Evidence-Based Practice

While reading about Applied Behavior Analysis (ABA), it will quickly become apparent that there is an emphasis on using evidence-based practice. But why is this an essential aspect of ABA?

The short answer is that evidence-based practices work. That is, the teaching procedures have withstood stringent testing and have resulted in clinically significant changes in behavior. However, an emphasis on evidence-based practice goes beyond this; it ensures quality control for our field. This quality control holds behavior analysts to an ethical standard for providing the most effective and efficient teaching protocols.

There are many different types of interventions for children with Autism. In fact, a quick google search for “autism interventions” will yield thousands of results, and it may be difficult to sift through to identify procedures that may work for your child. However, some treatments are more or less effective than others, and behavior analysts (and parents alike) must be able to identify which programs will lead to the best outcomes for their children. Unfortunately, sometimes popular interventions are not always evidence-based.

In the early 1990s, a communication system known as “facilitated communication” (FC) became a popular intervention for increasing communication for children with intellectual and developmental disabilities. The teaching system asserts that children with developmental disabilities have the cognitive ability to communicate, but their diagnosis prevents them to be able to effectively express their thoughts and feelings. FC involves providing the child with a means to communicate (e.g., keyboard, alphabet board), and a therapist-facilitator that gently guides the child’s arm or hand towards the letters. Initially, it seemed like a promising intervention, as children that previously had no means of communicating were forming coherent sentences.

However, controlled studies testing the effectiveness of FC quickly demonstrated that it was an ineffective method. For example, one study investigated FC by showing children and facilitators a series of objects that they were asked to label. Anytime the facilitator saw the same object as the child, the child correctly labeled the object. However, when the child was shown a different object than the facilitator, the child incorrectly labeled the object. Simply put, the children only responded correctly when the facilitator saw the correct image, suggesting that the facilitator was influencing communication – not the child. Similar tests have replicated these findings, providing evidence that the intervention is ineffective at teaching communication skills for children with developmental disabilities.

Despite these findings, FC is still being offered as a communication program for children with Autism. But why is this problematic? Unsurprisingly, using ineffective interventions can be costly, as they take away from the time that the child could be benefiting from evidence-based practices. Therefore, it is in the best interest of our children to provide them with positive outcomes using interventions that have been validated by empirical research.

Citations:
American Psychological Association (November 20th, 2003). Facilitated communication: Sifting the psychological wheat from the chaff. American Psychological Association. Retrieved from http://www.apa.org/research/action/facilitated.aspx

Mostert, M.P. (2001). Facilitated communication since 1995: A review of published studies. Journal of Autism and Developmental Disorders 31, 287-313.

Incorporating Games into Social Skills Instruction

Finding different ways for children with ASD to engage with their peers socially can be a challenge. Incorporating game play into the child’s social skills repertoire can be a great way to create new social opportunities for the child with his/her friends and family.

Skills that can be targeted using game play:

  • Asking someone to play
  • Turn taking
  • Waiting
  • Staying with the group
  • Team work- e.g. set up and clean up
  • Sharing
  • Appropriate voice level
  • Collaborative play
  • Resolving conflict- e.g. not going first or not getting the desired game piece
  • Handling winning and losing

Keep it simple! For children who have limited exposure to game play, don’t work on too many skills at once. As the child masters a skill you can build on that skill and target others.

Keep it fun! For some children, you may need to adjust the rules prior to playing so the game can progress more quickly. Be sure to look for signs of fading interest during the game and find a way to end the game successfully. For example, have each person take one more turn before ending the game. Keeping the experience fun is key so the child will want to play again.

Provide praise! Be sure to provide immediate and specific praise when the child exhibits the skills you are targeting. You need to meet the child’s level on communication when providing praise. For example, “Wow, you’re doing a great job waiting your turn!” or “Great waiting!” depending on the level of the child.

Make the game meet your needs! You may want to adapt the game to take out skills your child isn’t quite ready to work on yet. For example, in Candyland take out the cards that advance or move back your game piece if the child isn’t ready to work on handling disappointment. You can also adapt game by adding in skills you want to target. For example, add in cards that target asking another player a question before moving his/her game piece. You can also find ways to add in movement for children who need it. For example, every time someone lands on green you do 3 jumping jacks. Just think of the directions in the box as being suggestions so be creative and think of ways to make the game meet your needs.

Don’t give up! Remember that the first try might not go as planned so go easy on yourself. Continue to provide the opportunities to the child so they can continue to grow and learn. Progress can’t be made if opportunities are not available. Be sure to collect your data so you can track the progress.

Overall, games allow for a great opportunity for children with ASD to play with peers and family members while learning social skills and life-long leisure skills. Be creative and have fun!

Activities for a Fun Summer

Summertime is my favorite time of the year with warm weather, no school, and baseball! Below are my top three favorite summer time activities and suggestions for making them a hit with your child.

Sidewalk Chalk:

Sidewalk chalk is the perfect activity for kids with creative minds and perhaps not enough paper to write or draw on. It is also an enjoyable way to work on  shapes, letters, and color recognition.   Ed Emberly has a variety of step by step drawing books that use simple shapes to create an assortment of objects, animals, or faces.

Skills to add on:

  • Basic Concepts
  • Endless Expressive-Receptive Language
  • Fine Motor Skills: Writing Letters, Name, Numbers; Drawing
  • Gross Motor: Draw a maze to navigate through or ride bike/scooter

Scavenger Hunts:

Scavenger hunts can happen anywhere: your backyard, in a park, on a walk, or even inside your home on rainy days! Invite some friends/peers to join you and your child, which gives an opportunity to facilitate social interactions. Chelsey at Buggy and Buddy put together an amazing list of free printable scavenger hunts that are sure to keep you and your child learning while targeting some of the skills listed below.

Skills to add on:

  • Gross Motor Skills: Walking; Climbing (if needed); Jumping
  • Social Interactions
  • Shape/Object Recognition
  • Identifying items by feature, function, class

Water Play:

What better way to cool off on a warm summer day than to play in the water?! Here are a few water activities that are sure to keep you cool: colored water (food dye) mixing and pouring, water table, water balloons, and playing in the sprinklers.

Skills to add on:

  • Color Identification
  • Fine Motor-use an eyedropper, funnel, measuring cups to transfer water
  • Shape/Object Recognition
  • Imitation
  • Gross Motor
  • Play and Leisure Skills

I hope that you will enjoy these activities with your child this summer. Remember to incorporate meaningful activities into your daily routines and always take DATA!!

Teaching Appropriate Requesting

Teaching Appropriate Requesting as a Way of Reducing Challenging Behaviors

Often, children with Autism demonstrate a wide variety of ways of communicating their wants and needs. In the earliest form, babies request attention, food, or a diaper change by crying; they quickly learn that most parents will respond to crying. This is a natural form of communication that serves an important purpose for babies. However, after time, most children learn other ways of communicating. For instance, as a baby grows they may learn that they receive lots of attention for walking up to their parents with outstretched arms. This new behavior now replaces crying as an effective way of gaining attention, and is a more socially accepted way of communicating a need for attention.

It can be challenging for parents when their child does not naturally pick up on these more appropriate ways of communicating. Some children may not independently learn these skills, and instead may require extra support and practice to do so.

Limit Challenges & Teach Appropriate Requesting

While teaching children to request, it is important to a) select an appropriate way of communicating that is conducive with their current skill level, b) teach the child the appropriate way of communicating, and c) consistently require the child to request using the more appropriate way. Consider a situation in which a child wants food but does not have the words to communicate. They may go through a variety of behaviors while trying to tell their parents what they want, including pointing, guiding their parents to the kitchen, or trying to open the fridge. If the child does not get what they want (usually because parents are busy guessing what their child wants), we may see the child escalate to whining or crying. At this point, the parent may find the item that the child requested. However, this can be problematic, as we may have now set a “new standard” for that child, such that they may escalate to more extreme behaviors such as whining or crying in the future because they got what they wanted for doing so. Examples like this are often why we see children demonstrate more challenging behaviors when they are attempting to communicate their wants/needs.

It may be beneficial to identify a behavior that is appropriate for the child’s skill level and to begin teaching the child this new way of requesting. For instance, in the example above, the child does not independently vocalize while requesting but may have the fine motor skills to begin learning sign language. Therefore, it may be beneficial to initially prompt the child to sign “eat” as an approximation of the vocal word “eat” before they receive food. Then, once the child is consistently signing “eat”, parents can begin to require this request each time the child wants food, while simultaneously ignoring any inappropriate requests (e.g., whining, crying). By teaching the vocal word or sign “eat”, this allows the caretaker/parent to narrow down what the child wants, he/she is hungry. Once “eat” is being used functionally, specific foods items would be taught.

Although this is a simple description of a complex series of behaviors, the general outline can help parents identify areas in their child’s lives that could benefit from more appropriate communication. Whether the child cries to gain attention from their mother, or the child wants escape from a difficult task, it is important to teach and require appropriate ways of communication.

Summary

Teaching requests to reduce challenging behaviors:

  • Identify what your child wants
  • Identify a skill-appropriate replacement behavior
  • Teach the appropriate replacement behavior
    • Contrive situations for your child to practice this replacement behavior
      • For instance, if you are teaching the child to say “eat” you may consider holding their plate of food and prompting them to say “eat” prior to having each bite. This is a quick way of teaching the association between the word “eat” and receiving food.
    • Ignore the challenging behaviors and prompt the new appropriate behavior.
      • If your child whines for food at any point, do not provide food but instead prompt them to say “eat”. Then, you would immediately provide them with the requested food.

April is Autism Awareness Month

Autism affects countless families across the World every day. In 2007, The United Nations declared April 2nd as World Autism Awareness Day. This year will mark the 10th anniversary of World Autism Awareness Day. On this day, autism organizations around the world celebrate the day with unique awareness raising-events.

During April, which is recognized as Autism Awareness month, organizations, businesses, communities, and professional sports teams across the United States sponsor events to help raise awareness for Autism. There are countless ways to get involved, whether it’s as simple as wearing blue, volunteering to help with these events, or establishing new activities in your community.

Are you or someone you know looking for a way to get involved?

Here are a few different ways to participate in Autism Awareness Month in our community:

Kansas City Zoo Autism Awareness Day – Sunday, April 2nd 2017
Do you, your friends, or your family love animals? If you answered yes, then maybe you should check out the Kansas City Zoo Autism Awareness Day on Sunday, April 2nd. Free admission will be provided to people with Autism and the Zoo will offer reduced admission of $6 per person for those accompanying them to the Zoo. If this sounds like the purrfect event for you, check out the KC Zoo’s website for additional information and explore all nature has to offer!

Kendra Scott Gives Back Party – Friday April 7th 2017
Kendra Scott has two locations in the Kansas City metro area which will host the party featuring special pricing, with a portion of the proceeds benefitting Autism research. From 5:00pm to 7:00pm the Kendra Scott stores located at Town Center in Leawood, KS and 412 Nichols Road in Kansas City, MO will host the party. If you or someone you know has their heart set on some new jewelry, stop by one of these locations to shop till you drop! Contact the Kendra Scott locations for more details on the sale.

Papa Johns – 40% Off All Orders – Now through April 7th 2017
Too tired to cook, but still need to eat? Take advantage of Papa Johns discounted pizza from now until April 7th 2017. Orders must be placed online with promo code AUTISM40. Contact Papa Johns for more details.

Walk to show support and raise awareness for Autism – Saturday April 8th
Be a Hero and join the Eudora ACES for their 7th Annual Walk for Autism on Saturday April 8th from 12:00pm to 2:00pm. The walk will take place at CPA Park in Downtown Eudora, KS. For more details visit the Eudora ACES Facebook page.

Sporting KC Autism Awareness Game at Children’s Mercy Park Sunday, April 9th 2017
Love Soccer? Hit the pitch with Sporting KC and Light Up Blue at Children’s Mercy Park on Sunday, April 9th as Sporting KC takes on the Colorado Rapids at 6:00pm. To score tickets, head to Sporting KC’s website:  or SeatGeek and use Access Code: 17AutismCC.

Kansas City Royals Autism Awareness Night Friday, April 14th, 2017
Few things are better than spending a night watching the “Boys in Blue” play ball at The K. If watching baseball is a hit with you, you can check out the Kansas City Royals as they take on the LA Angels on Friday, April 14th, 2017. Hit a homerun and get your tickets at KC Royals Ticketing.

The Importance of Routines

Day to day routines can be stressful, a routine is, by definition a sequence of actions regularly followed; a fixed program. Routines are performed as part of a regular procedure rather than for a special reason.

Everyone has them; they are a part of everyday life. Morning routines, school/work routines, and bedtime routines. Many children with autism thrive on predictability and structure. Routines give children a sense of security. When establishing a routine, consistency within the routine is key to its success.

Establishing a new routine isn’t always easy; it’s often difficult, the work you put in while establishing the routine will pay off in the end.

Here is an example of what morning routine looks like for my children.

  • Get Dressed
  • Put pajamas away
  • Eat breakfast
  • Brush Teeth
  • Pack Backpack
  • Get in Car

It is important to be consistent in the teaching and maintenance of your routine.   It’s predictable, reliable, and repeatable. No matter what sequence of steps have been decided on, it is crucial that all steps of the routine are followed. Provide positive reinforcement along the way. When a step is completed, praise your child. Celebrate all successes, no matter how large or small!