Basics of ABA

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!