What kind of therapist will be a good fit for your child?

Not all therapists will have the same style of implementing common ABA therapy techniques. Some may be very gentle, others firm, where some may want to explain situations to a child who works well with logic, and others may want to make simple demands instead. Applied Behavioural Analysis (ABA) is a therapy that is implemented in a way that molds to your child's unique personality and needs.

Because of this, not all Applied Behavioral Analysis (ABA) therapist will be the right fit for your child. When you decide to terminate services, you may consider if you want somebody else. If this is the case, think about what it was about the last analyst that caused issues for you. Understanding what you disliked about the therapist style of teaching, and communicating it to the company, can help them find you a better fit. Making a concrete list of what you are looking for gives the therapist/company a way to meet your needs, and either refer you or find someone like that.

Whether it’s tone of voice, certain techniques you don’t agree with or simply the personality of your therapist, making sure all of those issues are met to your desires are important. Never be afraid to go with a different therapist until you find the right fit for your child. Every therapist practicing ABA will bring their own unique style and personality into the mix. Just like every child will bring their own personalities into the relationship.

7 dimensions of ABA

Applied Behavioral Analyses (ABA) is based on 7 core dimensions. Any interventions your therapist uses with your child will fall within or be defined by these 7 categories. Therapists use the anagram GET A CAB to remember each part of the therapy.

G is for Generalization: This is moving skills from one situation to another. Sometimes your child with autism may perform certain skills like using the potty in one location but not in another. Generalization is the process of moving this skill from one place to another.

E is for Effective interventions: All interventions are monitored to ensure effectiveness and to see how they impact the behavior you are trying to change. They must be strong changes that affect something for the better.

T is for Technological: Where interventions and procedures are described thoroughly enough that anyone trained can implement them.

A is for Applied: Socially significant behaviors are worked on, more so than others.  

C is for Conceptually Systematic: The concept of the interventions is chosen from a specific theoretical base, rather than just a trick.

A is for Analytic: All decisions for an intervention or anything within the therapy must be data related.

B is for Behavioral: Only behavior that can be observed and measured should be targeted.

In ABA when measurable behaviors are targeted based on how well it will help your child cope in society, data is collected and explainable interventions are tried and tested, then your child will go far. ABA is a therapy where you record the changes in your child for the better, or worse leaving nothing to chance. This is why this therapy is so effective and gets results more often than any other intervention.

Reinforces: How to make them effective

We talked about token boards and how they help reinforce good behavior during Applied Behavioral Analysis (ABA) therapy sessions. But there is a way you can improve on the token boards and other reinforces to make them as effective as possible. Your therapist should use some of the following methods to help your child move forward through their skills quickly.

When offering a token or sticker for each completed task, your therapist will ensure it is given as soon as the child completes the task. It is here reinforcement will be the most powerful, mostly due to instant gratification. If you promise a treat later for doing something they were asked to do, the behavior change will not be as rapid. This is why stickers and tokens on hand are such an amazing tool, there’s no wait period.

The stickers, token or reward must also mean something to the child/teenager. If the reward isn’t very exciting, then it’s not motivating. Sure they might do it for the benefit of getting a sticker, but they’d do it with more gusto and energy if that sticker was of their favorite cartoon character and not a gold star.

The therapist should give the treat frequently. It would be a little ineffective to tell your child, ‘if you behave all day you can get a sticker.’ Not only is that unrealistic (who doesn’t make mistakes? What child doesn’t misbehave once or twice?) but the goal is out of reach, and the reward isn’t tangible. It’s not something they can easily imagine themselves receiving. Giving your reward frequently reminds your child how awesome it feels to get it.

The therapist should also make the reward exciting with the use of social engagement. Compliments, hyping up the gift, and being as positive about the reward as possible are some examples.

Another mistake newer ABA therapists make is turning the reward into a negative. Instead of saying, ‘if you don’t do X you won’t get this’, the therapist should say, ‘if you do X you will get this cool sticker!’ In an upbeat happy tone. Now the sticker is exciting, the praise is rewarding, and the outcome is something they want to work towards.

Just think about how it feels when someone tells you that you can’t have something unless you do as they say. Instantly we evaluate if we want that thing anyway, which makes us less likely to be happy about getting it. This is just human nature. One simple change in language can do a lot for any child.

ABA therapy is such a simple therapy really when broken down. From the outside it can be confusing and even a little scary at first, but when we look at it from a common sense angle, it’s little wonder why this therapy is so vastly used in all sorts of fields. Tokens, and stickers are nothing new, and if you ever have any issues with how they are used you can always ask the advice of your BCBA certified analyst or therapist.

How your child can perform tasks successfully

Sometimes your child doesn’t have a skill that his peers have. Recently we’ve had problems getting an (almost 4-year-old child) to remove his shirt. This is obviously a skill he should be able to do by now if he was developmentally normal but alas Autism has him behind others his age in many ways.

There could be plenty of skills that your child has yet to achieve too! Such as; washing their hands, putting on clothes or brushing their teeth, etc. But that doesn’t mean there is no hope. Applied Behavioral Analyses (ABA) therapists have a specific technique for teaching skills like this and it’s called chaining.

What is Chaining?

Well, we can break it down like this. Almost every skill has a series of steps attached. For example, when you’re learning how to make a salad, you don’t go from someone who’s never seen a salad bowl to a bowl full of salad. First you have to look up a recipe, and then set out your ingredients, cut them up, put them in a bowl and add dressing. This example had five different steps involved that we don’t even think about, but for a child learning a new skill those are all the steps they have to learn to get the result of a salad for dinner.

A therapist can’t show an Autistic child how to do something and expect that they’ve understood their complex language, have the motor skill available, remember every single step, then execute it perfectly. Because of this they use chaining.

Chaining starts by teaching a child how to do something either backwards or forwards (depending on what is easiest). Take the example washing hands, this can be placed into steps like so;

1.     Pull the stool up to the sink

2.     Find the soap

3.     Turn on the tap

4.     Get your hands wet

5.     Apply the soap

6.     Rub your hands together under the water

7.     Rinse the soap

8.     Put away the soap

9.     Turn off the tap

10.  Get down from the sink

When chaining forwards a therapist will prompt step 1, then re-enforce it until the child can perform this task perfectly three times. They then move on to the next step, and so on and so on, until the child can perform all ten steps without prompts.

When chaining backwards the therapist completes all nine steps for the child, then prompts the final step. When the child completes it on their own, they get positive re-enforcement. They then complete steps 1-8 and prompt 9, and so forth.

 This technique is not only fun for the child, with lots of praise and very few errors, but it can teach a child how to perform almost any task successfully. This way they can lead a more independent life. Using this technique my son went from not even caring if he could take off his own shirt, to removing his own shit just by asking him to, within a week in an excited happy manner.

Get The Best Therapy From a Smaller Agency

Sometimes bigger is better, but when it comes to choosing the right therapist for your child. Bigger may not always be better. There are pros and cons to every decision and Applied Behavior Analysis, ABA therapy may be one of the biggest investments you make in your child with autism’s life. For this reason, here are a few simple things to consider when choosing a small versus a big ABA agency.

With a small agency you can always get to the top person in charge. With the larger agencies there are usually several people you have to go through before getting to anyone who can actually help you. With a smaller agency you have probably met the owner and be getting personalized ABA therapy.

With a smaller agency, the likelihood of turnover is usually less because of the direct 1:1 mentoring each employee gets, they are treated as team members instead of just another number. They may even get paid more because of decreased overhead.

With a smaller agency, you’ll have better quality people. Because a smaller agency can afford to make less mistakes than a larger agency, you can probably bet on more quality ABA therapy.

To be fair, I’ve listed some of the challenges you may face with a smaller agency.

One of the things to be aware of is that it make take longer to find the right therapist for your child with autism because fit will be more important. They may have fewer on call therapists and may have to look for one.

Paperwork may be slower because only a handful of people are wearing several hats. Billing may arrive late and graphs and data sheets may take longer to get.  

Overall when choosing an ABA agency for your child, it really doesn’t matter which ABA agency you go with as long as the BCBA working with your child is competent, has a good team of therapists, and is passionate about helping your child.

Check out Building Block Resolutions, Inc. in Los Angeles for ABA therapy for your child with Autism.

Get the Best Out of Your ABA Therapy Program

ABA therapy is time consuming and expensive. But in the end, if done right, it works!

I’ve seen non-verbal children talk, aggressive children become model students and parents brought to tears for the turnaround in their child. Unfortunately, ABA is also expensive, to achieve these kind of results, a a 30-40 hour a week program is recommended. Supervised at least 3 hours a week by a Board Certified Behavior Analyst, along with parent training. Put those cost somewhere over $1K a month for a good quality program.

Here are some things to keep in mind so you don’t end up wasting your valuable money:

-Make sure the program is being supervised by a Board Certified behavior analyst. Applied Behavior Analysis is the only discipline taught in universities which is validated to be effective with working which children with autism. The best practitioners have at least a Master’s degree and is certified as a Board Certified Behavior Analyst (BCBA) by the Behavior Analysis Certification Board, and at least 5 years experience implementing and supervising behavioral interventions.

-Make sure that a through assessment has been completed; Because each ABA program should be tailor fit to your child. Autism is a spectrum and since no to cases are alike no two program should be alike either. Furthermore, if the wrong treatment is being implemented behaviors could actually get worse or morph into completely different behaviors.

-Make sure the therapist has a good behavioral background and a good relationship with the analyst. Therapists do not have any fancy degrees but they do have to take the guidance of the BCBA and be good with children. Having a good relationship with your child would be best.

-Finally make sure data is being taking daily and shared with you on a bi-weekly basis. After all, it is your money you want to know where it’s going. Data is very important. It guides programing decisions and also lets everyone know very quickly if the current treatment is having a positive or negative effect on the child.

This is all very important because with autism, there is really only a small window of time to get the maximum behavioral results. If your insurance can cover it, great, but if not, it’s better to put that money in upfront than waste valuable time that could be spent working on your child while the brain is still very malleable and the child has not developed too many bad habits which would be hard, if not impossible to break later.

For more information, please go to www.buildingblockresolutions.com