Cleveland ABA therapy
Choosing the Right Cleveland ABA Therapy Provider for Your Child With Autism
ABA therapy is widely considered the gold standard treatment for children on the autism spectrum – and it’s particularly valuable when it’s intensive, starts early, and is combined with other critical interventions, such as speech therapy and occupational therapy. That said, finding the right Cleveland ABA therapy provider for your child can seem daunting – particularly if you’ve already had a negative experience.
When implemented appropriately, ABA has proven unequivocally to help children learn invaluable skills in areas like communication, self-regulation, social interactions, and self-care. It is our firm belief and practice that the best form of ABA therapy is naturalistic, play-based, and enjoyable for the child. That’s not to say we don’t challenge our patients. We do, as it’s necessary for them to gain the skills we’re trying to teach them. However, sessions that are too intense, rely too heavily on negative reinforcement, or use goals that are beyond what is realistic for a child will not only yield less progress, they may actually set your child back.
The unfortunate reality is that not all ABA therapists are cut from the same cloth, and not all clinics hold themselves to the high standards that we do at Therapy & Wellness Connection. Unlike more established fields like speech-language pathology, occupational therapy, or physical therapy, ABA therapy is less regulated.
Certified behavior analysts, or BCBAs, do have an intensive credentialing process. Among the requirements for BCBAs:
- Earn at least a master’s degree or doctoral degree in Behavior Analysis or related field such as psychology or education, with a focus on behavior analysis – with courses covering ethical conduct, principals of behavior analysis, research and data analysis, problem identification & assessment, intervention consideration, implementation management, etc.
- Complete a minimum 1,500 hours of relevant, supervised experience in an ABA setting.
- Pass a national certification exam.
- Apply for certification with the Ohio Board of Psychology.
- Attend a Pre-certification workshop and exam on Ohio ABA regulations (as detailed in Chapter 4783 of Ohio Revised Code and the Ohio Administrative Code).
- Renew COBA certification every two years (which requires proof of at least 23 hours of continuing education, with a minimum 4 hours of training in ethics, professional conduct, or cultural competency).
While these standards align with what one might expect in a field of professionals working one-on-one with children who have complex behavior needs and challenges, the same is not true of registered behavior technicians, or RBTs. And it’s RBTs who primarily administer Cleveland ABA therapy – under the supervision of a qualified BCBA.
RBTs are paraprofessionals. They are required to meet the basic eligibility requirements (at least 18-years-old, have a high school diploma, pass a background check, complete 40 hours of training, complete an initial competency assessment), then apply, take & pass the RBT exam, and then maintain their certification with ongoing supervision, adherence to ethics, and annual renewal. So where as it takes hundreds and lots of education to become a BCBA, RBTs are providing the frontline care with 40 hours of training.
Of course, there are many RBTs who are excellent and provide stellar ABA services to their clients. There is ample scientific data supporting the value of ABA in general. But as the number of autism diagnoses has risen steadily over the last two decades (the CDC estimates 1 in 44 children has an autism diagnosis), so too have the industries that serve them. Not every provider or clinic is as rigid about who they accept or how much oversight they receive. That can compromise the quality of care, as the value of ABA therapy rests heavily on who is administering it.
All of this can feel overwhelming for parents looking to find the best possible treatment for their child.
Our TWC Cleveland ABA therapy team has some questions parents can ask to determine whether a clinic/ABA therapy provider is right for your child:
- What is the ratio of BCBAs to RBTs at your clinic? The lower the ratio, the better, but there may be some variation depending on their patients’ severity level.
- What training and expertise does your staff have? As mentioned before, BCBAs must have extensive education and training, and they are the ones who will be developing treatment plans for your child. But it’s the RBTs who will be implementing them. Ask whether the providers encourages staff to undergo ongoing training. Inquire whether they have direct experience with your child’s specific challenges and needs.
- What types of intervention are used in your ABA clinic? ABA therapy is not a one-size-fits-all approach. There are actually many different ways to administer this research-based treatment. Ask the provider about their therapy philosophy and approach. Some tend to use more discrete trial training (which is more systematic and usually involves a child sitting at a table) while others prefer a more natural, organic approach to learning. Some therapy clinics will use both, depending on the child. You will also want to know whether they use positive reinforcement. “Punishment” or negative reinforcement may be effective in altering behaviors, but it’s not necessarily the best approach – especially because when there is potential for it to be over-used or abused. Positive reinforcement should be the primary approach.
- Does your clinic provide any other specialized services? Children on the autism spectrum may be prescribed a number of treatments, including speech therapy and occupational therapy. They may also benefit from tutoring, homeschooling, social skills groups, specialized therapies (music, equine, etc.), etc. It can be very helpful for these kids to have a “one-stop-shop” for these services. Therapy & Wellness Connection is one such place where kids can receive multi-disciplinary services and interventions.
- What is the treatment plan? Treatment plans must be created specifically for your child, depending on a functional behavior assessment. The plan should include both proactive and reactive strategies to manage and reduce problematic behaviors and encourage socially appropriate behaviors/responses. Ideally, the plan of care is going to have clear functional goals and objectives that identify age-appropriate challenges that are both engaging and fun for the child – and most likely to be generalized into other environments. It should also include parent involvement and training, to some extent. The more carryover we can get across environments, the better.
- What sort of safety measures are in place at your clinic? You as a parent want to know what measures are taken to prevent abuse, what the procedure is for reporting concerns with parents, how often parent observations are allowed, how inappropriate/excessive/dangerous behaviors may be dealt with, etc. You also want some insight into how secure the facility/session will be, particularly if your child is at high-risk for self-harm or elopement.
If your child has been diagnosed with autism and referred to Cleveland ABA therapy providers for services, our team at TWC can help answer any questions you have about our staff, our facility, our philosophy, and our practice.
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:
Low standards corrode quality of popular autism therapy, By Emily Sohn, Oct. 28, 2020, Spectrum News
More Blog Entries:
Cleveland ABA Therapists on Differences Between Bribery vs. Reinforcement, Sept. 10, 2022, Cleveland Behavior Therapy Blog
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
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
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.
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.
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
Cleveland ABA Therapy Strategies
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 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.
Brecksville ABA Therapists Offer “Time-Out” Alternatives
As Brecksville ABA therapists, our focus is on the study of behavior. When it comes to children with autism and other conditions, the interest is not only on what the challenging behavior is, but what the motivation – or function – is and how caregivers may be unintentionally reinforcing it. This brings us to the ever-popular approach of time-out.
You’re almost certainly familiar with the “time-out” strategy because it’s very popular. As explained by the CDC, timeout is when a child is removed from where the “misbehavior” occurred – deprived of fun, attention, or some other desired activity. Time-out is used for things like breaking a rule or not following a direction after a warning. It’s effective for lots of neurotypical kids because time-out is boring, and kids don’t usually like to be bored.
However, timeout isn’t effective for addressing all behaviors, and it’s may not be effective for every child. For children with autism spectrum disorder or developmental delay or some other disability, time-out can provide a safe space for them to work on calming themselves. However, it’s not going to be effective if:
- The child is aggressive or using self-injuring behavior.
- The child’s goal is to avoid the activity or interaction with others.
In both of these cases, time-out might inadvertently reinforce the challenging behavior. In the case of self-injurious behavior, putting them in a space alone isn’t likely to stop it. If the child’s goal is to avoid interaction or a non-preferred activity, time-out actually gives them what they want. In effect, adults may be inadvertently giving them a reason to engage in challenging behaviors to achieve the goal of getting in time-out.
Brecksville ABA Therapists’ Tips on Navigating Thanksgiving
Lots of families look forward to celebrating the holidays each year, with Thanksgiving being a particular favorite. But as our Brecksville ABA therapists understand, parents of children on the autism spectrum may be worried that such celebrations are far outside their kids’ comfort zones. After all, the goings-on are seemingly chaotic, and many of the faces, smells, and tastes are not part of the daily routine they’re used to.
The good news is that with some preparation, it is possible for everyone to enjoy these gatherings.
How Our Brecksville ABA Therapists Teach Flexibility
Flexibility is the quality of bending without being easily broken. Our Brecksville ABA therapists know that for kids on the autism spectrum, being emotionally flexible is an incredibly difficult – but critical – skill for success.
It’s not just kids with autism. Flexibility doesn’t come naturally for lots of people. Many of us are creatures of habit. Flexibility is something that must be learned. But it can be much harder for those on the spectrum to master this. In fact, autism is defined as being characterized by restricted, repetitive patterns of behavior, interests, or activities. It’s part of the diagnostic criteria for autism, and it’s manifested with insistence on inflexible adherence to routines, sameness, and ritualistic patterns of verbal/nonverbal behavior. Even the smallest changes can trigger a meltdown.
But why is this so important? Because change is a part of life. Realistically, no one can indefinitely eat the exact same thing, watch the exact same show, or be in the exact same place with the exact same people all day every day. And to whatever extent you may be able to help ensure continuity of certain patterns or routines, our ABA therapists recognize that helping kids on the spectrum learn to adjust to change will ultimately lead to them being happier, healthier, and more independent.
How Do Brecksville ABA Therapists Teach Flexibility?
Because rigidity is a characteristic of autism, intervening and treating it must be done very carefully. We’re not looking here to turn an inflexible person into a flexible one. What we want is to help each child learn to better adapt to a world that is ever-changing. The world is never going to be constant. There will be things outside of their control, and it’s important that they learn to cope when that happens.
Unlike many other life skills, flexibility is a bit more of an abstract concept. As such, it can be a bit tougher to teach. Our ABA therapy team focuses on stretching their tolerance to routine changes and then providing consistent, positive reinforcement where see it.
For instance, a child may love playing a certain game at therapy. We might start with testing their insistence to always play as the same game piece. Anytime they show increased flexibility, we reward that positively. We might eventually move to playing a different game altogether. The goal is for the child to ultimately adjust more easily (and without challenging behaviors) to unexpected changes in their routine. They can maintain a sense of assertiveness about what they like or what they want while still learning to calmly accept other changes. In other words: Greater flexibility.
Our ABA team also works with many of our clients in the real world, to teach them flexibility strategies to better tolerate change where they are most likely to encounter it.
It’s important that we’re not just tearing them away from rituals and patterns. We are first looking at behaviors we want to replace. That often means early on teaching them to request what they want, to wait for what they want, to self-manage big emotions (namely, anger and disappointment) and to problem solve. We do all this by intentionally, systematically introducing change in ways that are controlled – and then teaching them these skills one by one over time.
It’s important that when they are triggered, that we teach them a workable “plan of action.” This is going to highly depend on the individual, but the gist is to empathize (this is important) and then give them tools to help them de-escalate. This could be deep breathing, it could be squeezing a stress ball, it could taking a break. It’s important when we’re teaching flexibility to remind them that even when situations do shift unexpectedly, there are still things that are unchanged or that they can control. Empowering them to focus on those can go a long way toward improving flexibility in tolerating the larger changes occurring.
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:
Signs and Symptoms of Autism Spectrum Disorders, U.S. Centers for Disease Control and Prevention
More Blog Entries:
ABA Therapists: Helping Your Child With Autism Transition Back-to-School, Aug. 12, 2021, Brecksville ABA Therapists Blog
Cleveland ABA Therapy Insight: Helping Your Child Wear a Face Mask
Wearing a mask has become required in many stores, restaurants, public event sites and schools. But complying with these mandates can be very difficult for children with disabilities and/or sensory processing needs. But our Cleveland ABA therapy team knows that doesn’t mean they cannot learn to overcome these aversions, particularly when it is a public health issue.
School districts across Ohio have various degrees of restrictions (some remain closed with only virtual school provided, others give parents the option to participate in virtual or in-person schooling and some are fully open). But just recently, the CDC released a series of guidelines for what it will take to safely re-open schools. As The New York Times reports, “the point of most agreement (among pediatric experts) was requiring masks for everyone: students, teachers, administrators and other staff. All respondents said universal masking was important, and many said it was a simple solution that made the need for other preconditions to opening less essential.”
If your child struggles with mask-wearing, our Cleveland ABA therapy team can help by incorporating it into our sessions, little-by-little, with positive reinforcement. But there are also ways you as a parent can help your child with this as well.