The Parent's Guide to In-Home ABA Programs

Frequently Asked Questions about Applied Behavior Analysis for your Child with Autism

Elle Olivia Johnson

• Publisher: Jessica Kingsley Publishers
• Year: 2012
• ISBN:
  9780857007254
• Topic: Psychology
• Subtopic: Autism Spectrum Disorders
• Index: Psychology

What is Applied Behavior Analysis? What will happen when an ABA therapist comes into my home? Most importantly, how can ABA help my child? This quick guide answers all of the common questions that parents have when beginning an in-home ABA program.

ABA is an effective intervention for children with autism and other developmental disorders, but all of the data collection, reinforcement, and strange lingo can be confusing for parents who are not familiar with ABA therapy. Concise and practical, this handbook explains the ins and outs of Applied Behavior Analysis in a chatty question and answer format addressing everything parents need to know from what a typical session will entail, to how to navigate their relationship with their therapist, to how to get more involved and begin using ABA methods themselves.

This book is an ideal introduction for parents to help them understand and get the most out of their child's ABA treatment. It will also be a useful resource for newly-qualified ABA therapists and for ABA agencies to use with clients.

PART 1

The Basics of ABA Home Programming

CHAPTER 1

Getting Started

Vignette: Mia and Robbie

Mia is a 23-year-old single mother of three children, Robbie, Benny, and Joseph. Joseph and Benny are four-year-old twins, and Robbie is two and a half. Benny and Joseph seem to be doing well, but Robbie has been exhibiting severe behavior problems since his second birthday. He refuses to eat anything other than pretzels and yogurt, insists on drinking only out of his favorite bottle, and tantrums when his mother tries to put his shoes on. He repeatedly fills up and dumps out bins of toys and drops heavy objects on the tile floors. He is so loud, in fact, that Mia’s landlord has told her that neighbors have complained about his crying and loud bangs coming from their apartment. Mia worries that she will be evicted and cannot imagine how her life could be any more difficult. What’s more, Robbie has become almost silent and rarely plays with his brothers. He usually chooses the same toy, takes it to the corner, and plays alone.

Mia’s friend, Jenna, told her that Robbie might be able to be helped by a doctor. Mia takes Robbie to her local clinic, where the doctor suspects autism. Over the next two months, Robbie is given a provisional diagnosis of autism and assigned to an in-home ABA (applied behavior analysis) agency. The agency will be coming for their first visit on Monday. Mia worries that they will think that she has not been a good parent, and is confused about what ABA really is. She has never even heard of it! Is it going to help her son? How can she help? What should she expect?

As a parent new to ABA in-home programming, Mia has many questions. What is ABA? How is it used? How might it affect Robbie’s future? What will my role be?

1. What is ABA?

ABA stands for applied behavior analysis: a scientific approach to evaluating and changing behavior that is backed by years of research and analysis. ABA focuses on improving behaviors of social significance to a meaningful degree; it is rooted in the principles of behavior such as positive reinforcement and extinction, and systematically utilizes behavior change tactics derived from those principles; it targets behaviors that are observable and measurable, and is driven by data; and, it is generalizable, striving to have outcomes that last over time.

Whew! That’s a lot to take in! Let’s delve a little further into what ABA really is. Don’t worry; we’ll take a look at some examples to make things even more clear. To start, we will look at the first part of that definition.

Behaviors targeted for change are socially significant and the intent is to improve the quality of life for that individual and those involved in his life. For example, a three-year-old child with autism who is spending hours running circles in the living room is obviously exhibiting a behavior that needs to be altered in some way. When he begins to attend preschool, it is not in his best interests to run in circles at school, unable to settle down and learn. This behavior is viewed by ABA as a socially significant one... that is, if this child was running in circles for roughly two minutes a day, that behavior would be seen as less serious and less in need of change. A three-year-old child who is spending hours running in circles is exhibiting a behavior that is seriously impeding his social skills, communication, and learning. Significantly improving this behavior would increase this child’s quality of life as well as the quality of life of those around him.

Because ABA doesn’t just deal with problem behavior, it might help to look at another aspect of socially significant behavior. The first example looked at how ABA was used to decrease a socially significant behavior, now, let’s look at how ABA can be used to increase a socially significant behavior. Imagine Trevor, a ten-year-old boy with autism. He has a sister, Kim, who is eight. Kim earns an allowance by caring for the family’s guinea pig and goldfish. Trevor’s parents would like him to also earn an allowance by completing a daily chore. The family, classroom teacher, and in-home supervisor meet as a team to discuss how the responsibility of a chore at home can effectively tie in to Trevor’s educational and self-care goals. The team decides to teach Trevor to set the table for dinner every night. When an alarm clock rings at 4:45, Trevor will go to the kitchen, retrieve the needed plates, utensils, cups, and napkins, and will independently set the table.

At first, Trevor seemed to be doing well with his chore. He gathered the correct amount of dinnerware and placed them in the correct place on the table. On closer inspection, however, Trevor’s parents noticed that he almost always placed the four knives at one place setting, four spoons at another, and four forks at a third. The fourth place setting received no utensils at all!

Trevor’s in-home program supervisor designed an intervention to address the problem. The first week, Trevor practiced setting just one place setting correctly, using a photo of a correctly set table as a reference. His father shadowed him, pointing out mistakes immediately so that Trevor could correct them. Once he achieved this goal, he received a small increase in his allowance. The second week, Trevor learned to set two place settings correctly. Again, he received a small increase in his allowance. The plan continued until Trevor could set all four place settings independently. The photo was gradually used less often until Trevor stopped needing it. Trevor was proud of his “raises” and his family was proud of his success and contributions to the family!

ABA practitioners use the principles of behavior such as positive reinforcement, extinction, self-management, positive behavior supports, as well as many techniques based on those principles to change behavior. By looking closely at the program the ABA program supervisor developed, we can see how specific steps helped Trevor learn this new skill: The photo served as an easy reference for Trevor to follow while learning his task (a visual prompt), the alarm clock gave him a clearly defined schedule of when to begin setting the table (an audible prompt), and Trevor’s father acting as a shadow gave Trevor the opportunity to learn the task correctly.

Back to that definition of ABA. Behaviors targeted are measurable and observable, with a strong emphasis on data. Practitioners rely heavily on data to make decisions regarding program progress and change. You might find that your ABA therapist takes data on everything from the response to the words, “Come sit,” to the way in which they touch putty, to whether or not they wave goodbye. More about data and data collection later.

Finally...ABA programming will plan for generalization so that behavior changes will be long lasting. Practitioners will teach children to generalize skills across various settings and situations, with various people and materials, during different times of day, and even to other behaviors. In the future, Trevor might have a job where he needs to assemble or prepare items, or where he needs to begin or complete a task by a certain time. His practical experience at home gives him valuable skills and shows that Trevor can be taught a difficult task with some simple supports.

2. Why is ABA being used with my child?

ABA is widely considered to be one of the best ways to treat children and adults with autism. It gives teachers, ABA therapists, parents, and everyone else involved with a child with autism the tools they need to change behavior. You can view ABA as a toolbox: it contains various techniques that, when used correctly, can change socially significant behavior. The ABA practitioner will take detailed data on a problem behavior, analyze that data, and then use the ABA “toolbox” to select the most appropriate technique that can be used to alter the problem behavior. You wouldn’t call a TV repairman to fix the washing machine, would you? The same practical rules ring true for ABA therapy: if you have a child with autism, who has problem behavior, ABA therapy is a respected, research-driven, effective way to treat children with autism.

3. At what age should my child start an ABA program?

The sooner, the better! If you feel that your child might possibly benefit from ABA services, or suspect that your child has autism or another developmental disability, obtain help as soon as possible by having them professionally assessed by their pediatrician or other qualified medical professional. The sooner you obtain early intervention services for your child, and the sooner you learn the techniques and methods used by ABA practitioners and educators, the sooner you will begin to see results with your child.

4. What can I expect when my ABA program begins?

You may first have a meeting at the agency’s office or at your home. This will be a time when you can ask questions, fill out forms, and learn who will be on the team that will be working with your child. Present may be the agency director, team supervisor, behavioral therapists, or other service providers involved in the case, such as an occupational therapist or physical therapist. During this initial meeting, the ABA agency will discuss with you your child’s needs, and the needs of you and your family. They will also make a plan to begin assessing your child. These assessments may be done through interviews, standardized assessments, observations of home or school environments, and actual interaction with your child and the ABA supervisor and therapists. If you have specific concerns about your child or concerns about their academic, self-help, or communication needs, the assessment period is a great time to discuss these concerns. The ABA team will work with you to determine if these skills need to be immediately addressed and added to a program of intervention, or if they are age-appropriate for typically developing children.

Next, the ABA team will begin to assess your child. When the ABA team conducts an informal assessment of your child’s skills, it may appear that they are doing little more than playing. The therapist, however, is using this time to develop a rapport with your child while also assessing their abilities. The therapist wants your child to see them as a fun buddy who comes to the house a few times a week to play, not as a strict disciplinarian who demands that your child stack unending towers of blocks. For this reason, the therapist will use tasks interspersed with play to motivate and teach your child. Many times, the therapist is probing behavior and ability, that is, is gently testing your child to see what skills they have, and what skills may need to be worked on. The ABA team will spend a week or two evaluating your child in this way, before deciding on particular goals to work on.

5. How much time will it take?

ABA sessions may take between one and three hours, with occasional sessions lasting longer (particularly if the session involves a social outing, to the grocery store, for example). The number of sessions your child receives per week will depend on several factors such as the needs of your child, available funding, and approval from the funding source. Some children will receive just a few hours of ABA therapy per week while others will receive over 20 hours per week. Generally, ABA programs start with two or three days a week, and that time may be increased as the child becomes more accustomed to the format and demands of the instruction. It’s important to realize that even if your child begins with just a few hours a week, the ABA therapist will give you specific things to practice with your child. It is essential that you help your child practice the skills they are learning in their ABA sessions in all areas of his life.

6. What if I don’t like my child’s therapist?

The world is made up of many different people with many different personalities. We’re bound to encounter someone sooner or later that we just don’t get. However, even if you don’t get the therapist that is coming to your home, give them a chance. The program supervisor and agency h...