Applied Behavior Analysis (ABA) Assessment
Basic language assessments are used as pre-screening tools in autism intervention programs to help determine where a language program for a child with autism should begin. The Behavioral Language Assessment Form is an alternative to standardized language assessments and especially useful for children on the autism spectrum who have a limited vocabulary (100 words or less). It contains 12 different sections that cover early language skills and related areas.
Assessment of Basic Language and Learning Skills (ABLLS)
The Assessment of Basic Language and Learning Skills (ABLLS) is an essential tool in monitoring your child’s progress during the autism intervention program. It is also a useful tool for the autism behavioral therapist in setting appropriate goals and objectives. The Assessment of Basic Language and Learning Skills analyzes your child’s communication skills as well as his or her ability to learn from everyday experiences. The child’s parent or caregiver completes this assessment with help from the Board Certified Behavior Analyst (BCBA). It can be completed every three to six months after the initial assessment and serves as an excellent way to track your child’s progress during the Applied Behavior Analysis (ABA) autism therapy.
As one of the first steps after your child has been approved for care and services by Trumpet Behavioral Health, an autism behavioral therapist will conduct a structured behavioral interview. This Q&A-style interview allows the Board Certified Behavior Analyst (BCBA) to become more familiar with your child and your family since this will help make the autism intervention program successful. Our autism treatment experts use Applied Behavior Analysis (ABA) therapy to gather antecedent, behavior and consequence (ABC) data that helps determine the function of the behaviors your child is exhibiting. As noted by experts, collecting antecedent, behavior and consequence data describes the situation in terms of a child’s specific behaviors related to Autism Spectrum Disorder (ASD), environmental conditions and events associated with those behaviors. This information can help the team of parents and Board Certified Behavior Analysts (BCBAs) as they create the autism therapy program.
For you as a parent, there is an important guideline to remember when participating in a structured interview regarding your child’s challenging behaviors related to autism: try to remain focused on the facts surrounding the behavior (before, during and after) instead of your impression of why the behavior occurred.
Pairing with the Child
As another component of the language assessment involved in an Applied Behavior Analysis (ABA)-based autism treatment program, the Board Certified Behavior Analyst (BCBA) and skills trainer will pair themselves with highly motivating reinforcers. This is an important step for both the autism behavioral therapist and the skills trainer in order to earn and maintain instructional control with the child affected by autism. The goal in pairing is to establish a relationship between the autism experts and reinforcing objects so that the child’s perceived value of the autism behavioral therapist and skills trainer increases.
Pairing is a process that could take a few sessions or several weeks, depending on your child and the severity of his or her Autism Spectrum Disorder (ASD). You will know that the pairing is successful when the child sees the autism behavioral therapist or skills trainer and is immediately excited to see them. Experts have determined that a strong paired relationship is a prerequisite to any successful autism behavior program and in establishing the learning relationship between the child and the autism expert.
At Trumpet Behavioral Health our goal at the beginning of the autism intervention program is to develop an encouraging, supportive, and positive relationship with each child. Very often, building a strong bond with the child requires the autism expert to engage in thoughtful observation, positive interactions and, most importantly, give free access to positive reinforcement. During this start-up phase of autism therapy, the autism expert avoids placing demands on the child in order to minimize the possibility of being viewed as aversive. By providing positive reinforcement without contingencies, the autism therapy expert sets the foundation for successful pairing and strengthens the working relationship with the child. Slowly, the child learns to trust the autism behavioral therapist and will allow them to become involved in their environment. Once a bond has been created, the autism therapist will gradually begin to place demands on the child even though the interaction remains very playful.
In the parlance of Dr. B.F. Skinner, the father of behavioral conditioning, helping a child with autism learn to “mand” (request) is the first goal of Verbal Behavior, related to Applied Behavior Analysis (ABA). Accordingly, the autism behavioral therapist will begin contriving situations in which your child wants access to highly motivating reinforcers and finds ways for them to ask for the item or activity. For example, if the autism therapist has noticed that the child loves to spin in a swivel chair, the first mand they work on might be “spin.” By this point, your child has already come to the conclusion that when the autism behavioral therapist is around, great things happen. It’s only natural that your child would want to continue this fun interaction. At this point, being instructed to mand for a highly preferred activity is less likely to evoke challenging behaviors.
Gaining Instructional Control
Before an intervention program can be successful, the behavioral therapist must gain what’s known as instructional control over his or her interaction with your child. Instructional control has been earned once a child with autism becomes motivated enough to allow the skills trainer or consultant to decide on how they will interact. It’s also important for your child to learn how to follow adult-led activities. Experts have observed that the most effective way to obtain instructional control is to help a child with autism understand that he or she will get what they want when they follow directions while using appropriate language and behavior skills. The behavioral therapist can accomplish this by continuing to place more and more demands on the child while keeping reinforcement very high. The goal is to link your child’s cooperation with reinforcers.
“The laws of behavior are almost as certain as the laws of gravity: If you reinforce a behavior, it will go up, and, if you punish or withhold reinforcement after a problem behavior occurs, it will go down” (Barbera, 2007).
To better understand how behavior reinforcement can help a child with Autism Spectrum Disorder (ASD), consider the many daily things that reinforce our own behavior. For example, If you have a job, your employer reinforces your performance at work with a paycheck. Our behaviors are constantly being reinforced (i.e., your boss gives you a raise for a completed project, which possibly motivates you to take on more projects), or put on extinction (i.e., if your boss does not recognize your hard work and overtime, you may put forth less effort), or receiving social disapproval (i.e., loudly tapping your pencil in a meeting at work may cause your supervisors to glare at you, making you more aware of your actions and encouraging you to stop).
Now imagine the challenge a child with Autism Spectrum Disorder (ASD) faces as he or she tries to learn how to communicate needs and wants appropriately while navigating language barriers, inconsistent expectations, and varying responses to behaviors. Children with autism must also decipher how their communication and behavior applies to different situations. For both parents and autism behavior therapists, it can be extremely challenging to find ways to reinforce a child’s positive behaviors while modifying or putting challenging behaviors on extinction. However, the reward comes when they’re able to successfully and consistently implement autism treatment strategies for putting a behavior on extinction.
There is one caveat to keep in mind. Very often after an Applied Behavior Analysis (ABA) treatment program has been started, challenging behavior may actually increase (known as an “extinction burst”) before it is finally extinguished. There is another important factor involved in successfully putting a behavior on extinction: consistency. Both the parents and the therapy team must consistently have the same responses to challenging behaviors, all the time and in all settings. Unfortunately in some cases, all it takes for the behavior to come back (sometimes even stronger) is for a parent or caregiver to give in one time to a screaming tantrum. Accordingly, it’s important to consistently reinforce appropriate behaviors that you’d like to see more of including communication/language, social skills and activities for daily living (e.g., brushing teeth, using the toilet, bathing, washing hands, etc.).
How We Teach
There are many different applications or methodologies being used in the science of Applied Behavior Analysis (ABA) for autism therapy. Some examples include differences in the types of prompting, the ratio of table-time to teaching done in the natural environment, and the presentation of skills. Based on the research by Dr. B.F. Skinner, Trumpet Behavioral Health provides verbal behavior therapy designed to teach language to children with Autism Spectrum Disorders (ASDs). We also use individualized teaching strategies to address the various functions of language (for example, requesting an item versus labeling an item versus identifying various features of an item, etc.). The curriculum is assessed and modified throughout service delivery using tools empirically validated in the verbal behavior literature.