What does an ABA Specialist do?

What does an ABA specialist do? 

I'm often asked this question and there are a lot of misconceptions about what an applied behavior analysis does, so I'd like to give some specifics of what my job entails.

executive functioning skills

Executive functioning skills are those skills which help us plan, organize, prioritize, initiate tasks,
afford us flexible thinking ,monitor impulse control and provide us working memory:

*People with low impulse control have more difficulty monitoring what they say and what they do, they will often say whatever comes to mind.  When they see someone who has been at the gym working out, for example and are sweaty, they will tell that person they stink. When someone frustrates them, they will act out by hitting them rather than walk away from them.

An ABA specialist will practice social settings where they will encounter situations and what they can say that is socially appropriate. An ABA will practice skills to aide them with giving alternative behaviors to adapt rather than act in rash ways as well.  Reading social stories will also give social skills in this area.

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*People with low emotional control
have difficulty recognizing their emotions, they often over react or take extra long to regroup when things get rough. 

Practicing emotional control helps regulate emotions, an ABA will discuss situations that are likely to trigger an emotional situation and the two can practice appropriate emotional responses.

*People with rigid thinking have difficulty thinking outside the box, doing things different that their routine, or accepting any variables.

ABA specialist will aid a person in adapting to changes and unexpected events by brainstorming variables in life as well as changing schedules in safe environments.

*Working memory is being able to remember directions, so people who have difficulty in this area struggle when they are told to, 'read chapter one and answer questions 1 through 10'.  

Much of aiding people who struggle with working memory is changing the environment and working with other people such as teachers, employers, etc. Having instructions written down for them to refer to often is an effective tool, having timers to remind them of time limits, emails to send reminders, calendars of upcoming events, etc., all these tools aid the individual so they don't have to rely on their working memory.

*People with organizational difficulties need assistance knowing what part of a project is most important, they have difficulty starting a task because they freeze rather than know where to start, and they are often easily distracted by things such as visual or noise disturbances.

The ABA will aid in setting up the environment to aid the individual to be successful.  This includes such things as  decreasing visual stimulus such as posters, changing the color of walls, turning off music, eliminating clutter and unnecessary noise and traffic. Helping them getting started on a project by giving them an outline of steps to follow for the project.

boundaries and personal space

People with autism and sensory processing disorders often have difficulty reading social cues and expectations, such as allowing a space between them and others, to stay out of closed doors or not snooping through a woman's purse, or keeping clothes on in a public space, or not hitting someone they are angry with. They are concrete thinkers and many social rules are abstract.

They need simple, concrete, black and white rules to follow. For example if you say to them, 'follow the rules'  when playing a board game, this is too vague for them to understand what this means and they will likely continue to break the rules, causing frustration for everyone and others think they are being defiant. If you say instead, roll the dice, count the black dots, then move your piece that many times and stop.' they will have an easier time following these directions, as they are clear, easy to follow and concrete.

Before an activity:

1. Define the expectations

2. Provide guidance without expecting perfection and allow room for autonomy

3. If they begin to stray, block and redirect back to the activity. For example, if you are teaching them to walk from classroom A to classroom B, if they begin to walk down the wrong corridor, put your arm out to block them from the wrong corridor while saying to them, 'walk this way', then wait for them to walk toward classroom B.

4. Allow natural consequences while offering firm boundaries. For example if the child drops to the floor because they aren't getting to walk down the wrong corridor, wait them out with a calm voice and remind them what the choices are (always give choices), they can choose to go on to classroom B or return to classroom A. Not following directions by going down the wrong corridor is not a choice, however. 

5.  If possible negotiate beforehand with the child. What does the child want? What are the child's expectations? What are the consequences if the child doesn't follow through? What options are available if the task becomes difficult and the child has a meltdown? 

6. The more consistent the ABA (or parent or teacher) is, the more the child understand their boundaries and the more consistent their behavior will become. 

emotional regulation skills

Emotional regulation includes being aware of what emotions we are feeling, paying attention to our emotions, properly labeling our emotions, and properly modifying our emotional reaction to set them within the social boundaries. Poor emotional regulation leads to depression, aggressive behavior, poor performance; among other things.  Good emotional regulation can aid in good social and academic skills and mental health.  

ABA specialists work with the person to help them identify their emotions as well as put a name to what they are feeling. People along the spectrum often have a difficult time reading other people's facial expressions and understanding what emotion other people are conveying, so we work to help them read expressions and behaviors, both other people's and their own.

ABA specialists help the person understand when they are feeling strong emotions and how to cope with them, such as taking a break from a difficult task rather than throwing the task all over the room; or if a person is bothering them, to tell the person to take a step back rather than yell at them. 

independent living skills

Many people with developmental disorders need assistance living either independently or with minimum assistance.  Some of the skills they need help learning include managing money, using a debit card, making a shopping list, cooking on a stove, reading a recipe, cleaning a house, maintaining hygiene, learning the public transportation system, developing job skills, crossing the road, and buying food and clothes.

An ABA specialist will work with the person in teaching these skills to an acceptable level so they can live with minimum assistance.

safety skills

There are several skills people with developmental disabilities need practice to learn so they may be safe. They need to learn how to cross the street, unassisted or with minimum assistance; how to judge who is a safe person to ask for help and who is not; to not elope from home, school or other safe environments; how to judge hot surfaces and items such as stoves and water; to not put inedible and/or poisonous items in their mouths; to keep seat belts on when cars are moving; to not open car doors when cars are moving.

These are just a few of the many safety skills that need to be taught.

following directions

In conjunction with safety rules, it is imperative to teach following directions to children with developmental disabilities.  Because many children with disabilities have a difficult time comprehending the consequences of their actions, they often do unsafe things that neuro-typical children learn from naturally from their environment but children with developmental disabilities do not learn by observation alone.

They must learn through being taught, for example that a ball will hit them when thrown at them if they do not stop it by catching it or moving out of its way. They must learn that petting a dog that is growling at it may result in being bitten. They must learn that walking into a fast moving river may result in being swept away.  All these things are teachable, but take more work with a child that is not neuro-typical by teaching them how to follow directions rather than having them picking up cues from the environment. 

educational skills

Many ABA's such as myself work in school settings. Within the schools, we act as teachers, teaching all manner of educational skills from math, to reading, spelling, word processing. We assist teachers in P.E. home economics, computer skills, science, art, library, etc.  Our knowledge of subject matter must be wide and varied, we teach at all grade levels, from elementary to high school.

We also plan and coordinate with teachers and others staff and parents all in the best interest of the child.

behavioral regulation skills

Positive reinforcement, extinction, and the use of discrete trial are the primary tools to aid in helping the child with behavior regulation. Most children learn naturally by picking up cues from their environment. Children with autism have a more difficult time with learning from their environmental cues.  By having a more structured environment, the success of learning is increased for those with autism and other developmental disabilities.  

See this blog for examples of positive reinforcement, extinction and discrete trial.

alternative verbal communication skills

Many children with Autism are non-verbal or have limited verbal skills. There are several alternative communication approaches that are taught to increase expressive communication abilities.

The use of pictures is one such way; 

The child is taught to touch the picture of the item they want or need. In this way, they communicate their wants and needs through pictures rather than through screaming, hitting, or having a meltdown.

Often, even children with high verbal skills have a low verbal ability when they are frustrated and can benefit from this method.

Another method is to teach sign language. Sign is not just for people who have hearing loss. Sign language is a useful skill for the non-verbal and small children with few verbal skills. It is often easier for them to learn sign language than to learn verbal communications.

Another communication technique is the use of a voice box called a Vantage, or the use of programs on iPads or tablets. These programs augment speaking or verbal communicating, as well as provide a schedule, routine, teaching aides, transition aides, and offer choices.  

The ABA specialist must understand and use these methods as well as have a thorough knowledge of them in order to teach them and help the families and teachers and other professionals know which method to choose for their child. The ABA specialist also works with speech specialists, occupational specialists, parents, and many others to coordinate and communicate the best interests of the person.

I hope this list of skills gives you a better understanding of what you ABA specialist can do for you.

Tactile Sensory Flip Books

Some children with autism have a need to an increase of tactile input. I have made sensory books for children to touch and feel to help them calm down when they need extra tactile sensory input.

These flip books are small enough to carry and easy to make. They also are not very expensive.  I went to the local Lowe's Home Improvement Store and they gave me free carpet, outdoor carpet and laminate samples.

I then cut bright colors or card stock that were an inch larger than the largest piece of carpet. I then had the card stock laminated and one hole punched in the upper left hand corner. Make sure the hole is are enough away from the corner so tugging and throwing the flip books won't rip through the holes.

Then put a metal ring through the holes, and make a flip book out of them. Use a strong glue to glue the carpet and laminate samples to the pages.

You now have a Tactile Sensory Flip Book.

Motivation

What is motivation? It is the desire to do things.  What gets you up in the morning? What gets you to work? When I work with children with disabilities, they are often not very motivated to work. I must find something to motivate them to learn.

What motivates you? I love this TEDtalk by Dan Pink:

There is extrinsic vs intrinsic motivators, or external vs internal motivators. 

People who have even the most rudimentary cognitive skills necessary for their jobs are more motivated by:

1.autonomy

2. mastery

3. purpose

People who need only mechanical skills are motivated by:

1. bonuses

2. carrots and sticks

3. extrinsic rewards/motivators

What motivates

If giving an incentive for a behavior that isn't motivating, it will not incentivize.

If…then or carrots and sticks, external/extrinsic motivators are best for children and the cognitively impaired. For internally motivated, cognitively high functioning, look for autonomy, purpose and mastery as motivational rewards.

Managerial styles that use carrots and sticks will often find the employees unhappy at work, missing work, a high turn over rate, late work, missing work.

Using carrots and sticks for high functioning  will not be rewarding and will feel more like punishment.

Reinforcers

re·in·force

1.

to strengthen with some added piece, support, or material.

What motivates a person?  A reinforcer is something added to support a behavior you want to continue, or motivates them to behave in a desired way.  You can also reinforce a maladaptive behavior by adding support or attention to it.  There are two types of reinforcers, primary and secondary.

*Primary- a primary reward is one that doesn't have to be taught is desirable or motivating.  This is food/drink; you don’t have to teach that food and drink are motivating.

*Secondary- a secondary reward is one that does have to be taught is desirable or motivating.  A sticker has no innate value in and of itself.  Why would someone work for a sticker unless value is instilled in it? Earning a preferred activity or free time, positive affirmations or praise, giving a high five, are all learned reinforcers. 

*Satiation – When a reinforcer is offered to the point that the child has received enough to be full or satiated, they will no longer be motivated by the reinforcer. It is important, then, to only offer the reinforcer on a limited basis and/or in small amounts.

*Moving from primary to secondary – To move from primary to secondary reinforcers, pair the two together.  Do this by offering praise each time a primary reward is given.  Vary the reinforcer of primary and secondary.  If building in value of a sticker or activity, pair that with the primary reinforcer on a 1:1 basis and then a variable schedule. Fade the primary.

Stimming

Stimming

The word stim is short for self-stimulation. Stimming is the process of a repetitive behavior. We all stim to one degree or another. We tap our foot, tap a pencil, twist our hair, pick at our cuticles, rocking. What is different about the type of stimming that children with autism do, is the excessive amount or degree with which they do it.

Stimming helps block out excessive sensory stimulus, or it may provide extra sensory stimulus.  It may help manage emotions (this may be for the detriment or the benefit of the child/adult) thus emotions or difficult

situations may lead to an increase in stimming. Some stims serve the purpose of comforting or soothing.

Stimming, when done with boundaries, should be allowed and considered normal. There are times when stimming should be limited or an alternative stim should be found as a replacement.

We use all of our senses to interpret the world. When we walk into a room, we use sound, a kind of sonar, to determine the size of the room, the furniture placement, and our relationship to the room, how quiet or noisy the room is. We use visual see how many people are in the room, were furniture placement is, etc. Taste, tactile, all help us interpret the world around us. Our senses do this for us automatically without us being stimming                      conscious of this.

 A child with autism or sensory processing disorder, their senses and brain do not work in the same way. Their senses take in the information, but the brain does not process the information, or doesn't process it correctly. For example, some children, when they walk into a room, their auditory doesn't automatically tell them, through sonar, where they are in relationship to the size of the room or the location of the furniture. These children then immediately feel unsafe and uncomfortable, since they cannot place themselves in a new location. To feel safe, they will then need to adapt, they do this by running around the room to get a *feel* for the size of it and location of furniture. They will often start screaming to let their brain get a sonar picture as well, similar to what dolphins do.

Stimming, just like OCD, starts in the brain and the part of the brain that is in operation, has the neurons fire repeatedly. When this part of the brain is in operation, then other parts of the brain are not in use. When a child is stimming excessively, or for example, they are flapping their hands in front of their face for 30 minutes or more, they are not able to take in visual stimulus around them.  This limits their brains ability to take in visual information and then interpret the environment around them. In this way, stimming gets in the way of their ability to learn from their environment.

Excessive stimming also prevents other parts of the brain from developing. This is especially critical in childhood when the brain is still developing and learning and growing.  When large amounts of time are devoted to stimming, then that time cannot be used to interpret the environment, to learn new things such as reading or math, and only that part of the brain devoted to the stimming is being developed at the expense of other parts of the brain.

There are stims that are also harmful, either to the child or to others, or create a maladaptive environment. A child who bites themselves, pulls their hair out, are examples of bringing harm to themselves. A child who screams in a classrooms inhibits the learning environment for the other students and creates agitation in the other students and teachers. Any stim that is self-harming or harming to others should be limited and an alternative stim should be actively found.

Stims that are done to excess should also be limited, as this prevents healthy brain development in the child. Stims can be used to motivate the child to finish their work, can be used as a reward and should be limited. 

For example, a child who needs to flip a rubber band on their wrist, they can be given the rubber band after they finish a school assignment, for following the rules, after they eat, or when they are being quiet in their room. In this way, they still have access to the stim, but on a limited basis.

It's important to remember that the stim provides a vital role for the child and should not be eliminated, just boundaries put around it. A stim provides comfort for many children, so in stressful situations, offering the stim as comfort or after completing a difficult task is highly motivating for the child.

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Generalization

Generalization is the process of teaching a skill or behavior in one setting and having that skill or behavior transfer to another setting.  In most children, this happens naturally and does not need to be taught. With children with autism, this does not always happen naturally.

For example, if a child is taught to measure a cup of flour at home, the child can naturally measure a cup of flour at school. If a child is taught to sit with quiet hands at school while the teacher is talking, the child can sit in church with quiet hands.

A child is able to generalize when they are able to work with a variety of people, in a variety of therapy as well as natural settings, with a variety of stimuli (using different materials), and produce the same responses in different ways (count to ten with blocks, on their fingers, on pater, etc).

When working with a child that doesn't generalize naturally, it is important to teach the new skill in a therapeutic setting. The new skills must then be taught in other settings. The skill can be taught in another classroom, in the hallway, with other children present, outside, etc. By using multiple settings, the skill can be generalized to

multiple settings.

It is important to use formal and informal settings, as the more informal setting occur more naturally.  Reinforce the new skill as often as possible to increase the rate of learning. It is also important to move from continuous reinforcement to intermittent reinforcement, as this is a more natural reinforcement rate and actually increases the rate of the behavior. Just as in Vegas, they reinforce intermittently and get a higher rate of behavior, so you will, too.

If it is possible, have other people teach the skill. This helps the child learn from other people and to generalize to take instruction from other people. This can be another aid, the parents, peers, etc.

Once the skill has been taught in a therapy setting, take the child to more natural settings, such as the lunch room, the playground, the hallways, etc.

Vary the language: For example, if you are teaching shapes, say, 'show me a square' the next time you could say, 'where is a square?' the next time, take him around the room, and ask, 'do you see a square?'​

Vary the materials: have the child count blocks, puzzle pieces, numbers on a paper, door handles, etc.

Differential Reinforcement

Any behavior that gets attention will likely be reinforced and repeated in the future.

​While there are aspects to all of these that can be beneficial, there are two primary ones that are most beneficial; positive reinforcement and extinction.  We all need praise and to know that our efforts to improve are being noticed, and children are no different. Catching a child or adult in the act of being on task, doing their work well, finishing their work on time, being quiet, are all important in increasing these behaviors.

Behaviors that are maladaptive should receive the least amount of attention as possible, as paying attention to them increases the likelihood they will be repeated. When a child turns in their school work late and the teacher reprimands them, they have just increased the likelihood that the child will turn in school work late in the future. Rewarding children who turn their homework in on time, and giving little attention to the lateness will increase the likelihood of promptness. A child who habitually turns in late work and one day turns it in on time, should get as much positive reward as possible.​ 

An adult who maintains a messy work area and is told how messy they are, will likely maintain a messy work area in the future, since they get attention for this behavior. An adult who finishes their work on schedule and is promptly rewarded by being given the afternoon off, will likely get work done on time in the future. 

Things like a break or time out should only be used when the child's safety or another person's safety is at stake. Punishment does not provide an alternative behavior to the maladaptive behavior and does not change future behavior, it only stops the present behavior. Likewise for adults, when they are punished by being told in front of co-workers (adding an adverse stimulant) that they are always late to work, will not change this

behavior in the long term.

Negative reinforcement is used a great deal in schools. It increases the likelihood that a behavior will increase in the future.

Differential reinforcement

The use of extinction in conjunction with positive reinforcement is called differential reinforcement.  This is alternating between conscious ignoring the maladaptive behavior and then giving positive reinforcement when they exhibit the alternative behavior. Example: If the child is hitting, you back away so they are not being reinforced for the hitting, turn your head away so they are not getting your attention for the hitting, tell them to have quiet hands, then as soon as they put their hands down, reinforce that they have quiet hands.

For an adult, you consciously ignore the maladaptive behavior of being late, and at the same time, when they show up to work on time, reward that behavior by noticing it and rewarding it.

Reinforcers

Positive Reinforcement *Adding a stimulant to increase a behavior *Designed to increase behaviors, by increasing the likelihood the behavior will increase in the future *Penny chart *Praise *Primary reward *Preferred activity *High five *Reinforce 1:1 in beginning *Varied reinforcing more reinforcing 1:2	Punishment *Designed to decrease behaviors by adding an  aversive stimulant *Does not teach an alternative behavior *Works  on Highly conscious children *Natural consequences *Time out *Spanking * Works while in the authorities’ presence, not so effective when the authority is not present * Does not change behavior, only temporarily stops it
Negative Reinforcement *Taking a stimulant away *Taking away a stimulant to increase a behavior *Designed to increase behaviors in the future *Penny charts, sticker charts *Response cost *Take away a preferred activity (video game, access to cell phone or TV) *Take away time from recess *For each minute they waste from your time, take a minute away from lunch time, recess, TV, etc.	Extinction *Designed to decrease behaviors by taking away a stimulant *Conscious ignoring *Take attention away from behaviors *Expect an initial spike in the behavior at the beginning (child is used to gaining attention and will increase the behavior to get the attention)