Welcome to the Mariposa Autism Service Center.

Take Home Points

What is Autism? Defined by behavioral deficits and excesses:  Lack of verbal skills or limited expressive communication  Lack of socialization or limited play skills  Excessive repetitive behaviors (stereotypy)

Principles of Behavior  You cannot change behavior without changing the immediate environment.  Behavior is shaped by consequences.  Positive consequences are more effective in shaping behavior than use of negative consequences.

Autism Spectrum Disorders (ASD)

 Complex developmental disability.  Appears within the first 3 years of life.  Affects different areas of the child’s development.

CDC – 1:110 Incidence of autism is consistent around the globe; it is 4 times more prevalent in boys than girls. Statistics

Because the Autism Spectrum Disorder is only identifiable by certain behaviors, we cannot understand autism without understanding the lawfulness of behavior. Looking at Behavior

Applied Behavior Analysis (ABA)

 ABA is a science whose methods and procedures are validated by experimental research.  ABA uses behavioral methods to measure behavior, teach functional skills, and evaluate progress.  ABA individualizes programs based on the learner’s skill set.

Why ABA? ABA is observable. ABA is empirical. ABA is replicable.

Components of ABA  Behavioral Definition  Direct Observation Assessments (Baseline) Interventions (Treatment)  Visual Analysis

ABA has been proven to be the most effective discipline in improving communication, social interaction, cognitive skills, self- help skills, and reducing inappropriate behaviors of children diagnosed with autism and other developmental disabilities.

Who should oversee an ABA program and why?

 Board Certified Behavior Analysts (BCBAs) are obligated to maintain professional ethics.  The professional code requires BCBAs to promote the health and welfare of their clients and to promote effective services.  BCBAs use techniques that are scientifically valid.

Behavioral Concerns within the Autism Spectrum  Language  Social  Stereotypy  Problem Behaviors  Functions of BX  ABC

There are only three trends in behavior:

 Behavior can increase.  Behavior can decrease.  Behavior can stay the same. The rate of a behavior is determined by its consequences.

Behavior is maintained by either positive or negative reinforcement.

That is, our behavior allows us to get/obtain something we want or allows us to avoid/ escape something undesirable.

Reinforcement?  Positive Reinforcement (+)  Negative Reinforcement (–)  The consequence following a behavior either adds something to our environment, or removes something from the environment.

Types of Positive Reinforcement

 Presentation of a stimulus after a behavior and the behavior continues or reoccurs.  May be access to a desired tangible.  May be access to attention from another person.  Maybe it is automatic.

Access to Tangibles  You put away candy that your child was eating.  Your child begins to pull your pant leg.  You turn around to prompt him to stop as you continue cooking.  With your back turned, your child opens different cabinets and starts crying.  You feel discouraged and tell yourself all you can do is give him back the candy he was eating although it is time to have lunch.

Access to Attention A child is in a crowded day care facility. There are 14 children and only 2 adults. The children who are quiet and follow the rules get ignored and the children who scream, cry, throw toys get yelled at...

Automatic Reinforcement This is not delivered by anyone else. The person receives some sort of sensory input by engaging in a particular behavior. Examples: rubbing your head when you think, twirling your hair, humming, clicking a pen…

Making positive reinforcement more effective: Remember DISC  Deprivation  Immediacy  Size  Contingencies

Deprivation  How long has it been since the child last had access to this type of reinforcer?  The more you get it, the less you want it.  If you become satiated, you will not work as hard to gain access to this reinforcer.

Immediacy  How quickly do you gain access to your reinforcer following the behavior?  Children earn gold stars after every assignment, and access to the treasure chest at the end of the week.  Adults get paid twice a month or once a month.

Size  What is your behavior worth?  Does your child earn an allowance?  If you did a special project at work, how hard would you work for special recognition? The front parking spot? A certificate? A gift card to the movies? A cash bonus?

Contingencies  This is the relationship between a target behavior and a specific reinforcer.  How do you earn access to the reinforcer?

Quiz Mother is busy in the kitchen, when her son throws a toy across the room at the television. Mom comes in and plays with her son. What kind of reinforcement is this?

Answer Child is seeking attention from his mother so he has learned to get her attention by throwing a toy. This behavior has been positively reinforced because it leads to what the child wants, which is getting attention.

Negative Reinforcement Who remembers what negative means in behavior analysis? –Something undesirable is removed after a behavior occurs and the behavior continues or reoccurs. –Terminates or avoids an unwanted activity or interaction with another person.

Your child may engage in inappropriate behaviors when he/she does not have the appropriate way to tell you that he/she does not want to do something. Inappropriate Behavior that Allows Escape

Automatic Negative Reinforcement This is not delivered by anyone else. The person receives some sort of sensory input by engaging in a particular behavior. Examples: scratching a bug bite, chewing off finger nails, popping zits

Example of Negative Reinforcement A wife nags her husband to do the dishes, when he complies, the nagging stops. –the removal of the nagging is what strengthens the compliance. A child is given math problems at his desk, he pushes the material off his desk and yells. He is sent out of the room. –the removal of the material is what strengthens the behavior to occur, because it removes something that is undesirable.

Punishment Is NOT Advised  Just as in a reinforcement procedure, punishment can be positive or negative.  Punishment is less effective in long lasting behavioral changes  Other ways to manage behavior  Teach incompatible replacement behaviors that CAN BE REINFORCED

Punishment Disadvantages  Emotional response  Escape/avoidance  Aggression  Modeling  Perpetuation of punishment (continued use even when ineffective)  No establishment of alternate behavior  Punishment is reinforcing. (It negatively reinforces the punisher’s behavior.)

How to reduce behavior without punishment:

 Change the contingencies in the environment.  Rearrange the behavior/ consequence relationship.  If a person’s behavior has a history of gaining access to a certain reinforcer, you can eliminate that reinforcer, or require new behaviors to obtain the same reinforcer. This is known as Extinction!

Extinction:  Technique used to reduce the occurrence of undesired behavior.  Refers to stopping a reinforcing event that follows a behavior, resulting in a decrease in the behavior.  When an extinction procedure is used, the behavior may initially and temporarily increase or become more severe – the person will try harder to gain access to the desired reinforcer.  This is known as an Extinction Burst.

Game Time! We need a volunteer.

Goal The goal is to motivate the person using a variety of strategies and positive reinforcement to ensure sessions are enjoyable and productive. We want the learner to achieve highest level of independence.

Language and Communication Communication: Expressing needs to others.

 Children learn to communicate from an early age  Early communication is non-verbal.  Non-verbal communication includes pointing, reaching, leading, showing, smiling, making eye contact, crying and laughing.

Language and Communication Positive Reinforcement: if a newborn gets food and attention when she cries, she will learn to communicate her needs by crying. Negative Reinforcement: if a newborn gets a diaper change when she cries, she will learn to communicate her needs by crying

Language and Communication Reasons children communicate: Requesting: child wants an item or action. Commenting: child is telling you about something. Asking questions: child might want access to information. Social interaction: child wants attention.

Language and Communication As children grow, they learn verbal communication: babbling, making sounds, using words, combining words with gestures, and short phrases. This is shaping a small prerequisite behavior into a much more difficult and complex skill.

Language and Communication  Skills for children to learn to talk:  Observing  Imitating others  Listening  Repeating what they hear

Language and Communication  Delays in verbal communication:  Non verbal behaviors may continue  Inappropriate behaviors may develop  Example: a child may continue crying or start throwing tantrums to get what he/she needs. It is important to teach children an appropriate way of communication.

Language and Communication  Eye contact or smiling can initiate interactions and start communication.  We share, engage others and take turns; we try to make the other person feel successful so they will engage in communication with us the next time there is an opportunity to do so.

Play Skills

 Children learn and develop important skills through play.  Play can be used to promote cognitive, physical, and communication skills.  Example: Playing with toys with buttons teaches children that their actions (e.g., pushing a button) have an effect (e.g., producing sounds or movements.) In this case, children learn the concept of cause and effect.

Play Skills  Delay in play skills may result in a delay in the development of important behaviors.  It may necessary to teach children how to play.  To learn to play, the child has to be able to imitate the actions of others.

Self-Help Skills

 Developing self-help skills (e.g., using a spoon to feed, taking off shoes, bathing) promotes self-esteem and independence.  When children become more interested in activities they are more likely to continue independently.  Social praise and positive reinforcement is very important in developing self-help skills.

Motor Skills  Gross motor milestones within the first year: sitting, crawling, standing, walking.  Fine motor skills develop in early years : small muscle movements  For instance, eye-hand coordination is used to pick up items or hold onto toys.  If delayed in these areas, it can affect cognitive, play, and social/emotional skills.

Problem Behavior

Causes of Problem Behavior 1.Receive attention, as when a child works to be the best in his/her class. 2.Receive access to objects or things (tangibles), as when a child says “cookie” to get a snack. 3.Escape or avoid negative events as when the child says “no” if mom says “let’s take a bath.” 4.Receive internal stimulation (as when the child sucks his/her thumb).

Inappropriate Behavior Sometimes children have difficulties using appropriate behavior (for instance, appropriate communication) to obtain attention, tangibles, and escape from requests by complying. Children sometimes learn that it can be more effective to use inappropriate behavior to get what they want.

Causes of Problem Behavior In order to eliminate a behavior it is necessary to know the cause of the problem behavior or its function. To identify the function is not always easy…

How do we find the function of a behavior?

We need to know:  What happens before the behavior (antecedents).  The specific behavior that occurs.  What happens after the behavior (consequences). This is called the ABC (antecedent, behavior, consequence) analysis.

ABC Form  Parents can easily track behavior  Analyze the environment that produces behavior  Determine the possible function(s) of a behavior

ABC Analysis AntecedentBehaviorConsequence

ABC Analysis Antecedent Mom on the phone. Child playing by himself. Has some difficulty with one of the pieces. Behavior Child whines. Consequence Mother helps Child with the puzzle.

ABC Analysis  The next time the child needs help, what is he likely to do to get the help?  Whining has been reinforced: the child knows that he needs to whine in order to get help and he will whine every time he needs to obtain something that he wants…  The ABC analysis has told us that the inappropriate behavior is maintained by access to tangibles (the puzzle).

Quick Quiz Describe the components of the ABC analysis. Why is the ABC analysis important? What does the ABC analysis tell me?

Self-stimulation (stereotypy) The child may engage in inappropriate behaviors that may provide him/her with automatic reinforcement. For instance, he/she scratches his/her skin because of how it feels. When you do not see that the inappropriate behavior occurs in order to get attention, tangibles or to escape, then the behavior may be maintained by automatic reinforcement.

Functions of Behavior When we know the function of an inappropriate behavior we are ready to start an intervention. The following section explains the behavioral strategies to reduce inappropriate behavior and to increase appropriate behavior.

Behavioral Strategies  When we know the function of inappropriate behaviors, we can begin intervention strategies.  There are numerous strategies you can use to correct inappropriate behavior.

Behavioral Strategies: Important Considerations  Collect data on inappropriate behavior.  Decide what you would like your child to do in place of the inappropriate behavior.  The replacement has to serve the same function as the inappropriate behavior.  Provide opportunities for the replacement and reinforce the use of replacement behavior.

Selecting Alternative Behaviors

Talking back: Positive response such as “ok” or “yes” or “I have a question.” Being off-task: Any on-task behavior such as looking at a book, writing, looking at a teacher. Talking out: Raising hand and waiting quietly. Hitting, pinching, kicking, pushing: Using verbal expression of anger. Inappropriate use of materials: Holding materials appropriately.

Behavioral Strategies  The following slides will show you how to intervene for different inappropriate behaviors.  We are going to use the examples of inappropriate behaviors that are maintained by getting attention, tangibles, automatic reinforcement and escape.

Antecedent Interventions State what you want your child to do (walk in store and get three items). Modify which aisle you choose to walk through. Engage your child in the process of shopping (have him put items into cart or count the items). Set up a daily schedule where you spend a certain amount of time playing (e.g., one hour). Verbal and physical distraction. Tell, show, guide (prompt).

Consequence Interventions Reinforce him with praise for helping you. If appropriate behavior in store, offer him a choice of candy. Use extinction for attention seeking behaviors, And use redirection (from verbal to full physical prompts), and never withdraw the demand when the behavior is being exhibited to avoid or escape a demand.

Now what?  Now you have some tools.  Helping your child learn behavior requires you to change your behavior first.  How do you change your own behavior?

We offer 1:1 Sessions –Objective assessment of skills –Behavioral plan developed –Individualized 1:1 intervention at home or in the community –Data! Data! Data! –Analysis of progress –Progression of programs

Other in-home services that we offer Functional Behavior Assessment Parent Training Classes –We will be offering a series of educational classes for parents. This will be an 8 week course – 2 hours a week (16 total hours) Team meetings – collaboration with teachers, occupational therapists and speech therapists

Thank You! Autism is a growing epidemic, and the more awareness we have as a community, then we can better advocate for necessary services to help individualism with a diagnosis. Your time and attention are appreciated.

Questions?