Trellis ABA

Trellis provides ABA therapy to help children with autism.

applied behavior analysis

What is Contemporary ABA?

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Clinically Reviewed by Genevieve Marshall Ph.D., BCBA-D, LBA 

People often say that history is written by the victors. When the colonists won the American Revolution, they described the war as a noble struggle to escape tyranny. Had the British won, history books might have called it a heroic effort to save the empire from ungrateful rebels. 

In the same way, most people in America are able-bodied, so they decide what is “normal.” For example, we might see an autistic brain or someone with poor eyesight (but stronger other senses) as less valuable. But really, these are just different ways of thinking and living. 

For more than 60 million Americans with disabilities, this can be a challenge. They have to fit their lives into a world designed for able-bodied people, even though it would be easy to make the world work for everyone.  

Ableism and Ableist Misconceptions

Contemporary treatments include the individual in planning when possible. Contemporary practices change in response to the voices of those who have received therapy in the past. 

Ableism is when able-bodied people assume everyone is like them and fail to see the challenges people with disabilities face.  

Ableism includes unfair ideas, such as thinking people with disabilities always need help, even if they don’t ask for it. Not all disabilities are visible, which can lead to wrong assumptions about mental illnesses being different from physical ones. These false beliefs make it harder for people with disabilities to be treated equally and included in society.  

 

ABA Intervention

Applied behavior analysis (ABA) is widely regarded as the most effective treatment for autism, supported by decades of research. It isn’t a single therapy method. Instead, it’s a flexible approach that uses different techniques to help children build the skills they need to thrive at school and in daily life. 

Recently, ABA has increasingly become the target of much controversy as self-advocates are speaking up about their experiences. They reject the idea that teaching people with autism the skills deemed necessary without their input or choice. Some advocates say independence is meaningless without happiness and that people with autism should choose their own goals, which might not include fitting in with others.  

ABA, which is essentially the science of good teaching, has a long history and was originally developed in the 1960s by a group of researchers at the University of Washington. ABA was used to treat individuals with developmental disabilities and initially was a rigid, highly structured and teacher-directed program, which led to some of the negative experiences and associations with ABA. Historically, for example, ABA was used to reduce or eliminate “stimming” – repetitive physical movements and sounds that may soothe and reduce anxiety. We now better understand that stimming helps people with autism manage their sensory processing and their environments. 

Just like in other areas of medicine and science, the field of ABA has advanced in a significant and meaningful way to become a play-based, naturalistic, family-focused and individualized, contemporary treatment that is tailored to the unique needs and goals of everyone. A good ABA program collects and reports data to show effectiveness. Providers must demonstrate success, validated by parents, through goals set with the family. If your provider doesn’t follow this approach, they may not be using best practices.  

ABA now adapts to individual needs by learning from adults. While negative experiences must be addressed, dismissing ABA entirely overlooks its success for many. Good programs focus on the client, seek consent, and value input. Research and ask key questions when choosing a provider. 

What to Look for in an ABA Program 

  • Will I participate in determining the goals of treatment for myself/my child? 
  • How are your staff trained? 
  • How is my child’s program developed? Do all clients receive the same program or are they individualized? 
  • Will there be parent goals as part of my child’s program? 
  • How often is my child’s program modified or revised? 
  • How is data collected and reported? 
  • How often will I see data on my child’s progress? 

Your child’s program should be client-centered and future looking, which means that your family and relevant caregivers are providing input into your child’s strengths and challenges, and that you and your child are helping to guide the goals of his/her program based on your preferences and needs. 

The science of ABA has a long history with decades of research to support its development and evolution. While ABA is most widely known in its application to autism, ABA was developed, and has been applied, to address many circumstances regarding behavior that matter to society. ABA is applied in many different areas, including mental health, animal training, organizational behavior management, marketing, forensics, sports, and physical health, to name a few. Just as other areas of science and medicine advance and application of treatments change, so has the field of ABA. Many lives have been impacted by ABA for the better. It is incumbent upon the professional community to listen, learn, and evolve its practice so that their services are as relevant and effective as possible. After all, the purpose of ABA is to help children with autism achieve the goals that matter most to them and their families — goals that foster growth, independence, and joy in their everyday lives.  

Why Early Diagnosis Matters For Children With Autism

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Why does early diagnosis for autism spectrum disorder (ASD) matter? Dr. Genevieve Marshall explains early signs of autism, how to receive an evaluation, and what to do after a diagnosis. Be sure to subscribe for more helpful tips and discover more resources by checking out our blog here: https://lrnbvr.com/Blogs

Advancing Autism Services: Our Commitment to Public Policy

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Written by Dr. Ashley Williams, Ph.D., LABA, BCBA-D, Vice President

National Social Justice Day is a time to reflect on the progress made in creating a more equitable and inclusive society. At LEARN Behavioral, this commitment goes beyond the confines of our therapy rooms; it extends into the heart of public policy advocacy. Our dedication to social justice is evident through our active involvement in various organizations and our continuous efforts to champion policies that support the autism community.

1. Advocating for Autism Services Nationwide

LEARN Behavioral is proud to be an active member of the Council for Autism Service Providers (CASP). Our leadership team actively participates as CASP Special Advocacy Group Leaders in 11 states where LEARN Behavioral operates. This engagement allows us to contribute firsthand to the shaping of policies that impact individuals with autism and their families. Additionally, our membership in the National Coalition for Access to Autism Services (NCAAS) underscores our commitment to addressing state and federal barriers to autism services. By collaborating with like-minded organizations, we strive to create a unified voice advocating for positive change on a broader scale.

2. Advancing Autism Equity Through State Organizations

At LEARN Behavioral, we understand the importance of grassroots efforts in promoting social justice. Our active involvement in local trade and professional organizations, including CalABA, BABAT, WAPA, ORABA, MAC, MIBAP, reflects our dedication to the larger behavior analytic community. Through volunteering and membership in these organizations, we aim to contribute to the development of equitable services for the diverse communities we serve. We believe that fostering connections within the behavioral community is crucial to creating a more inclusive and supportive environment for all.

3. Leading National Advocacy Efforts for Autism Policy Reform

LEARN Behavioral is fortunate to have resident experts in public policy who actively contribute to the advancement of the autism community. LEARN leaders have published peer-reviewed journal articles on public policy, presented at local and national conferences, and provided numerous testimonies advocating for access to care. Our chief clinical officer, Dr. Hanna Rue, is a beacon of leadership in this regard. Her participation in NCAAS’s “day on the hill” in Washington, D.C., exemplifies our commitment to effecting change at the highest levels. By engaging with House and Senate offices, we strive to influence initiatives that positively impact the autism community on a national scale.

4. LEARN Advocacy Network

The LEARN Advocacy Network, led by Dr. Rebecca Thompson, is a vital part of LEARN Behavioral’s public policy efforts, providing a monthly meeting ground for leaders from each state. Driving our advocacy initiatives, this collaborative team engages in meaningful discussions, sharing insights, and staying abreast of the latest developments in public policy. The network serves as a platform where LEARN Behavioral leaders exchange information, ensuring a well-coordinated and informed approach to navigating the complex landscape of policy initiatives.

As we observe National Social Justice Day, it is imperative to recognize the multifaceted approach LEARN Behavioral takes to contribute to a more just and equitable society. Through active participation in national and state organizations, as well as championing public policy initiatives, we are dedicated to making a lasting impact. Our commitment to social justice extends beyond our therapeutic interventions, reflecting our belief in the power of advocacy and policy to create positive change for individuals with autism and their families.

Making the Most of Summer Break by Building Essential Skills

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As the school year draws to a close, summer break ushers in a bit of a recess for parents — a hiatus from packed lunchboxes, school runs, and homework.

For families with children with autism, though, summer break can also mean disruption to your routine. It can create a lack of social interaction, and it can mean there are more demands on your time as a parent.

Here’s where you can turn those challenges around. Summer doesn’t have to be a lull in the progress your child with autism has been making all year. All you need is a strategy to leverage summer break to be a time to help your child build essential skills.

That starts with setting clear goals, creating a new routine, and incorporating skill-building into fun activities. But how do you do that?


Look for Structured, Play-Based Programs

The first step is to find a program that can keep your child engaged in social activities. Providers in cities across the country offer structured, play-based social skills programs. These programs are crafted with children in mind, aiming to bolster key skills such as socializing, communication, cognition, and sensory perception — all through the power of play.

These summer programs often take place in play-based, group settings, mirroring the school environment, but with the added benefit of one-on-one support. They foster collaboration and inclusion, often welcoming siblings to join, too.


Building a More Trusting Environment

Next, make sure your child is engaged in the process. In the world of applied behavior analysis (ABA), behavior technicians and behavior analysts lead summer social skills programs and promote group activities that help children build friendships.

Programs group children of similar age and skill level and include age-appropriate games and activities. This helps them to learn and communicate effectively.

You might hear your ABA provider using terminology like taking an “assent-based practice.” That’s an approach that focuses on making sure your child agrees to participate in treatment. Using an assent-based practice, therapists encourage children in the program to step out of their comfort zone and try new things. This approach is person-centered and fosters a safer and more trusting environment.


Staying Active to Prevent the ‘Summer Slide’

The “summer slide” refers to the learning loss students experience during summer breaks. Social skills programs for children with autism can play a crucial role in preventing the “summer slide” by promoting continuous growth and development.

These strategies can turn summer break challenges into opportunities to:

  • Build a consistent routine: A summer social skills program that provides a consistent daily schedule is often comforting to children with autism.
  • Help your child retain skills: By continually practicing social skills throughout the summer, your child can retain and even improve upon the skills they learned during the school year.
  • Encourage peer Interaction: Summer programs offer opportunities for social interaction with peers, which is critical for building friendships.
  • Foster personal growth: Summer social skills programs can boost self-esteem and confidence by providing opportunities for success and achievement.
  • Give you a respite: Summer programs can also provide parents with a much-needed break, allowing you to recharge while knowing your child is in a safe and nurturing environment.

Summer break can be more than just a pause from school. With the right approach and resources, it can be a valuable opportunity for your child with autism to continue their development and build essential skills.

By integrating structured play-based programs into your summer routine, you can foster a trusting environment that encourages personal growth and social interaction, while also providing a much-needed respite for you as a parent.

So, view this summer not as a challenge, but as a chance to fuel your child’s progress, further nurturing their unique potential.

Click here for more ideas on making the most of summer.

A Fresh Approach: Empowering Children with Autism

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Written by Alison Spanoghe, Behavior Analyst, Autism Spectrum Therapies (AST)

When I first started working in a school system with children on the autism spectrum in the early 2000s, my leaders told me to stick to my instructions — no matter what. They told me this would be best for the children in the long run. As a newbie, I followed orders.

Often, though, that approach led to anger, tears, and resistance from the children who needed my help the most. Despite science backing up the “follow-my-orders” approach, it didn’t always feel “right.”

Today, my approach has evolved to something called “assent-based practice.” It’s a model that puts an end to instruction through coercion. It prioritizes the child’s agreement to participate in therapy rather than mandating that they follow orders.


The Old Way: Extinction

If you’re familiar with applied behavior analysis (ABA), you may have come across the term “extinction.” In simple terms, extinction means not reinforcing a previously reinforced behavior. The aim is to reduce the chances of that behavior happening again.

Let’s say your TV remote stops working. After a while, you’ll stop pressing the power button and maybe look for batteries or ask for help instead. The same principle applies to ABA services. If a certain behavior — like screaming — is not encouraged, the child will eventually stop doing it. You could then teach them a better way to communicate their needs instead of screaming.

While that might be good in theory, behavior isn’t always that straightforward. Also, the extinction approach can sometimes lead to other issues, like longer tantrums, aggression, or even distrust toward caregivers. That’s where assent-based practice comes in.


The New Way: Assent-Based Practice

Assent-based practice focuses on making sure the child agrees to take part in therapy — even if that agreement is nonverbal. When a child is actively engaged, that’s one indication that they are communicating that they agree with participating in treatment.

This type of approach involves:

  • Constant check-ins
  • Respecting when the child no longer wants to participate in treatment
  • Adapting the approach based on the child’s response
  • Teaching the child to communicate

The goal of this technique is to equip children with autism with skills that are useful in any situation. It also helps them advocate for themselves and make it clear when they want to say “no.” It’s more of a compassionate way of providing care.


Why Assent-Based Practice?

There are many benefits to using assent-based practice. It can:

  • Build Trust: It helps establish a safe and trusting relationship between the child and the therapist.
  • Promote Expression: The child learns that they are seen and heard. It encourages them to express their feelings.
  • Respect Autonomy: The child’s “no” is respected, promoting their dignity and independence.
  • Enhance Learning: This approach avoids standoffs. It allows more reinforcement of language use and engagement in the session.

Assent-based practice has become a popular topic in ABA services. It emphasizes getting the child’s agreement before continuing therapy. It teaches children to express their feelings. It also respects their dignity and independence.

Therapists can use this approach with any child at any time, leading to faster learning and better rapport with the child. While our understanding of assent-based practice continues to evolve, it is a worthwhile approach to consider because it puts the child first.

Alison Spanoghe is a behavior analyst with Autism Spectrum Therapies (AST).

How ABA Therapy Helped Our Children Succeed: Insights from Two BCBA Moms

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In this informative video, two Board Certified Behavior Analyst (BCBA) moms, Heather and Trisha, share their personal experiences with Applied Behavior Analysis (ABA) therapy and how it has helped their children succeed. For more information about our ABA Therapy services visit: https://lrnbvr.com/yt-aba-moms

Q&A About ABA Therapy for Children with Autism

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FAQ for Caregivers

Was your child recently diagnosed with autism? Are you beginning to navigate treatment for your child? Before you get started, check out these FAQs about ABA therapy.

What is the goal of ABA therapy?

ABA therapy is designed to support autistic individuals and their families, achieve their identified goals, and improve their quality of life. ABA-based interventions are supported by decades of research and enhance social, communication, play, and adaptive skills. Services incorporate the needs and interests of the autistic individual and their caregiver(s). A behavior analyst delivers the ABA services with the help of behavior technicians, who often provide direct care to the autistic individual. Services are tailored to the individual’s unique needs, with their feedback, and evolve over time. Services for children may look quite different than services for adults, given the individuals’ needs differ over time.

What is “contemporary ABA” therapy?

At LEARN, we refer to our approach as “contemporary ABA.” It is an evolved approach to ABA therapy that promotes individualized treatment, naturalistic and play-based teaching, and is person-centered. LEARN provides a contemporary approach that acknowledges the evolution of ABA, values the individual and their family, and creates space for individuality. Practicing contemporary ABA therapy means that our behavior analysts deeply understand their responsibility to positively and meaningfully impact the lives of the individuals served.

How many hours of ABA therapy will my child receive?

Your child’s hours will be determined between you and your behavior analyst. Your behavior analyst recommends hours based on assessing your child’s needs, other therapies received, and your feedback as the parent/caregiver. Focused programs range from 10-25 hours per week, and comprehensive programs range from 30-40 hours weekly. At LEARN, we provide home-based, center-based, and community-based services, and you can reach out to your local clinical director to find out which services are available in your area. Check out this video to learn about the number of hours clinically recommended for your child.

Are your ABA therapy services individualized?

Absolutely! Each autistic person we serve is unique, and we believe that should be celebrated. Our goal is to promote individual interests and incorporate those into ABA therapy. Behavior analysts make individualized recommendations for services, including hours based on the child and customized goals that fit their needs. Behavior therapists receive training on how to understand the preferences of their clients and include those in sessions to make them fun, rewarding, and engaging.

How is neurodiversity integrated into your approach to ABA therapy?

Listening to the perspective of autistic folks has informed our approach to ABA therapy and led us to incorporate neurodiversity into our practice. Our goal is to elevate the autistic voices in our community, including the individuals we serve, our neurodivergent employees, and the greater neurodivergent community. We’re deeply committed to person-centered ABA therapy practices and promote assent-based care, meaning we validate the identities and experiences of neurodivergent folks and create space for autistic voices to be heard and upheld. Learn more about our commitment to neurodiversity here.

Will my child be required to do discrete trials and sit at a table?

Not all autistic folks benefit from discrete trials or table-top work. For example, a two-year-old child with lots of energy may benefit more from a play-based approach with the therapist sitting on the floor and embedding learning opportunities in play with their favorite toy. Behavior analysts overseeing the treatment plan take time to assess the individual’s needs and work collaboratively with the family to identify an approach to treatment that will work best for the child.

What if someone doesn’t want ABA therapy?

We understand that not everyone seeks ABA therapy, feels it’s the best fit, or perhaps, thinks it’s the right time to try. As with other medical services, the patient (along with their caregiver, if a child) has the right to decide when, if, and what treatment is right for them. Not all ABA therapy providers have the same approach, either, and LEARN supports a family’s right to choose a provider that meets their needs and is a good match for their treatment goals. We want families and our clients to be excited about services and encourage collaboration on our journey together.

Reviewed by Dr. Ashley Williams, PhD, LABA, BCBA-D, Sr. Clinical Director

To learn more about ABA, visit our website. You can also search our locations here.

How Neurodiverse Voices are Influencing the Evolution of ABA

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Dr. Becky Thompson, Director of Clinical Services for the Wisconsin Early Autism Project (WEAP), and Reux Lennon, Non-binary member of both the LGBT and Autism community and Lead technician with WEAP join us to share their work on the Person-Centered ABA team and the Neurodivergent Advisory Committee.  Dr. Thompson leads LEARN’s Person-Centered ABA team, which is a group of clinical leaders within LEARN who are dedicated to compassionate and individualized ABA services. Reux shares how their work as one of the original members of the Neurodivergent Advisory Committee is creating change and including neurodivergent voices and perspectives.

For more information visit:

https://learnbehavioral.com/culture/neurodiversity

All Autism Talk (https://www.allautismtalk.com/) is sponsored by LEARN Behavioral (https://learnbehavioral.com).

Celebrating Women in Autism this International Women’s Day

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For decades, women have played a crucial role in diagnosing, understanding, and treating autism spectrum disorder (ASD). As ASD becomes more prevalent, women continue to be instrumental in developing and refining treatment through vast areas of research. There is much to be recognized, not only for women’s incredible contributions to the autism field but also for their experiences living on the spectrum.  

In honor of International Women’s Day, check out our top five All Autism Talk podcast episodes featuring notable women.  

1. Dr. Temple Grandin – Navigating Autism

2. Dr. Ronit Molko- Girls and Autism: Diagnosis, Treatment, and New Research

3. Devon Sundberg- Women in Behavior Analysis

4. Jennifer Cook- Female Life on the Spectrum

5. Adrienne Bradley- Race and How it Impacts ABA and Our Community

All Autism Talk is a leading autism podcast that offers friendly conversation with inspiring individuals in the autism community. To learn more about All Autism Talk, please visit https://www.allautismtalk.com/  

5 Tips for Navigating Autism Treatment for Your Multilingual Child

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Maia Jackson, M.S., BCBA
Clinical Development Manager, LEARN Behavioral

Language development is a critical component of the day-to-day lives of young children. It is used within a variety of contexts, including playing with peers, building relationships, functionally communicating needs, etc. As such, there is a heavy emphasis on language and communication built into most applied behavior analytic (ABA) programs. Because such a heavy emphasis is placed on language, it is important that practitioners are mindful of the specific language or languages that are incorporated in the therapeutic setting. In order for ABA programs to be socially significant, services should represent and accommodate for the dominant language of the family. By doing so, children and their families will experience a variety of benefits.

By promoting the use of the family’s native language, children have an increased likelihood of communication opportunities with their immediate and extended families, friends, and community. In addition to having more opportunities to communicate, the quality of the interactions will be more meaningful as caregivers are more likely to effectively express their own emotions, hold their child’s attention, and more thoroughly discuss topics of interest when using their native language (Zhou, et al., 2019). There are also benefits to multilingualism outside of the familial unit. Research has shown that children who are raised in multilingual homes tend to demonstrate higher perspective talking skills than children who do not (Zhou, et al., 2019). Despite all of the benefits to speaking one’s native language, families often face a number of barriers, especially when seeking out autism-related services.

While we live in a culturally diverse country, English remains the dominant language in most regions of the U.S. When children turn on the TV, chances are the shows they watch are in English. When they go to school, they will receive a primarily English education and their peers will speak primarily English. Autistic individuals who receive behavior analytic treatment in the U.S. are likely receiving those services in English. Despite all of these barriers, there are ways for parents and caregivers to advocate for their bilingual children and family.

1. Look for providers who speak your native language. 

One of the first measures to take when selecting a service provider is to request clinicians who speak your native language. Bilingual service providers can be hard to find and it may take time, but let your provider know your preference so they can attempt to hire and/or pair you with appropriate staff members.

2. Request translation services. 

In cases where there are no staff members available to provide services in your native language, consider asking for translation services. Even if you are proficient in English, it may be easier or feel more comfortable for you to communicate in your native language. Per the Behavior Analyst Certification Board’s (BACB) Ethics Code for Behavior Analysts, the clinician you are working with should make every effort to effectively communicate with you and provide you with the opportunity to ask questions and participate in the development and implementation of your child’s program.

3. Consider the assessment language.

If your child speaks a language other than English, it is important to discuss the benefits of your child being assessed in that language. Providers use assessment results as a tool to guide the clinical program and decision making. Having the results of the assessment in your child’s primary or dominant languages will give a more accurate picture of your child’s strengths and areas of need. The starting point of the program will be more representative of your child’s language abilities.

4. Ensure the program is visually representative of your child and your family.

Visual tools and stimuli are often used as prompts, supports, and/or reinforcement systems within many ABA programs. These visual supports may serve to outline a schedule for the day, visuals might accompany a short narrative or story describing a social scenario your child might encounter, or you might see visual images used as reminders or prompts of what steps come next in routine with multiple steps, such as hand washing.  These visual items should be representative of your child and your family. Discuss incorporating your native language and culture into these items in order to promote their use and acceptance by your child. If your child accepts the stimuli and is motivated to use them, effectiveness of their intended purpose will likely increase. 

5. Discuss your language and other cultural values with your team.

Per the Ethical Code for Behavior Analysts, your cultural norms, traditions, and expectations should be extended through all aspects of the ABA program. Social interactions, communication, play activities, and activities of daily living are areas that are addressed in many ABA programs and are going to be affected by language, culture, and traditions. Discussing the ways your language and culture impact your day-to-day routines and expectations will help the clinical team develop and implement a program that is best suited to your child and your family.  

Serving as the navigator and advocator of your child’s services is a huge role. Advocating for language will often be just as important as advocating for hours, goals, or other supports.  Use your team to provide support and to feel empowered to be the advocate your child and your family need.

Supports at LEARN:

  • Document translation services
  • Translation services
  • Language Resource Library
  • Staff training and tools related to Diversity, Equity and Inclusion

Zhou, A., Munson, J.A., Greenson, J., Jou, Y., Rogers, S., Estes A.M. (2019). An exploratory longitudinal study of social language outcomes in children with autism in bilingual home environments. Autism, 23(2), 394-304.