Colorado ABA Therapy and the ABA field have been hit hard by COVID-19. Our frontline heroes have been doing their best to continue to provide high quality therapy services while following the health orders from the state and federal government. We are still here to support you and your family during this time!
Just how has COVID-19 affected us and our field?
We closed down our early intervention therapy center in March 2020.
Several other ABA providers in the Denver Metro area have also closed permanently or temporarily.
Some services had to be moved to telehealth in order to reduce foot traffic within the homes.
Many families needed to pause ABA services due to the increased health risks of their children and other family members.
Some families still have not been able to restart services with their provider.
Some insurance companies did not allow for telehealth ABA services, therefore, those services were temporarily paused or canceled.
ABA professionals have had to change their direction due to family members being sick, spouses losing jobs, or just wanting to be closer to home.
ABA has had to adapt to a whole new service delivery model utilizing telehealth.
What is Colorado ABA Therapy doing to keep our services going AND overcome this pandemic stronger than before?
First and foremost, we don’t give up! We understand our services are essential for your child’s success. That’s why we still provide in home 1:1 services.
Our RBTs have stayed committed to our mission to provide great services in home despite the risks.
Our BCBAs and BCaBAs have rose to the occasion to support our families by completing continuing education and ethical trainings about telehealth.
We have utilized any and all government available assistance to maintain the services we do have in place.
Our therapists follow safety guidelines during therapy to include PPE, increased hand washing, cleaning materials, and completing health screenings before each session.
We are looking for new therapists to join our team! We know the unemployment rates are high right now, so we are doing our part to hire and train new and experienced staff members.
We are so very proud of our professionals and we look forward to a bright future in 2021!
When the doctor gives a parent a referral for ABA Therapy, the most common response is, “What is that?” Without any further guidance, you go home to sit at your computer and type in the only phrase you know, “ABA therapy”. Up comes page after page of resource centers, providers, informational websites, blogs, Facebook pages, and everything in between which you are expected to sift through in order to find the best fit for your child. This is the point at which most parents become overwhelmed, confused, lost, and end up feeling around in the dark as to how this whole process comes together. It can be an overwhelming maze for parents to find the right services they need for their child. You need to know the key elements and questions to get where you need to go.
In this article, we are going to look at how to streamline your search using key community resources, understanding the different types of ABA service providers, and key points you should be looking for in an ABA provider.
Community Resources
Community resources are the best first step in your search for service providers. Most have resource pages with lists of providers in the area all in one place. In the Denver metro area, here are a few to check out:
Autism Society of Colorado
Autism Speaks
Colorado Department of Health Autism Resources
Colorado Community Center Boards
Some of these organizations can also connect you with additional service providers such as Speech, Occupational Therapy, Physical Therapy, and Respite care.
Types of ABA Providers
Although all ABA providers have the same type of services, they are not all alike in their practices, service locations, and program tools. It is important for parents to understand their child’s needs and discuss them with each provider to find the right fit. Here are some major points of interest you should know about each provider you choose to interview:
In-Home, Center-based, community based, or a combination
Age range for services
Specialties within the clinic i.e. non-verbal, high behavior
Specialties in teaching methodology i.e. natural environment or teaching at a table
Each of the above options gives the provider strengths and weaknesses within their therapy practice, which makes your choice as a parent even more important in finding the right fit for your child. For example, if you child is in need of intensive therapy for high behaviors with more than 4 therapy hours per day, a center-based program may be most appropriate. Likewise, if your child needs therapy to prepare for independent living, a community-based approach would be most beneficial. Another example would be if your child needs intensive instruction that can only be taught in a highly structured setting. You would want to find a provider who focuses on what is called Discrete Trial Training, where skills are typically taught at a table similar to a classroom.
Evaluating Potential Providers
Once you have selected the providers you are interested in, it is best to have an idea of what qualities to look. You should also be prepared with questions you would like to ask each of them in order to compare their services.
Here are the top questions you should ask when choosing the best provider for you:
What type of assessments do they use?
Here we are looking for standardized assessments such as ADOS-2, Vineland, VB-MAPP.
Do they offer parent training?
How is it structured? It is covered under your insurance policy?
What types of service levels do they offer?
Do they have small groups, trainings, consultations, IEP support, or advocacy?
What are their emergency policies?
Most companies use physical restraint programs all of which are different.
How many therapists are assigned to each family?
The lower number on your team the better.
How does your scheduling work?
Some providers will have therapy only Monday through Friday while others do weekends and nights.
Desired Qualities in an ABA Provider
Have a good rapport within the community and other families.
Respond promptly to all calls and/or emails.
Have a means of contacting the owner directly
Give timely reports and updates of progress
Have continuity of care, i.e. consistent staff members; collaborate with other providers the child may be seeing.
Data is collected and reviewed with you after each session
Training is provided consistently to all staff
Have more questions? We would love you help you! You can set up an appointment with us by email at admin@coloradoabatherapy.com or find us on Facebook to request an appointment.
This is the number one question parents ask in the field of ABA.
Why is she acting this way?
Why is he hitting his friends?
Why won’t he stop screaming?
All behavior follows a predictable pattern when using the right roadmap. Our roadmap in ABA is written using the acronym ABC:
Identifying the ABCs in our everyday lives:
1. Antecedent
These are the triggers that cause behaviors. Parents can usually pick out this part of the roadmap pretty easily:
Every time my child is asked to share he… Every time I tell her to clean her room she…
More often than not, antecedents can be observed right before the behavior occurs. Understanding this section of the ABCs will help us better identify when behaviors happen.
2. Behavior
This may be the easiest one to identify. This is the stand out action and main focus of what we want to influence in the child. Behaviors include crying, screaming, punching, and fidgeting. It is also important to identify appropriate behaviors that we wish to encourage. This can include following directions, sharing, kind words, and manners.
3. Consequences
Consequences can take a little bit of self-awareness to recognize. This happens directly after the behavior. When a child is screaming, crying, or hitting, what is our natural response? How we react to behaviors can show us the consequences we impose.
Consequences can also tell us what the child wants from engaging in the behavior. This could be attention from you, access to an item, escape from an activity or person, or simply because it feels good.
When looking at this roadmap, you may be surprised at what you find!
Let’s look at a few examples!
In this scenario, Julia is alone and wants her mother’s attention. Since Julia does not have her mother’s attention, she decides to implement a behavior (throwing her toy) as a response to her lonely play time. Julia’s mother then comes over to play with her. Julia now has her mother’s attention and will no longer throw the toy.
But here’s the catch!
We know that consequences will either encourage or discourage certain behaviors in the future. In this example, the consequence (Julia’s mother coming over to play) encouraged the behavior (Julia throwing the toy) to occur again!
Next time Julia wants attention, she will be more likely to throw a toy again in order to receive it, since this method has worked for her in the past.
So, what do we do?
In general terms, we prompt! Every case is unique and will have their own intricacies pertaining to behavior severity and the child’s skill level. But with all else being neutral, we can prompt Julia to appropriately ask her mother to play with her. Once Julia asks appropriately, her mother can honor her request by playing with her.
Our new ABC chart will add the prompt component, and look like this:
By prompting this behavior, we are reinforcing appropriate requests for play rather than the throwing of a toy. This will increase the likelihood of appropriate behavior in the future!
Let’s look at another example!
In this instance we see the antecedent, behavior, and consequence working together in a positive way! Mike is asked to do his homework and his appropriate response is to complete it. The consequence for his behavior is access to video games for 45 minutes.
Assuming Mike loves video games, we can infer that the consequence (45 minutes of video games) will encourage the behavior (completing his homework) in the future!
In summary, understanding behaviors will help us identify the antecedents (triggers) and consequences (how we responded) in our everyday actions. We encourage you to take notes on the ABCs of behavior for your child!
Once you find the patterns, ask yourself the following questions:
Can I prepare my child for triggers that are about to happen?
Can I prevent/change the triggers in any way to reduce behaviors?
Can I help my child get what they want in another way?
How are my own behaviors contributing to my child’s behaviors?
Imitation is such an important skill for our learners, especially young learners.
Most people, without realizing it, learn the majority of their skills simply through observation. As a child, your parents, siblings, and friends were models for learning. Your mom or dad may have cooked, cleaned, or done other activities around the house. This improved your understanding of the appropriate way to live in a home. You watched how other kids played on the playground and were able to pick up on what you should do to join in. Through imitation you understood the rules, strategies, and how to play fairly without upsetting the other kids.
Learning Behaviors
For many of our children, learning by observation may not occur naturally. This is why building strong imitation skills is so important.
It is impossible to teach every single skill a person could ever learn, but we can start by teaching “learning behaviors” such as imitating others. Learning behaviors help our kids acquire skills on their own. You’ve heard the old saying “give someone a fish and you feed them for a day. Teach someone to fish and you feed them for a lifetime.” Rather than giving our kids a fish (teaching a specific skill), we want to teach them to fish on their own (provide learning behaviors). By practicing simple imitations, we can generalize this learning behavior to more easily learn many complex and difficult skills.
But how do we go about teaching imitation?
Here are a 6 simple steps that we use to get started:
1. Identify a reinforcer:
In order to motivate your kid to learn imitation, we must control access to a preferred item or food. This can be as simple as a pretzel, their favorite toy car, or even some tickles! Keep this item handy during this exercise. Because preferred items may change, it is important that the item is currently reinforcing to your kiddo!
If you are having a difficult time finding a reinforcing object for your kiddo, it is sometimes helpful to place them in an array like this.
Providing options gives the child the opportunity to choose for themselves. This is one of many preference assessment strategies that can be used.
2. Gain attention:
This one may be tricky, but definitely important.
In order for the next step to be effective, we must have the attention of your child. The attention does not have to be for too long, but just long enough for the direction to be given.
If you are having trouble, the reinforcer may be shown to your kiddo in order to gain their attention!
3. Provide verbal instruction and model to imitate:
Once attention is gained, it’s show time!
First, give a verbal direction to your child to
imitate. This may be something simple such as “do this!” or “copy me!” Then
provide the model you wish for them to imitate.
Depending on the child’s skill level, the model may be
something as simple as raising their hands, or a more complicated activity such
as cleaning up.
Verbal models may also be given! First, give a
direction to imitate speech such as “say this” or “say….” Then provide the
verbal model. Similar to the physical imitation, this may vary from simple
sounds (ex. “ahhhh” “mmmm”), single words (ex. “mom” “dad”), or sentences (ex.
“I want food” “Give me toy”). Of course, this is depending on the ability of
the child.
4. Provide physical prompt (with another person present if possible):
Because we are teaching this new skill, the child will
more than likely not know how to respond to the direction. Not to worry! This
is where prompting comes in.
Gently physically move the child’s hands to complete
the imitation. Ideally, during this exercise we will have a third person
available to initiate the prompting. This allows the parent or therapist
teaching the imitation to continue modeling the desired action. The child will
then be able to see the action to imitate at the same time as being prompted.
This reduces the chance of confusion and helps create a better connection
between the model and the prompt.
Prompting with Third PersonPrompting with One Person
5. Reward!
At this point, your child has just witnessed you make
a pose or model and felt themselves prompted to do the same. So how do we tie
it all together? Reward it!
Tickles can be a very easy to provide and enjoyable reinforcer!
Once the child has been prompted to properly imitate
an action, give them access to the reinforcer that we identified in step one. Imitation
is great and we want your child to think it’s great! So by pairing the action
of imitating with their preferred item, we are teaching your child to associate
feelings of joy with imitation. In order to make this connection, it is
extremely important that the reward is presented IMMEDIATELY after your child
performs the appropriate imitation behavior.
Some kids prefer a more gentle approach, and of course, a little bit of iPad time!
6. Do it again!
So you’ve completed steps 1 – 5 with your child. Awesome! Imitation has now been completely mastered and there is no need to ever do it again…
If only, right? Nobody learns by doing things just one
time, and like anything else in life, these skills take practice.
But again, as we all know, things are not always as
simple as articles on the internet make them out to be. What happens if we
follow all of these steps and still see no improvement?
BCBAs at Colorado ABA Therapy are especially trained
to handle the challenges of learning. They ensure the proper prompt fading procedure is incorporated.
They look out for certain setbacks like prompt
dependencies. They can even develop alternative prompt strategies to better accommodate your child’s learning.
Every strategy is research based and data backed to support the growth and
progress of your child.
Next
time you are with your child, think about what you are teaching and how
imitation plays an important role either directly, or as a foundation skill to
your targets. We encourage every parent to practice these skills with
their child, but if ever there is a bump in the road, feel free to contact your
BCBA for extra help and information!
Questions for your consideration:
1. Is my child able to learn through observation?
2. How can imitation skills be incorporated into my daily routine?
3. What are long term and broad benefits of my child learning imitation skills?
When we first start an ABA program with a new family, we often talk about pairing as our first objective.
Pairing is the process we therapists go through in order to:
1. Build rapport with the child.
2. “Pair” ourselves with what the child already finds reinforcing.
This allows the therapist to become reinforcing by transferring the reinforcement of the activity or item onto ourselves.
This is extremely important for several reasons:
1. We get to become the child’s new best friend!
2. We get to learn about all the things the child likes. Knowing what they like might allow us to use those item/activities as reinforcers for desired behaviors.
3. We start therapy in a positive place. The more reinforcing we become, the more progress we can make over the course of therapy.
You may also see our therapists pairing not only when they first meet your child, but periodically throughout the course of therapy as well. Over time, the reinforcing value of items, activities, or people can change. A child’s preferences are continuously changing and evolving. We always do our best to remain a positive person for the child which will allow our relationship to maintain throughout all of the behavioral challenges we encounter.
