either the whole touch screen or parts of it that you select. Using guided access on your device enables you to determine the amount of time your child spends on the iPad for educational activities. I hope these suggestions are helpful and please let me know if you have any questions or feedback on the apps. Rachel Heese, M.S. CCC-SLP Speech Language Pathologist
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I was lucky enough to stumble upon a website today that can give all parents hope to be great behaviorists!
Carrie Cariello is a mom of five children, one of whom has autism. Her most recent post, called "Shoe Shopping", is an anecdote about how she turned a tough day for her son Jack into an incredible learning experience...for both Jack and herself! When Jack threw a tantrum because they stopped for lunch somewhere other than where he wanted to go, Carrie was very tempted to leave. Who wouldn't be? As she says of his siblings, "They're used to these scenes, but they never really get used to these scenes. And neither do I." I have to tell you that, even for expert teachers who encounter these scenes not just daily, but sometimes hourly, there is just something incredibly unnerving about them. You're tempted to do whatever you can to make it stop so that people will stop staring, so that you can continue on with what you were doing, and most of all to give the poor child some relief! But what experienced professionals and parents (like Carrie) realize is that giving in and stopping the tantrum NOW will increase the likelihood that it will happen again later. And again tomorrow. And the day after that. So what do you do? You do what Carrie did. Nothing. Children, ALL children, need to learn to cope with change. With disappointment. When Carrie decided that she and her other sons would just keep calm and carry on with their lunch, something happened. Jack realized he would not be leaving. He was even able to enjoy his chicken fingers! He learned something very powerful that day: throwing a fit will not get me lunch where I want to eat lunch. And Carrie learned something powerful too: she is powerful. Autism does not need to control a family, but a family does need to control autism. The principle behind why Carrie’s decision worked is called “extinction”. This simply means NOT reinforcing a behavior that has previously been reinforced. (Remember, in ABA we reinforce behaviors, not people). At some point in his life, Jack learned that throwing a tantrum got him something he wanted. It may have only worked sometimes, but even that is usually a good enough reason for a child to give it a try THIS time. Here’s the fine print with extinction: sometimes it looks like it’s not working. Sometimes it looks like it’s making things even worse. This is called an “extinction burst”, and the reason for it is, “Hey, this worked before, but it’s not working now…maybe I should try harder. Better yet, maybe I should try something worse.” We’ve all been there, and it’s not pretty. But if you give up and give in, guess what? You just reinforced the something worse. Ouch. Now it will take even longer to get through the burst. They key to this is consistency-without it, you're just spinning your wheels. We all know that children with autism and other disabilities can be extremely bright and learn very quickly, so why do we struggle so much with behavior? Fear. We're afraid of being embarrassed, of doing the wrong thing, of making it worse. When in doubt about how to deal with a behavior, do not be afraid to do nothing! Worst-case scenario: you didn't give your child another reason to tantrum by accidentally reinforcing the behavior with attention or escape. Best-case scenario: you taught your child that throwing a tantrum would not get him/her what she wanted. And yes, you can use this on your typically developing children, your mother-in-law, and your spouse too. References: Cariello, C. (2012, August 27). Shoe Shopping [Web log post]. Retrieved from http://carriecariello.com/2012/08/27/shoe-shopping/ If your child is on the autism spectrum or has a disability that requires similar instruction, chances are you've heard of applied behavior analysis (ABA). Many schools are now choosing to open “ABA classes” for their students with autism because it is less expensive than sending those students out of district. I’ve heard parents express many different concerns about placements in these types of classrooms: What if he gets bored? Who will she play with? Will he be put in a cubby to do his work? There are these and many other misconceptions about what ABA is, and it's important to really understand what the term means.
There is an article that was published in the Journal of Applied Behavior Analysis that is considered by many to be the definitive overview of ABA, but is not light reading. The article is called “Some current dimensions of applied behavior analysis” (Baer et al., 1968), and provides descriptions of each of the “dimensions” of ABA: Applied; Behavioral; Analytic; Technological; Conceptually Systematic; Effective; and Generality. [Full article can be accessed by clicking here] While these dimensions have not changed, I’m going to venture out on a limb and say that, considering the article was published in 1968, it may no longer be “current”. When this article was published, electroshock therapy was still considered to be an acceptable intervention—I rest my case. In the past 44 years, we have come a long way in developing effective strategies that are based soundly on these dimensions, but are more “kid friendly” than, say, small rooms with boring white walls and knee to knee instruction with a scientist. "Applied Behavior Analysis" is a practice that is based on very basic principles of human behavior. To oversimplify: we do things that get us good results more, and do things that get us unwanted results less. We can use this principle to reward ("reinforce") behaviors we want to increase, and either punish or ignore behaviors we want to decrease. We also collect data to make sure that our instruction is effective, and so we will know to make changes if it is not. Sometimes this looks like what people usually assume ABA is: one teacher and one student working together at a table, repeating the same skills over and over again until they are mastered. Usually, it does not. Why? Because each child is different and has different needs. If you've ever used a sticker chart to reward your toddler for using the potty, you were using a behavioral principle. If you took data on it and used that data to decide how often to give out the stickers, you were being analytical too—and well on your way to becoming an ABA practitioner! ABA targets "socially significant" behaviors. This means we are not training kids to do tricks like puppies (although some of the principles used are the same). We use basic principles to teach behaviors that will help improve quality of life—we want students to apply the skills. Teaching your three-year old to sing, "I'm sexy and I know it" may be super-cute (Toniann's son does it--it's hysterical!), but it will not likely improve his quality of life. However, teaching him to use the potty (no easy feat) will make a big difference in his day-to-day life (and Mommy's too!). Other examples of socially significant behaviors are saying “Hi, Sally!” when Sally walks in the room, brushing your teeth, using the computer mouse to click on a photo you want to see…you get the idea. Now let’s get to the less obvious "dimensions" of ABA. The different strategies that come from the general principles are considered technology. But, for these technologies to be considered ABA, they should be defined in a way that anyone could understand and use, they need to be effective, and they must be able to generalize to different situations and people (they need to work for more than just one person). In order for these strategies to be considered conceptually systematic, they need to be based on concepts of behavioral development and need to be able to be expanded upon as needed. Huh? Ok, let’s break this down into plain English. A sticker chart can be considered a behavioral technology because it has been proven to be effective in many different situations with many different people (generalized). It is considered to be conceptually systematic because, when used correctly, it is based on principles of reinforcement and can be modified as needed (size, color, type of sticker, number of stickers, etc.). So what do all these “dimensions” look like in a classroom? Imagine this: You walk into a classroom with bright posters on the walls that the students can use as visual cues while completing their work. There are several color-coded bins where each student keeps his or her materials. You see a few students sitting at a horseshoe shaped table with a teacher and a math game. One of them is earning “behavior bucks” for adding two-digit numbers, another is earning stickers for naming the numbers, and the other is allowed to draw for two minutes each time he says, “it’s your turn” to a friend. You see another student in the back working independently on work in a folder. When he is finished, he stands up and puts his folder in a bin marked “finished work”, checks off “independent work” on his schedule, and gets a book to read quietly on the carpet. Yet another student has finished working with an aide, and has traded in six of her “lucky pennies” for six minutes of computer time. A teacher assistant is at the sink with a student, teaching him to pump the soap into his hands (after he masters this, he will learn to lather the soap by rubbing his palms together). Everyone is engaged, everyone is busy, everyone is learning what they need to learn. You may not even notice that each adult in the room is collecting data on each student’s individual goals, or that certain questions are asked of some children but not others, or that the teachers are using non-verbal prompts to help the students when they struggle. You can’t see that everything going on around you has been pulled from researched methods, tailored to each individual child, and adjusted until it fit “just right”. You don’t see the graphs, the schedules of reinforcement, the “discriminative stimulus” (change in the environment) that should evoke a certain response. To you, this looks like a regular old classroom, just with fewer desks. Well, now you know better. You don’t need to be intimidated by the immense amount of “behind the scenes” activity that goes on when using ABA to work with your child. We are here to help! Every parent can learn to work with their child in the ways that work best and fit your own family. These principles can be applied the minute your child gets off the bus and continue until bedtime, and have incredible results in your own home. Here’s the kicker... your child is already using them on you. References: Baer D.M, Wolf M.M, Risley T.R. Some current dimensions of applied behavior analysis. Journal of Applied Behavior Analysis. 1968;1:91–97. There is a widespread belief in the autism community that gluten free and/or casein free diets can be used to "treat" certain characteristics of autism. Here is what the literature from peer-reviewed journals has to tell us about diets and autism:
Not much. Disappointing, I know. Wouldn’t it be nice if we could make an environmental change like that and cure our children of autism? The truth is there is NO cure for autism at the moment, only treatments. You may be saying, "But wait…didn’t that article I read in Everything-You-Need-To-Know-About-Parenting-A-Child-With-Autism say that these diets have been scientifically proven to help my child show improvement?" The key question here is: What kind of “scientific evidence” are these studies based on? For example, anecdotal evidence is sometimes used in studies, but is really only what someone wrote down or reported in narrative form. “Little Johnny seemed so much better after we removed the gluten from his diet!” What does “so much better” look like? HOW much better is “so much better”? What are you comparing this to? Do you mean “so much better” than he was when he was a toddler? Or “so much better” than that other kid in his class? Or “so much better” than his two-year-old brother? Did Johnny also start a new behavioral intervention at the same time he started his diet? Did he start sleeping better at night around that time? Did that kid in his class that he really didn’t like move away just before the diet started? Most magazines are not concerned with the validity of experiments or studies, only on reporting what the results were. This means that the procedures the researchers followed may not have been scrutinized by their peers before the article was published. A study is not truly an “experiment” unless all the variables remain constant EXCEPT the one being tested, which in this case is diets. While there have been studies conducted, the results have been extremely mixed. Furthermore, a 2009 article in Research in Autism Spectrum Disorders evaluated fourteen of them, concluding that: “…the current database contains no studies that are capable of providing conclusive evidence, and only eight studies that utilized a recognizable experimental design. Of these eight, only three studies were of sufficient experimental rigor to qualify at the preponderant level of certainty. Based on this review, we must conclude that the published studies we located do not support the use of [gluten free casein free] diets in the treatment of ASD.” English translation: most of the studies out there are not experimental, and even the few that are have inconclusive results. The best place to find the most valid information is a “peer-reviewed” or “scholarly” journal such as Research in Autism Spectrum Disorders, the Journal of Applied Behavior Analysis, the Journal of Experimental Analysis of Behavior, or the American Journal of Psychology. The studies in these journals can be extremely difficult to read and very technical, but the information will have been scrutinized by experts. Here's a helpful hint: if you stick to the "discussion" section of a research study (all the way at the end), you can get a pretty good idea what the results were and what they mean. There are also some articles in these journals that are not research studies and are a bit easier to digest, which could also have helpful information. But remember, no matter what the study is about or where you found it, QUESTION THE RESULTS (ask yourself: Are the people in this study like my child? Is this an intervention that would work in our home or at school too? Did the researchers account for changes in the participants' routines that could have affected the results?). The results may be accurate, but question them anyway. Every scientific or experimental study has certain limitations (i.e. “this treatment was not tested in children with a history of self-injury”) that could prevent the intervention from being effective for YOUR child. And your child is the one we’re talking about here, right? References: Mulloy, A. et al. Gluten-free and casein-free diets in the treatment of autism spectrum disorders: A systematic review. Research in Autism Spectrum Disorders (2009), doi:10.1016/j.rasd.2009.10.008 "IEP, FBA, BIP..." What are they talking about???
Here are three important acronyms you need to know to understand your child's special education: I.E.P. An "Individualized Education Plan", or I.E.P., is a legal document that a school-aged child* receives when he or she becomes classified as having a disability. In New York State, this document includes information about your child's current levels of academic, social, physical, and behavioral functioning, as well as what services he/she will receive and goals for the upcoming school year. *School-aged is considered kindergarten through 12th grade. Children that are not yet in kindergarten receive an I.F.S.P. (Individualized Family Support Plan) which contains slightly different information. F.B.A. This stands for "Functional Behavior Assessment". Even schools and classrooms that do not use ABA have begun to use this process to develop behavior plans for students. This is a process where a professional records data about a few specific problem behaviors (that should be CLEARLY defined in the FBA) to figure out WHY it is happening, or the "function" of the behavior. This information is then used to develop a... B.I.P. or B.S.P. This stands for "Behavior Intervention Plan" or "Behavior Support Plan". This plan is developed by a team that works with the student to determine how to best address the behavior in terms of its "function". This plan should answer three important questions: How will we prevent the behavior in the future, what will we do if it occurs again, and what will we replace it with that will help the student still accomplish what he/she was trying to do? Thanks for checking out our blog! At Little Steps Great Success, we believe that all it takes are little pieces of knowledge to make a GREAT difference in your child's progress! In our blog, we'll regularly post tips to help families navigate the world of special education and applied behavior analysis. Check back often...you never know when you'll find another "little step" that takes your family to "great success"!
-A & T |
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May 2013
About the Authors...Amy and Toniann, owners and operators of LSGS, are NYS certified teachers for students with disabilities and have focused their careers on teaching children with autism and with similar needs. |