So Justin and Joe have decided that they miss each other during COVID. One strategy that they have implemented is to offer their segments called Rants with Justin & Joe. Each rant is given a chapter name and features a leader with something to say about a topic related to ABA.
I love that Justin and Joe have decided to disseminate information about ABA in a new way. These events are free for participants but they cap the event in order to keep it intimate. Some of the past topics have included Chapter 2 with Dr. Bob Ross who chatted about current and past posts on social media related to behavior analysis and intervention for individuals diagnosed with ASD and Chapter 4 with Dr. Ron Leaf who chatted about the early days of ABA intervention with Lovaas himself.
So you can imagine my excitement when they asked if I would join them for Chapter 8. Today we will be chatting about different perspectives on ABA. While I’m a BCBA and have a professional perspective, I’m going to focus today on my role as a sibling and guardian for Mac and how ABA has helped him. I hope you can join us!
A lot of people think that conferencing is just about getting CE’s for certification renewal. Conferencing actually has multiple purposes. First, it is an opportunity to learn about a new area of interest. Remember, the BCBA credential is an entry level credential. The scope of practice for a new BCBA is extremely limited. Thus, conferencing can be a great way to start training on a new area/scope of practice.
Regional Conferences (i.e., your state association such as Florida ABA or CT ABA, or Mass ABA) provide an opportunity for you to remain current about issues within your state. Perhaps your state is trying to push for licensing of behavior analysis. You need to attend to be in the know! For Florida, the current issues around medicaid are a key focus for many providers.
Did you know you also have an ethical obligation to your state association? yes! under the BACB Professional and Ethical Compliance Code, 6.01 b), “behavior analysts have an obligation to participate in behavior-analytic professional and scientific organizations or activities.” Therefore, you should conference because it’s ethical!
Conferencing is a great time to network with other providers, scientists, product development teams, and sometimes payors. Put your best foot forward and make those connections!
Finally, conferencing is a wonderful time to see friends and colleagues. Rest up before conferences so you have the energy and stamina to get it all in. Check out these photos from our fun times together.
We are thrilled to announce that we will now be serving the Flagler Beach area of Florida!
We have immediate openings for ABA therapy in homes, communities, and schools. We are also available to contract with schools for a variety of services.
If you are interested in receiving services in our new catchment area, please call our toll free number: 844.854.7400
For some background info…. staff at CARD in the R&D department as well as some of the staff in the Training Department (now known as the Institute for Behavioral Training) conducted this study on E-Learning. In full disclosure, I worked at CARD when staff conducted these studies.
We know that training parents to implement ABA is possible. (See some of Dr. Hancock (now Blackmon) and Dr. Kaiser’s vast work in the area of training parents to implement EMT and other language interventions).
I love this excerpt from the National Research Council’s book on educating children with autism (National Research Council 2001. Educating Children with Autism. Washington, DC: The National Academies Press. https://doi.org/10.17226/10017.)
The committee recommends that families’ participation should be supported in education through consistent presentation of information by local school systems, through ongoing consultation and individualized problem solving, and through the opportunity to learn techniques for teaching their children new skills and reducing behavioral problems. Although families should not be expected to provide the majority of educational programming for their child, the parents’ concerns and perspectives should actively help shape educational planning.
The introduction section of this paper builds the case for parent training. For example, see this statement, “Thus, it has become the consensus that all treatment for children with autism spectrum disorders (ASD) should include substantial parent and family training (Brookman-Frazee, Stahmer, Baker-Ericzen, & Tsai, 2006; Matson, Mahan, & Maton, 2009; McConachie & Diggle, 2007).“ And while we have little data on the amount of parent training provided to parents as part of on-going ABA programs, we do know that insurance companies reimburse ABA providers for the service of parent training and for group parent training (when fewer than 8 parents participate). Additionally, we know that E-Learning is an effective tool for teaching fact based knowledge regarding ABA concepts. Thus, the purpose of the study is logical: “evaluate the effectiveness of an eLearning program for training family members of children with ASD in the principles and procedures of ABA treatment”
The authors recruited 28 family members (mostly moms) to participate in this study. The majority of participants held a bachelor’s degree or higher. All participants spoke English and had access to high speed internet. 25 of the participants reported that their children currently received ABA services. The combination of these factors would suggest that the results of the study might not be generalizable to all populations but rather to those with higher education and SES.
The authors utilized a group design study and randomly assigned participants to one of two groups: treatment and waitlist. This design removed any ethical concerns regarding a no treatment group. Thus, the participants who were assigned to the no treatment group would ultimately receive training, just at a later date. In our online meeting, we discussed the limitation regarding the wait. Participants only had to wait one week after taking the pre-test before receiving access to E-Learning. We felt that a longer waiting period may have been better because participants may have been tested too much, too close together. Specifically, participants in the waitlist group took a pre-test, waited a week, took the pre-test, then started training and took the pre-test again.
The authors reported that the E-Learning resulted in improved performance on the test with the treatment group improving, on average, from 63% to 90% correct and the control group improving from 51% to 92% but only after they received training.
I think we can all agree that E-Learning is a viable option for teaching concepts. As the authors noted, having this technology available for parents is helpful to reach parents who live in rural areas. Using E-learning also allows families to proceed at their own pace. And finally, neither clinicians or parents have to travel to provide/receive the training.
And while of these are advantages for E-Learning, our bigger struggle is the next phase of training: application of principles.
If you enjoyed this article, you may also enjoy reading this article where the authors used the same E-Learning Program to train therapists. Here is the full reference: Granpeesheh, D., Tarbox, J., Dixon, D. R., Peters, C. A., Thompson, K., & Kenzer, A. (2010). Evaluation of an eLearning tool for training behavioral therapists in academic knowledge of applied behavior analysis. Research in Autism Spectrum Disorders, 4(1), 11-17.
Our FREE journal club met on Monday night. We discussed Fallagant & Pence 2017. You may access the article here or here.
The introduction to the paper consisted of a nice review of some of the work done to date in this area. The authors discussed why the Preschool Life Skills are so essential.
The authors also discussed using a Response to Intervention (RTI) model for teaching these skills. You can learn more about RTI here or here. Essentially, in Tier 1, skills would be taught to a larger group or entire class. In Tier 2, small group instruction would be provided to the students who didn’t acquire the skills in Tier 1. Then in Tier 3, 1:1 instruction would occur for the students who didn’t learn the skills in Tier 1 or Tier 2.
The research was scientifically sound in terms of demonstrating experimental control. The authors used a multiple baseline across behaviors and then replicated that over 6 students. Like most research, a few flaws existed. For example, by using a multiple baseline across behaviors, experimenters lose a little bit of experimental control when the student demonstrates response generalization to an untrained behavior.
The participants in the study may have come from a convenience sample which was most likely a university affiliated preschool program. Each of the special education teachers in the school held master’s degrees in special education. The assistant teachers all held bachelor degrees.
The data in the study consisted of measuring the life skills being taught: responding to name, requesting/manding adult attention, requesting/manding adult assistance, delay tolerance, denial tolerance, and independent versus prompted responses. The authors indicated they also collected data on challenging behaviors but those data were not presented in the paper. The authors also reported high IOA data as well as high fidelity data (which is not always reported).
The authors provided a great description of the modifications provided to students who did not acquire the skills in Tier 1, 2, or 3. For these students, this included the use of an AAC device (i.e., proloquo).
One of our big discussion points occured around the author’s use of least to most prompting during Tier 1. We discussed if the results would have been different had they used most to least prompting and decided this should be a point of focus in a future study!
Another area of discussion for us revolved around the authors’ use of only 8 trials per session. This hardly seemed like enough practice for a preschooler, let alone a pre-k student with disabilities (the children had autism, Down syndrome, or DD).
We discussed, and the authors mentioned, the use of AAC and whether the students would have acquired the skills in Tier 1 had the AAC been available during that phase of instruction.
We also discussed the lack of preference assessments and whether the authors’ use of social reinforcement may have been potent enough to reinforce skill acquisition.
And finally, we discussed the limited generalization observed to peers. Some of the kids generalized skills to the adults who are obviously more skilled than the peers. But we also discussed the fact that with such few learning trials (N=8), that the kids may not have developed fluency in the skills thereby limiting their ability to readily generalize the skills. And of course, the authors mentioned that they did not program for generalization so this may have impacted generalization as well.
Bottom line, these seem to be some essential skills that we could easily teach in classrooms to increase the social skills of students.
I have identified a few extra resources. First because of all the tolerance discussion, we should look at some of the original tolerance studies. The following studies utilized FCT combined with Tolerance training.
Bird, F., Dores, A. P, Moniz, D., Robinson, J. (1989). Reducing severe aggressive and self-injurious behaviors with functional communication training. American Journal on Mental Retardation, 94, 37-48.
Brown, K. A., Wacker, D. P., Derby, K. M., Peck, S. M., Richman, D. M., Sasso, G. M., Knutson, C. L., & Harding, J. W. (2000). Evaluating the effects of functional communication training on brief functional analyses of aberrant behavior. Journal of Applied Behavior Analysis, 33, 53-71.
Carr, E. G., & Carlson, J. I. (1993). Reduction of severe behavior problems in the community using a multicomponent treatment approach. Journal of Applied Behavior Analysis, 26, 157-172.
Day, M. H., Horner, R. H., O’Neil, R. E. (1994). Multiple functions of problem behaviors: Assessment and intervention. Journal of Applied Behavior Analysis, 27, 279-289.
Fisher, W. W., Thompson, R. H., Hagopian, L. P., Bowman, L. G., & Krug, A. (2000). Facilitating toleraance of delayed reinforcement during functional communication training. Behavior Modification, 24(1), 3-29.
Hagopian, L. P., Wilson, D., & Wilder, D. (2001). Assessment and treatment of problem behavior maintained by escape from attention and access to tangibles. Journal of Applied Behavior Analysis, 34, 229-232.
Harding, J., Wacker, D. P., Berg, W. K., Barretto, A., & Ringdahl, J. (2005). Evaluation of relations between specific antecedent stimuli and self-injury during functional analysis conditions. American Journal on Mental Retardation, 110(3), 205-215.
McConnachie, G., & Carr, E. G. (1997). The effects of child behavior problems on the maintenance of intervention fidelity. Behavior Modification, 21, 123-158.
Symons, F. J., Fox, N. D., & Thompson, T. (1998). Functional communication training and naltrexone treatment of self-injurious behavior: An experimental case report. Journal of Applied Research in Intellectual Disabilities, 11, 273-292.
And here are some extra resources on Preschool Life Skills
Hanley et al 2007
Luczynksi & Hanly (2013)
Luczynski, Hanley, & Rodriguez (2014)
Beaulieu, Hanley, & Roberson 2012
Beaulieu, Hanley, & Roberson 2013
Hanley, Fahmie, & Heal 2014 (in headstart)
Francisco & Hanley (2012)
Robison, Mann, & Ingvarsson (in press)
Dogan et al 2017 (training parents)
Halfdanardottier, Sveinbjornsdottir & Ingvarsson (in process but looking at life skills in older students)
If you know anything about me, you know that I am passionate about providing quality services for children with autism as early as possible to ensure that every child has the opportunity to progress as far as possible and to potentially recover from autism. I’ve written about this topic here, here, and here.
If you think I’ve already had a few too many to drink today, please check out this professional video from the University of Connecticut. The researcher in this video is a Licensed Clinical Psychologist. Her name is Deb Fein and she is really good at diagnosing children. She realized she needed to study this further when a child she had previously diagnosed returned to her several years later and did not meet the criteria for autism.
So she began researching this very topic. While recovery from autism describes what she sees, Dr. Fein has chosen to use the words Optimal Outcome to describe the children who ultimately obtained optimal outcome and no longer met the criteria for autism.
In our journal club meeting on Monday, we read and discussed the following article:
Moulton, E., Barton, M. Robins, D. L., Abrams, D. N., & Fein, D. (2016). Earlycharacteristics of children with ASD who demonstrate optimal progress between age two and four. Journal of Autism and Developmental Disorders, 46, 2160-2173. You may access a free copy of the article here: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4860351/pdf/nihms761908.pdf
We were a little disappointed in this paper in that it didn’t address treatment and optimal outcome but rather predictors of optimal outcome. 190 children participated in the study with 19 of them achieving optimal outcome.
At the beginning of the study, researchers classified all children into 4 groups: PDD-NOS; Asperger’s; ASD; and ASD Low MA (mental age less than 12 months). On average, all children were diagnosed around 26 months of age. Re-assessment occurred around 48 months.
Before we go further, it is important to note that the children in this study were Caucasian and far above the poverty line. Also, the study didn’t control for early intervention so it’s hard to really say other than the obvious:
Children who were originally diagnosed with PDD-NOS were more likely to lose their diagnosis at re-evaluation.
No children with ASD-Low MA met the criteria for optimal progress (OP) at follow up assessment.
Children in the OP group showed less severe symptoms in the area of social skills, stereotypies, and sensory abnormalities
Children in the OP group showed fewer DSM-V symptoms at initial diagnosis
Children in the OP group showed stronger adaptive abilities
Lesser symptoms of restricted interests and repetitive behaviors predicted OP.
It is super important that we not think of this as mis-diagnosis but rather, the earlier the diagnosis, the earlier the intervention, the more quantity of intervention, and thus, better outcomes that result in losing the autism diagnosis.
We are super excited to attend the MassABA event on the new CPT Codes with Dr. Wayne Fisher. It should be a very informative event. And we will have until 1/1/19 to prepare.
ABAI and BACB and APBA have released the crosswalk. Does it make your head spin too?
About 1.5 years ago, we expanded our services to the east coast of Florida (Melbourne area). While it took some time to build our brand recognition there, we are excited to say that our reputation for quality, home-based services, behavioral feeding therapy, behavioral toilet training, and effective school consultation is getting out. It is now time to hire quality, experienced, BCBAs and RBTs to meet the need of all the referrals we have received.
If you think you have what it takes to join our team, please fax a cover letter and your updated resume to our office. We will keep your inquiry confidential.
If you live somewhere cold and want to escape to the beach, NOW IS THE TIME!
Our pay surpasses all others and we offer a cadre of benefits. Feel free to write or call for more information.
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