Type of Treatment

Behavior Analysis is the study of behavior using scientific methodology. Research on behavior is published in professional journals, and is held to the high standards fundamental to all scientific disciplines.

ABA is Applied Behavior Analysis. Taking the principles learned through the research and using them to change behavior to a socially significant extent is ABA treatment.

The U.S. Surgeon General’s Report on Mental Health (1999) states that ABA is the only documented treatment intervention to be demonstrated through controlled research to increase communication, learning, and appropriate social behavior for individuals with autism.

Basic Practices In The BTTC Day Treatment Program

There is no standard ABA program. ABA is not a specific teaching methodology.  Behavior Analysis is the scientific study of behavior.  Applied Behavior Analysis is the clinical application of the principles of behavior established from research.  A program is an ABA program if it utilizes the principles of the research of behavior analysis and it is supervised by a trained Behavior Analyst. ABA is a science of behavior managed by trained professionals; not just a list of cook book techniques that anyone can implement.

Through our years of practical experience we have developed some basic approaches to behavior that we routinely implement with the students of the BTTC Day Treatment program unless their individual assessment indicates different procedures would be more effective.

This is just an overview of the basic practices. For more information please talk with either Kelly or Christie.

1. Prompting Sequence

Explanation: When an adult gives a directive to a child the child should respond by performing the task. The adult should only have to tell the child one time. Often children have a history of not attending to adults because the adult typically repeats themselves over and over and there’s no real consequence for not following directions, except maybe the adult gets louder. The consistent application of the prompting sequence across all settings teaches children to listen when adults speak to them and that they will be reinforced for following directions.

Procedure for motor tasks:

Initial instruction: Given clearly, without extra words, when the child is attending. The instructor is in position to provide additional prompts if necessary or to praise/reinforce for compliance. The instruction is given only once and not repeated again in the prompting sequence. Wait only 3-5 seconds for an initiation of a response before moving to the next prompt level.

Verbal prompt: This is not a repeat of the initial instruction but a more specific directive. For example the instruction may have been to “brush your teeth” and the additional verbal prompt could be “get your toothbrush out.” Wait only 3-5 seconds for an initiation of a response before moving to the next prompt level.

Gestural prompt: The adult silently makes a gesture toward the direction the child needs to move, or toward the object he needs to manipulate. The instructor does not touch the child at this level of prompt. Wait only 3-5 seconds for an initiation of a response before moving to the next prompt level.

Physical prompt: The adult silently touches the child to get them started moving in the correct direction to comply with the directive. The adult lets go right away to see if the child will go ahead and comply. Wait only 3-5 seconds for an initiation of a response before moving to the next prompt level.

Total physical prompt: The adult gently and quietly guides the child physically through the correct response. This is not a punishing experience but simply helping the child comply with the directive so they can access reinforcement.

The prompting sequence for language responses includes:

Verbal prompt: giving the initial sound of the word
Tact prompt: showing the item or picture of the item
Echoic prompt: saying the word for the student to repeat
Directive: telling the student what to say

Prompting language requires that the instructor understand the different forms of language as they were defined by B.F. Skinner.

2. Rapid Rotating Trials

Explanation: Research has shown that special needs children often respond slowly because we teach them slowly. Our own experience has shown that repeating the same directive several times in a row to a child leads to boredom and slow responding. Traditionally there is difficulty in getting the special needs child to pay attention to the actual directive (I said “give me” not “touch”, or I said “what color is it” not “what is it”). Rapid rotating trials keeps the learning environment fun and teaches the child to pay close attention because they don’t know what the next directive is going to be. By alternating directives for tasks that are fun or not so difficult for a student with the more challenging directives, we get a lot better effort from the student.

Procedure: Rotate between different training objectives, keeping the training pace quick and lively. We are careful to actually be rotating between objectives in different skill categories and not just varying the objective within the same skill category. For example we would offer a fine motor task, followed by an expressive language task, followed by a gross motor task, followed by a receptive language task, followed by a social skill, followed by a fine motor task, etc. It is not rapid rotation when you offer different pictures and objects but the task is still expressive language.

3. Differential Reinforcement

Explanation: Research has shown that all people will spend their time engaged in the activities for which they get the greatest reinforcement. Therefore I come to work on days when I would rather go to the library and read quietly (I can go to the library but I won’t get paid). Often a child’s history is that there has not been clear differential reinforcement of appropriate behaviors. If the consequence is the same whether the child performs the task quietly or while screaming and slamming the training materials on the table, then they may have no motivation to perform appropriately. When parents say sometimes he does this and sometimes he won’t, we always ask and what different (better) happens when they do it? Too often there is not difference in the consequence and the child has not had the opportunity to learn which behavior has the greatest reinforcer pay-off.

Procedures: When two behaviors occur, one is reinforced while the other behavior receives no reinforcement or a lesser reinforcer. For example if the student is throwing a toy, that response gets no attention or reinforcer, but if they roll the toy on the table they get attention and reinforcers. If attention and the reinforcer being used are in fact reinforcing, then the student will spend their time engaged in rolling the toy and not throwing the toy. Another example, if the student says the word clearly they earn an edible reinforcer with verbal praise, if they mumble it unclearly (and they can say it clearly) they receive verbal praise only.

4. Language Training

Explanation: Communication is built on several distinct skills. B.F. Skinner defined the different skills and under what conditions they are taught. He demonstrated that there is no reason to believe learning one skill will necessarily lead to being able to do the other skills. It is often necessary to teach each skill, which we then put together to allow overall communication. We specifically teach the mand initially (requesting something you want). A tact is learning to say a word (or sign it) when shown the item or a picture of the item. An intraverbal is when something is said in response to another person talking (I say “how are you?” and you respond “I am fine”).

Procedures: Language training is on-going throughout all activities. We are always looking for opportunities to prompt language. We prompt the correct response, but accept approximations initially (using shaping). We work hard at setting up language opportunities by not giving the child all of everything he needs, or blocking his access to something he wants so he is motivated to ask for it using his language.

5. Shadowing

Explanation: We do not want the children to become dependent on a one on one staff person who follows them around and interprets the world for them. The intent is for the children to learn to respond correctly to events occurring in their environment.

Procedures: There are many activities during which we don’t want the child attending to their one on one staff. For example during a game with another student, the focus should be on the other student, not looking at the trainer for prompts. Also during any group training activities where one staff is the designated “leader”, the student should get their direction and reinforcers from the leader and not from their one on one. The one on one trainer needs to know when to step back into the shadow role and provide only gestural and physical prompts from behind.

6. Don’t let errors get chained in

Explanation: Once an error is made, it is more likely to be made again in the future. It is best to teach with an errorless method, but occasionally a student is faster at getting a response in than we can block and an error occurs. If an error correction is not conducted immediately to get the correct response, then every time the child is presented with that request or activity they will include the incorrect response. This happens often when people just correct the incorrect response instead of starting over. For example if I hold up a red and green card and ask the student to point to the red and he points go green, if I say “no the red” and he switches to pointing to the red and I reinforce him then he doesn’t really get a chance to learn the correct response to the directive “point to the red.” That directive to him means touch all the cards and at some point the teacher will give you a reinforcer.

Procedure: When a student makes an error the response is stopped immediately without comment. The student is returned to the original position when the directive was given and the directive is repeated. This time the staff shadow and prompt the correct response so it is completed without an error in the middle of it. This would be true also for following a directive such as “go stand by the door.” If in response to this directive the student crawled under the table and ran around in circles, the BTTC staff would without emotion physically redirect him back to his chair, give the directive again and this time physically guide him to walk directly to the door where he could be reinforced. Now he had the opportunity to learn what “go stand by the door” means. End the trial and start over again with a new presentation of the Sd and this time be certain that an error doesn’t get inserted before the correct response. We often will separate trials with some simple motor imitations before reintroducing the Sd.

7. Regain the student’s attention

Explanation: Often trying to get a student’s attention by telling them to pay attention or to look at you can lead to challenging behaviors, probably because it doesn’t sound like much fun. On the other hand when a child has been taught that looking at someone and imitating their behavior gains a specific reinforcer, you can often gain a child’s attention by just say “do this” while engaging in some simple motor activity. We have experienced that this is an excellent way to get many children back on task in a pleasant manner.

Procedure: We start by doing many trials of imitation reinforcement so that “do this” becomes an Sd for easy reinforcement. We call this little chain of responses a compliance sequence. Then when we need to use it to regain attention we differentially reinforce by praising compliance with the compliance sequence but hold out the more powerful reinforcer for a repeat of the original directive.

Of course it doesn’t work for all students, but when we first meet children this is the procedure we use until we have a better procedure for them individually.

8. Data documentation

Explanation: Direct observation data is the way we determine whether or not our teaching procedures are being effective. It is not necessary to document data on every single trial conducted, but it is important to have a systematic data collection system to keep a measurement of progress.

Procedure: The basic codes used on the data sheets are as follows, but some students will have individualized data sheets with some modifications specific to their responding:

SI = self-initiated

V = verbal prompt (for a verbal response if the beginning sound is made to get the student started, a V would be recorded)

G = gestural prompt (for a verbal response if an item or picture is held up for the individual to tact then it would be counted as a G response)

P = partial physical prompt (for a verbal response if the student echoes the correct response a P is recorded)

TP = total hand over hand

0 = never could get an appropriate response

9. Attend to the behavior you want and not the behavior you don’t want

Explanation: Research shows that giving any attention to a behavior may be enough to maintain the behavior for some individuals. Children are often particularly sensitive to adult one on one attention. It’s a simple matter of differential reinforcement; we want to be certain that the inappropriate behavior is not the way to gain the most or best reinforcement.

Procedure: We give our verbal attention to appropriate behaviors. If we need to correct a behavior we give a directive for a competing appropriate response that we can then reinforce. Instead of saying “stop kicking the chair” we say “put your feet flat” and they we can prompt the correct response and reinforce following directions. Instead of saying “leave that alone” say “do this” and clasp your hands, and then reinforce good imitation.

10. Don’t let inappropriate behavior be the way to get a prompt

Explanation: Individuals will develop chains of behaviors that lead to reinforcement. It is often true that the earlier responses in the chain actually don’t have anything to do with accessing the reinforcer at all but if we have experienced doing several responses and then getting reinforced we may think that all those responses were important and continue to exhibit them. For example I soothingly carress my old car’s steering wheel and whisper sweet nothings to it and then I gently turn the key in the ignition and it starts. Probably the sweet nothings and carrassing has nothing to do with the car starting – I would guess it has everything to do with turning the key in the ignition, but I wouldn’t dream of attempting to start it without the entire chain just in case. What often happens with our special needs children is they will start to tantrum or display an inappropriate behavior or scream and an adult will come immediately to them and prompt them “use your words, what do you want?” Then when the child says “toy” or whatever, the adult praises them and gives them the item they wanted (or takes away what they did not want). The problem is from the child’s point of view when they want something they believe they are suppose to act out to get the adult’s attention and then the adult will tell them what they are suppose to do to get the item/activity they want. The adult is accidentally reinforcing a chain that includes inappropriate behavior in it.

Procedure: We are careful to provide prompts before the student starts to exhibit an inappropriate behavior. For example if he starts to pucker up his face with frustration you can quickly say “what do you want? Help?” and then reinforce the appropriate response. But if you wait until he starts to cry or scream or throw things, then it is too late to ask “what do you want?” If you prompt him to use his words then, he just learns that the way to get you to prompt him into the correct response is to act inappropriately.

11. Errorless Learning

Explanation: Research shows that learning through your mistakes is not actually the best way to learn. In fact, making errors while trying to learn how to do a difficult task will often lead to frustration, anger, and giving up even if someone is sitting there saying “nice try, try again.” Once an error is made, then it is easier to emit the same error in the future. Catching a response before an error is made and prompting through the correct response results in rapid acquisition and a pleasant learning environment.

Procedure: We want the students to be very successful in every response and to access as many reinforcers as possible, therefore we conduct training for new skills using the errorless learning methods described in the literature. We provide prompts necessary to get the correct response before the student gets a chance to make an incorrect response, fading the prompts at each trial.