Effectively Using Applied Behavior Analysis Interventions in Home Settings. Prepared by Sheri Kingsdorf, MA, BCBA, CABAS TI, TII, MT

Transcription

1 Effectively Using Applied Behavior Analysis Interventions in Home Settings Prepared by Sheri Kingsdorf, MA, BCBA, CABAS TI, TII, MT

2 What do you think?? That. Effectively Using Applied Behavior Analysis Interventions in Home Settings means??? How do you get this done?.to MUCH PRESSURE?!? How are you a part of this goal? Kingsdorf, Nov

3 It is TOUGH! Getting this job done is hard for all of us even those that have been in the field for a while. Why is that? BEING IN ANOTHER PERSON S HOME IS DIFFICULT! What are some issues that perpetuate this struggle? Kingsdorf, Nov

4 Doing the best you can! YES there are always going to be certain barriers we are up against when providing home services. BUT armed with your arsenal of ABA knowledge you can do a great job! So what do you need in that arsenal? Kingsdorf, Nov

5 Arsenal contents! Sure fire ways to gain instructional control Methods to condition yourself as a reinforcer Ways to make programming fun and better Strategies to build in the action and movement (getting away from the table) Tactics to get the parents on your team, professionally Kingsdorf, Nov

6 What is instructional control? The attention behaviors or attending responses of a client that are needed to teach. (Greer & Ross, 2008) The control of verbal stimuli (verbal instructions/commands) over a listener s behavior (over the behavior of the person listening). (Skinner, 1957) Kingsdorf, Nov

7 Gaining instructional control effectively So how do you do it? What are some things that you do to get this instructional control?? Are reinforcers a part of this? Kingsdorf, Nov

8 Gaining instructional control effectively Find the reinforcers, then: Use those reinforcers effectively!! Pair the reinforcers with you and the teaching environment: Providing these reinforcers contingently for good behavior. When contingently delivering these reinforcers make yourself a big part of them by: Having the child look at you when you deliver the reinforcer (place the reinforcer near your face if needed). Provide animated verbal praise with the reinforcer delivery. Provide touch with the reinforcer delivery if appropriate. Also, be sure to provide the reinforcers in the therapy area; to start making the therapy area a reinforcing place. Kingsdorf, Nov

9 Gaining instructional control effectively Now, add simple instructions to the play. These instructions are usually for things that your client is likely to already want to do. For example: If your client is likely and able to complete an insert puzzle, take control of all the pieces, deliver them to the client discretely with a simple SD (antecedent) like put in. Reinforce this direction following contingently. Also try this with: Opening and closing toy containers. Picking up and putting down items. Kingsdorf, Nov

10 Gaining instructional control effectively Remember to.. Take control of the instructions. This is about anticipating your client s actions before they occur, as an opportunity to gain SD control = having YOUR direction control the action, resulting in YOU delivering reinforcement! For example: If your client is about to stand up, give the direction to stand up BEFORE the behavior occurs, then reinforce it you take control of the behavior! Kingsdorf, Nov

11 Gaining instructional control effectively Continue with the instructions. Since he wants to follow these directions you can easily reinforce this direction following with more fun and reinforcing items. Over time you begin to increase the amount and difficulty of the instructions as your child becomes more willing to work for the reinforcing items and activities you are offering. Kingsdorf, Nov

12 Gaining instructional control effectively If you need to, start with compliance training: Working on the 5 basic compliance (attentional) programs (Greer & Ross, 2008): Running trials on the following programs, before addressing more difficult programs. 1. Sit : The client coming to his chair and sitting within 3 seconds of the command. 2. Sit still : The client sitting still (no movement, feet on floor, bottom on the chair) for progressively longer periods of time before receiving reinforcement. 3. Look at me : The client looking at the therapist when presented with the command for progressively longer periods of time before receiving reinforcement. 4. Do this : The client completing the action following the command do this and the model of the action presented by the therapist. 5. Do this as generalized imitation: As specified in number 4, but with novel actions. Kingsdorf, Nov

13 You had the control- but oh no Getting it back! What are some things that you do now to regain instructional control when you are having a difficult time gaining compliance from your client? Remember to avoid reinforcing inappropriate behaviors! Kingsdorf, Nov

14 You had the control- but oh no How about.. Using behavioral momentum! Have an easily accessible list of fluently mastered SDs (antecedents/directions etc..,that reliably evoke correct responses) at hand Think low response effort Present the commands very quickly to build the behavioral momentum then, throw in the direction that you were initially targeting and was met with noncompliance Kingsdorf, Nov

15 You had the control- but oh no How about.. Using behavioral momentum! Can you see this happening? Let s take a few minutes to set it up! Think of a current client that you have and put a brief list of antecedents together that you can stick in the program book- to get the behavioral momentum going when needed! Let s hear the lists, you may inspire one another. Kingsdorf, Nov

16 You had the control- but oh no How about.. Redirecting your attention to the parents or siblings Showing that your attention is contingent on compliance! But try not to.. Engage in bargaining or negotiations Redirect the child to a more preferred activity Provide more attention rather than less Why not do those things??? Kingsdorf, Nov

17 You = Fun I touched upon this earlier too, but what does it mean to make yourself a conditioned reinforcer?? How is this done?? Kingsdorf, Nov

18 You = Fun Think stimulus-stimulus-pairing! What?? Systematically pairing together you and the client s existing reinforcers You are always the one holding the bag of goodies You always have the good toys near you You hand the client his/her snack You interact with the child during his/her breaks You sing along to your client s favorite songs when they are playing You are the magic that turns on the television or computer Kingsdorf, Nov

19 Capturing incidental teaching opportunities Okay, so you ve got the instructional control down, and the kid is excited to see you coming, now what??? Think about ways to make your teaching even better! Kingsdorf, Nov

20 Capturing incidental teaching opportunities Incidental language training or naturalistic language interventions (Hart & Rogers-warren, 1978; Warren, McQuater, & Rogers-Warren, 1984), emphasize the importance of capturing naturally occurring motivational conditions to obtain optimal teaching and learning opportunities involving language. This is also referred to as Natural Environment Training (Sunberg & Partington, 1998). Kingsdorf, Nov

21 Capturing incidental teaching opportunities Taking advantage of these opportunities not only makes learning more natural, it also decreases behaviors. Think.when an opportunity for an antecedent (SD/direction etc ) occurs, take it and consequate it (provide a consequence for it)! Using your standard reinforcement and correction procedures. Kingsdorf, Nov

22 Capturing incidental teaching opportunities These opportunities lend themselves particularly well to building language. Whenever you see the opportunity to ask another question, relevant to the current situation, take it and consequate it! What are some ways that you could do this, or are doing this, now? Kingsdorf, Nov

23 Capturing incidental teaching opportunities Looking at how to take advantage of these natural learning opportunities: Example scenario: Your client is in the play area, he begins playing with a puzzle, with colored shape pieces. Although he does not have a program in place for responding to questions about colors and shapes at the moment, you take the natural opportunity to provide antecedents like: Pointing to the shape pieces and saying What shape is this? or What color is this shape? Can you please hand me the green triangle? Remove a needed piece from your client s view so that he has to ask (mand) for the piece to complete the puzzle. There are many, many more ways that you could take advantage of this natural learning situation. Just remember to always contingently reinforce or provide a correction for ALL responses. What else could you do? Kingsdorf, Nov

24 Capturing incidental teaching opportunities Looking at how to take advantage of these natural learning opportunities: Example scenario: Your client arrives home from school and shows you a picture he made in art class. Although he does not have a program in place for responding to WH questions, you take the natural opportunity to provide antecedents like: What did you use to make your picture? Who else made a picture in your class? Where do you want to put your picture now? There are many, many more ways that you could take advantage of this natural learning situation. Just remember to always contingently reinforce or provide a correction for ALL responses. What else could you do? Kingsdorf, Nov

25 Capturing incidental teaching opportunities Looking at how to take advantage of these natural learning opportunities: Example scenario: Your client is coloring at the therapy table during a break, but the break time is now ending. Although he does not have a program in place for following directions, you take the natural opportunity to provide antecedents like: Please put your coloring book in the top drawer of your desk. Please hand me your crayons. Please go get the materials for our next program off of the kitchen table. There are many, many more ways that you could take advantage of this natural learning situation. Just remember to always contingently reinforce or provide a correction for ALL responses. What else could you do? Kingsdorf, Nov

26 Capturing incidental teaching opportunities Looking at how to take advantage of these natural learning opportunities: Example scenario: Your client has just returned from a bathroom break and is returning to the table to start working again. Although he does not have a program in place for following directions, you take the natural opportunity to provide antecedents like: Close the door. Sit down. Present materials, Open the bag. There are many, many more ways that you could take advantage of this natural learning situation. Just remember to always contingently reinforce or provide a correction for ALL responses. What else could you do? Kingsdorf, Nov

27 Capturing incidental teaching opportunities REMEMBER!!! The more learning that occurs the better = the more opportunities that you capture the better!! Why? Presenting constant antecedents that are contingently reinforced or corrected helps build and maintain instructional control. These natural learning opportunities, while they are not about current targets, but expansion, can still help with generalization. Kingsdorf, Nov

28 Making instruction more naturalistic Capturing the natural learning opportunities like we just discussed works to make instruction more naturalistic. But what else can be done to facilitate naturalistic teaching for current targets? Ideas?? Kingsdorf, Nov

29 Making instruction more naturalistic Naturalistic instruction is about incorporating programming into the natural environment; making playtimes, and transitions about running programs too. For example: Determining how to run your colors program in the play area using blocks and cars, while delivering the necessary antecedents and consequences for that program, and collecting data. Kingsdorf, Nov

30 Making instruction more naturalistic How are your sessions normally run? How are your programs normally targeted? Considering these pieces, and the incorporation of naturalistic instruction, how can you change the way a current program is run? Take a minute to walk through this Kingsdorf, Nov

31 Get moving with multiple exemplars! While we are on this path of making every moment a learning opportunity and providing the best instruction possible, let s take a look at using multiple exemplars. Guesses on what multiple exemplars are?? Kingsdorf, Nov

32 Get moving with multiple exemplars! Multiple exemplars: Think lots of examples of stimuli! When you are teaching the child to identify a cup you are not using 3 picture cards of a cup. You are using LOTS of different real cups, and as many novel pictures of cups as possible. When you are teaching sight words you are targeting the words in different books, written on different types of paper, and in different fonts and colors. Kingsdorf, Nov

33 Get moving with multiple exemplars! Using multiple exemplars of stimuli: Targeting 2D and 3D stimuli simultaneously Presenting novel stimuli as much as possible I.e., in a program targeting labeling (tacting) dog, the stimuli of dog are presented using a 3D dog figurine, the client s real dog that is present in the house, different 2D pictures of dog that are randomly generated in a Google images search, pictures of dogs in assorted story books, etc These are all targeted at the same time if possible. This actually programs in generalization from the start! Kingsdorf, Nov

34 Get moving with multiple exemplars! Making multiple exemplars part of multiple exemplar instruction.. Using different SDs for the same targets. I.e., when teaching responses to questions (intraverbals) target randomly rotating the SDs Why do we go to the doctor s? and Where do we go when we are sick? at the same time. I.e., teach the receptive (point to) and expressive (tact) response for the letter A by randomly rotating the 2 corresponding SDs at the same time. Kingsdorf, Nov

35 Get moving with multiple exemplars! Making multiple exemplars part of multiple exemplar instruction.. Some response types for rotation include: Point, label/tact, and match responses for vocal verbal behavior programs (expressive and receptive language). Production (i.e., composing or spelling) and selection (i.e., circling or underlining). Topographically dissimilar production responses such as writing, vocal spelling, and reading (textually responding). Topographically dissimilar selection responses such as pointing and matching. Kingsdorf, Nov

36 Generalization So many of the pieces discussed thus far are addressing generalization. Remember generalization is essentially about your programming working across different settings, people, and targets, etc But the way that this happens is by making sure that we program for generalization from the start. Kingsdorf, Nov

37 Generalization Making instruction natural helps with this. How? Using multiple exemplars helps with this. How? A client that does not generalize really means a client whose programming needs adjusting. Kingsdorf, Nov

38 Bringing some of these pieces together Let s bring together some of the pieces that we have discussed to see their impact on a session: Capturing natural learning opportunities, not targeted in current programming Naturalistic teaching for current programming Using multiple exemplars Kingsdorf, Nov

39 Bringing some of these pieces together Pick a current client/case that you are working on. Then, on a piece of paper write out the following: Some background information on the client (age, level of functioning, types of programs he/she is working on, common reinforcers, typical session structure) Two specific programs that the client has, names and current targets of those programs Two specific ways (for each program) to run these programs in more natural ways Two specific ways (for each program) that natural learning opportunities can be captured that are not part of the current programs (expanding the programs essentially) Kingsdorf, Nov

40 Bringing some of these pieces together We will go around the group and share what everyone has written. Please feel free to contribute additional ideas to one another. Kingsdorf, Nov

41 Now that these pieces are all good Even when all of your ABA sessions are running perfectly.. You have the aberrant, or bad, behaviors under control, and you are teaching lots of new and better ones What happens after your sessions end? Yes we work on generalization so that the ABA will continue, but what is really key here? Kingsdorf, Nov

42 Getting the parents involved! ABA can only work the way that it should for these kids if the interventions are long lasting and consistent. That equals PARENTS! So how involved are parents right now? What are your feelings on this? Kingsdorf, Nov

43 Getting the parents involved! Really getting the parents involved means taking the steps to incorporate them into your programming..scheduling them into your sessions essentially. Inviting them to play games that are being targeted Modeling great ABA behavior in front of them Providing them with positive reinforcement for their good behavior Having them be the communicative partner when working with PECS or on other communication based programs Kingsdorf, Nov

44 Getting the parents involved! Thinking about making this practical Again looking at the programs that you selected and wrote about previously (or you are welcome to select two new programs if you d like). Think about how you can specifically incorporate the parents/caregivers/siblings into these programs. Kingsdorf, Nov

45 Getting the parents involved! Thinking about making this practical Remember to include: How you will initially get parents involved (approach them for their involvement). How you will instruct the parents on how to be involved and maintain the integrity of the ABA programming. How you will provide feedback to the parents during their participation. How you will make suggestions to the parents on ways to maintain their ABA behavior after you leave. Kingsdorf, Nov

46 Getting the parents involved! Thinking about making this practical After you have written these pieces and we discuss them, let s try role playing a little! You ll need: A therapist A client A parent/caregiver/sibling Information on the programming you are running Kingsdorf, Nov

47 But remember boundaries Although we do want the parents to be a vital part of the sessions, we have to remember to keep the boundaries in place. Keep all talk during sessions light and limited to the child. Avoid personal conversations. Avoid spending any extra time, before or after your scheduled session time there. Kingsdorf, Nov

48 Keeping it professional! Avoid situations that may result in conflicts of interest: This can occur when you have a vested interest in the outcome of the child s program Direct and frequent interactions with the family puts you in close contact with the client and family members in natural settings Be careful not to develop personal relationships that cross professional boundaries Kingsdorf, Nov

49 References Cooper, J. O., Heron, T. E., & Heward, W. L. (2007). Applied behavior analysis. Upper Saddle River, NJ: Pearson. Greer, R.D., & Ross, D. E. (2008). Verbal behavior analysis. Boston, MA: Pearson Education. Hart, B. M., & Rogers-Warren, A. (1978). A milieu approach to teaching language. In R. Schiefelbusch (Ed.), Language intervention strategies (pp ). Baltimore: University Press Park. Schramm, R. (2007). Educate Towards Recovery: Turning the Tables on Autism. Lulu Publishers. Kingsdorf, Nov

50 References Skinner, B. F. (1957, 1992). Verbal Behavior. Acton, MA: Copley Publishing Group and the B.F. Skinner Foundation. Sunberg, M.L, & Partington, J. W. (1998). Teaching language to children with autism and other developmental disabilities. Pleasant Hill, CA: Behavior Analysts. Warren, S.F., McQuarter, R.J., & Rogers-Warren, A. K. (1984). The effects of mands and models on the speech of unresponsive language delayed preschool children. Journal of Speech and Hearing Disorders, 49, Kingsdorf, Nov