Cleveland ABA therapists

Cleveland ABA Therapists on Differences Between Bribery vs. Reinforcement

As Cleveland ABA therapists, so much of what we’re able to achieve with our pediatric patients is because of our tactical use of reinforcement. Reinforcement can be positive (game time, a sticker, a favorite song/dance, a gummy treat) or negative (typically ignoring or denying a preferred activity). Where possible, we lean toward the use of positive reinforcements. But we recognize that from the outside looking in, this might seem like bribery.

So, what’s the difference between bribery and positive reinforcement in Applied Behavior Analysis treatment for kids on the autism spectrum?

Here’s our Cleveland ABA therapists generally outline the difference:

  • Bribery is what takes place when a child has already started engaging in a problematic or unexpected behavior and then something like screen time or a special treat is offered in an effort to get them to stop engaging that behavior. It’s not really used as a learning moment or opportunity for a child to gain a new set of skills or engage in a different pattern of behavior. Bribery often stems from a one-time interaction where a child gets some sort of preferred item, food, or activity in exchange for changing their behavior. It might be effective in the short-term (which is why so many parents use it!) but that behavior is going to happen again and again – and won’t change unless you offer the same/similar “bribe” to offset it. Ultimately, it’s the child who maintains control in this scenario.
  • Reinforcement occurs when the preferred item or activity is given only after – and contingent upon – the expected/appropriate behavior change. That might sound really similar to bribery, but we’re delivering the reinforcement only after we see the child “change the channel” and their behavior as a means to increase that behavior.

To illustrate the difference, let’s give a dinner time example.

Let’s say you’ve spent time preparing a meal for your family and place it in front of your child and encourage a bit. The child immediately bursts into tears, throws themself on the ground, and demands chicken nuggets. You respond, “If you will stop crying, I’ll go make you some nuggets.” The crying stops, the child gets their nuggets – win-win, right?

Except that was bribery. It “fixed” the immediate issue, but the same scenario is going to happen again and again – and your child isn’t going to eat their dinner if they know chicken nuggets are on the table as on option – if they have a “big reaction.”

Instead, our Cleveland ABA therapists would recommend a reinforcement approach. Take a deep breath. Then rather than wholly giving in to the child’s demands, make them this deal: You will make chicken nuggets. Plan to do so ahead of time, in fact, if you know this is likely to be a point of contention. Then you use the chicken nuggets as the reinforcer. You require first a bite of dinner in exchange for each chicken nugget. With this tactic, you are reinforcing the expected behavior (eating the dinner you prepared) with the reinforcer (they chicken nugget they really want).

In the end, the goal of “bribery” is for the person giving the “bribe” to get what they want. But with reinforcement, the goal is ultimately to benefit the child/learner.

When we talk about reinforcement tactics in ABA, we sometimes hear from parents that they are reticent to “bribe” their child to do what’s expected of them in the first place. But this is where they are confusing bribery with reinforcement.

Look at this way: If what you’re doing is not effective, trying something new may be necessary. And reinforcement involves a bit of planning on your part. You know your child is likely to take issue with the dinner you prepared. Set them up for success by motivating/teaching them upfront.

Cleveland ABA Therapists Tips for Parent Positive Reinforcement

As ABA therapists, our sessions take a fair bit of planning to ensure we’re targeting the goals/skillsets of each child with whom we’re working. But parents can use some of these same basic strategies at home to help facilitate desired results.

A few ideas:

  • Catch” expected behaviors. You may already be planning to provide your child with some type of treat, like game time or some chocolate. All the better if you can do so after “catching” them engaged in expected/appropriate behavior that you want to target or encourage. The more you do this, the more expected behaviors you’ll see.
  • Make sure you’re targeting an appropriate behavior to reinforce. You want to be sure it’s something your child is actually capable of. Start with easier tasks and then work your way up to more challenging skills. Remember: You want to set them up for success and improve their confidence that they can reach their goals!
  • Keep an eye out for warning signs. In ABA, one of the first things we learn is to study the “ABC’s” of behavior. This involves carefully observing the antecedent (what happens right before an inappropriate behavior), the behavior itself, and then the consequence. By altering either the antecedent or consequence, we can help children alter behaviors and gain new skills. Watching out for warning signs is knowing what antecedents are likely to trigger a meltdown or other inappropriate behavior that you’re trying to target. Go into situations you know may be triggering prepared with tools to help reinforce when they engage in expected/appropriate behaviors.

In the event a tantrum or meltdown occurs, it’s important to wait until they are in a calmer place before initiating any sort of reinforcement. (They’re unlikely to be able to respond much at all when they’re in such a heightened, emotional state.)

When they do start to calm down and get a reign on their emotions: Praise them for it! This is positive reinforcement to. Praise them using their calm-down strategies (deep breaths, counting to 10, squeezing their palms, etc.). Then when they are truly calm enough to engage in meaningful communication, you can outline the terms of the reinforcement (i.e., three bites of dinner = 1 chicken nugget).

If you have questions about the difference between positive reinforcement and bribery and how best to implement positive reinforcement at home, our dedicated Cleveland ABA therapists can help.

Therapy & Wellness Connection – your connection to a life without limitations – provides ABA therapy to children in Akron, Cleveland, Brecksville-Broadview Heights and surrounding communities. We also offer summer camp, day programs, education services, vocational counseling and more. Call us at (330) 748-4807 or send us an email.

Additional Resources:

Applied Behavior Analysis, Autism Speaks

More Blog Entries:

How Our Cleveland ABA Therapists Teach Kids With Autism Personal Hygiene Skills, Aug. 11, 2022, Cleveland ABA Therapy Blog

Cleveland ABA therapists

Stimming with Autism: FAQ With Our Cleveland ABA Therapists

Our Cleveland ABA therapists are far from the only ones who are well-informed on the fact that restricted interests and repetitive behaviors are among the primary criteria for defining autism in diagnostic criteria. What is less common knowledge, however, is the fact that this can encompass a very broad range of traits that can appear in a vast array of varying combinations and with different levels of severity. Stimming, a common behavior among people with autism, can be generally be understood as a form of repetitive behavior – but it gets a little more complicated than that. And understanding WHY people do it is important to informing how we approach it in therapy, at home, at school, and in everyday life.

Repetitive behaviors are among the first to appear in very young children with autism. They’re often apparent for people across the spectrum, but they may be more obvious or pronounced in those with cognitive deficits. However, they are less studied (and therefore less understood) than the other primary identifier of autism: Social and communication difficulties.

What Exactly is Stimming – and How is it a Repetitive Behavior?

Stimming can be thought of as a subset of repetitive movements.

It can involve things like:

  • Spinning
  • Flapping hands
  • Snapping or flicking fingers
  • Twirling
  • Rocking
  • Repeated verbalizations
  • Fiddling with objects

They’re categorized as a repetitive behavior because the person engages in them over and over again in a given time or place.

Does Stimming Behavior Have a Function?

The word “stim” is short for “self-stimulatory behavior.” Some Cleveland ABA therapists and other professionals shy away from categorizing the function as solely self-stimulatory, there may be intensified pressure on the person with the diagnosis to suppress them. And this may not be a good thing because, as people with autism will often say themselves, stimming can serve important functional purposes to their own mental health and physical well-being.

This is important to note because historically, parents, teachers, and others have labeled stimming behaviors as “disruptive” or “inappropriate.”

But there’s a growing body of evidence that stims can help people with autism relieve themselves of sensory overload. In turn, this helps them better cope with intense anxiety, avoid meltdowns, and express their emotions.

Others say that engaging in stimming helps them to generate or hang onto a sense of body awareness. It may also help them focus their concentration when they’re feeling otherwise overwhelmed. Further, it may be a means of communicating their emotional or mental state to others when using words to do so is difficult.

So forcing kids not to engage in stimming may be unhealthy, ultimately causing more harm than good.

Of course, different people on the spectrum may have different purposes for different stims – and it may even shift from time-to-time in the same individual, depending on what’s happening around them.

In some cases, it can be harmful to themselves or others. For instance, if a repetitive behavior stim involves banging their head against a wall, that can’t continue.

There is also, of course, the potential for social alienation or academic/professional consequences for engaging in stims.

Should I Be Encouraging or Suppressing My Child’s Stimming?

This answer to this question truly comes down to the behavior, the individual, and the setting.

Years ago, the common consensus was to eliminate these behaviors – sometimes in ways that were extreme (and often incredibly harmful) such as powerful antipsychotic drugs or physical interventions.

It’s really important for parents, teachers, Cleveland ABA therapists to come together as a team to discuss whether certain stimming behaviors truly need to be addressed, or whether there’s an opportunity for better education/awareness/accommodations in service of what’s best for the child.

When there is a repetitive behavior stim that appears to be disruptive or if it’s preventing the person from participating in meaningful activities, educational opportunities, or relationships, then we may want to start by analyzing the function of that behavior. From there, we can figure out if there’s a way to help them meet their needs or serve that function without impeding their everyday lives.

For example, let’s say the stim is spinning in circles and it’s preventing a child from participating in their preschool class instruction and it’s disrupting the other students. We study the “why” of the behavior, and determine it’s helping the child to soothe their anxiety when their in the classroom and feeling overstimulated. We may be able to suggest another calming action or behavior that they can engage in that is less disruptive. Sometimes, having regular movement breaks and sensory input can help reduce this anxiety/need for the stim in the first place.

In that scenario, we do not categorize the stim as “bad.” In fact, we recognize it’s serving an important purpose. We respect and meet the needs of the individual with an alternative that helps them to still engage in their daily lives and avoid adverse consequences to their education and peer relationships.

If you have questions about your child’s stimming or how to handle it, our dedicated Cleveland ABA therapists can help.

Therapy & Wellness Connection – your connection to a life without limitations – provides ABA therapy to children in Brecksville-Broadview Heights, Cleveland, Akron, and surrounding communities. We also offer summer camp, day programs, education services, vocational counseling and more. Call us at (330) 748-4807 or send us an email.

Additional Resources:

Understanding Stimming: Repetitive Behaviors with a Purpose, Dec. 7, 2020, American Psychiatric Association

More Blog Entries:

5 To-Dos After Cleveland Autism Diagnosis, May 13, 2022, Cleveland ABA Therapy Blog

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Finding the Function of Behavior: Cleveland ABA Therapy Insight

When it comes to the science of behavior, the first question our Cleveland ABA therapy team wants to have answered is: Why?

Every behavior has a function. It is finding out the function of behavior that allows us to formulate effective intervention strategies to help change it. For our Northeast Ohio behavior analysts, determining the function of behavior is – without question – one of the most essential parts of this job.

Parents and caretakers also may benefit a great deal when they understand why a behavior occurs. We teach parents basic strategies on how to do this, allowing them to troubleshoot in the moment. This is important because when we don’t know the true cause of a behavior and our response is reactive, we may in fact end up reinforcing that behavior, unintentionally.

Why is my child face down screaming bloody murder in the grocery store when all I did was take his fingers out of his mouth? Why won’t my child stop throwing his food onto the floor when I’ve begged, coaxed, and even yelled at him not to do that?

It’s key to understand that there is a reason behind all behavior. All behavior has a function. If the goal is a different response or outcome, we must find out why the behavior is occurring in the first place. We must also understand unintentional reinforcements. For example, if the function of a behavior is to gain mom & dad’s attention (which is a pretty common function), then mom & dad yelling or having some big response to a behavior has the exact opposite effect of what they intended. They are unintentionally reinforcing that behavior – and that is going to take some time to undo.

Cleveland ABA Therapy Team IDs Top 4 Behavior Catalysts

When it comes to motivation for behavior, there is no one-size-fits-all. That’s why we are behavior scientists. We use tried & true methods to test our theories and hypotheses. We carefully study the ABC’s of behavior (antecedent, behavior, and consequence). What happened just before the behavior? What was the behavior itself? What happened immediately after? Then we see if tweaking the antecedent and/or consequence has any bearing on the behavior. If it doesn’t, we can keep trying different strategies, or we may have to adjust our initial theory about the function of the behavior (i.e., maybe the goal isn’t attention-seeking, but rather sensory input).

At our Cleveland ABA therapy clinic, we’ve identified the top four behavior motivations that can help provide parents with a good starting point in their own analyses. They are:

Attention. This is probably the most common behavior motivator. Here, a child will engage in a certain behavior because it gains them attention. Young kids are going to be constantly looking to seek parents’ attention, but it might also be teachers, therapists, siblings, peers, etc. And bear in mind: Not all attention-seeking behavior is the same. A child may shout out of turn in preschool. They may kick their parent from the grocery store cart. They may run away (knowing mom or dad will run after them & catch them).

Escape. Children often engage in avoidance behavior as a means of getting out of unwanted situations. “Escape” could mean throwing a tantrum to get out of brushing teeth before bed. It could be throwing non-preferred foods off their plate and onto the floor. It could be bolting out the door and down the street. Parents have to be really careful with this one because a common “punishment” is time-out – but if the motivation is escape, they’re unintentionally reinforcing this behavior.

Access. The child may be engaging in a certain behavior to get access to a desired thing or activity. An example might be if they rip a toy from their sibling’s grip, simply because they wanted it. Doing so gave them access – and immediate gratification.

Automatic. We might also call this “sensory motivation.” The child engages in this behavior mainly because it feels good. For kids with autism, this could mean flapping their hands, banging their head, spinning in circles, etc. These can be some of the toughest behaviors to tackle because there often isn’t a good “consequence” for these. We may need to look closely at whether these are behaviors we truly need to address, or whether it is harmless stimming/self-soothing.

Our ABA therapy team uses evidence-based methods to help determine the child’s motivation, but also use positive reinforcement to help them to find more appropriate responses.

Therapy & Wellness Connection – your connection to a life without limitations – provides speech therapy to children in Akron, Cleveland, Brecksville-Broadview Heights and surrounding communities. We also offer summer camp, day programs, education services, vocational counseling and more. Call us at (330) 748-4807 or send us an email.

Additional Resources:

Observing Behavior Using A-B-C Data, By Dr. Cathy Pratt, BCBA-D and Melissa Dubie, M.S., Indiana Resource Center for Autism

More Blog Entries:

5 To-Dos After Cleveland Autism Diagnosis, May 13, 2022, Cleveland ABA Therapy Blog

Cleveland ABA Therapy Strategies to Use at Home

Cleveland ABA therapy strategies to use at home

Parents are a key part of the puzzle when it comes to successful Cleveland ABA therapy for kids on the autism spectrum. Knowing how to work on the skills we target in therapy in a home setting is important for the sake of consistency, and helps those lessons to stick.

Applied Behavior Analysis, also known as ABA therapy, has been deemed the gold standard in autism treatment. It’s a branch of behavioral science that can be achieved either in-clinic or in-home by a trained therapist known as an RBT (registered behavior technician) and overseen by a Board-Certified Behavior Analyst, or BCBA for short.

It’s an evidence-based intervention predicated on the principles of behavior science, focusing on how people learn, behave, and change. A core foundation is what we call the “ABCs of Behavior.” That is, we study the antecedent, behavior, and then consequence – before determining what interventions will be most successful in addressing unexpected behaviors and promoting expected/helpful behaviors. Successful Cleveland ABA therapy helps improve kids’ quality of life, teaches them important life skills, and helps reduce disruptive behaviors.

As professionals, we’ve spent a great deal of time and dedication learning the science and strategies. That said, one of our key goals is to empower parents to implement similar tactics at home. Here, we detail a few of the basic strategies you can employ with your child across settings.

Positive Reinforcement

This is perhaps the most common strategy in ABA. Positive reinforcement is the idea that when something positive happens after a behavior (what we would refer to as the antecedent), it can have a positive impact on whether that behavior is likely to be repeated.

So a behavior followed by positive reinforcement is more likely to happen again – and continue happening.

Lots of parents use this strategy all the time with neurotypical kids. For instance, they do a chore, you reward them with an allowance. That motivates them to keep doing it.

ABA therapy Cleveland

With kids on the autism spectrum (or other conditions for which ABA therapy is prescribed), the reward usually needs to be more immediate, and perhaps more tangible. (Money is tangible, but its concept is a little abstract for some kids.) We may start small, especially for younger kids. Let’s say the LOVE blowing bubbles. If the goal is to get them to make a request for something, you immediately give them access to a few rounds of bubble-blowing after.

Depending on the targeted behavior and age/skill level of the child, there different reinforcement schedules we could choose from. These are:

  • Continuous schedule. The behavior is reinforced after every occurrence.
  • Fixed ratio. Behavior is reinforced after a certain number of occurrences (every 3, every 4, etc.)
  • Fixed interval. Behavior is reinforced after a certain amount of time (i.e., after 1 full week of expected behaviors).
  • Variable ratio. Behavior is enforced after varied number of occurrences (after one occurrence, then after four occurrences, then after two, etc.).
  • Variable interval. The behavior is enforced after a variable amount of time (after 5 minutes, then after 10 minutes, then after 2 minutes.)

You can discuss with your child’s ABA therapist what schedule they think would be most effective for targeting certain behaviors with your child.

Providing Prompts

Anytime you’re teaching your child something new, you can provide prompts. Lots of us do this naturally in parenting, but kids with autism and other conditions may need additional prompting to be successful.

There are many different kinds of prompts. For example, a physical prompt involves physically helping your child do something. A verbal prompt is telling your child something that will help them complete the task. If you provide a model prompt, you show them how to do it first. A visual prompt is a visual aid that helps your child complete the task. Gestural prompts are when you use body movements or gestures to help guide your child into completing something. Lastly, auditory prompts – like a stop watch or timer – that use noise can help support skill independence.

Cleveland behavior therapy kids autism

Some examples of prompts you can use at home:

  • Setting a timer to help your child transition from one activity to the next.
  • Providing your child with a visual schedule of the day’s routine, so they know what to expect.
  • Physically assisting your child with brushing their teeth.
  • Showing your child how to zip their coat.
  • Pointing to an object you want them to retrieve.

If you need some help with planning your prompts, our ABA therapy team can help.

Operant Extinction

This is the idea that a behavior that was previously reinforced (often unintentionally) can be decreased if we stop reinforcing it. Essentially, the goal is for your child to stop engaging in a certain behavior because they are no longer experiencing the same outcome as before. (Again, we’re focusing on changing the antecedent, or what happens immediately after the behavior.)

Keep in mind: All behavior is a form of communication. Your child communicates their wants, needs, and aversions with behavior. They may be trying to avoid certain non-preferred activities or foods. They may be wanting your attention. or they may be engaging in the behavior as a form of sensory input/avoidance. A behavior can be unintentionally reinforced when a child gets what they’re looking for by engaging in the behavior.

So let’s say a child has a temper tantrum that involves throwing themselves on the floor, screaming and crying. To quiet them down in a public place, you give them your phone. The child learns that engaging in screaming, crying, and laying on the floor, they are rewarded with game time. If you stop providing them with the phone when they engage in this behavior, eventually, the behavior will stop.

(Keep in mind, though: Temper tantrums are different than meltdowns, and may need to be approached a bit differently.)

Here’s another example. While seated in a grocery cart seat, your child kicks and hits you repeatedly. You get upset, use angry words and raise your voice. It continues to happen every time you go to the store. Eventually, you talk to your child’s ABA therapy team and determine the goal of this behavior is to get your attention. It doesn’t matter that the attention you provide is negative; you are still unintentionally reinforcing it. To achieve operant extinction, you must start to completely ignore this behavior. And then when your child is behaving in a way that is expected – lavish them with LOTS of attention and praise. By shifting the reward cycle, you can often change behavior.

Cleveland ABA Therapy Team Urges Consistency

The whole concept of rules and boundaries is based on the basics of behavioral science. In ABA, establishing rules – and then staying consistent – is imperative if you want to achieve better behavior.

Have a clear set of rules for each setting. These can start off very basic, such as “No hitting,” “No jumping on furniture.” But they can start to be more complex as your child progresses.

Break it down as much as needed. For example, it’s not just “house rules,” but “bathroom rules,” “bedtime rules,” “breakfast rules,” etc. Use visual schedules and auditory prompting, if need be. And then stay consistent. Kids who know what to expect are going to have an easier time behaving in a way that is expected.

If you have questions, our dedicated Cleveland ABA therapy team can help.

Therapy & Wellness Connection – your connection to a life without limitations – provides ABA therapy to children in Brecksville-Broadview Heights, Cleveland, Akron, and surrounding communities. We also offer summer camp, day programs, education services, vocational counseling and more. Call us at (330) 748-4807 or send us an email.

Additional Resources:

Treatments and Intervention Services for Autism Spectrum Disorder, U.S. Centers for Disease Control and Prevention

More Blog Entries:

5 To-Dos After Cleveland Autism Diagnosis, May 13, 2022, ABA Therapy Cleveland Blog

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Cleveland ABA Therapy Strategies

Cleveland ABA therapy

Approaches to Cleveland ABA therapy for children with autism can be varied depending on the provider. If your child is on the spectrum and you’ve been referred to behavior therapy by your pediatric specialist, it’s important to talk to the behavior therapy provider not only about the goals they have for your child, but the strategies they employ.

At Therapy & Wellness Connection, our strategies may need to be adapted for each child, but they primarily involve positive reinforcement.

The goal of our Cleveland ABA therapy services is to provide kids on the autism spectrum with the spills they’re going to need to be independent in all types of environments. We help lay the foundation, the building blocks, to help them learn – which in turn is going to help them not only function, but fully engage – whether that’s at home, in school, or pursuing their passions as they get older.”

-Jaclyn McClymont, Therapy & Wellness Connection Owner & Founder

The basics of ABA usually involve things like:

  • Learning to make requests
  • Waiting a reasonable amount of time to have that request fulfilled
  • Transitioning from one activity to another
  • Completing tasks
  • Accepting “No”
  • Following directions
  • Mastering skills relating to health, safety, and important tasks needed for learning

Typically, we start with a functional behavior assessment, which helps us determine which behaviors we want to target for extinction, and which we want to promote/encourage.

Wherever possible, our Cleveland ABA therapy team will work to ensure that the “why” of what we’re learning makes sense to the child. So if the goal is for them to be able to put on their own jacket, we avoid initiating that task randomly. We do it, for example, to prepare to go for a walk or some other task.

We offer our services both in-home and in-clinic. In both cases, we try to use as many real-world examples as possible. So for example, if we’re trying to teach a child how to get ready to eat lunch, we want to give them opportunities to do things like choose their spoon from a kitchen drawer, as opposed to pointing to a flashcard of a spoon.

Understanding Antecedent-Based Interventions

One technique we frequently employ in our Cleveland ABA therapy sessions involve antecedent-based interventions.

To explain how this works, it’s helpful to understand how ABA therapy views learning. That is, we focus on a three-stage process referred to as the ABCs of behavior (Antecedent –> Behavior –> Consequence). The antecedent looks at what happens immediately before the behavior, what triggers it. Then we analyze the behavior itself. From there we look at the consequence, or what happens immediately after that may be enforcing it (intentionally or unintentionally).

For example, let’s say your child has major meltdowns while you’re making dinner. The antecedent may be their own hunger. The behavior is their meltdown. This may be unintentionally reinforced by a consequence of giving them a high-sugar snack, right before dinner.

As ABA therapists, we look at whether the behavior can be modified by altering the antecedent or consequence. We may modify the environment to reduce triggers. We may identify when bodily needs are triggering the behavior (hunger, fatigue, overstimulation) and work to address those. For example, a child who is overstimulated may need a movement break/exercise/quiet time at certain times of the day or when certain things are happening – to be able to better cope and avoid meltdowns.

In addition to modifying the child’s learning environment, another antecedent-based intervention is to give a child choices. Rather than asking a child to complete a worksheet, we may give them a choice: Worksheet A or Worksheet B. Having a choice helps children to feel more confident and in-control – and increases the odds they’ll complete the task, rather than defiantly saying no.

Finally, we may engage children using motivating items, such as a toy, a favorite food, or a game/activity.

Consequence-Based Interventions and Extinction

And we also look at altering the consequences, or reinforcement. Parents and other caregivers sometimes unintentionally reinforce unexpected behavior with a “consequence” like time out or verbal admonishment that actually gives the child what they want (a break, attention, etc.). They may not necessarily see it as “negative,” even if it’s carried out in that context.

Redirection is one that we use frequently. It’s when we distract a child from a problem behavior, drawing their attention to a more appropriate solution/behavior.

Therapy & Wellness Connection – your connection to a life without limitations – provides ABA therapy to children in Brecksville-Broadview Heights, Cleveland, Akron, and surrounding communities. We also offer summer camp, day programs, education services, vocational counseling and more. Call us at (330) 748-4807 or send us an email.

Additional Resources:

Applied Behavior Analysis, Autism, and Occupational Therapy: A Search for Understanding, July/August 2016, The American Journal of Occupational Therapy

More Blog Entries:

ABA Therapy Explainer: What’s a Functional Behavior Assessment? March 9, 2022, Cleveland ABA Therapy Blog

ABA Therapy

ABA Therapy Explainer: What’s a Functional Behavior Assessment?

When your child starts ABA therapy, there are a lot of vocabulary words and acronyms that seem to get thrown around, and it can take some type to truly get a grasp on it all. Functional Behavior Assessment, or FBA, is the one we’re going to focus on here.

A Functional Behavior Assessment is one of the primary ways our behavior therapy team works to identify a certain problem behavior, and then we develop a plan to address them – ultimately eliminating them or at least reducing them to a point they aren’t so prevalent.

Going through the process step-by-step helps our Cleveland ABA therapy team to get to the source of the behaviors so that we can start introducing replacements. The problem with trying to tackle a problem behavior without an FBA is that then you lack the “why.” WHY were they engaging in that behavior in the first place? Every behavior has a function. Trying to effect the extinction of a behavior without first figuring out its function is going to create a gaping opportunity other difficult behaviors to take root in its place. An FBA helps us figure it out first.

FBAs can be used in IEPs or as part of an ABA program. We only initiate them when the behavior has become an impediment. We’ll be looking at it as a team – in collaboration with parents too – to assess whether it’s urgent (is there a risk of harm to self or others?), whether there’s an underlying medical reason, whether it’s cyclical, and if it appears to be new or if this is a long-standing issue that has maybe just gotten worse. Finally, we want to know if this is something that is happening on a consistent basis. If it was a random, one-off reaction to a substantial – and uncommon – change in the environment, we probably don’t need to develop a plan to treat that, though we may note it. In cases where there may be multiple unexpected and detrimental behaviors, we’re likely to target them one at a time, beginning with the one likely to have the most significant adverse outcomes.

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Akron ABA Therapy Insight: Introducing a Child With Autism to New Foods

Some people call it “picky eating.” Others call it “selective eating” and struggling with “food aversions.” Any way you slice it, lots of kids go through it. It’s an especially significant challenge for children with sensory processing issues, as is the case for many on the autism spectrum. Our Akron ABA therapy team (and our occupational therapy team, as well) can offer insight into how to help your child gradually overcome some of their food aversions and incorporate a more varied, healthier diet.

Akron ABA Therapy Tips to Tackle Picky Eating

Selective eating can take a lot of different forms. Every child is going to be different, so it’s best to consult with your child’s ABA therapy and/or occupational therapy team before initiating any of these strategies, particularly for a child on the autism spectrum.

That said, here are a few ways we might advise introducing new foods and/or increasing the variety of foods your child eats at home.

  • Pair non-preferred foods with preferred foods. Try putting the food they won’t eat on the same plate with a food they love. If they’re having a hard time even tolerating that, put a “no thank you” plate or bowl next to their eating plate. This way, they still have the opportunity to see, smell, and touch the food, which is really the first step toward getting it anywhere near their mouth. But continue to encourage them to try it. Let them see you eating – and really enjoying – it.
  • Change up food consistency. If your child consumes lots of liquids but struggles with solids (due to sensory issues and not oral motor function, which is a whole separate issue that should be addressed with feeding/swallowing therapy), try blending some non-preferred foods into liquids. Or if your child loves popsicles, try making them out of certain fruits you would like to see your child eating more of. Offer thin apple slices instead of apple sauce or whole apples. If your child tolerates the different texture, you can slowly experiment with others.
  • Alter the size of the food. Sometimes big pieces can seem visually overwhelming as much as the taste or texture of the food itself. Maybe your child isn’t going to gobble up a huge piece of broccoli, but they might bird-peck at some bite-sized pieces. You can always slowly increase the size as your child eats more of it. (If your child is very picky about the size/shape of the foods they eat, try starting by slowly mixing it up with their preferred foods; get them used to tolerating changes on their plate.)
  • Mix foods together. If your child is super into applesauce but you’d like them to eat yogurt, try mixing the tiniest bit of yogurt into the applesauce. See how it goes. If your child loves pizza but loathes vegetables of any kind, try mixing the tiniest bit of cooked, blended vegetables into the pizza sauce. If they tolerate it, you can slowly (very slowly) change the ratio.
  • Dish up positive reinforcement. Set up a preferred food or positive activity ahead of time. Then encourage your child to take a tiny bite of the non-preferred food. Don’t make it a battle, but if they do it, immediately give them their preferred food/positive activity and heap on a big helping of praise.
  • Model. Don’t underestimate the power of modeling good eating habits. Have the foods you’re hoping your child will eat in the house and regularly available to all family members. Make sure your child sees you and others in the home modeling healthy eating behavior.
  • Take it slowly. Lots of kids take time to get used to certain foods. Consider there were lots of things you couldn’t stomach when you were a kid that you may love now. (And maybe a few that still make you cringe.) Kids on the spectrum and other picky eaters need more time than most to incorporate different foods into their diet. Often, taking a bite is too much to ask to start. Begin by having them play with it, tolerate it on their plate, smell it, lick it. With no pressure and lots of positive reinforcement, you can slowly encourage them to try new foods one morsel at a time.

Therapy & Wellness Connection – your connection to a life without limitations – provides ABA therapy to children in Cleveland, Brecksville-Broadview Heights, Akron and surrounding communities. We also offer summer camp, day programs, homeschooling, alternative schooling, virtual therapy and education, vocational counseling and more. Call us at (330) 748-4807 or send us an email.

Additional Resources:

SOS Approach to Feeding

More Blog Entries:

Sensory Meltdown vs. Tantrum: What’s the Difference? Akron OT Explains, Jan. 20, 2021, Akron ABA Therapy Blog

Brecksville ABA therapists

ABA Therapists: Helping Your Child With Autism Transition Back-to-School

Summer vacation has FLOWN by far too fast this year! Soon, we’re going to start seeing those bright, yellow school buses rolling through our neighborhoods as the new school year begins. Our Brecksville ABA therapists know this has been a unique and trying few years for many kids – and families. As it is, transitioning from summer break to another school year can be especially challenging for children on the autism spectrum.

A key goal for our pediatric ABA therapists and occupational therapists at Therapy & Wellness Connection is to help facilitate smoother back-to-school transitions. These can undoubtedly be difficult, but preparing ahead of time can make for a much easier ride into the next school year.

ABA Therapists’ Tips to Transition to Back-to-School

Some strategies you may consider implementing:

  • Talk to your child – a lot – about what to expect in the coming school year. This can truly go a long way in reducing your child’s anxiety.
  • Get a visual calendar. Some kids on the spectrum struggle with anxiety about when school will start and the changes you discuss will become reality. Just getting a simple calendar and physically crossing off the days will give your child something they can better conceptualize.
  • Start practicing your school year routine. Start by waking him/her up a bit earlier than what they’ve become accustomed to over the summer. Do a few practice runs of what your morning routine will be before they leave for school. Having a visual schedule for this might be helpful as well – noting everything from waking up to brushing teeth to getting dressed to eating breakfast to getting on shoes and coat.
  • Ask to take a tour of the school. Reach out to the school principal or your child’s IEP team. You might not get to meet the teacher, but at the very least, maybe you can arrange a tour of the building so your child can get acquainted with all the important spots (library, bathrooms, main office, playground, cafeteria, gym, etc.). Consider taking pictures that you can use for visual schedules or social stories throughout the year, if need be.
  • Discuss emergency procedures ahead of time. Lots of children on the autism spectrum struggle with sensory issues related to noise volumes and unexpected breaks in routine. But of course, schools have fire drills and tornado drills as a matter of safety. Talk about this ahead of time with your child’s teacher, IEP team and your child. Point out where they will go and what will happen. Maybe keep headphones in a handy spot in case the noise of the alarms is too overwhelming.
  • Make a visual daily school schedule. Lots of teachers of younger students already do this, but if you’re child is a bit older, they may not. Creating a general, visual schedule of what occurs in a typical day may go a long way in reducing anxiety.
  • Send the teacher a note explaining a bit about your child – their strengths and weaknesses, sensory struggles, dietary restrictions and most effective reinforcements. Maybe your child can even help. This will be invaluable for the teachers and other staff. Make sure to include positive things about your child. Providing copies to the principal, aides, therapists, bus driver, music teacher, gym teacher, art teacher, etc. can be very helpful when it comes to the strategies they use to educate your child.
  • Allow them to take their favorite sensory item with them the first day or even week. Kids coping with sensory overload can find great comfort in certain objects (fidget spinners, squish toys, stress balls, etc.). If that’s true for your child, consider allowing them to take one of their favorite items with them – and make sure your child’s teacher, bus driver, aides and others are aware of it and why your child has it.
  • Meet the bus driver. If at all possible, see if you can take a quick tour of one of the school buses.
  • Write a note of thanks. If the first several weeks go well, let the teachers and other staff know how much it means to you that they’ve helped facilitate a smooth transition!

Finally, don’t be afraid to ask for help. If you have any questions about how to ensure your child has a smooth transition into the 2021-2022 school year, our Brecksville ABA therapists and occupational therapists are available to help you find solutions!

Therapy & Wellness Connection – your connection to a life without limitations – provides ABA therapy to children in Cleveland, Brecksville-Broadview Heights, Akron and surrounding communities. We also offer summer camp, day programs, homeschooling, alternative schooling, virtual therapy and education, vocational counseling and more. Call us at (330) 748-4807 or send us an email.

Additional Resources:

Helping kids with autism transition back to in-person school: 10 tips, UC Davis Health

More Blog Entries:

Brecksville ABA Therapist Insight: Autism and Self-Injurious Behavior, June 21, 2021, Brecksville ABA Therapy Blog

behavioral regulation ABA

Study: Behavioral Regulation Difficulties Linked to Sleep Problems Among Kids With Autism

A new study found that difficulty sleeping – a common problem for children on the autism spectrum – is associated with behavioral regulation difficulties later in childhood. This longitudinal study drives home the importance of helping families address the sleep problems kids with autism have as early as possible.

Of course, this isn’t entirely shocking news to our Brecksville ABA therapy and occupational therapy team. It’s been well-established that getting high-quality sleep is key for everyone’s general health. A child who isn’t well-rested (just like any adult) is going to be cranky and more tantrum-prone. Still, the research sheds additional light on how vital it is for doctors and therapists to provide the support and tools to help children with autism struggling with sleep issues. In turn, this may help foster improved behavioral regulation as they get older.

The analysis, published in the journal Sleep and reported Spectrum News, is one of the first studies to look closely at the long-suspected connection between executive function (mental skills that include the ability to manage one’s own behavior to achieve certain goals) and poor sleep quality among children with autism.

Of course, many kids have sleep troubles the first few years of life. These too are associated with lower executive function, but these typically resolve after a few years. Children with autism are known to be more likely to suffer from long-term sleeping problems, which many researchers had previously opined were connected to poor executive function.

This study, which began in 2005, followed 217 children with autism, starting between the ages of 2 and 4 and then again several years later. The children’s executive function, as reported in surveys by parents and teachers, were evaluated four times when they were between the ages of 7 and 12.

What they found was severe sleep troubles were linked with reduced ability to regulate behavior. Interestingly, other types of executive function (ability to order their own thoughts, reflect on them, etc.) didn’t appear to be tied to sleep trouble.

Further, researchers concluded the age at which sleep disturbances occur can make a difference. For instance, kids who struggled to fall asleep between the ages of 2 and 4 didn’t have any behavior regulation issues a handful of years later. But when kids were taking a long time to fall asleep when at the ages of 6 and 7, they showed noticeable behavior regulation issues the following year. As for why this is, study authors opine it may have something to do with the fact that many kids between the ages of 2 and 4 wake up frequently, whereas older kids typically don’t.

It’s important to note the study doesn’t clearly indicate a causal relationship between poor sleep and reduced executive function, though that is what many researchers suspect. It’s probable, though, that executive function is impacted by a variety of factors, sleep patterns included.

Our Brecksville pediatric occupational therapists have several strategies we can share to help your child with autism get a better night’s sleep. These include addressing sensory seeking or avoiding behavior (weighted blankets, looser pajamas, developing bedtime routines and social stories, etc.), managing the child’s physical environment and helping families adjust their schedules to make for smoother transitions.

Therapy & Wellness Connection – your connection to a life without limitations – provides occupational therapy to children in Cleveland, Brecksville-Broadview Heights, Akron and surrounding communities. We also offer summer camp, day programs, education services, vocational counseling and more. Call us at (330) 748-4807 or send us an email

Additional Resources:

Autistic children’s sleep problems linked to behavioral regulation issues, July 5, 2021, Spectrum News

More Blog Entries:

How Occupational Therapy Can Help Treat Children With Sleep Problems, Feb. 15, 2020, Brecksville Occupational Therapy Blog

 

Akron ABA therapists

ABA Therapists Can Help With Autism Food Aversions

Mealtimes are awash in rich sensory experiences, with an array of smells, temperatures, textures, sounds, tastes and interactions. Most people enjoy mealtimes and sharing these experiences with loved ones. But our ABA therapists recognize that for children on the autism spectrum, mealtimes can present significant sensory challenges, leading to stress, sensory overload and meltdowns. Difficulties with communication can pose additional challenges for everyone.

Of course, it’s not uncommon for any child to be picky at times, but kids on the autism spectrum may be highly sensitive not just to something’s flavor, but its texture, shape, smell and color. They may have a strong preference for a very small selection of foods, and might even have an overwhelming need to eat those same foods on the same plate or in the same place at each meal.

You may notice that people with autism sometimes develop their own strategies to limit their sensory input during mealtimes. They may become:

  • Overly selective in their foods.
  • Inflexible in their mealtime routines.
  • Refuse to eat/eat limited amounts.
  • Prone to escape (elope, cover their ears, eyes, nose and/or mouth).
  • Repetitive in their behaviors to self-soothe.