Monday, April 10, 2017
THE BIG PICTURE: Focusing intervention for autism
Gail J. Richard, PhD, CCC-SLP, a former chair, professor emeritus and director of The Autism Center at Eastern Illinois University, emphasizes the importance of incorporating all aspects of development when targeting treatment - including not only the speech profile but also social, sensory, and motor. These separate factors all play different imperative roles throughout the child’s life; roles that may affect how they function in the real world. For example, furthered education may be effected by a decreased ability to perform executive functions tasks (initiate, plan, organize materials, and manage time and academic expectations). As stated by Richard, “their strong intellectual potential cannot be realized without an infrastructure to facilitate their success.” (Richard G.J., 2017). By assessing all aspects of development, therapists can focus their intervention on the big picture and gain the best results possible. At Therapyland, all areas of discipline approach their treatment goals with this theory in mind. Whether it’s physical, occupational, language, speech, feeding or behavioral, the target is consistent with the ‘big picture’ – generalizing skills with each child’s unique ‘real world’ factor in mind. The vast collaboration amongst disciplines further facilitates this objective.
To dive more into this educational read, check out the full article ASHA leader published in their latest magazine: http://leader.pubs.asha.org/article.aspx?articleid=2615520&resultClick=3
Friday, February 3, 2017
Pediatric Feeding News by Krisi Brackett MS CCC/SLP
Check out Krisi Brackett's blog where you can find an abundance of information on pediatric feeding difficulties. Her most recent blog post is about how stress may explain digestive issues in kids with Autism. Carly Morris at Therapyland follows many of her principles and believes in a medical, motor and behavioral approach to feeding. For more questions regarding feeding therapy and what it can do for you, please contact her at carly@therapyland.net.
Monday, January 30, 2017
More about ABA...by Sandi Rivers, M.Ed. BCBA
What About When Behaviors Occur? CONSEQUENTIAL STRATEGIES
* Refer back to the Functions (EATS). Do your best to gauge the function so a pay- off is minimized for their problem behavior.
* Planned ignoring – to ignore minor problem behaviors “junk behaviors” and respond then to first appropriate behavior, i.e. being quiet, sitting nicely, etc. Then give them the words they may use to get attention or a desired item they want if possible.
* Pivoting – providing attention to other peers for appropriate behavior while using planned ignoring for another child’s problem behavior. Pivot back to child with problem behavior upon first appropriate behavior and provide praise, reinf., etc.
* Best Practice is to NOT tell the child what NOT to do, yet tell them what TO DO. For example, tell a child to fold their hands or sit down instead of telling them to “stop,” “don’t run,” “no, that hurts,” etc.
* NO Rationalizing during problem behavior, this is attention. This is why IF/THEN Boards are important to set expectations. Your words go away not visuals.
There is nothing wrong with talking to the child at a separate time or once calm to address the problem behaviors and expectations.
* IF a demand has been placed, use 3 step prompting thus eliminating verbal attention.
1. TELL WHAT TO DO,
2. GESTURE OR MINIMAL ASSIST FOR WHAT TO DO,
3. PHYSICALLY PROMPT FOR WHAT TO DO.
However, you may need to wait the child out for when you are unable to physically prompt.
* IF a child needs to be removed due to sensory overload or more intense behaviors, do your best to NOT provide preferred items/activities until calm, displays some form of compliance, i.e. clap your hands, pick up an item, sit in a chair, etc. then provide the communication for the child to get what they want using their words.
* Behavior Momentum / Redirection – Many times you can redirect a child starting to engage in problem behavior by using simple directions, i.e. clap your hands, high five, touch your nose, etc. then reinforce.
* You need to give strategies approximately 3 weeks before you rule out that they are not working.
* Refer back to the Functions (EATS). Do your best to gauge the function so a pay- off is minimized for their problem behavior.
* Planned ignoring – to ignore minor problem behaviors “junk behaviors” and respond then to first appropriate behavior, i.e. being quiet, sitting nicely, etc. Then give them the words they may use to get attention or a desired item they want if possible.
* Pivoting – providing attention to other peers for appropriate behavior while using planned ignoring for another child’s problem behavior. Pivot back to child with problem behavior upon first appropriate behavior and provide praise, reinf., etc.
* Best Practice is to NOT tell the child what NOT to do, yet tell them what TO DO. For example, tell a child to fold their hands or sit down instead of telling them to “stop,” “don’t run,” “no, that hurts,” etc.
* NO Rationalizing during problem behavior, this is attention. This is why IF/THEN Boards are important to set expectations. Your words go away not visuals.
There is nothing wrong with talking to the child at a separate time or once calm to address the problem behaviors and expectations.
* IF a demand has been placed, use 3 step prompting thus eliminating verbal attention.
1. TELL WHAT TO DO,
2. GESTURE OR MINIMAL ASSIST FOR WHAT TO DO,
3. PHYSICALLY PROMPT FOR WHAT TO DO.
However, you may need to wait the child out for when you are unable to physically prompt.
* IF a child needs to be removed due to sensory overload or more intense behaviors, do your best to NOT provide preferred items/activities until calm, displays some form of compliance, i.e. clap your hands, pick up an item, sit in a chair, etc. then provide the communication for the child to get what they want using their words.
* Behavior Momentum / Redirection – Many times you can redirect a child starting to engage in problem behavior by using simple directions, i.e. clap your hands, high five, touch your nose, etc. then reinforce.
* You need to give strategies approximately 3 weeks before you rule out that they are not working.
Friday, January 20, 2017
"It's FINE to work on OT skills at home"
5 Simple Ways to Help Kids Develop Fine Motor Skills at Home
Monday, January 9, 2017
What is ABA? continued by Sandi Rivers, M.Ed. BCBA
III. The Building Blocks
A: Antecedent-the environment, the events or the behavior that precedes the Behavior of Interest, or Target Behavior. Also known as the "Setting Event," the antecedent is anything that might contribute to the behavior. It may be a request from a teacher, it might be the presence of another person or student, or even a change in the environment.
B: Behavior-what the student does. This is sometimes referred to as "the behavior of interest" or "target behavior.” It is the behavior that you are focusing on, that is either pivotal (leads to other undesirable behavior, or contributes to other undesirable behaviors) a problem behavior that creates danger for the student or others, or a distracting behavior, that removes the child from the instructional setting or prevents other students from receiving instruction.
C: Consequence. It is the outcome that is reinforcing for the child (the FUNCTION / EATS), so it in turn reinforces the problem behavior. Is the consequence that the child is placed in time out, therefore avoiding a task? Does the parent give the child a preferred item or food, in order to stop the behavior?
IV. So Now What? ANTECEDENT STRATEGIES
* Pairing is MOST IMPORTANT!! RAPPORT has to be built and the child should desire to come to the staff member and/or place. Special Reinforcing boxes with preferred items for the child can be presented immediately upon drop off.
* May be helpful to interview the parents in re: to what the child’s preferences are and to send in favorite items with their child.
* Reward Systems to set expectations. Token boards or reinforcing on a schedule.
* Seating priority for easier redirection and to provide more frequent reinforcement.
* Visual spot to sit on or in for a chair, i.e. special carpet piece, rubber circle, bubble seat, sit spots, yoga ball to sit on.
* A fidget to hold or for putting in mouth so hands are busy (amazon and ARK therapeutic)
* Choice making – empowers the child, i.e. do you want to sit in the blue or red chair, etc.
* If/then visual supports (premack principle or grandma’s rule)
* Timers for how long to participate or before receiving a desired item
* Reinforcer choice boards, easily made on google images.
* Visual Schedules for what the morning will look like, actually great for all students too.
* Other students telling child vs adult directions or holding their hand to walk
* Lap weights for sensory feedback (fill tube socks with corn or rice)
* Noise canceling headphones
* Tents or sheet over table for calm area with a pillow inside
* Being allowed to roam or hold a preferred item noncontingently during activities
* Painters tape on carpet for giving boundaries or places to sit
* During group activities, try to have some part hands on such as puppets
* Intersperse the time with various activities to provide preventative sensory activities, i.e. carry a heavy box or chair to their seat or next location, wear ankle or wrist weights, pull self on scooter board to next location, jump on a yoga ball or jump hard prior to next activity, wheel barrel walk, etc. These are easy to do during transitions to embed sensory preventative activities.
* Communication – Teach them prior to the behavior what words to use, i.e. break, lets walk, go, ipad, tap on shoulder, etc. Goal is to have them communicate prior to using problem behavior.
A: Antecedent-the environment, the events or the behavior that precedes the Behavior of Interest, or Target Behavior. Also known as the "Setting Event," the antecedent is anything that might contribute to the behavior. It may be a request from a teacher, it might be the presence of another person or student, or even a change in the environment.
B: Behavior-what the student does. This is sometimes referred to as "the behavior of interest" or "target behavior.” It is the behavior that you are focusing on, that is either pivotal (leads to other undesirable behavior, or contributes to other undesirable behaviors) a problem behavior that creates danger for the student or others, or a distracting behavior, that removes the child from the instructional setting or prevents other students from receiving instruction.
C: Consequence. It is the outcome that is reinforcing for the child (the FUNCTION / EATS), so it in turn reinforces the problem behavior. Is the consequence that the child is placed in time out, therefore avoiding a task? Does the parent give the child a preferred item or food, in order to stop the behavior?
IV. So Now What? ANTECEDENT STRATEGIES
* Pairing is MOST IMPORTANT!! RAPPORT has to be built and the child should desire to come to the staff member and/or place. Special Reinforcing boxes with preferred items for the child can be presented immediately upon drop off.
* May be helpful to interview the parents in re: to what the child’s preferences are and to send in favorite items with their child.
* Reward Systems to set expectations. Token boards or reinforcing on a schedule.
* Seating priority for easier redirection and to provide more frequent reinforcement.
* Visual spot to sit on or in for a chair, i.e. special carpet piece, rubber circle, bubble seat, sit spots, yoga ball to sit on.
* A fidget to hold or for putting in mouth so hands are busy (amazon and ARK therapeutic)
* Choice making – empowers the child, i.e. do you want to sit in the blue or red chair, etc.
* If/then visual supports (premack principle or grandma’s rule)
* Timers for how long to participate or before receiving a desired item
* Reinforcer choice boards, easily made on google images.
* Visual Schedules for what the morning will look like, actually great for all students too.
* Other students telling child vs adult directions or holding their hand to walk
* Lap weights for sensory feedback (fill tube socks with corn or rice)
* Noise canceling headphones
* Tents or sheet over table for calm area with a pillow inside
* Being allowed to roam or hold a preferred item noncontingently during activities
* Painters tape on carpet for giving boundaries or places to sit
* During group activities, try to have some part hands on such as puppets
* Intersperse the time with various activities to provide preventative sensory activities, i.e. carry a heavy box or chair to their seat or next location, wear ankle or wrist weights, pull self on scooter board to next location, jump on a yoga ball or jump hard prior to next activity, wheel barrel walk, etc. These are easy to do during transitions to embed sensory preventative activities.
* Communication – Teach them prior to the behavior what words to use, i.e. break, lets walk, go, ipad, tap on shoulder, etc. Goal is to have them communicate prior to using problem behavior.
Thursday, December 1, 2016
Applied Behavior Analysis (ABA)- What is it? by Sandi Rivers M.Ed. BCBA
We will be presenting a weekly series on ABA therapy and strategies to implement in the home, classroom or group setting by Sandi Rivers M.Ed. BCBA...
I. Applied Behavior Analysis (ABA) – What is it?
Applied-means that interventions are geared toward achieving socially-important goals, helping people be more successful in natural settings such as homes, schools, and communities. Behavioral means that ABA focuses on what people say or do, rather than interpretations or assumptions about behavior.
Analytic-means that assessments are used to identify relationships between behavior and aspects of the environment (e.g., screaming occurs most when Johnny is given a difficult task and allows him to delay or avoid that activity) before proceeding to intervention.
Popular practices based on the principles of ABA have incorporated some or all of these features. For example, reward systems, if/then boards, visual schedules, planned ignoring, and removing privileges are commonly used in the schools. When applied appropriately (e.g., making sure rewards are actually enticing to students), these strategies can promote positive behavior. Early intervention programs and programs for children with autism often emphasize arranging the classroom or home environments (e.g., using pictures, bins for items); these can be considered antecedent interventions.
Read more: www.autismsupportnetwork.com
II. Functions of Behaviors – Why do the children engage in the behaviors?
I. Applied Behavior Analysis (ABA) – What is it?
Applied-means that interventions are geared toward achieving socially-important goals, helping people be more successful in natural settings such as homes, schools, and communities. Behavioral means that ABA focuses on what people say or do, rather than interpretations or assumptions about behavior.
Analytic-means that assessments are used to identify relationships between behavior and aspects of the environment (e.g., screaming occurs most when Johnny is given a difficult task and allows him to delay or avoid that activity) before proceeding to intervention.
Popular practices based on the principles of ABA have incorporated some or all of these features. For example, reward systems, if/then boards, visual schedules, planned ignoring, and removing privileges are commonly used in the schools. When applied appropriately (e.g., making sure rewards are actually enticing to students), these strategies can promote positive behavior. Early intervention programs and programs for children with autism often emphasize arranging the classroom or home environments (e.g., using pictures, bins for items); these can be considered antecedent interventions.
Read more: www.autismsupportnetwork.com
II. Functions of Behaviors – Why do the children engage in the behaviors?
Remember EATS!!!
ESCAPE
|
ATTENTION
|
TANGIBLE
|
SENSORY
|
To escape/avoid an aversive
task or situation
|
To gain attention from
another person, usually in shared attention situations.
|
To access a desired item or
activity
|
Automatically reinforcing
themselves bc feels good or to avoid unwanted stimulation.
|
Jon is told to sit in a
group, it’s loud, crowded, etc. He screams and is removed from group to go
bounce on a ball
|
Tim is in group worship,
starts to shake his legs, bump other kids, lay back on his back. Teacher continuous calls on Tim and
redirects him then staff come sit next to Tim and rub his back.
|
Sue is denied a ball she
wants and screams then hits staff. She
then picks up the ball and plays.
|
Paul is in a classroom during
free play, it is loud and child attempts to run outside of class
continuously. He receives small breaks
from the time the staff are having to get him.
|
Friday, November 18, 2016
PT vs OT Who Does What?
Check out the video below to better understand the difference between Physical and Occupational therapy.
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