Best ABA Practice- My Way- Skills Based- Happy, Relaxed, Engaged Treatments

Introduction to Skills Based Treatment

SBT- was developed by Dr. Greg Hanley and FTF Behavioral Consulting.

We are using SBT to teach clients communication, tolerance and functional
skills.

This includes teaching them how to ask for what they want, tolerating when they
can't have what they want, and what to do while waiting.

In this gradual process we slowly increase what we are asking our clients to do before giving access to what they
want.

After this intervention is complete, the child is better prepared to learn in a variety
of different environments.
Here are some of the questions people commonly have: 

Why do you teach a non-specific request like “my way”?
When children come to us with problem behavior, our first priority is addressing that behavior, which will then allow us to focus on language development. We start with this general-sounding request (sometimes called an “omnibus request”) because it can be taught quickly and yields multiple reinforcers at once.

Teaching several different specific requests takes longer, and research has shown that problem behavior persists until all
the relevant specific requests have been taught (Ghaemmaghami et al., 2016)

Some kids may already have some specific requests. However, in many cases, they do not use these words precisely—that is, they make a request, but they do not seem to want what they have asked for—or they do not use the words when they really need to
(i.e., in challenging situations).

Therefore, we will need to work with them on this. When we teach an omnibus request, it often serves a “gatekeeper.” That is, the child may begin to use specific requests after that. If the child does not use specific requests, we will explicitly teach them after the omnibus request had been learned. Research shows that teaching an omnibus request does not preclude the later development of specific
requests, and we have specific recommendations for how to teach specific requests following the omnibus request if they do not develop on their own (Ward et al., in press).
Finally, it is important to remember that for many children, being “in charge” is a much more important reinforcer than any particular item. Therefore, an omnibus request such as “my way” may actually communicate the most important information, even to a novel
listener (i.e., “my way” means “follow my lead, do what you think I want” whereas a request for the iPad doesn’t tell the listener anything about how to behave after s/he has handed over the iPad).

? Why do you practice similar interactions so many times?
Children need a lot more practice to learn new skills than we tend to expect. That’s why some adults get so frustrated when they correct a child, and then five minutes later the child makes the same mistake. Once—or even 30 times—just isn’t enough in many
cases.
If we waited for naturally occurring opportunities to practice a skill, consider how long it might take a child to learn to do it well. If a child tends to have tantrums when asked to brush his teeth, and adults try to use naturally occurring opportunities to teach him a
better response, most children will only get two practice opportunities every day.

At this rate, it will take a long time for the child to get enough practice to start using a more appropriate response on his own.
This is why we set up concentrated practice opportunities in our treatment-- so that children get the practice they need to become great at the skills.
You’ll know a child has learned the new skills when he uses them quickly, easily, and independently during practice opportunities. When that happens, we won’t have to practice as often. You’ll be able to go about your regular routines and expect the child to use his skills as opportunities arise.
? What if a child seems to get frustrated with the practice?
Practice is hard work. Just like reps at the gym, your fifth rep is harder than your first, but you don’t get strong very quickly if you only do one rep. However, we do not want children to be frustrated with this process. If you notice that your child is frustrated,
please let his/her clinician know.

There are a number of things the clinician can do to help, such as making the reinforcement interval (child’s way) longer and more varied in
duration, or having some pre-session discussion and post-session debriefing conversation with the child as appropriate.
? Why are you working on cooperating with just one direction? We usually have a problem with long tasks.
From assessment, we often learn that children engage in problem behavior when they are asked to do particular tasks. If this is the case for your child, we want to teach your child that these tasks aren’t that bad—not too long, not too unpleasant-- that if s/he
cooperates, it will pay off. We start with lots of exposure to short, easy little bits of the task and high quality pay off, and then get longer and more difficult as your child develops his/her coping skills.
? If a child has learned a particular skill, why do you keep rewarding it?

All people stop doing things that never pay off. We want kids to continue using their words and responding maturely to disappointment, so we need to make sure these behaviors pay off now and then, even if they’re really good at them.
Steps for Skills Based Treatment:
1. Complete a simple functional communication training. This is saying "My Way " when he does not want to engage in a task or stop a preferred activity.
2. Complete a tolerating response "ok" after denial
3. Relinquish the preferred item
4. Transition to a work space
5. Complete work activities or a daily living skill.

A Perspective on Today’s ABA by Dr. Greg Hanley

"Today’s ABA (applied behavior analysis) is about continually learning about the predilections of the autistic person being served so that preferred learning contexts can be developed en route to developing skills that can be appreciated by the autistic person as well as others. What follows is a guide for those implementing today’s ABA but written for those who are curious about what today’s ABA
involves.
Learn by listening.
Ask the autistic person and/or ask people who know and love the autistic person about what he/she/they loves and hates. Be sure to review the love, aversion, and indifference towards activities, objects, furniture, contexts, and especially social interactions.

Ask that person about the autistic person’s voice. How do they routinely communicate?

And, especially, what are they communicating with their problem behavior? In other words, today’s ABA starts with asking questions, listening, and learning about the autistic person by people who know and love the autistic person.
Learn by creating joy.
From that conversation, put together a context in which the autistic person will be happy, relaxed, and engaged, one in which they will feel safe and in control.

Enrich this space with all of the objects and activities that they love. Don’t be stingy with the stuff–more is better. Be sure to include all the things that they have lost in the past because they could not handle their removal or because they engaged with them in unique, stigmatizing, or disruptive ways.
Do not restrict in any way their freedom to do or move. Keep the door open. Follow their lead, physically and conversationally. Let the autistic person bring other materials to this context, remove materials in this context, reposition objects and people in this context, and essentially redesign it with either their actions or words.
Be sure to create clear signals of your submission (i.e., remove all signals of dominance—hovering too
close or standing above them). During this time, avoid all acts of redirection, prompting, teaching, questioning, and language expansion. Be 100% available to the autistic person but do not add your “two-cents” to the situation unless asked.

Reserve even praise unless the autistic person initiates by sharing what they are doing or just did with you and you are authentically impressed.

Do not supervise the experience; share in it without taking it over in any way.
Respond to all attempts to communicate–this will happen the sooner you stop trying to lead the situation. Help them, for instance, not when they struggle, but when they indicate they would like assistance.

Be earnest in your attempts to help even when you are not sure how to do so. Do not let any behavior towards you be ignored; react to their behavior in normal ways, just do not attempt inspire the next interaction—let them lead.

Continue revising the context and your manner of interaction until the autistic person does not want to be anywhere but there. Let them “vote with their feet.” Besides being dignifying and avoiding regrettable physical management, allowing them to leave the space provides good information. Leaving means something important is missing or something aversive is present.

Keep working on building and refining the context until the autistic person is happy, relaxed, and engaged for an extended period.
Recognize that happy, relaxed, and engaged looks very different for different autistic persons, which is why it is essential that someone who knows and loves the autistic person is present at this and the next step of the process.
In sum, teach the autistic person that you know them, you see them, you hear them, and you are there for them. This is the first and crucial step in today’s ABA.
Learn by empowering.
After you are confident that you can create a safe and engaging context and there is zero probability of any severe problem behavior in this context, it is time to empower the autistic person further and establish trust between you and the autistic person. It starts by clearly signaling that the prevailing conditions are about to change, and for the worse, but be clear and kind about it.

Through normal actions and words, make it clear to the autistic person that you would like them to stop what they are
doing, set aside their materials, move in a different direction, inhibit any self-stimulatory behavior, and transition to an area in which developmentally appropriate instruction/expectations will commence. Be sure this area of high expectations is set aside to some extent and populated with all the challenging activities and expectations reported by those who know and love this autistic person as important for
his/her/their development.
If the autistic person shows any explicit sign of distress, discomfort, or protest in the form of either minor or severe problem behavior while transitioning from essentially their way to your way, acknowledge it immediately and relent.

Let the autistic person return to their way and resume following their lead until he/she/they gets back to their version of happy, relaxed, and engaged for a short period.
Repeat this process until it is obvious that the autistic person is empowered and understands that they do not need to comply against their will and they do not need to escalate to escape or avoid the things they don’t want or obtain the things they do want. Teach them that you see them, hear them, and understand them even more now, despite the sometimes lack of precision or general acceptability of
their communication.

Teach them to trust you. In this period, be clear, be alert, be quick, and be consistent. From this resetting of the relationship, you will eventually restore balance and be able reintroduce the ambiguity and challenges of life without problem behavior returning.
Learn while teaching.
The path to a joyous lifestyle for families with autistic persons is paved with skills.

The big pavers are play/leisure skills, communication, toleration, and cooperation.

Once these are set, the branching paths are endless. Today’s ABA process continues by replacing the behavior revealed in the empowerment phase with an easier one that will be better received by others. The process involves gradually introducing ambiguity as to whether the new communication skill will work and by stretching the periods of cooperation.

The pace and aims of this treatment process are continually informed by feedback provided by the autistic person, both in terms of what they say and do."  Greg Hanley 

Gone are the days of bad ABA- this is the new way- supporting autonomy and neurodiversity.  

Site empowered by
WebOnTheFly