Sudden Change in Behavior

Hi and welcome to Ask Missy Mondays where I respond to a question from readers regarding a behavioral problem. Today’s question comes from a speech and language pathologist who works in a center for individuals with autism. The question is:

“The question I have is regarding a 3-year-old boy who has been diagnosed with autism. He started therapy with us and progressed very well. He is now able to follow commands. He imitates well and he is starting to vocalize single word utterances. He was able to focus for approximately 20 min with a reward and he really cooperated well. However, in the last 3 weeks, all of this positive behavior has changed. He now throws tantrums throughout the session. He bites if his needs are not met  and this is particularly if he does not get what he wants. We have tried rewards with the child but he cries and throws a tantrum for the reward if we only give him a part of it. In the session, we ignore the tantrums. It is unclear if the parents are ignoring the behavior at home or if they are giving in to the behaviors.”

Thank you so much for contacting me. Any time a child’s behavior changes suddenly, the adults should stop and ask “what has changed in his life”?

Any Changes in Home/School?

• is he in a new classroom?
• has his home environment changed?
• has his feeding routine changed?
• has a new therapy program been added/changed?

Any Medical Conditions or Medical Changes?

The other question to ask is about his medical condition. Medical conditions can impact behavior.

• is the child constipated?
• was he recently vaccinated?
• was he recently sick?
• is he teething?
• is he tugging at his ear or are there signs of a sinus or infection?

Functional Behavioral Assessment

Once you have run through those questions, the next step is to complete an FBA. You have to document what is happening before and after the behavior to find out what might be causing the behavior or what might be maintaining the behavior. Typically, children use their tantrums to try to get things they like:

• get attention
• get favorite toy
• get favorite activity
• get favorite sensory

Sometimes, children use tantrums to avoid things they do not like:

• avoid non-preferred person (e.g., therapist who makes me work)
• avoid a non-preferred toy
• avoid a non-preferred activity (e.g., work)
• avoid sensory

Additionally, the child may engage in tantrums for any of the reasons combined (e.g., avoid work and then obtain favorite toy while on break).

Behavior Intervention Plan

Following a good assessment, then the team will need to develop a solid behavior intervention plan.

• Staff and parents will learn how to prevent the behaviors
• Staff and parents will learn how to teach replacement behaviors
• Staff and parents will learn what to do after behaviors if they happen.
• Staff and parents will learn how to reinforce the new replacement behaviors to that they continue to occur.

Please keep me posted on the outcome!

Thanks again for writing. Readers, if you have a behavioral question, email me at askmissy at applied behavioral strategies dot com.

I would appreciate any advice you can provide us in trying to help this child. As you might be aware services and facilities for children with autism are limited so any information you give us will be very useful.

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Where Have You Been?

Hi and welcome to Ask Missy Mondays where I respond to a question from readers regarding a behavioral problem. Recently, I was asked, “Where have you and Rebecca been? We have missed the regular blog postings.”

Busy IEP Season

In all honesty, neither Rebecca or I followed our own advice regarding Individualized Education Program (IEP) season. We both had a number of annual reports to submit in preparation for meetings.Those reports need to show how much progress our clients have made over the past year and we need to document our clients’ present level of performance (PLOPs) for the schools’ IEPs.

Independent FBAs

However, in addition to those items, we have both been asked to complete Independent Educational Evaluations (IEEs) of behavior. It is not uncommon for a school to complete a Functional Behavioral Assessment (FBA) as required under the Individuals with Disabilities Education Improvement Act (IDEIA). But the IDEIA also affords the family a right to an independent FBA should they disagree with the findings from the school FBA. Independent FBAs also take substantial time.

Conferences

Both of us have been conferencing. First we had the Association of Behavior Analysts Annual Convention in Seattle. This conference is a must for behavior analysts or anyone interested in the field of behavior analysis. Days are filled with research, practical application, and behavior analysis across contexts while nights are filled with socialization and mingling with other behavior analysts (about 5,000 of your closest friends). While there, we conducted a day-long workshop on Special Education Law and Ethical responsibilities for behavior analysts. We also presented ethical responsibilities for completing FBAs, Behavior Intervention Plans (BIP), and the proposed law on restraint and seclusion.

Region 17 invited me to speak at their Autism Conference in Lubbock, Texas. If you live in the area, this is a conference that should not be missed. Anna Phillips runs an amazing conference with great speakers and a wide variety of topics. The exhibitors are also great and participants can purchase books, teaching materials, and even fun jewelry. I presented on behavioral feeding techniques, data collection, and using the iPad to teach communication, language, and academic skills.

Webinars

We offer continuing education for Board Certified Behavior Analysts and we try to offer a topic each month. We have recently completed webinars on Special Education Law and Using the iPad to Teach. While the webinars are designed for behavior analysts, anyone is welcome to attend. If you are interested in our upcoming webinars, check out our website for additional information or for registration instructions.

We Are Hiring!

Finally, Applied Behavioral Strategies continues to get referrals for ABA therapy, behavioral feeding therapy, and assessments. Because of all of these referrals, we are in need of a Board Certified Behavior Analyst (or two) as well as good front line therapists. So, if you like what we do, please consider applying for a position. If you live in Connecticut, contact me directly. If you live in or near Austin, contact Rebecca.

So, we apologize for our absence in recent weeks but we appreciate your on-going support.

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Why is PJ Tantrumming?

Take a look at our picture below. (Thanks go out to Bil Keane for this wonderful cartoon (c) 1976.) See if you can guess why PJ is tantrumming. When there is a reason for a behavior, behavior analysts called it a function or a purpose. This is the first time we have tried a poll so please participate! We will post the answer tomorrow! Thanks for playing.

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State Laws for Behavior Plans

Here at Applied Behavioral Strategies, our 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. The title of today’s article is State Special Education Laws for Functional Behavioral Assessment and Behavior Intervention Plans. Perry Zirkel authored the article and Behavioral Disorders published it in August, 2011 (Volume 36, number 4).

Purpose

The author set out to analyze state laws regarding Functional Behavioral Assessments (FBA) and Behavior Intervention Plans (BIP). For background information related to federal requirements for FBAs and BIPs, read Dr. Zirkel’s introduction. He provides information regarding the law, regulations, and federal interpretations of the law.

Method

The author searched  for state laws regarding FBAs and BIPs. Keep in mind, states may only add to federal legislation, not take away from requirements. Then he tabulated the information adding a “when”, “who”, “what”, and “how” column. Specifically, the “when” column identified if a state identified when the FBA and BIP were required. The “who” column indicated when a state identified the parties responsible for completing the FBA and developing the BIP. The “what” column indicated when a state defined the FBA and BIP. Finally, the “how” column identified when a state included information about how to complete an FBA and BIP.

Results

Key finding #1. Thirty-one of the states have requirements regarding FBAs and BIPs.

Key finding #2. Twelve of the 31 states fail to identify both the “who” and the “when”.

Key finding #3. Zero of the 31 states require both an FBA and a BIP when a child’s behavior interferes with the child’s learning or that of others. May we note that this seems absurd to us? How can a BIP be developed without an FBA? And how could an FBA not result in a BIP? We are terribly saddened by this finding.

Key finding #4. Only 2 states provided information about how to complete both an FBA and BIP. Meanwhile 12 states provided some information about how to complete a BIP.

Key finding #5. Seventeen states define FBAs and BIPs with only 14 of the 17 mentioning “function” with regards to FBA.

Conclusions

As parents, teachers, behavior analysts, and/or advocates for children with behavioral challenges, we have a duty to make changes at the state level to ensure that students are protected with policies that will result in appropriate assessment and intervention. Protective policies regarding FBAs and BIPs will most likely prevent the use of scream rooms and other inappropriate behavior reduction techniques.

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We Heard THAT in an FBA!

We have been to a number of IEP meetings where the results of a Functional Behavioral Assessment (FBA) were presented. You won’t believe some of the things we have heard! Check out this list:

1. Your child doesn’t need an FBA. FBAs are for children who have severe emotional problems.
2. Here is our FBA form, let’s fill it out so we can write the Behavior Intervention Plan (BIP).
3. You cannot ask for an independent FBA. An FBA is not an assessment.
4. We finished your child’s FBA. The function of your child’s behavior is anxiety.
5. We finished your child’s FBA. The function of your child’s behavior is control.
6. We tried to do an FBA but your child does not have any behaviors.
7. I don’t know how to graph your child’s functional analysis results. They didn’t teach me how to graph in school.
8. We don’t need a behavior analyst to do the FBA. Our special education teacher took a class on behavior. She can do it.
9. Why did your report say the child escaped? Our staff keep children within arm’s length at  all times.

And the number 1 craziest thing we have heard about FBAs:

10. We cannot do an FBA as part of the initial evaluation. We have to see how he behaves in special education first.

Please share! What crazy things have you been told about an FBA? Behavior analysts, what have you heard?

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What’s the Difference Between an FBA and a Functional Analysis?

Hi and welcome to Ask Missy Mondays where I respond to email questions from readers who have questions about behavior. Today’s question actually comes from a list serve rather than an actual email to me directly.

A number of parents have been discussing the issue of scream rooms or seclusion timeout rooms. If you are interested in reading about this more, please check out our previous posts on the topic here, here, here, and here.

As part of the discussion about these rooms, a number of people mentioned the importance of having a functional behavioral assessment (FBA) done combined with developing an appropriate behavior plan. Other people then posted about the importance of a functional analysis. That is when a parent asked,

“Could you please explain the difference between an FBA (functional behavior assessment) and a Functional Analysis?” “Also, please explain who can do a functional analysis and why it’s important you get a qualified person to do it.”

We have written about FBAs on this blog before. We described an FBA here, we described when to do an FBA here, and we reviewed some legal cases on FBA here.

So, for a recap, remember:

The FBA is a multi-step process that may include some or all of the following:

• record review
• parent and staff interviews
• student interviews if appropriate
• the completion of rating scales such as the Motivation Assessment Scale (MAS) or the Question About Behavior Function (QABF)
• direct observation of the student in the problem activity/setting
• functional analysis.

A good FBA will include a graph summarizing the observations and/or functional analysis.

The FBA should result in a statement or statements that tell you WHY the child is engaging in the behavior.

Additionally, according to federal special education law, an FBA must be completed under these conditions:

• If, during the IEP meeting, the team determines that the child has a behavior that is impeding his/her learning (or that of others)

• If the child’s placement needs to become more restrictive because of the challenging behaviors
• If the child’s behavior has resulted in an emergency change of placement
• As part of the initial and full evaluation if necessary

What is a Functional Analysis?

 The functional analysis is one step or possible component of the FBA. The functional analysis is a manipulation of events to PROVE why the behavior is happening. For example, if the assessment data suggests that a child may be attention seeking with his/her behavior, then the functional analysis will be implemented so that in one condition, the child is given a toy immediately following the challenging behavior but in the comparison condition, the child is given attention immediately following the challenging behavior. Then, the behavior analyst will count and graph the number of times the child engaged in challenging behavior in each condition. If the child is truly attention seeking, the rates of challenging behavior will be higher when the child receives attention for his/her behavior when compared to rates when the child received a toy following his/her behavior.

I have simplified the description of the analysis in order to show readers the difference between an FBA and a functional analysis. Many functional analysis conditions can be completed and they may be quite complicated depending on the child’s behavior and other relevant information.

By definition, a functional analysis results in an increase in challenging behavior in some or all conditions. Thus, only appropriately trained people should oversee the design and implementation of such conditions. Additionally, the functional analysis results may be influenced by the implementor, the setting, the language in which the instructions are given, and other variables. Thus, the functional analysis should be completed in conditions that are as close to the natural setting as possible (including people, materials, and location).

Finally, the functional analysis ALWAYS results in a graph depicting the results of the analysis.

I hope this helps clarify the difference between the two procedures.

If you have questions about behavior be sure to email Missy at askmissy at appliedbehavioralstrategies dot com.

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Alternatives to Time Out Rooms

One of our goals for improving the quality of lives through effective intervention is to share with our readers research on effective treatments. We do this by summarizing peer-reviewed research articles. Yesterday, in response to our post on Scream Rooms (also known as Time Out Rooms), a twitter follower asked, “what else can teachers do?” Thus, it seems appropriate that we should review a study that demonstrates one effective alternative to time out.

Mark Durand and Ted Carr authored the article in 1992. The Journal of Applied Behavior Analysis published the article and you may read it yourself here.

Study Purposes

The purpose of the study was to determine which of two interventions would be effective at reducing attention-maintained challenging behavior (when children act out in order to get reactions from their teachers).

The authors also set out to determine which effects of the two interventions would generalize to untrained teachers. For example, a teacher could implement a behavior plan in her class but when the substitute teacher is present, he may not implement the intervention. If the child’s good behavior happens with the trained teacher and with the new/untrained teacher, it is said to generalize. If the child’s good behavior does not happen with the new/untrained teacher, the effects failed to generalize. Obviously, teachers would want interventions that work with them as well as with their substitutes.

Participants

Twelve children participated in the study. Children ranged in ages between 3.5 years and 5 years of age.  The children were diagnosed with a variety of conditions including attention deficit disorder, language delay, autism, or developmental delay. The children engaged in a variety of inappropriate behaviors including aggression, opposition, tantrums, and property destruction. Six children were assigned to one treatment group and six children were assigned to the other treatment group.

Assessment

The authors completed a functional behavioral assessment (FBA) for all 12 students. As part of the FBA, the authors completed a functional analysis to demonstrate that all 12 children engaged in various challenging behaviors in order to gain attention from their teachers (The authors referred to this as Study 1). This type of behavior is known as attention-maintained behavior.

Baseline

Before treatment, the researchers observed children during regular school work activities. The work was considered easy work but the teachers did not provide a high rate of attention for appropriate behaviors.

Intervention

The researchers compared the results of two interventions. (The authors called this Study 2). One intervention was time out. We discussed time out and its variations here yesterday. The second intervention the authors studied was called Functional Communication Training (FCT). You may read more about it here (You will find other evidence-based strategies on that website if you are interested). FCT has a substantial research base to support its use. With FCT, teachers simply teach children to communicate instead of acting out to get what they want. Often we teach children to talk but sometimes we teach children to use pictures to communicate if they cannot speak very well.

In this study, teachers implemented time out by simply removing all instructional materials and turning their backs to the children for 10 seconds each time the child engaged in challenging behavior.

During FCT, teachers taught the children to ask for teacher attention by saying things like, “Am I doing good work?”

Once the researchers demonstrated that the intervention was working, a new/substitute teacher was brought in to see if the intervention effects would generalize. (The authors called this Study 3).

Results

Time out effectively reduced the rates of challenging behavior for all 6 children in the treatment group. Similarly, FCT effectively reduced the rates of challenging behavior for all 6 children in the treatment group.

However, when the new teacher worked with the children, the results were remarkably different. Specifically, children who received the time out intervention, failed to generalize their good behavior to the new teacher. Essentially, their challenging behavior returned to pre-treatment levels with the new teacher.

On the other hand, children in the FCT group, generalized their good behavior to the new teacher. Not only did they maintain good behavior, they used their new communication with the new teacher.

Thus, while brief time out from teacher attention may be effective at reducing attention-maintained behavior, the improved behavior will not generalize to new, untrained teachers. However, FCT teaches children to use communication instead of challenging behavior. This results in improved behavior and the improvement carries over to new, untrained teachers.

So, if you find yourself wondering what to do instead of time out, try teaching the child to communicate instead of acting out.

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Scream Rooms Violate Children’s Rights

An elementary school has come under fire in Connecticut for using “Scream Rooms” as a method of discipline. If you haven’t heard, you may learn more about it here, here, and here.

What is a Scream Room

According to reports, parents described the rooms as 6-by-4-foot spaces with concrete walls used to isolate students with special needs who are disruptive in the classroom. As best as we can tell, Scream Rooms is simply another name for a Time Out Room or more specifically, a Seclusionary Time Out Room.

So what is a time out room? Let us first define time out.

• A time out is a period of time when opportunities to access reinforcement are prevented.
• Most people think of a time out as sitting in a chair and not being able to play.
• Time out may also be missing recess for 5 minutes.
• Time out may also include losing TV time after dinner.

Time out may be administered within a classroom so that the student does not lose instructional time. For example, the child may be asked to sit at the back of the class where she can still hear instruction but where she may not interact with others. This type of time out is called inclusionary time out.

Seclusionary time out is when the student is removed from the instructional setting and placed in isolation so that minimal or no interaction with others is allowed.

Thus, a time out room or a seclusionary time out room is a room where someone might go so that no other forms of reinforcement may be accessed (e.g., no social interaction, no music, no toys).

What is the Purpose of a Scream Room or Time Out Room?

Historically, time out has been used as a consequence to challenging or disruptive behavior as a type of punishment. The underlying philosophy is that if the child is engaging in behavior to gain attention, placing the child in isolation for brief periods of time immediately after the challenging or disruptive behavior will teach the child that acting out will not result in attention.

While this method has been supported with substantial research, the technique is often used incorrectly. Before a time out may be planned as part of an intervention for a student, a behavior analyst must first assess the behavior and determine why the child is mis-behaving. This is called a Functional Behavioral Assessment (FBA) and we have talked about it here, here, and here.

Once the assessment is completed, an intervention is developed based on the assessment results. If the child engaged in challenging behavior to gain attention, a time out from attention following challenging behavior may be part of the behavior plan. If the child engaged in the challenging behavior to gain access to preferred items such as computer time or television time, then a time out from computers or television following challenging behavior may be part of the plan. If a child is engaging in challenging behavior as a way to get out of non-preferred activities such as school work or home work, time out from school work would be inappropriate and ineffective.

When time out is used as part of a treatment plan, its use must be carefully monitored with data collection and ongoing analysis to verify if the intervention is working as planned. All staff who use time out as part of a treatment plan must be trained to use the procedure. Additionally, the time out procedure must be supervised to ensure that staff are implementing it correctly.

Sadly, it does not appear that time out is being used in this way in this particular school. Based on the reports we have read, it seems as if staff sent children to these rooms to “calm down”. Based on the reports we have read, staff were not following carefully developed behavior plans. Instead, teachers appeared to be sending children to these rooms when teachers became frustrated with student behavior.

Rules for Restraint and Time Out

Currently, no federal legislation exists preventing schools from using seclusionary time out or time out rooms. However, federal legislation has been proposed. We used Wright’s Law(a helpful website for parents and teachers alike) to find additional information about seclusionary time out rules in each state. Many states have specific rules so parents, teachers, and behavior analysts should become familiar with the rules in their states. These states include: California, Colorado, Connecticut, Iowa, Illinois, Massachusetts, Maryland, Maine, Minnesota, Montana, North Carolina, New Hampshire, Nevada, New York, Ohio, Oregon, Pennsylvania, Rhode Island, Tennessee, Texas, and Washington.

Connecticut has specific rules regarding the use of seclusionary time out. You may read the rules here.

The rule states that “no provider shall involuntarily place a person at risk in seclusion (there are two exceptions). This means that a child may not be placed there against his/her will (with those exceptions).

The state went on to define seclusion as the confinement of a person in a room, whether alone or with staff supervision, in a manner that prevents the person from leaving.

Seclusion may be used in an emergency. But remember, an emergency does not happen daily as described in these news reports. The rules also state that if seclusion is used, “it must be part of the IEP of that person AND that other less restrictive, positive behavior interventions appropriate to the behavior exhibited by the person at risk have been implemented but were ineffective.”

The rules also state that if seclusion as a behavior intervention is repeated more than two times in any school quarter, the IEP team must meet to review the use of seclusion, consider additional evaluations or assessments, and may even revise the child’s IEP.

Most importantly, when a student is placed in seclusion, school staff must attempt to notify the parents on the same day or within 24 hours. They may use phone, email, or a note home. Parents must receive a copy of the incident report within 2 days. The state even provides a sample of the incident report form that could be used.

And finally, the rule states that any staff who uses seclusion must be trained in that technique.

Please note that this rule applies only to students who have an IEP. Students who do not have identified disabilities do not have the same rights.

What Should Parents Do to Prevent the Use of Scream Rooms/Time Out Rooms?

If your child does not have a disability, then you should meet with your principal to discuss the use of such procedures. Again, your child does not have the same rights as children with IEPs.

If your child has an IEP, then you should:

1. Learn your state’s rules about seclusionary time out
2. Review your child’s IEP to be certain that it does not include seclusionary time out
3. If you have concerns about your child’s behavior, you should request the IEP team to complete a Functional Behavioral Assessment (FBA)

We hope that none of your children have experienced these rooms. We also hope that we have helped you prevent the use of these rooms on your child.

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Homework Habits that Work

Hi and welcome to “What Works Wednesdays” where we share a success story from one of our clinical cases. All names have been changed to preserve the privacy of the child and family. Our intent is to show readers how successful ABA can be.

Today’s success story is about Grace and Sophia, two school-aged girls (7 years an 10 years) who were giving their parents and after-school tutor headaches. The girls engaged in a screaming, tantrums, fighting, back-talk, and non-compliance. Their behaviors were so bad that the tutor had threatened to quit if something didn’t change fast.

A quick observation of the scene on two or three different days allowed us to see some antecedents and consequences that may have been contributing to the homework headaches. First, the girls came off the bus without any plan. Sometimes they played outside, sometimes they watched television, sometimes they had snack, and other times they started homework right away. Second, when the girls misbehaved, each of them received a great deal of attention from the tutor as she lectured them about how and why they needed to behave. When he behaviors escalated to a high enough point, one or both parents swept in to save the poor tutor. The parents intervened by threatening loss of consequences, yelling about how badly the children behaved, or simply instructing the children to “cut it out and get to work”.

Once we assessed the situation, we developed a plan. All good behavior plans consist of antecedent modifications (antecedents are the events that happen before the behavior), the identification of target or replacement behaviors, and modifications of consequences (the events that happen after the behavior).

Antecedent Modifications

Right away, we asked the parents to develop a consistent homework routine. Because of their ages and different needs, one child ate her snack first and then played for 30 minutes before starting homework. The older child ate her snack while organizing her homework. Both girls had the responsibility of putting backpacks, shoes, and lunch boxes away prior to commencing any other activity.

We asked the parents, if they were home and not on a conference call, to come in immediately after the bus and give lots of positive attention. We instructed the parents to remain out of the room during all outbursts, tantrums, an inappropriate behavior. We also asked the parents to come in and give the children praise for any good behavior they observed (sitting, working, staying on task, etc).

Target and Replacement Behaviors

Instead of focusing on how rotten or awful the children were, we asked the tutor to focus on how wonderful the girls were. We identified several behaviors that she wanted to see more of:

• sitting during homework
• attending during instruction
• working when asked
• working without yelling
• asking for assistance without crying or yelling
• putting personal items away without being asked

Changes to Consequences

We implemented a token system for the girls. Each girl had a sticker chart. When the sticker chart was full, the girls could trade it in for $.50 they could deposit in to their bank account. Stickers could be given out freely by either parent or the tutor. We asked that whoever awarded the sticker to take extra care and identify exactly which target behavior resulted in the sticker award.

• “excellent Sophia. You started work without yelling.”
• “wonderful Grace, you put your lunch box away.”

We implemented a brief time-out procedure for Grace, who loved television. We made 10-minute TV Time coupons. Each day at the beginning of homework, the parents identified how many minutes of TV time were available (30 minutes or 60 minutes). Each time that Grace involved in yelling, screaming, tantrumming, back-talking, or non-compliance, the tutor removed one of the coupons.

Within 2 days, the frequency of inappropriate behaviors decreased to zero! The behaviors have maintained for 6 weeks with no signs of reversing. Congratulations to Grace and Sophia for your homework progress. Congratulations to your parents and tutor for helping you do it.

Readers, please share. What strategies do you use during homework sessions? What works for your children? Behavior analysts, what strategies have you used? How well did they work?

 

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ABA Assessment: What to Expect

Yesterday we discussed questions to ask an ABA provider during an assessment. Today we will address what to expect in an ABA assessment. We would like to clarify that this process should not be limited to ABA providers only. A full and initial evaluation of a child as part of the special education process should also follow this model.

Currently, the field of ABA has no rules and regulations  regarding initial assessments for ABA services. Thus, each agency will follow its own assessment protocol. Early intervention and special education services, on the other hand, have specific rules and regulations regarding assessments. You will find more information about those rules here for children age 3-22 or here for children under the age of 3.

We will attempt to describe a variety of assessments commonly conducted as part of an assessment for children with autism. Our advice to you is to become informed so that you know how to ask for assessments that your child needs.

We have described the different types of assessments on our website. In summary, your child should have a formal diagnosis so that the severity of autism is documented. The diagnostic assessment should be conducted each year as one measure of your child’s progress. The diagnostic assessment should be completed by a licensed psychologist. Texas Education Agency has a helpful list of diagnostic and screening tools related to autism.

Following the diagnostic assessment and before services begin, your child should have a comprehensive developmental assessment for every area of development.  Our recommendation is that norm-referenced assessments be completed annually as a second measure of progress. At a minimum, your child should be assessed in speech and language, adaptive skills, fine and gross motor, social and emotional development, and cognition. The Texas Education Agency has provided resources related to developmental assessments here.

The developmental assessments provide information about where your child is functioning compared to his/her same age peers. Norm-referenced developmental assessments should not be used to develop program goals and objectives.

Your ABA provider may provide some or all of the aforementioned assessments depending on the type of personnel employed by the agency. In order for an agency to develop a program for your child, other types of assessments will be needed. These are the assessments we will focus on.

Standardized Assessments

Criterion-Referenced Assessments

A number of criterion-referenced assessments are available for use by ABA providers. The Brigance is a widely used assessment with substantial research to support its reliability and validity. This assessment provides information about the skills children have acquired as well as what skills should be learned next. The assessment covers all areas of development and may be repeated as a measure of progress towards goals and objectives. The Brigance has been used to assess children with and without disabilities and is not autism specific.

The Verbal Behavior Milestones Assessment and Placement Program (VB-MAPP) is an autism specific assessment that may be used to determine which skills a child has mastered as well as which skills should be taught next. The VB-MAPP focuses on language and challenging behaviors. Thus, additional assessments should be used in combination with the VB-MAPP. Peer-reviewed research studies regarding reliability and validity are still needed.

The Assessment of Basic Language and Learning Skills (ABLLS). The ABLLS provides information regarding skill development in a number of areas including language, social interaction, self-help, academic and motor. Peer-reviewed research studies regarding reliability and validity of the measure are still needed.

We mentioned the SKILLS assessment and curriculum yesterday. This tool assesses skills in all areas of development. Unlike the ABLLS and VB-MAPP, peer-reviewed studies have been completed on the SKILLS.

Providers of services for infants and toddlers may use an assessment called the Hawaii Early Learning Profile (HELP). This tool has substantial peer-reviewed research related to its reliability and validity. The tool is also comprehensive and assesses all areas of development. The tool is designed to develop IFSPs and would thus be appropriate when developing your child’s ABA program. However, the assessment should not be used to determine your child’s eligibility for services.

Your provider may use other measures for program development. These may include checklists, rating scales, and parent report/interview.

Other Assessments

Other standardized assessments are available for your ABA provider to complete. These assessments may or may not be used during the initial assessment. They will most certainly be used over the course of the program.

When children engage in challenging behavior, a functional behavioral assessment (FBA) is required in order to assess the behavior and develop an appropriate Behavior Intervention Plan (BIP). At a minimum, the assessment will include a record review, parent/teacher interviews, and direct observations of your child. Providers may also use rating scales completed by parents and/or teachers. Finally, providers may complete a functional analysis where conditions are manipulated to assess how environmental changes affect your child’s behavior.

At some point in a program, providers will complete preference assessments for your child. Formal preference assessments include the systematic presentation of items to determine if your child interacts with or engages with various stimuli. Informal preference assessments may be completed on a daily basis in order to determine how to best motivate your child to work. The provider may simply watch how your child uses toys and which toys your child gravitates toward during free play. Providers may also ask you to limit your child’s access to highly preferred toys and activities to keep him/her interested in them during therapy.

Informal Assessments

ABA providers, early intervention personnel, and school staff may also complete a number of informal assessments. Most likely, they will request copies of records from your child’s medical and related service personnel. A comprehensive record review is almost always utilized during program development.

Providers may create agency specific forms they use when developing programs. Providers may also ask families to complete intake forms in order to gather information from parents and other providers. Completing and returning these forms as soon as possible will help your provider prepare for any upcoming visits or assessments.

Providers may complete observations of your child in a variety of settings such as home, school, and community. Providers will be able to develop better programs after observing your child in as many different settings and activities as possible. It will be important for providers to observe your child under his/her best performance. However, it is equally important for providers to be able to see situations when your child is not successful.

Providers may also complete skill probes. These are mini-tests where the provider asks your child to engage in a skill to see if your child complies or if your child is capable of performing the skill. For example, the provider may introduce a toy set. After playing with your child for a few minutes, the provider may ask the child to find a red car. The provider may document if the child completes the skill as asked. Skill probes may be conducted prior to program development. However, they may also be completed within the first couple of weeks of your child’s program.

As we have stated, this list is certainly not comprehensive or all-inclusive. Hopefully, it will help prepare you for your child’s initial assessment and program development.

Has your child recently completed an assessment? What would you add to help first timers through this process?

 

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