ABA early interventions 26 Mar 2019

BY: admin

ABACAS Team

Comments: No Comments

ABA Early Interventions – What do we focus on?

Applied Behaviour Analysis (ABA) is often misunderstood. Parents say to me “well you work on behaviour don’t you, so how will that help my child socialise, or communicate?”  What a good question! Let’s look at the history a little to clarify. Behaviour Analysis goes back a long way, but the most revolutionary (in my opinion) was B.F. (Burrus Frederic) Skinner. Skinner was the first to define the Verbal Behaviour Operants, which we have talked about in previous posts (Mands, Tacts, Intraverbals). He was also the first person to accept thoughts as behaviour.

You can count something as a behaviour as long as it is objective, observable by at least one person (hence observing your own thoughts), and measurable – even heart rate is a behaviour. Now that we’ve broadened definition, I can begin to explain what this means for your child and their development.

There’s more to ABA than behaviour in early intervention

ABA early interventions focus on a whole range of skills.  I’m going to break down how these are behaviours.

Vocal Language
  • Vocal language, or speech, is a behaviour that is measurable, observable and able to be objectively defined. ABA works on increasing children’s communication by increasing their repertoire of sounds or words, and providing meaningful functions for these.
  • There are many types of vocal language, labelling items, requesting items and answering and asking questions. Children with Autism sometimes need specific teaching to be able to use the same word in different contexts.
Play
  • Play can be broken down into many, smaller behaviours, which we can then teach into a one big complex behaviour. An easy example would be doing a puzzle; you can measure how many pieces a child can accurately place and teach matching skills to support children identifying which pieces together.

In summary, ABA is definitely focused on behaviour, but that means something different than just looking at tantrums, or problems. Please come and talk to us about what skills we can teach, not just what problems we can help with! You can call the team on 9274 7062.

Jasmin Fyfe

Program Manager, ABACAS

https://www.childwellbeingcentre.net.au/services/aba-child-and-adolescent-services-abacas/

19 Mar 2019

BY: admin

ABACAS Team

Comments: No Comments

The benefits of intensive early intervention

Intensive Early Intervention is critical for young children on the Autism Spectrum. A 2015 study found that the average age for children to receive an Autism diagnosis was 4 years and 1 month (Bent, Dissanayake, & Barbaro, 2015). In the scheme of a lifetime this seems early, however in the scheme of Early Intervention, it is a great deal of time lost. We know more about development than ever before, the brains plasticity, and crucial developmental windows. Although we can continue learning our whole lives, the early years are most formative for our language development, and many other skills.

How much intervention?

Intensive Early Intervention, starting as soon as possible, will provide your child with the best opportunity to start their life with a solid foundation of skills. The Behaviour Analysis Certification Board (BACB) recommends a minimum of 10 hours per week of ABA, starting as early as 18 month, with new research looking at starting even earlier. Here at ABACAS we can provide you with an Intensive Early Intervention Program, which addresses multiple domains of development, is motivation-based, and works with you and your family to set and meet achievable goals.

So why do an Intensive Early Intervention Program?

It sounds like a great deal of stress, and financially can be difficult. There can be a lot of appointments and you might have other children to consider too. These are all valid concerns, and we will work with you to address them. However when we look at the benefits, there are many. A meta-analysis (which means that someone read all the recent and historical research on one topic) found that “…long-term, comprehensive ABA intervention leads to (positive) medium to large effects in terms of intellectual functioning, language development, acquisition of daily living skills and social functioning” (Vitues-Ortega, 2010). This study also supported that dose and intensity (frequency and length of therapy sessions) are important factors in whether ABA produces clinically significant outcomes.

If you’re interested in knowing more about Intensive Early Intervention please call one of our team to discuss. We will be addressing a few different area’s of early intervention including expressive and receptive language, social skills, verbal behaviours, echoic repertoire’s, play skills and imitation over the next few posts.

You can also read more about how we work by following the link:

https://www.childwellbeingcentre.net.au/services/aba-child-and-adolescent-services-abacas/

Jasmin Fyfe

ABACAS Program Manager

References

Virués-Ortega, J. (2010). Applied behavior analytic intervention for autism in early childhood: Meta-analysis, meta-regression and dose–response meta-analysis of multiple outcomes. Clinical psychology review30(4), 387-399.

Bent, C. A., Dissanayake, C. and Barbaro, J. (2015), Mapping the diagnosis of autism spectrum disorders in children aged under 7 years in Australia, 2010–2012. Medical Journal of Australia, 202: 317-320. doi:10.5694/mja14.00328

 

19 Feb 2019

BY: admin

ABACAS Team

Comments: No Comments

Escape is not an option!

For some children performing a particular skill may be challenging for them, which often leads to problem behaviours. Therefore, it is important to determine the functions of the behaviour. Behaviours may include: attention, tangible, sensory, and escape.

What does escape look like?

Today, we are going to focus on escape. Typically, a child will try to “escape” whenever the demand that is placed upon them is too much or when the task is too difficult for them. This behaviour may look like: running away, crying, shouting, placing their heads onto the table, “shutting down” (or refusing to respond), throwing things off the table, and hitting.

For a child who has difficulty expressing himself/herself, these behaviours are just a means for them to communicate to us that they are not able to perform the task.

What can we do when a child’s behaviour is about escape?

With children who are non-verbal or partially verbal, the first step might be to look at teaching them functional communication.  For example: handing over the ‘help’ compic whenever they require assistance with something. Obviously we need to also teach to the skill deficit. In other words, teach them the skill they cannot do.

For younger children, we would usually prioritise learning to learn skills. Instead of telling them to “sit down” and “behave”, we will focus on skills such as eye contact, sitting still on the mat/chair, manding (requesting), joint attention, matching, etc. Without these skills, a child will not be able to attend to new information as they are being presented to them. Nor are they ready to learn new skills.

For higher functioning children, we still need to identify the skills that needs teaching. However it may look very different to a younger child’s needs. The skills needed may be more of a social skills. Some children find social interaction really challenging. Therefore we might look at skills like maintaining eye contact, respecting other people’s personal space, knowing when it is appropriate to interrupt a conversation, how to interrupt a conversation appropriately, reading another person’s body language, understanding other people’s emotions, recalling past events, staying on topic, etc.

By stepping back and looking at the function of the behaviour, we can gain insight into what supports the child needs. From there its about breaking down a difficult task into small achievable steps via task analysis.  At the end of the day we want our children to develop competency across the range of skills needed in daily life.

Please feel free to contact myself or Jasmine Fyfe on 9274 7062 for further information on how we can help your child.

Rachel Puan

Assistant Program Manager, ABACAS

https://www.childwellbeingcentre.net.au/services/aba-child-and-adolescent-services-abacas/

Toilet Training 12 Feb 2019

BY: admin

ABACAS Team

Comments: No Comments

Toilet training children and ABA

Some children ‘just get it’ when it comes to toilet training. Others, not so much. Toilet training is a huge developmental milestone. It increases independence, helps social relationships and it can be a really important skill when thinking about school readiness. For those young ones who aren’t having success with conventional methods of toilet training ABA can help.

Let’s look at the example of “Johnny” (not his real name!). He’s been engaged in therapy for about a year, responds well to reinforcement, is making lots of gains in his program.  However he’s about to go into Kindy and has been unsuccessful in his toilet training attempts with his parents so far. Johnny’s mum approaches her ABA Program Manager about this skill and they develop a program to toilet train him. Within three weeks he goes from zero toilet use to independent requests for the toilet for both wee’s and poo’s!

How did we toilet train?

There are a few key area’s that need to be addressed in toilet training. First, you need to be able to “catch a wee”. This then gives you the opportunity to reinforce weeing in the toilet. Second, you need to teach the sensation of a full bladder and teach this as a natural antecedent to Mand (request) the toilet. Third, fine motor skills for pulling up and down pants are important if the child’s toilet use is going to be independent.

In a typical toilet training intervention, we will work on all of these skills through a very intensive program. This will include taking the child to the toilet regularly and providing reinforcement, then thinning out the schedule and increasing teaching opportunities to request independently.

In summary, ABA can help toilet train almost anyone! This case reflects the success of a young child, but these methods can be implemented with a child of any age, both younger and older.

When thinking about toileting interventions, your practitioner will need to get medical clearance from your GP first. They will need to rule out any underlying medical problems that may be causing toileting problems.  The next step is to meet the parents/carers and talk through strategies and to explain any risks and the realistic time commitments before you begin. An intensive intervention around toileting can be hard work…but very rewarding too!

Please feel free to contact Rachel Puan or myself should you want to know more about our toileting interventions on 9274 7062.

Jasmin Fyfe

Program Manager ABACAS

https://www.childwellbeingcentre.net.au/services/aba-child-and-adolescent-services-abacas/

16 Jan 2019

BY: admin

ABACAS Team / Psychology Team

Comments: No Comments

Our new team members for 2019

January is often thought of as a quiet month but not at the Child Wellbeing Centre! It’s our second week back in January and it feels like we have hit the ground running!

We have two new and one returning team member to tell you about.

Toni Schmitz (Behaviour Therapist and Provisional Psychologist)

Toni came to us last year as a Curtin University student on placement. She did such a great job with the children that she worked with that she got a job offer! In her paid role with us this year, Toni will be working as a Behaviour Therapist and Provisional Psychologist on different days of the week.  Toni will starting off first learning the ropes as a Junior Behaviour Therapist and picking up a psychology case load towards the end of February. She will be available to work with the families she saw as a student last year.

Penny Ya Fen Wong (Senior Behaviour Therapist)

Penny joins the ABACAS team as a Senior Behaviour Therapist. She will be working with individual families providing therapy and be available for parent and school behavioural consultancy. Penny has over 15 years experience  in working with ABA programs and a broad range of experience with children with disabilities, developmental delay and learning difficulties. We’re also hoping that Penny will also have her application for provisional registration as a psychologist approved so she is able to provide psychological consultancy services.

Simone Lombardo (Psychologist)

After having some parental leave last year, Simone returns to the Centre in early February on Saturdays. As a psychologist, Simone has a broad range of experience in working with children with Autism Spectrum Disorders. She also has a an interest in working with children presenting with social and emotional difficulties. Simone will be be available to see old and new clients. We’re really looking forward to Simone join the Saturday team of psychologists again.

We still have a few more staffing changes to tell you about. The Centre is currently recruiting another psychologist and we are also in the process of appointing a casual receptionist. I hope to have some news about both of those changes in the near future.

Naomi Ward

Clinical Director

27 Nov 2018

BY: admin

ABACAS Team

Comments: No Comments

Behaviour is communication

When working with a client recently, I was reminded again that children often use behaviour as a way of communication.  In many of our  posts we have covered, more than once, that there are four functions of behaviour, escape, tangibles, automatic and attention. Behaviours can provide access to more than one of these simultaneously and these behaviours may be appropriate or inappropriate.

All behaviour has a purpose

Inappropriate behaviours are never just something to be reduced to manageable levels, they are communicating a need. It could be “I don’t want to do this” or “I don’t have the skills to do this”. Sometimes it’s “I’m having a great time, but I don’t know how to show you” or “I need something”. For many children on the Autism Spectrum, there are skill deficits that can leave a gap between what a child is trying to say, and what they are able to communicate effectively to another person. Hence the importance of standing back sometimes and thinking about what is happening.

So, what does this mean for practice?

I speak about “replacement behaviours” often and that is first and foremost what needs to be addressed through therapy. Children have a right to develop the skills to independently communicate, so long term they can be their own advocates and control their own lives.

In the mean time, before those skills are developed and consolidated, as parents and therapists we can make environmental changes to reduce the demands on children, provide visuals that support them to understand the rules and what is happening next.  It’s important to remember the onus is on us to support them. Children don’t act out to be malicious, or to spite anyone – we are responsible for their behaviour.

Our Program Managers are there to help if you have a child who is displaying problem behaviours and you’re unsure what they are trying to communicate.  We can help you tease it the behaviour out, and develop a plan with you to work on reducing the problem behaviours, modifying your environment, and reducing the skill gaps.

Jasmin Fyfe

ABACAS Program Manager

13 Nov 2018

BY: admin

ABACAS Team

Comments: No Comments

Preparing for the long holidays when you have a child with Autism

I know you may not want to hear it be we are approaching the end of the school term and the long holidays. Many parents of children with autism often face this time with a range of emotions – relief and anxiety.  Relief that there is an end in sight for the daily school & daycare routine. Anxiety when you think about how you will be keeping your child occupied over the holiday period.

Start planning for the holidays now (while you have the time and energy!)

Here are three ideas/strategies to help you cope with what’s to come:

  1. Create a visual holiday routine/schedule

For someone who struggles to differentiate between the days of the week, it is essential to establish a routine for a child with autism. By establishing a routine, you will be able to offer a sense of control and structure. It will also be much easier to transition to the back to school routine once the school term starts again next year too.

When a child is anxious about what is going to happen it will often come through in their behaviour. For example, I have seen children ask repeatedly for swimming throughout the day as they do not have an idea what they will be going next. Obviously, it’s a rare parent and child who is not going to be stressed by this behaviour (in the child’s case note being able to go swimming on demand). And yet, this behaviour may be avoidable.

With a visual schedule, children can see what is expected of them and what they can expect to do next. From a therapy perspective I would encourage you to think about including some time to practice the skills that they have mastered during therapy sessions too.

Your therapy team can help you work out how to create a visual schedule so please let them know if you’d like this help. Putting one in place now (even when it may not be as needed) is a nice way to transition into the holidays too.

  1. Let’s keep learning!

Learning does not end when the school term ends. When therapy stops (e.g. at the end of term) we often see a decline in skills acquisition and maintenance over the long holiday period. Being out of routine and not having therapy can lead to lots of stimming time and not enough skills practice.

Apart from keeping up with regular therapy sessions, I recommend my parents to spend time generalising the skills that their children have mastered within sessions. Holiday time can be spent expanding their skill sets and to exposing them to new stimuli. For example, teaching children to tact zoo animals when you make a visit to the local Perth Zoo or teaching them to tact car colours while playing “I spy” on the road.

  1. Have some down time

Being a parent is hard work. Therefore, it is very important to look after yourself during the holidays. Be it spending some alone time by the beach or even taking a short 5 minutes break to sit and sip on a hot cup of coffee before it gets cold. Do it. Because you deserve it. And remember, happy parents usually make for happy children too!

Holidays don’t have to be stressful!

In actual fact, holidays can be a lot of fun. Start thinking about how you will set up your days, particularly once you get past Christmas.

Please talk with your Program Managers about the activities that you could do to help generalise the skills that your child has learned during their therapy sessions.  While the office will be shut from the 22nd December through to the 7th January, most of the team will be on board through-out the rest of January.  We usually have a bit more flex during the holidays so increasing therapy sessions is also an option.

Rachel Puan

Assistant Program Manager (ABACAS)

01 Nov 2018

BY: admin

ABACAS Team

Comments: No Comments

Back to Basics (Part Five) – Behaviour Change…What does it take?

In the last post of this series, I want to talk about behaviour change and ABA. I spend a lot of time on this blog talking about ABA being more than just tackling problem behaviour.  ABA build skills, provides early intervention, social training, and much more. However, tackling problem behaviour is something we do, and often do very well. Working with problem behaviours requires multiple steps, and commitment from a number of people.

What’s involved with behaviour change?

I’ve outlined some basic steps for effective intervention below:

  1. Baseline
    Your Program Manager will want to establish a stable base-line before they intervene. This can tell us a number of things such as, is the behaviour naturally decreasing and maybe doesn’t need intervention? What situations does the behaviour occur in, and are we able to predict it accurately? What does the behaviour look like?
  2. Function
    All behavioural interventions should be function based. Interventions which are function based are supported in the research to be the most effective. Evaluating this might require formal testing, or can sometimes be done through observations.
  3. Replacement Behaviours
    How can this child get their needs met in other ways? People have a right to get their needs met, and others have a right to have theirs met too. The solution should involve not only reducing the problem behaviours, but increasing skills and tolerance of the reasonable preferences of others.
  4. Plan
    Once all this information is gathered, there needs to be a long term plan to fade any artificial systems that might need to be put in place to increase tolerance and skill building to a level that can be maintained by the natural environment.

Making sure everyone is on board

The initial phases are the easier part, once all this information is gathered and a plan is written, all the people involved in the child’s life will need to buy-in to the plan. This means that they commit to following the recommendations consistently, across the board, and increase to the next stage of the intervention only when criteria is met in all environments. This part of the process is just as important as the plan itself.

For more information about ABA and how we can help with challenging behaviours please talk to your Program Manager (Rachel or I). We will be able to work out with you the best way to help.

Jasmin Fyfe

ABACAS Program Manager

24 Oct 2018

BY: admin

ABACAS Team

Comments: No Comments

Back to Basics (Part Four) – Reinforcement and Punishment

The collective gasp of all the people in the room is a familiar sound every time I mention the word “punishment”. I can thank some poor ethical choices from 50 years ago, and the confusion between the word punishment in regular language versus what it means in the context of Behaviour Analytic literature. This article will cover what reinforcement and punishment are in terms of behaviour, and hopefully you will have a better understanding of how we use these effective techniques, in a safe and ethical way.

Reinforcement

Let’s start with reinforcement. Reinforcement is the addition or removal of a stimulus, that increases the future frequency of a behaviour. Any time behaviour is increasing (or maintaining) you are reinforcing it. You can reinforce your partner doing the dishes or them sitting on the couch, your child’s tantrums or their use of functional communication. There is no good or bad in reinforcement, it only refers to the behaviour increasing.

Punishment

This is the same for punishment. Punishment is the addition or removal of a stimulus, that decreases future frequency of behaviour. Once again, there is no good or bad, and punishers are not necessarily things the average person would find aversive or see as harmful. Let’s look at some examples.

Antecedent (before) Behaviour Consequence Future Frequency
A parent says “please do your homework” Child completes homework Parent praises the child Behaviour increases, more homework is completed (reinforcement)
A parent says “please do your homework” Child completes homework Parent praises the child Behaviour decreases, less homework is completed

(punishment)

We may think we’re doing one thing…but actually  children see it as another!

In this example the same sequences of events occur, and we see different effects on the child’s behaviour. It is these effects on behaviour that determine what is punishment or reinforcement. We see this happen in our daily lives all the time, we think that we’re helping, but behaviour isn’t changing or it’s getting worse. When we break it down something that we are doing in earnest, is actually punishment (reducing behaviour).

In conclusion, reinforcement and punishment are not about good and bad, they are scientific terms that help us understand behaviour. Once we understand a behaviour then we can change the environment, or up-skill people around us, to help a child better succeed and have a happier time in their home, school or community.

Please call Rachel or I on 9274 7062 for more information about your child’s program or about any of our services.

Jasmin Fyfe

ABACAS Program Manager

09 Oct 2018

BY: admin

Uncategorized

Comments: No Comments

Back to Basics (Part Three) – Verbal Behaviour

In the next of our five part series, we look at verbal behaviour in children. Some children come into our ABA program with little or no expressive language.  Some of our young clients expect their parents to “read their mind” and just “know” what they want. In other cases, parents have developed really good skills of predicting or anticipating the child’s needs. For example, parents learn very quickly that when their child starts climbing up the bookshelf – it usually means that they want something.

For many of our young clients, the first step is to teach them the value of language. From a behavioural perspective,  this may mean teaching the child the function behind a word. A child may be able to say the word “help”. However being able to say the word, is not the same as knowing that “help” is the word to use whenever the child requires assistance. For example, being able to use the word “help” becomes very handy when trying to reach that thing that’s out of reach.

Types of Verbal Behaviour

In order to understand this better, let’s have a look at the types of verbal behaviour. According to Skinner, verbal behaviour can be categorized into these parts: echoics, mands, tacts and intraverbals:

Echoics Repeating what is heard vocally or with the use of manual sign imitation – for example,  saying “water” after another person says “water”.
Mands Requesting for something – for example, asking for “water” because you are thirsty.
Tacts Identifying objects, verbs, situations by labelling them – for example, saying “water” when you see water.

 

Intraverbals Answering questions – for example, saying “water” when another person asks: “What would you like to drink?”

An Example of Teaching Verbal Behaviour

Programs focusing on verbal behaviour often start by working out what a child is able to do. There is no point trying to teach a child to use the word “water” if they are not yet able to produce the correct sounds. A child may first need to be taught how to say “water” and to learn how to pronounce it correctly so that others can understand (using echoic strategies).

From there, the next stage it to teach the child that saying the word “water” will lead to good things happening (in this case being given something to drink or to play with). This is the process of teaching mands. Positive reinforcement is important as it will lead to the child being more likely to say the word “water” whenever he/she wants a cup of water. A flow on effect from this is that in increasing the child’s vocabulary, we might be able to reduce problematic behaviour (e.g. sinks being flooded and fridge doors left open).

Of course, we also want the child to be able to use this new word in other contexts. For example, being able to apply it to new situations (e.g. looking at the ocean and commenting on the “water”) through to being able to answer other people’s questions (e.g. “what would you like to drink?”).

Where to from here?

All of our clients enter into our programs with different levels of language. The job of your ABACAS Program Manager is to understand their current level of skills and work out next steps.

Please feel free to talk to either of the Program Managers about any questions you may have about verbal behaviour and your child.

To find out more about our services in general please call the Child Wellbeing Centre on (08) 9274 7062.

Rachel Puan

Assistant Program Manager, ABACAS

Side bar