Many times when I am working with a family their child is involved in multiple therapies, both across home and school.

These other therapies can include speech therapy, occupational therapy, social skills playgroups,  psychotherapy or counseling, physical therapy, and many more. Not to mention the multiple teachers and paraprofessionals at school that work with my client daily. Sometimes  I get the opportunity to meet and connect with the various professionals, and sometimes I do not. When I do get the chance I always am grateful for it. It is always beneficial to talk to other professionals who work with your client and have a different perspective from you.

When I meet with these professionals they usually ask me questions about problem behavior, learning motivation, and coping skills. Typically the related professionals want a kind of mini-crash course in ABA strategies to better work with the client.

If you serve Autistic clients as a therapist, teacher, nanny, baby sitter, etc., I hope you find this post helpful. These are simple ABA tips to know and be aware of so you can better understand behavior management.

Understand the ABC's of behavior. This is your "detective tool kit" to methodically locate the function of any behavior. A=antecedent, B=behavior, and C=consequence. The antecedent means "what happened before the behavior", and the consequence means "what happened after the behavior". For example, if every time you arrive at the house to begin a session (antecedent), the child begins to cry and run away from you (behavior), and you then spend several minutes chasing the child through the house to have them begin working (consequence), then it is very likely the function of the behavior is escape from demand. To correct the behavior, you would find a new behavior that serves the same purpose. 

Learn what incompatible behaviors are, and use them. An incompatible behavior is simply a behavior that the child cannot do at the same time as the target behavior. For example, if you are working with a child at a table and the child  knocks the materials onto the floor a simple incompatible behavior is to have the child place their hands in their lap when you are putting out stimuli. This provides no opportunity to knock things onto the floor.

Consistency! Being inconsistent in your reactions to the child's behaviors is equivalent to intermittent reinforcement. By "sometimes" being firm, and "sometimes" letting things go, you are intermittently reinforcing the behavior which will cause it to increase. 

Understand reinforcement. Reinforcement is a way to increase behaviors you want to see again. If the child does something appropriate, give them a smile, hug, high five, tickle, etc.  Reinforcement is a powerful way to shape behavior and also has the added benefit of making the child more interested in spending time with you. Over time you will become reinforcing to the child because in the past you have delivered reinforcement.

Finish out instructional demands. Do not give demands that you are not prepared to prompt if necessary. If the child is across the room playing don't shout out to them "Come sit down" unless you are able to go and assist them with sitting if they do not respond. 

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Tameika Meadows, BCBA, Blog Author

I had a supervision session yesterday with a new hire, that made me think of a topic for a blog post: Prompting!

Prompting in ABA is a method or tool used to move the learner from incorrect responding to correct responding. When done correctly, prompting increases the rate of responding, lowers frustration, and helps the individual learn more efficiently.
If I know you don't know how to bake a pie, I wouldn't say to you: "Make me a cherry pie" and then just stand back and watch you struggle. Practicing errors impedes learning. I would step in to provide you with prompting and guidance as much as you needed, in order to help you be successful.

There are many ways you can prompt:

Hierarchy

(Some prompts will be much more intrusive than other prompts. This is not an exhaustive list of ALL possible prompts. it is simply a way to understand types of prompting)

• Physical - Hand over Hand (HOH), leading a child by the hand, or physically moving a child
•  Verbal - Can be partial verbal or full verbal
•  Model - Demonstrating for the child what you want them to do
•  Gestural - Gesturing, pointing, making a non verbal motion to show the child what to do (*note: don’t combine with words, that’s actually 2 prompts) 
•  Visual - Larger stimuli, brightly colored stimuli
•  Spatial (proximity) - Putting the correct choice nearer to the child than the incorrect choice
•  Sequential (order in which things are presented) - Working on easy tasks first and building up to difficult tasks
•  Textual (written) - Writing out the steps of the task
•  Tactile - Using the actual stimuli as a prompt/reminder, such as placing a briefcase by the front door so you don’t forget it the next day

To increase prompting to improve learning, move UP the prompting hierarchy (from least to most intrusive).  To fade out prompts and prevent prompt dependency move DOWN the prompting hierarchy (from most to least). Generally, the most to least prompting hierarchy would be: Full physical, partial physical, full vocal, partial vocal, modeling, gestural. *This is a general guideline, and is leaving out many other types or prompts

During a therapy session you will use many different types of prompts at different times, usually when teaching a brand  new skill. The client shouldn't need much prompting for a known skill. If they do you may want to examine your teaching procedure and also make sure the client has the prerequisite skills needed for the current target.


The therapist I supervised yesterday was making a common error that can happen with new therapists and also with parents. She was over -prompting and then reinforcing those prompted responses.
I brought this to the therapists attention who was completely unaware of her error. She asked me, "How do I know if something I am doing is a prompt?"  There is an easy way to determine this. Ask yourself, "If I remove this step, would the client still be able to do the task?" If the answer is no then you are over -prompting and need to remember to fade prompts as rapidly as possible.


Something I used to do as a new therapist was arrange learning materials with the correct item closest to the client. There was no particular reason I did this other than a bad habit that went on for too long. During a training session with my supervisor, this was pointed out to me and then we did a few practice trials where the materials were arranged in a different way each time. My supervisor was able to demonstrate to me that the position of learning materials can absolutely serve as an inadvertent prompt, if I'm not careful. Lesson learned for me!

Sometimes you have to purposely change the way you do something to see if you are using a prompt.

If you remove a glance, a touch, a word, a facial expression, or a gesture, and the client "suddenly" can't perform the task anymore then you were likely over- prompting the task all along.

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Tameika Meadows, BCBA, Blog Author

Photo source: www.parents.com

Spanking, or corporal punishment as it is also called, can be a somewhat controversial topic in this field. I had a meeting with a parent this week who is very upset that an older family member is very-pro- spanking. The parent wanted me to talk to the family member and make her "less spanking" and "more ABA". Sounds easy, right? :-)


As a professional in this field it isn't unusual for clients to ask for your opinion or recommendations on services, therapies, methods, schools, etc. The best practice is to provide the family with solid evidence based knowledge. It is not advised to recommend something to a client you really don't know much about. So if a parent asks you "Should I spank or not?", what should you say??

What I typically do is explain to the client that research does support that spanking can have many negative effects that can be long term. I then advise the parent do their own research and reading, and make a decision as  a parent what they want to do.
Sometimes a family member who views therapy as being "too soft" on the child will make a statement to me about how all the child's Autism would just go fixed with one good spank/swat. If this happens to you take the opportunity to educate the family member. 


Remember: successful ABA intervention requires a team. The more members of the family you can get on your side the better.

Below is an example of how I would respond to a client or relative of a client who asks me "What's so bad about spanking?!":

"I do understand your opinion about spanking, as many people were spanked as children, and view it as a discipline tool. There is quite a bit of research on the topic of spanking and corporal punishment,  and I can recommend some books too if you are interested. I can tell you that in general, reinforcement will always be more effective than punishment. However, I do have a few questions for you--
 How effective is the spanking? Is the behavior decreasing as a result? As with any behavior intervention, if the target behavior does not decrease then the intervention isn't working. Are you having to spank your child daily, or constantly? If so, then that is not an effective intervention. Also, what are you doing to teach the child what to do instead? Punishment doesn't often teach brand new skills. Lastly, are you concerned about inadvertently teaching your child that hitting is okay? I have worked with children who get spanked, and will hit/swat at peers when angry or upset. I would suggest you think about all of these possible concerns, and if you need help creating a new behavioral intervention to try I would be glad to be of assistance."

Just remember that as a professional you want to give informed, evidence based recommendations. If you have limited knowledge of a topic, tell a client that before answering their question. If a topic is very sensitive or controversial to you, you must remove your own personal biases before giving advice to a client.

Also, I am careful to preface advice with "in my opinion" unless I am directly referencing research. Especially a topic like spanking, which can be a cultural land-mine issue. Avoid judgmental or "parent blaming" statements and instead start a respectful dialogue.





Recommended Reading:

Straus MA, Sugarman DB, Giles-Sims J: Spanking by parents and subsequent antisocial behavior of children. Archives of Pediatrics and Adolescent Medicine 1997, 151:761-767.

Gershoff ET: Report on physical punishment in the United States: What research tells us about its effects on children. Columbus, OH: Center for Effective Discipline; 2008


Straus MA: Beating the devil out of them: Corporal punishment in American families and its effects on children. 2nd edition. New Brunswick, NJ: Transaction; 2001.

Baumrind D, Larzelere RE, Cowan PA: Ordinary physical punishment: Is it harmful? Comment on Gershoff (2002). Psychological Bulletin 2002, 128:580-589.

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Tameika Meadows, BCBA, Blog Author

Sensory boxes, tables, or bins, are a fun tool you can use as a reinforcer/reward, during naturalistic teaching, or for calming/transitioning purposes.

Sensory boxes and bins can also be taught as a leisure skill activity or a play choice. Sensory boxes can be as diverse and varied as they need to be, based on what the client likes. 

Get a container with a lid that can be securely closed and fill it with various items such as pieces of fabric, beads, beans, rice, clay, sand, flour, water and ice, water and bubbles, glitter, confetti, pieces of string, lace, etc.

A word of caution: before creating a sensory box check with the family first and make sure the client has no allergies. If you are working with a client who has mouthing behavior be sure to supervise them closely when they are manipulating a sensory box. I would also avoid very small items like beads, with a client who mouths as these could easily be a potential chocking hazard if placed in the mouth. Look for larger items like pieces of fabric, OR things that are fine to eat such as dry cereal. Placing/cutting holes into a closed and see-through box can also be a way to manage mouthing behaviors while manipulating the sensory box/bin.

I typically use sensory boxes/bins with clients who need a calming, structured activity to engage in during transitions or down-time. It's also just a fun activity to engage with together during therapy sessions. 

For example, when I arrive to a session I might place a sensory box on the table as I prepare my materials so the client has something to engage with, and isn't just sitting and waiting for me to be ready. Then I slowly add myself into the play, and we transition away from the sensory box.

Sensory activities should not be used in a way that will reinforce inappropriate behaviors, or to allow an escape from instructional tasks. Be sure to avoid using sensory tools, toys, or items in ways that will strengthen problem behaviors over time.

Sensory boxes are simple and cheap to make. I am always a fan of free/ low cost ideas that can be incorporated into therapy. ABA does not need to break your wallet.

All of the containers below can be purchased at any craft supply store for a few bucks,  and the items inside can be purchased, made, or may already be present in the client home.

This is a sensory box filled with sand. I use purchased sand rather than sand from a beach or park so I know it is clean and not filled with dirt, bacteria, or wood splinters. Place a few items inside the box  such as multicolored rings (I got this from a toddler ring stacker toy). This way you can embed learning tasks by saying things like "Give me the red ring" or "Pour sand on the orange ring".

These boxes are filled with varying pebbles/marbles and stones. Again, I purchase these rather than collect them from outside. I put in different textures, colors, and sizes so they are more interesting to manipulate, if the client enjoys cool items just store the box/bin the fridge between uses (the stones will be very cool to the touch!).

This is a pasta box. You can use any type or color pasta you would like. Some parents don't like to use sensory boxes with food items inside (flour, pasta, etc.), because the client may try and eat the items. 

This box has beans inside. Another way to incorporate language into this activity is to gently close the box by placing the lid on, and then prompt communication using the client's communication method. Once a request is made to open the box/remove the lid, provide immediate access.

This box is filled with rice. The rainbow effect on the rice can be obtained by adding a few drops of food coloring to the rice, stirring the rice, and then letting it sit and dry. Another language tip is to use the sensory boxes to teach choices. To do this I will place a highly preferred sensory box on the table, and something that is very non- preferred, like a book. The client can then vocally or non-vocally indicate which item they want, by making a choice. So this combines fun and language instruction, all in the same activity.



For parents, if you have difficulty in public situations such as waiting at the doctors office try bringing a small sensory box or bin along so your child has something to do while they are waiting. Waiting can be made easier if little hands can be kept busy and engaged.


*Resource: A parent told me about this GREAT website called Small Potatoes that has some of the most creative and imaginative sensory boxes I have ever seen!

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Tameika Meadows, BCBA, Blog Author