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Posts Tagged ‘Applied Behavior Analysis’

Parents and professionals working together

Parents and professionals working together

Hi and Welcome to What Works Wednesday! where the focus is usually the description of a successful case story. The general public is slowly beginning to learn and appreciate the fact ABA works. However, in an ongoing comprehensive ABA program for individuals, more than just good ABA is required. Parent and professional collaboration is an essential ingredient. In ABA teams at Applied Behavioral Strategies, the BCBAs work to ensure that every case has 4 hours of parent-professional contact at a minimum each month. Collaboration occurs in a variety of contexts.

Team Meetings

In a comprehensive program, it is important for the team to meet frequently to guarantee that the team is implementing programs correctly and that programs are modified so that the child will continue to make progress. In most cases, the team meets twice per month for 2 hours. The first order of business at every meeting: parent concerns. The team includes all therapists, the supervisor (BCBA), the parents, and other outside professionals.

Clinic/Team Meeting Notes

During the team meetings, detailed notes are taken so that team members may review them before therapy. Everyone receives a copy of the notes, including the parents. The notes are also placed in the child’s program book so they are handy for team members.

Communication Logs

In cases where the child receives therapy in a setting where the parent is not present, therapists and supervisors keep a detailed communication log that is sent home with the child each day. These logs keep the parents informed about the child’s day and serves as another way to build cohesive team communication.

Phone Consultation

Supervisors at Applied Behavioral Strategies make themselves available by phone. Supervisors are extremely busy but a great time to return calls is between appointments when driving from place to place (don’t forget to use your headset!). Parents, if you need to speak to your supervisor, let him/her know so that time can be made for the call.

Emails

Finally, email is another way to remain in close contact with parents. Emails can be returned at any time of day; especially when talking by phone is not possible. Emails also provide a written record of your requests and decision making.

In summary, professionals be diligent to ensure parent-professional collaboration. Parents, do not be timid. Partner with your BCBA and team to help propel your child’s progress to its maximum potential.

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graphHi and welcome to Ask Missy Mondays where I respond to a question from readers. Today’s question was posted on a list serve for parents and family members of individuals with autism. The mom wrote,

“As far as data collection, I hear about the BCBA doing it but I have never seen it nor heard specific results. I requested the data and the BCBA told me that as an outside consultant she is not allowed to provide it.

Having taught a course on Ethics and Professional Issues for behavior analysts, and in addition to offering on-going coursework related to ethical issues for Board Certified Behavior Analysts, hearing things like this really upsets me.

Guideline 2.0 Responsibility to Client

The Behavior Analyst Certifying Board (BACB) has developed a set of Guidelines that BCBAs and BCaBAs must follow. These guidelines are called the Guidelines for Responsible Conduct and they may be viewed here. One of the guidelines states that “the behavior analyst has the responsibility to operate in the best interest of the client“. When the client is a minor or incapacitated (i.e., unable to make decisions for him/her self), the client’s parents or guardians become the client.

In the case above, the BCBA is claiming that her responsibility lies with the school district who is paying her salary. Unfortunately, the school district is a third-party payer. While the BCBA has responsibilities to her employer, those responsibilities cannot override her primary responsibility to the client. In fact, the guidelines address this issues.

Guideline 2.05 Third Party Requests for Services

This guideline has two parts. First the guideline states that “When a behavior analyst agrees to provide services to a person or entity at the request of a third-party, the behavior analyst clarifies to the extent feasible, at the outset of the service, the nature of the relationship with each party. This clarification includes the role of the behavior analyst (such as therapist, organizational consultant, or expert witness), the probable uses of the services provided or the information obtained, and the fact that there may be limits to confidentiality.

The guidelines go on to state that “If there is a foreseeable risk of the behavior analyst being called upon to perform conflicting roles because of the involvement of a third party, the behavior analyst clarifies the nature and direction of his or her responsibilities, keeps all parties appropriately informed as matters develop, and resolves the situation in accordance with these Guidelines.

So, while the district is paying for the services, the client is the child and his/her guardian. When he client requests their data, the behavior analyst must make those data available.

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In light of all the discussions this week regarding ADHD and medication, Using ABA to Address ADHD, and a research study on Addressing ADHD in Classrooms, this cartoon seems relevant!

Thank you Hank Ketcham for your brilliance all these years!

Dennis and Impulsivity

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Teacher and SudentsHere at Applied Behavioral Strategies, the mission is to improve the quality of life through effective intervention. One way we hope to do that is by reviewing research articles for our readers. Today’s research review continues the discussion this week on using principles of ABA to address ADHD. See Monday’s post and Tuesday’s post for additional information.

Researchers from a variety of institutions collaborated to author “Peer Tutoring for Children with ADHD: Effects on Classroom Behavior and Academic Performance“. Authors included: George DuPaul, Ruth Ervin, Christine Hook, and Kara McGoey. The Journal of Applied Behavior Analysis (JABA) published the study. Readers may download the entire article here.

Background

Children with ADHD need two types of intervention. First, teachers and parents must provide reinforcement for appropriate behaviors and research has shown this to be effective. However, reinforcement alone is not enough. Teachers and parents must also concurrently address academic behaviors. One method for addressing academic behaviors is peer tutoring. Peer tutoring consists of two or more students working together on an activity with one student providing assistance, instruction, and feedback to the other. Various models of peer tutoring have been studied by great educational researchers such as Charlie Greenwood and Doug and Lynn Fuchs.

ClassWide Peer Tutoring

One model of peer tutoring is Classwide Peer Tutoring (CWPT). Classwide Peer Tutoring is an evidence based instructional practice based on principles of Applied Behavior Analysis (e.g., prompting, reinforcement, modeling). In CWPT, students work together in pairs taking turns tutoring each other. Students address skills that have been previously taught by their teacher. The teacher also develops appropriate teaching materials for the students to use. This approach provides students with more opportunities for asking questions and getting answers.

Study Purpose

The purpose of the study was to examine the effects of CWPT on  the task engagement, activity level, and academic performance of children with ADHD and children without ADHD.

Study Methodology

Participants. Eighteen students with ADHD who were not taking medication participated in the study. Children ranged between 6 and 10 years of age. Additionally, 10 comparison children participated in the study. These children were matched to the other children on age, gender, and class (i.e., in the same class as one of the targeted students).

Measures. Researchers measured classroom behavior (on task, off task, and fidgety) using a 15-second partial interval recording. Researchers also measured academic performance using teacher-developed pre- and post-tests each week. Finally, researchers also measured social validity by asking teachers and students to rate the intervention at the end of the study.

Design. Researchers used an ABAB (or reversal) design to determine intervention effectiveness. In this design, researchers measure behaviors with no intervention. Then they measure behaviors during intervention. Then the intervention is terminated while researchers continue to measure behaviors. And finally, the intervention is reinstated while behaviors continue to be measured.

Study Validity. The researchers took two additional steps to measure the validity of the study. First, they monitored accuracy of implementation using fidelity checks. Second, the researchers measured inter-observer agreement to ensure that data collection was consistent and accurate.

Results

During baseline, students with ADHD were on-task about 29% of the intervals. This increased to 80% of intervals during intervention. When the intervention stopped, this behavior decreased down to an average of 21% of intervals but when the intervention was reinstated, it increased again to 83%. Changes in fidgety behavior were observed in some but not all students. It is important to note that even without intervention, the occurrence of fidgety behaviors was low (i.e. 6% of intervals). Pre-and Post-test scores improved with intervention for almost half of the students with ADHD. Finally, the intervention received high marks of satisfaction across both teachers and students.

Comments

In the discussion section of the paper, the authors note how the results of their study compared to the results of studies on stimulant medication. Essentially, effective instructional practices work just as well as medication without all the side effects. The authors also noted that anecdotal data suggested that student engagement increased as well. Use of stimulant medication does not necessarily result in increased engagement. Interestingly, the comparison peers also showed improvements in on-task behaviors and academic performance.

Readers, do any of your children engage in CWPT? Behavior analysts, is this an intervention that you teach others to use in classrooms? Teachers, how difficult is it to implement CWPT in your class?

 

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English: A child not paying attention in class.

After yesterday‘s post regarding the use of ABA to treat ADHD, readers expressed interest in learning more. So today, one intervention to address ADHD behaviors will be discussed.

Reinforcement

Readers should not be surprised to hear that reinforcement is a recommended intervention. Reinforcement is a key topic in almost every single post on this blog. The important thing to remember is that reinforcement must be individually designed and administered in order to obtain maximum results. Individualization is not easy for teachers or parents. However, if appropriate reinforcers and correct schedules of reinforcement are utilized, great changes in behavior will be observed.

Differential Reinforcement

There are many types of differential reinforcement:

  • differential reinforcement of other behavior (DRO)
  • differential reinforcement of incompatible behavior (DRI)
  • differential reinforcement of alternative behavior (DRA)
  • differential reinforcement of higher rates of behavior (DRH; designed to increase desirable behaviors!)
  • differential reinforcement of lower rates of behavior (DRL)

Essentially, differential reinforcement is the use of reinforcement for one behavior and not for others. Differential reinforcement requires implementors to reinforce one behavior while withholding reinforcement for another.

Differential Reinforcement of Alternative Behavior (DRA)

In this intervention, reinforcement is provided when an alternative behavior is observed but not when inappropriate behaviors are observed. Specifically, if a child is engaging in off task and distractable behaviors, alternative behaviors would be identified. It is important to know why (e.g., to get out of work, to get teacher attention, etc). An assessment must first be conducted to know why a behavior is occurring. To read more on assessment, check here, here, and here. Once the assessment has been completed, then alternative behaviors to obtain the same reinforcers are identified.

If a child is trying to get out of work, an alternative behavior is to work faster so that play and non-work time may be accessed. If a child is trying to gain teacher attention, then the child is taught to use appropriate behaviors to get teacher attention.

The next step is to reinforce the new/alternative behavior. If the child is working quickly, she needs to be reinforced with a nice long work break or play time. If the child appropriately recruits teacher attention, the teacher needs to come over quickly to give attention.

Thin Reinforcement

As with any intervention, the goal is to get appropriate behavior then to thin or reduce reinforcement so that the child may function like the rest of children in the class or home. It is important to thin reinforcement at a pace that will prevent the ADHD-type behaviors from escalating.

I hope this helps readers better understand one way that ABA may be used to address ADHD.

Related articles

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Last week, I (Missy) shared information about the Congressional Hearings on autism and I questioned why the news media had not picked up on the story. Clearly, they had more important things to talk about:

  • Lindsey Lohan getting arrested again
  • The lucky winners of the Powerball

Clearly, relying on television news media is not the best

Image representing Google Alerts as depicted i...

Image via CrunchBase

way to keep current on all things autism. For those of you who want to be in the know but who lack endless hours in front of the computer, I will share a few of my tricks with you.

RSS Feeds

One way to keep current, is to find your favorite webpages and set up RSS feeds so that you are alerted each time there is a change. I like to set up my RSS feeds right in my Outlook calendar so they appear like emails. You can also use Google to help you.

Google Alerts

I have several Google alerts set up including alerts for autism and applied behavior analysis. This is super easy! Visit this website and enter the term or terms that you are interested in. You will then receive alerts when those news items appear. Please note that you can set up weekly alerts and daily alerts and so forth.

Twitter Feeds

Several Twitter programs are available to assist you with information on Twitter. I tend to lean towards TweetDeck. I can set up columns on topics such as Step Parenting, Parenting, Autism, and behavior analysis. Within those columns I can read the twitter feed on that topic. You can also set up lists so that you organize your Tweeps by topic or content. I have a list on autism, GFCF, and behavior analysts. I have also written more in depth on Twitter and you can read about that here.

So, don’t feel overwhelmed as you try to keep up with the latest on your favorite topic. Many resources are available at your fingertips!

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Ginger rated her behavior during carpet time

Hi! and welcome to What Works Wednesdays where a success story from clinical files is shared. Today’s story is about a little girl named Ginger who happens to be a typically developing 3rd grade. Ginger’s teacher contacted Applied Behavioral Strategies to assist her with Ginger’s behavior because Ginger had difficulty paying attention during morning meeting, sitting quietly during group instruction, and staying on task during independent seat work.

Record Review

A review of Ginger’s academic records indicated that she was performing at grade level in all areas. While she had some struggles learning to read, with focused intervention, she has remained on a 3rd grade reading level. Ginger is also very active and has difficulty keeping her hands, arms, and legs still. Finally, Ginger is highly distractable. Her focus is disrupted by butterflies, peers walking by, and particles on the floor.

Ginger’s teacher felt overwhelmed because she had tried verbal reminders, notes home to parents, and seating arrangements. She felt that none of these strategies worked effectively.

Student Interview

The behavior analyst asked Ginger why she had difficulty sitting quietly, completing her seat work, and listening to teacher instruction. She responded that, “I try to sit still and listen but my friend talks to me” and “I try to do my work but I have to sharpen my pencil” and “I sit away from my friend but she comes to sit next to me”.

ABC Observation and Analysis

Direct observation revealed that a variety of consequences followed these target behaviors. Sometimes Ginger received a verbal warning, sometimes the class received a reminder, and some times, no consequence occurred at all.

Self-Management

The behavior analyst needed more time to complete the assessment

so she developed a brief self-monitoring plan for Ginger to use until the assessment and behavior intervention plan could be completed. The self-monitoring plan consisted of Ginger evaluating her own behavior following each instructional activity. Her teacher reviewed the evaluation and confirmed if the evaluation matched reality. Ginger received praise and positive feedback for desired behaviors and her parents provided additional positive attention each day when Ginger shared her rating at home.

Additional Tips

The form was printed and put onto Ginger’s favorite color of construction paper. Then it was laminated so that one side showed the seat work and the other side showed the carpet time. Using a dry erase marker, Ginger could self-rate each day and then the chart could be wiped clean for the next day.

Ginger rated her behavior during seat work

Success

After 2 weeks, the assessment had to be put on hold because Ginger’s behavior improved. As with any student, Ginger continues to have difficulty when substitute teachers are present. However, this simple intervention worked to focus on Ginger’s strengths by reinforcing desirable behaviors.

Readers, have any of you tried self-management? What worked? Parents, have any of your children been placed on self-management plans? Did you like it? Did your child?

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