This is a guest blog by Brittany Mealey, a Registered Behavior Technician with 8 years experience with ABA, and currently finishing her master's thesis.
We also have another blog on troubleshooting common ABA problems.
How to Use ABA for a Child with SATB2
The most important principle in ABA (Applied Behavior
Analysis) is positive reinforcement – in layman’s terms, rewards. This includes
rewards such as praise, tickles, and high fives, as well as tangible rewards
like candy or favorite foods, stickers, toys, privileges, and favorite
activities. In ABA, these rewards are called “reinforcers”. This is how you are
going to motivate your child to participate in therapy.
So to start off with, try to identify your child’s best
reinforcers. Ideally, pick something your child LOVES, but doesn’t often get. Getting
to play games on your phone or tablet is often effective for many kids, as is blowing
bubbles, or small treats like M&Ms or Goldfish crackers. But those are just
suggestions – you know your child best, and the most important thing is to make
sure whatever you pick is MOTIVATING to your child! I can’t stress this enough:
IF YOU CHOOSE AN INEFFECTIVE REINFORCER, YOUR THERAPY WILL
FAIL!!!
Remember also that kids’ interests and motivations change,
sometimes minute to minute! Understand that what worked last week, or a day
ago, or even two minutes ago to motivate your child may not work now. If your
child is losing interest, he may need a break, or may simply need a different
reinforcer. You can allow him to choose between things you think may be
motivating by showing him his options and allowing him to reach for or point to
the one he wants. Whatever you choose as the reinforcer, in order to have
maximum effectiveness, make sure your child DOES NOT HAVE ACCESS to that
reinforcer for ANYTHING ELSE other than therapy. For the sake of simplicity, I
will write the rest of the blog as if you are using M&Ms.
ISN’T THIS A BRIBE? I DON’T WANT TO BRIBE MY KID.
There is a difference between bribery and positive
reinforcement. Bribery implies that you are giving a reward to someone in
return for them doing something dishonest.
If you disagree, and you view any
reward as bribery, then you must also accept that your boss “bribes” you (with
money) to go to work, that your teachers in school “bribed” you (with good
grades) to do your schoolwork, and that you “bribe” your hairdresser (with
money) to give you a good haircut. Offering an incentive for doing good work is
not bribery, and that is all you are doing for your child.
BUT WON’T MY CHILD LEARN TO ONLY SPEAK WHEN I HAVE
M&MS AND NOT OTHERWISE?
Maybe at first, but it won’t be that way forever. Speaking
is a really difficult skill for your child right now. If someone asked you to
learn something that was really hard for you (e.g. trigonometry, or advanced
chemistry), you would probably resist it too, unless you could see that there
was a point to learning it. Right now, your child likely doesn’t understand
that there is a point to her speaking, so she has no motivation to learn it. So
you’ll need some artificial motivation (M&Ms) to motivate her to learn
enough speaking skills to where she starts to realize that speaking helps other
people understand what she wants – and then she will speak because she finally
sees a point to it, and she won’t have a need for you to use M&Ms all the
time.
THE IMPORTANCE OF IMITATION
Learning how to speak, sign, or really any new skill, requires
the ability to imitate (copy) someone else. You have to know how to imitate in order to
add a brand new sign, sound, or word to your repertoire. If your child doesn’t
yet have the skill to imitate you, that is the very first thing you need to
teach him. Even though speaking is most likely the end goal, it is easiest to
start with teaching imitation of motor skills, because you can physically help him
be successful. After he can imitate motor skills, you can move on to things
that will help more with speech.
There are two different types of motor skills: gross motor
and fine motor. Gross motor tasks are
physical tasks that use the larger
muscles and create large movements
(like waving arms, patting a table, kicking a ball, or standing up). Fine motor tasks are physical tasks that
use the smaller muscles and create smaller movements (like doing the sign
language alphabet, picking up a Cheerio with a finger and a thumb, or wiggling
fingers).
You will want to start with gross motor tasks, because you will need to physically help your
child imitate you, and it’s easiest to just grab and wave his arm than to try
and force his little fingers into a specific shape. The gross motor task you
choose needs to be one that your child already
knows how to do— because you aren’t teaching him how to do an action – you are teaching him how to
imitate an action, and he won’t be
able to imitate if he physically can’t do the action yet. Some possibilities
are: patting his head, patting a table, raising his hand, or waving. For the
sake of simplicity, for the rest of the blog I will write as if you chose
patting the table.
HOW DO I DO THERAPY?
1)
Sit your child in a chair at a table, and get her
attention.
2)
Show her the reinforcer (visible but out of her
reach), then say “wait” and simultaneously place your child’s hands on top of
one another, resting on the table. Hold her hands there (using one hand) for 3
seconds.
3)
When 3 seconds are up, say “do this” (NOT “pat
the table”) as you pat the table with the hand that is not holding your child’s
hands down. As soon as you finish patting the table, immediately, before she
has a chance to do the wrong thing, reach over and take your child’s hand and
make her pat the table (this is called a physical prompt – you are physically showing
her muscles how to make the right response).
4)
Immediately PRAISE enthusiastically (“WOOHOO,
you did it! You copied Mommy! I am so proud of you!”) etc… while simultaneously
giving her her reinforcer. It actually helps a lot if you have someone standing
behind your child who can help with both arranging your child’s hands for
“wait” and prompting your child for patting the table, as this way you can
concentrate on praising and delivering her reinforcer. It also decreases the
likelihood that your child will become dependent on you prompting her.
5)
Give her about 30 seconds with her reinforcer if
it’s time with a toy, or let her have time to eat it if it’s edible. After 30
seconds, move it out of her reach and immediately begin again with steps 2 through
4. Wash, rinse, repeat… for as long as she is motivated for the
reinforcer. Once you can tell she is
starting to lose interest (but before she is actually showing any bad
behavior), call it a good therapy session and go off and do something else for
a while.
HOW DO I TELL IF HE IS GETTING IT?
Once you have been physically prompting your child for
several sessions, you can test him out by saying “do this” and patting the
table, and then only halfway prompting him to do it (maybe take his arm and
lift it towards the table, but don’t pat for him) and see if he will do the
rest by himself.
If he does, throw an even bigger praise party for him “Wow!
You did it by yourself!” and give him about twice as long with his reinforcer
(or give him twice as much if his reinforcer is edible). Then the next time you
can test him by prompting him even less, or maybe even not prompting him at
all. The more he does independently, the bigger the praise party and the more
reinforcer he should get.
If he doesn’t do the rest by himself, it’s okay. Prompt him
the rest of the way so he can still be successful, and just keep chugging along
with your complete physical prompts and keep testing him out occasionally to
see if the concept has clicked yet. Some kids will get it quickly (3 or 4 times
and they’ve got it), others will take longer (several days’ worth of therapy),
and others will take still longer (a month or more). Every child learns at his
or her own pace.
MY CHILD CAN NOW IMITATE PATTING THE TABLE! NOW WHAT?
Once she can imitate you patting the table by herself, move
on to teaching another gross motor task, such as patting her head, raising her
hand, or similar – in the same way as you taught the first skill, complete with
immediate physical prompts. Once she has mastered two or three different tasks,
start to mix them up. For example, in the same session you can ask for patting
head once, then raising hand once, then patting head again, then patting the
table, etc. Aim for teaching at least 8-10 different tasks.
HOW WILL I KNOW IF MY CHILD HAS LEARNED HOW TO IMITATE?
After you have taught 8-10 different tasks and your child
can easily imitate all of them presented in any order, you can test to see if
he really has learned the skill of imitation. You can test him by saying “do
this” and then doing a brand new gross
motor task that you haven’t specifically taught yet (still one you have seen
him physically do before, though), and DON’T prompt him at all. If he copies
you successfully, celebrate! Your child has officially learned how to imitate,
and that is a HUGE milestone that will help him immensely in learning how to
speak or sign!
MY CHILD HAS OFFICIALLY LEARNED HOW TO IMITATE! NOW WHAT?
Congratulations! Where you go from there will depend on
whether you want to focus more heavily on signing or speaking. If you want to
focus more heavily on signing, move to fine motor imitation. Teach her the
signs for her favorite things (you can look up specific signs on the internet).
If you want to focus more heavily on speech, move to oral motor imitation
(things like opening mouth wide, sticking tongue out, closing lips tightly, and
smiling).
Best of luck to you all!
