Archive for April, 2008

Why Parents Need Coaching and Support

April 27, 2008

I was watching the talk show The View last week. Elisabeth Hasselbeck was sharing her difficulties with her young daughter named Grace. She had said that she was trying to do away with the night time pacifier by having the Binkie Fairy come . Basically, a little ceremony would involve the child giving up their pacifier for The Binkie Fairy. The Binkie Fairy would then give it to other new babies that needed it. In the morning, if the child was good, they would receive a thank you gift from the Binkie Fairy for giving up their beloved (overly attached) pacifier.

 

Unfortunately, Elisabeth reported that this did not work very well and that her daughter cried for her binkie late into the night. So Elisabeth has been losing sleep because she goes to comfort her crying daughter until she falls asleep in her bed. This has been going for several nights.

I WANT my BINKIE!!!

 

The interventions for these issues have been featured on Super Nanny and Nanny 911. Elisabeth did try though what was the missing piece?  It was the direct support and coaching.

 

When parents watch the Super Nanny and Nanny 911, it looks sooooo easy. All the changes just fall right into place. What parents do not fully realize is, that the actual person advising is a very important component to the success of the intervention. Super nanny Jo is right there to be in the interaction of all the changes. (observing and measuring) The parents and the children are reacting/responding to an objective , motivational advisor. Their environment has changed. Plus there is a reactivity factor of all the cameras filming in the house.

 

Sometimes when I start to work with a family, they will say, “Hey, you can be like the Super Nanny.” I just smile and state that I am higher credentialed than the Super Nanny, though like her, I hope to make positive changes in their home. Usually after the fact, parents have said, I am even better than the Super Nanny. Now that is nice to hear. (positive reinforcement for me and probably because I explain the ABA principles)

 

Though I always wonder, out of all the families worked with on the tv shows Super Nanny and Nanny 911, how many families actually kept up on maintaining their new behaviors?

 

The point I do want to make is, us interventionists, either myself as a Behavior Analyst or the Super Nanny – it takes a lot of experience, energy and high skills to promote positive behavior changes in people’s lives. It might look easy on tv, but it is not. It takes much work.

 

I do give credit to Elisabeth for sharing her trial and tribulations. No parent has it easy. Though if I had been the interventionist, I would have provided support and coached Eliisabeth through her daughter’s binkie transition and sleeping in her own bed alone. (with observation and measurement) The additional advisement (push in the right direction and reinforcement) might have been what was needed to make a success happen.

 

 

More Misconceptions about ABA

April 22, 2008

I recently attended a lecture series that had invited a Child Development Psychologist to be its speaker. There were two parts to this lecture. A morning session that was a presentation to a large group and an afternoon session geared for a select smaller group

 

This presenter’s topic for the day was about Autism Treatment. I had thought, okay, perhaps a good review. I also encouraged my BCBA students that I supervise to attend.

 

Unfortunately, the morning session at times, bashed ABA. My BCBA students were quite appalled at the lack of understanding this Developmental psychologist had regarding Applied Behavior Analysis. My students came to me and asked, “how could she bash ABA like that ?  She mentioned interventions but did not credit ABA principles. ABA is not just about the Lovaas Method. Us ABA professionals implement a lot of the strategies that were presented.”  Yes indeed, us ABA professionals do. My students even started to talk about how some of the strategies presented should be evaluated first for effectiveness and perhaps would need to be adjusted according to the client and their environment.  All I had to say was, very good my ABA Students!  During the presentation, one of my graduated ABA BCBA students was sitting with me and she kept saying, “No that is not right, I disagree with this speaker.”  I just nodded my head in agreement.

 

Given that I am a Board Certified Behavior Analyst, I am bound ethically to educate others about ABA. So on the feedback eval form for this speaker I wrote the following;

 

Not ALL ABA professionals are robotic/high structured ABA technologists. Some ABA professionals actually are innovative, try to create teaching opportunities, use natural environment teaching and believe in increasing functional skills. Please do not stereotype ALL ABA professionals. Thank you, Board Certified Behavior Analyst 

 

Lucky me,  I had been selected to attend the afternoon special session. I was not looking forward to it at all. I ate lunch with my current BCBA students as they all tried to rally me up to sit through another bashing ABA session. You did not need to be a behavior professional in order to predict its outcome.

 

So, I went up to sit in on the afternoon session. Since Board Certified Behavior Analysts are still quite rare ( approx. 5,000 in the world) , I said to myself,  it is important to represent our field. So as individuals were introducing themselves and their credentials, I was the last one. I announced that I was a Board Certified Behavior Analyst with confidence.  So, one may think that the Psychologist presenter would be more careful in how they spoke about ABA, but not so.

 

She basically summed up our ABA field as being teaching skills and then providing a M&M candy as a reward. The bashing continued i.e. as to how RDI, Floortime and the TEACCH program had more to offer than ABA. I just kept shaking my head and thinking what misconceptions.

 

True, some ABA professionals just do discrete trials, but NOT all. RDI, Floortime and TEACCH all have ABA principles that ABA professionals do utilize and implement. Behavior Analysts do use motivational systems, Token economies, teach functional skills, work on social / interactive and play skills, implement picture schedules etc etc. Not all ABA professionals can do everything; however, there are ABA professionals that are trained and experienced to do other things besides distributing M&Ms.

 

Additionally, the presenter then was show casing her Autism diagnostic checklist as an innovative new tool, which by the way was not impressive. It basically had some of the same questions from the leading Autism checklists like ADI-R, CARS, GARS, ADOS etc. How do I know this? Well because my graduate research paper was on Autism Diagnostic Tools at UMDNJ.

 

She continued on to say how the learning/behavior strategies were so important from the other disciplines and said again that they were probably not done by ABA professionals. At that point I left the room.

 

My concern was that ABA was being depicted in a very incorrect manner. ABA is much more involved than just teaching things with M&Ms.  In particular, there was a producer from the Discovery Channel who had announced to the group that she was doing 2 documentaries about Autism. So I utilized my time wisely during my absence from the afternoon presentation and found the producer. I spoke to her about ABA, encouraged her to look at my website and other informational sites about Applied Behavior Analysis. ABA is not just discrete trials and giving out M&Ms candy.

 

Now do I think that ALL Child Development Psychologists are no good?  No, not at all, it depends upon the individual, their integrity, training and experience.

 

 

 

 

Why Hire a Behavior Analyst ?

April 14, 2008

It is April and it is Autism Awareness Month. I was recently at a Provider Resource Fair for an Autism Walk in NJ. Luckily, $80,000 was raised for the cause. The money is used to educate parents and teachers.

It was really nice to see so many families and friends all together working for the same cause. Because I was a resource provider, many parents approached me to ask for info about our expanding ABA field.

Many parents with children who have Autism do not realize that Board Certified Behavior Analysts are still quite rare. Currently, there are only about 5,000 certificants who hold the BCBA ( Masters or Ph.D level) and BCABA ( Bachelors level) credential in the world. In addition, Behavior Analysts are not just limited to serving the Autism population. It depends upon the Behavior Analyst’s education, work experience, populations serviced and expertise background. Some Behavior Analysts only deal with Verbal Behavior, others work with a broader range of behaviors, some only work with children, some adults, some can teach parents, some work in business, others work with typical kids etc., etc. ABA is applicable to many things, not just Autism.

It was refreshing to speak with a few parents who were more aware of Applied Behavior Analysis and its many positive uses. They understood that changing their behavior would help their child with Autism.

Now some might say, if you want to change behavior then just go buy a book and implement the techniques yourself or go attend a behavior workshop and apply it yourself. These avenues are fine, though where is the true guidance ?

These parents that I met were very interested in getting direct training/coaching in the home. They felt that perhaps they do know some ABA, but a professional would be better to objectively assess the needs and provide the necessary teaching to improve/modify/maintain behaviors.

Changing behavior is similiar to learning a brand new skill. We all needed teachers throughout our lives, why not a Behavior Analyst to teach how to change our behaviors ?

Changing behavior is not easy, it is complex.

April 2008 is Autism Awareness Month

April 6, 2008

“Children and adults with autism exhibit atypical, repetitive behaviors and deficits in social and communication skills. Autism is usually diagnosed during the first three years of life and is four to five times more prevalent in boys than in girls. It knows no racial, ethnic or social boundaries.

Autism, Asperger’s Disorder and PDD-NOS are commonly referred to as Autism Spectrum Disorders or ASDs.  This label conveys the continuum of ability levels, but is not itself an official diagnosis.  Autism spectrum disorders affect approximately 1 in 150 individuals.”1

1. Fombonne, E. (2005). The changing epidemiology of Autism. Journal of Applied Research in Intellectual Disabilities, 18, 281-294. 

On February 9, 2007 the CDC issued the most current information on the prevalence of Autism Spectrum Disorders in the United States. 14 states were studied in 2000 and 2002, the results found an average prevalence rate to be 1 in every 152 children. Though, the prevalence in New Jersey was higher which indicated a rate of 1 in every 94 children. 

Visit this CDC site for further info on Autism.    

http://www.cdc.gov/ncbddd/autism/

Autism Causes ?
Right now, the cause of autism is not known. Current research suggests that autism could be a genetic disorder that could be influenced by environmental factors. No proven research to date supports the thinking that autism is caused by psychological factors in the child’s environment. 

Visit www.exploringautism.org for further info

Diagnosing Autism ?
Usually parents suspect a problem when their child does not exhibit the typical developmental milestones. Individuals with autism may have age-appropriate skills in one area and be delayed or have skill deficits in other areas. As an example, an Autistic child may not be able to point to objects or initiate saying “Hi” but may be able to play a simple video game easily. Medical tests to accurately diagnose autism are not yet available. The diagnosis of ASD is based upon behavior observations and skill development levels of the child. An interdisciplinary team (that may include a psychologist, developmental pediatrician, neurologist, speech/language therapist, Board Certified Behavior Analyst, learning consultant, social worker etc) could assist in the diagnosis process and subsequent therapy needs.  Visit this website for further info to learn the signs of Autism and act early. http://www.cdc.gov/ncbddd/autism/actearly/

Can autism be treated?
Early diagnosis and appropriate intervention are very important. Research has indicated that Autistic individuals do respond well to very structured, highly specialized education programs. Therapeutic interventions utilizing well-researched methods/principles, such as Applied Behavior Analysis (ABA), are proven to be effective in assisting children and adults to learn new skills and work towards their full capacity potential. Visit these sites to learn more about Applied Behavior Analysis

Remember, Autism just does not affect children, it also affects adults too.

They all need help.

Autism is a life long disability. There is currently NO known cure.  

What can you do to help the Autism cause?

– be knowledgeable about Autism

– send donations to support Autism organizations and agencies

– show support for Government Autism Initiatives

– volunteer for Autism organizations and agencies that serve Autism clients 

– get a job working with clients who have Autism, there is always a need to fill positions

– make others aware about Autism, be an advocate for children and adults with Autism