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 prompting can help during ABA

Prompting is a wonderful tool in applied behavioral analyses therapy (ABA) and probably the reason some children learn to communicate at all. This simple way of moving a child through the motions of an action/response so he/she can see the consequence is so powerful yet so simple. It really answers the question, how do you teach a child that can’t understand language intuitively, what you are asking of them?

My son was completely non-verbal until his speech therapist used hand-over-hand prompting to show signs and slowly weaned him through the process of prompting until he could mand (request things) for himself.

Here is a list showing some most invasive to the least invasive prompting.

Most invasive: Full Physical Prompting

This is when your therapist will essentially use your child’s hands to carry out a request. For instance, she/he may say, ‘pick up your toys,’ then take the child’s hands and close them around the toy, guiding it to the toy box.

Next Invasive: Partial Physical Prompting

In this case the therapist will put the child’s hand onto the toy to show them what she means and wait to see if the child carries out the rest of the direction. Normally this is the first step taken once the child has mastered full physical prompting.

Next Invasive: Modeling

The therapist will act out what she wants the child to do. For instance, she will pick up the toy and put it in the box after asking them to do it and wait to see the child’s response.

Next Invasive: Gestural

Where the therapist will point at the toy and the toy box to gesture to the child what is needed of them.

Next Invasive: Positional Prompt

The therapist places the object close to your child and tells them to clean it up.

Least Invasive: Simple Direction

The therapist will simply ask your child to clean up their toys and expect that they will do it without further help.

When we move down this chart the child slowly learns what is expected of them, or basically, what you’re asking them to do! Much of the time, just telling them what to do and showing them won’t work for an autistic child. Going from most invasive to least invasive (depending on the specific skill set of your child and what they are asked to do) teaches them in a way that they will actually understand. It’s so simple and effective but works beautifully.

The Guilt of Active Ignoring and Why You Shouldn’t Feel It

It’s difficult navigating the autistic space when a child does something for attention. On the one hand, it’s hard because you want to give them all the attention in the world; on the other hand, they have a lot less ways than other kids of gaining the attention they need.

As caregivers it can lead our heads in a spin; is ignoring their behavior when it is attention seeking the right thing to do? Are we neglecting their needs? Shouldn’t we be their strength of communication for them by speaking/acting/advocating for them?

With Applied Behavioral Analyses (ABA) therapy a technique called active ignoring is used in certain circumstances, where the child is trying to get attention, or what they want, with socially unacceptable behavior, like spitting, whining, or violence.

We don’t ignore them because we want the child to feel abandoned or unheard, but because it encourages the child to search for new ways to gain the attention. We can’t explain with our words why they shouldn’t spit, so we have to explain with routine and patterns (or basically, in the way an autistic child can understand).

It’s important to not feel guilty when you’re ignoring whining for food, or other things that seem necessary or even neglectful to ignore. Remember, you are actively ignoring inappropriate behavior that won’t serve them, not ignoring their needs. You will meet their needs, just not right that second.

For example, you’re playing with their sibling so they take his toy, this forces you to turn your attention onto them to ask them to give it back. They now have your attention moved from their sibling and onto them. In their minds they’re not worried about the social repercussions, all they know is they have gained the thing they wanted;. You looking at them and talking to them instead of their sibling.

You need to speak the autistic child’s language here. Turning your attention to them to scold them doesn’t teach them anything when they don’t understand a full range of empathy, verbally explaining the situation does nothing when they don’t understand everything you are saying.

However, giving the other child tons of attention, taking the toy back without even looking at them, blocking the snatching, and actively ignoring, teaches: this action doesn’t get a desired result. But (and this is where we as caregivers can breathe a sigh of relief) once the undesired behavior stops, or the child uses a more appropriate way of asking for attention, you can lavish them with praise and affection.

The two should always be used together, otherwise ignoring will be in-effective and seemingly random for the child. This is all about routines and patterns, and giving your child a way to communicate and to latch onto that they understand.

Active ignoring is different from ignoring a child. You actively make a conscious decision to ignore a specific behavior and give attention to other behaviors. It can feel unnatural at first, but once you see your child blossoming into speech, or other appropriate means of asking for your attention, your relationship will be much stronger.

Techniques for Sensory Issues

The other week I discussed reasons for why a child would act out. We then went through techniques an Applied Behavioral Analysis (ABA) therapist uses when a child elopes.

But what about techniques for sensory issues?

Sensory integration is the process of normalizing sensation and making it easier for your autistic child to cope with them.

Occupational Therapy

Alongside ABA your child may benefit from Occupational Therapy if you find they have a lot of physical issues. OT in simple terms helps people do what they want to do in everyday life, be it taking off a t-shirt or using a pen. Sometimes these issues are accompanying sensory problems, like the feel of fabric, or not knowing you are squeezing too hard. An OT’s job is to identify the sensory issues and guide your child through them until they can physically handle the task. They’re a perfect addition to ABA.

Applied Behavioral Analysis Therapy

An ABA therapist identifies why your child is having an issue and either teaches them something new, or reduces it. When a child can’t handle, or process sensory information because of autism they may have extreme reactions to it, such as self harm, violence, or meltdowns. It’s important to identify when your child is behaving this way because they simply don’t want to do something or don’t know how to communicate, and when they truly cannot process what is going on around them.

This is no easy task.

We cannot personally dive inside their minds, so we can only observe, watch and wait until we know the answer. Which is what your ABA therapist or analyst will do before they introduce an intervention.

Communication Skills

Sometimes, our children have a meltdown when there are bright lights or loud noises because they don’t know how to ask to leave the situation. In this case, the therapist would prompt the question of leaving and the stimulation would stop. For e.g.

Therapist, “Say, turn the light off.”

Child says, “Turn the light off.”

Therapist turns the light off.

This way your child learns that communication is a wonderful way to remove uncomfortable stimulation.

Reducing Stimuli

In other cases we can tell when a certain situation will be triggering in advanced, and know that our child has to go through it and get out the other side; like grocery shopping or school. In these cases tools are used, such as noise blocking headphones and weighted vests. These keep the child grounded and block out sounds, thus reducing the sensory stimuli to begin with.

Sensory Integration

Other times our child has to get through a stimulatory process, but there is no way to reduce it. Like brushing hair, or clipping nails. Either way they have to brush their hair and clip their nails, for health and cleanliness reasons. In this circumstance the child can’t ask to leave the situation and we can’t reduce it, so what does the therapist do?

Sensory integration is teaching the child how to handle sensory input, with breathing techniques, and practice. Just like when we as adults have irrational fears and have learnt how to face them—like public speaking, or roller coaster rides—our children have to learn how to face their fears and remain calm too.

It will be heart wrenching to watch at first as they scream and cry, but guiding them through it slowly, and teaching them how to step over their fears is something all parents should teach their children no matter whether they have autism or not.

The only difference here is that autistic children will often scream and tantrum rather than whine or talk about it, because they either have no other way to communicate or little understanding of the consequences of the tantrum in a social setting. All they know is, if I scream I won’t have to do this.

An Example of Sensory Integration

A child was petrified of nail clippers; he wouldn’t even let you cut your own nails. He would scream, cry, and have meltdowns every time someone used a pair. We would have to hide them and his nails never got clipped. This had the added down-side of learning to use his nails as weapons to cut open people’s skin, when he got mad. We couldn’t reduce the stimuli, and we had to clip his nails, so the therapist slowly introduced the stimulus to him.

At first she showed him videos and clippers.

Next she cut her own nails and the nails of others.

Then she placed the clippers on his skin.

And finally she cut one finger nail.

This took more than a month, and on every step he screamed at the top of his lungs like he felt petrified. He cried and fought and sobbed his eyes out, until he didn’t. Until he barely even noticed what you were doing. As a parent at first though, it was traumatic to watch every new stage brought with it a wrenching feeling in the parent’s gut.

But by the end? Even though he still screamed and cried, he would ask the therapist to do it! He had grown courage, and the ability to see his fear as irrational, despite still feeling it. He had learned something that takes even adults a long time to learn; fear will not kill me. A life lesson that will serve him. So although listening to his fear was uncomfortable for many parents, seeing how this process empowered him makes it all worth it.

Techniques on how to encourage your child to stick out

The behavior of trying to escape a situation in all children is common, but especially so with autistic children who have a lot going on and little to no attention span.

In applied behavioral analyses therapy (ABA) avoidance techniques are tackled head on, to build up the child’s tolerance to accept and even enjoy certain situations—such as sitting down to read a book.

A child won’t be allowed to escape a situation (since this will re-enforce that escape is preferable to getting through to the other side) so what does the therapist do to make sure the child feels they can make it through that moment?

ABA Techniques: How to Encourage a Child to Stick it Out

A lot of now vs then techniques may be used. Sometimes autistic children have a hard time understanding that this moment won’t be forever. Timers are set up to show this will end and posters explaining now vs then.

Rewards are also great. Rewards such as music, and toys when they finish a task can help a child get excited to finish, instead of unmotivated and blah.

Replacing behaviors is another tool. Instead of your child running away and hiding, the therapist teaches them to ask for a break. If they ask too often, it is lined up with the other techniques and tolerance built up.

For older children the work you are doing together could be too hard, do they understand it or getting too frustrated by how difficult it is? Maybe everyone needs to step back and look at whether this is a reasonable ask.

For older children, help him/her discover their why, what positive thing they will get from learning or ‘surviving’ this task? Talk out the positives and help them view the task from a new light.

If the amount of time it takes is too overwhelming, a therapist may cut the work into parts, doing some now then taking a break and some later.

Our therapist uses awesome token systems, which are Velcro tokens of their favorite characters. Every time they complete one step they get a new token and they love it!

The Therapist Doesn’t Expect Perfection

The effort should get rewarded more than the outcome.

If your little one tried really hard but got the answers wrong, this won’t be penalized. For e.g. If we’re teaching a child to do the dishes, and stick it out, but they leave mess on a couple of cutlery, oh well! The point is they stuck it through and should be rewarded. Everyone makes mistakes and perfection isn’t the outcome we want here, it’s getting through the situation.

The therapist will always praise your child as they take steps through a non-preferred task, they deserve it. It is difficult to do anything when your world is full of noise and distraction, sometimes they just want to do something easy; but as we all know we can’t always do this as adults.

This is Something We All Do

Often ABA is just common sense. I bet you ask for help, know why you want things, take breaks and reward yourself for getting through boring tasks too! For instance,

“This meeting will take 20 minutes, I’ll learn some valuable things and when I go home and take a bubble bath.”

“I would like to be healthier for my family; I can ask my friends for help and have a special meal on the weekend. If I lose 10lbs I can get a new wardrobe.”

The procedures your ABA therapist uses isn’t alien, these are things even non-autistic people need to learn to optimize their days! And they set your child up to conquer the more uncomfortable aspects of later life, like boring work, meetings and chores.

Why your child is acting a certain way

Every child, anywhere, regardless of autism, acts a certain way for a reason. We don’t do things out of nowhere. Honing down those reasons are the key to helping a child overcome a behavior that won’t serve them in their adult years.

Let’s look at some common reasons people engage in certain behaviors so you notice what makes your child act the way they do!

Sensory

Sometimes we do things because it feels good to do them. Even though soda is bad for us, when we drink it the taste feels worth it, or the energy it gives us feels good. Sometimes we know we shouldn’t do something but we do it anyway because it makes us feel something we crave.

For an autistic child they may involve themselves in sensory stimulation, like flapping, rubbing their hands on things and spitting. This behavior is self soothing; they do it because it feels good! You may see it occur more when the child is frustrated, bored or even excited.

Escape

If you could escape from a painful situation without consequence, instead of facing it head on, would you? Most of us would!

Autistic children are known to bolt (they call it eloping now, officially) they run from situations, they hide under tables and do anything they can to escape doing something. Sometimes that something could be as simple as putting their plate in the sink. It’s not always because of doom and gloom circumstances.

A client of ours loves to use this behavior, he has several places in the house he knows is hard for adults to get to and as soon as you ask him to do something unpleasant (like chores) off he runs to hide under the bed.

There are other ways to escape situations like violence and yelling.

Children do this when they don’t want to engage in something. Maybe that something is boring, scary, annoying or too hard for them.

Attention

Yup, people do things for attention. This is a difficult one for some people to understand because it has such negative connotations wrapped around it. It shouldn’t, ‘attention seeking’ is just communicating that you want someone’s attention in the wrong way.

This is probably my middle child’s favorite reason to act out. He is a show star, he is loving, cute and by golly if he can be center of attention he will find a way! His autism (low empathy) means he often pushes children, hits them or bullies them so he can take their attention from them. It’s not about the child being a ‘bad kid’, this is just a child that doesn’t know how to say, “Hey I want a connection with you right now but I don’t know how to do it.”

Children do this when they want social interaction, or they want you to connect with them.

Tangibles

A few of our clients are obsessed with electronics. When it comes to trying to take them away the term ‘out of my cold dead hands,’ comes to mind. Sometimes children act out because they want something, plain and simple. They just don’t know how to communicate that want or they are terrified if you take it away they will never see it again.

This is the way that an ABA therapist looks at your child’s behavior, and a great thing to do for yourself as a parent. Sometimes putting meaning to situations helps us cope, and also gives us insight into how we can help our child in that moment.