Month: August 2018

Great communication can make the experience with your ABA provider much more positive. On the flip side, an ABA center with bad communication can cause you serious frustration. Let’s walk through some ways that you can tell if a center has poor communication skills before you enroll.

Daily, two-way parent communication

If you dropped your child off at an ABA center for 8 hours a day, would you like to know how their day went? Would it be important to know if they had a good day or a bad day? Did they have a lot of behavior issues? Did they acquire a new skill? If an ABA center is not routinely providing you information on how your child’s day went, the center is probably lacking in parent communication skills.

Additionally, just like you should want to know about your child’s time at the center, the supervisors of your child’s therapy program should want to know about your child’s time at home. Did they get a good night’s sleep? Were there any interruptions in their eating? Did they take their medication? These are all things your ABA center should want to know because they may impact therapy.
A high-quality ABA center should have a system in place that creates daily, two-way communication between parent and staff. Such a system makes it easy for parents to know how their child did throughout the day. This communication system also makes it easy for the parent to tell the ABA center about what’s going on at home.

One example of a two-way communication system, is a daily communication binder. A communication binder gets passed between the parent and the center. Upon picking up their child from a day at the ABA center, the parent would also pick up the communication binder. The binder would include notes about how their child’s day went, their successes and their challenges. The parent would take the binder home for the night and could add notes to the binder about anything going on at home that night. The next day when the parent takes their child back to the center, they will also return the communication binder. As a result, both staff and parents will have a better understanding of the child’s progress.

A communication binder is just one example. There can be many other ways that ABA centers provide daily, two-way communication. Just make sure that the center provides a simple, well-integrated system for both the parents and the center to monitor your child’s behavior and skills.

Access to Face to Face time with Staff

Are you able to come into the center any time during the day and talk to the staff? Can you get face-to-face time with the ABA therapists that work with your child?
Generally, ABA centers will have locked doors during regular therapy hours and only individuals with keys or door fobs will be able to enter. A quality ABA center will provide you with the means to access the building during the day so that you can walk in and speak with the staff.

It’s not a great sign if you can’t see a center at all during therapy hours. Often, centers are hiding the chaos and messiness that their less-than-adequate therapy programs are producing. Not to mention, this shows a general lack of willingness to be available and helpful.

Ability to get ahold of BCBA’s managing your Child’s Program

Is it possible for you to email your BCBA during the day and get a response? A quality center will have BCBA’s that are attendant to parents.
You might need to contact your BCBA to let them know that you are worried about something specific regarding your child. Perhaps your child isn’t sleeping very well, is taking a new medication, or something else that you haven’t told the center yet.

If you send your BCBA an email about your child, wouldn’t you want to hear back at some point? Wouldn’t you want to know that they received your email and any action items that are going to come as a result?
If you never hear back from your BCBA, that’s a red flag. Perhaps your BCBA has an overly large case load and is unable to focus much attention on each individual child. It could also mean that your BCBA simply doesn’t care about communicating with parents; which is of course a huge problem as well.

Center Communicates with your Child’s other Providers

Is your child is receiving more medical and therapeutic services than just ABA therapy? Your child might have an occupational therapist, speech pathologist, child psychiatrist, or pediatricians to name a few. The school they may attend spends time with them every day and understands their skills and behaviors in a classroom setting. A quality ABA center will often seek to consult with these professionals regarding your child’s therapy program.

Here’s an example. Your child has been receiving speech therapy from a speech pathologist, once per week. Your child then starts going to an ABA center. This is a relationship that the supervising BCBA will want to start from day one! The program supervisors can collaborate with your child’s speech pathologist on ways to develop their skills and incorporate speech goals into their daily ABA program. Through other therapy professionals, the ABA center gets insight and expertise into your child that they wouldn’t have otherwise. If the ABA center never consults with your child’s other therapy providers, they are ignoring possibly valuable information that can enhance the therapy’s effectiveness.

Center Communicates with your Child’s School

Let’s not forget what can be one of the most important goals of ABA therapy: transitioning your child back into a school setting. If an ABA center isn’t working with your child’s school, principal, and teacher before a transition, a transition into school will prove to be difficult. Most children with autism will often need an Individualized Education Plan(IEP) in the public school system, which is primarily left up to the parents to initiate. If your child needs an IEP, you want to know that the ABA center is going to be available as a support for certain aspects of the IEP. A Quality ABA center might provide teachers with information about your child’s goals, support systems, behaviors, preferences and other things that can better equip school teachers to provide a positive learning experience.

Here are 6 questions (and answers!) a parent of a child with autism might find themselves asking

How can I make doctor/dentist appointments easier on my child, so there aren’t tantrums?

There are a number of things parents can do to make these necessary visits as easy as possible. Simply things such as buying play stethoscopes or creating picture books can go a long way. If you own an iPad or iPhone, you guessed it “There’s an app for that,” it is called iPrompts a visual program for people with autism.

Walk your child through what is going to happen at the visit, so they understand what to expect before getting there. The same is true for dental visits. It may take multiple visits before your child will actually sit in the dental chair, but you can help them get comfortable enough to tolerate most of these visits.

How can I tell when something is hurting my child, he/she is nonverbal?

According to Rebecca Landa, the director of the Center for Autism and Related Disorders at the Kennedy Krieger Institute located in Baltimore, “We know that autism is a multisystem disorder. When it’s not evident that there’s a certain body system not working as it should, we have to look to other indicators. Any time there’s an alteration in a child’s behavioral pattern; this could tell us something we need to be paying attention to medically.” This is why it is important that you know if your doctor works with other patients that have autism.

How do I know which support groups to join, there are so many out there?

Your doctor should at least know of a few support groups that are nearby to recommend. The key to joining a support group, of any type, is to make sure you are joining a group of people that have accepted the issue (in this case the diagnosis of autism) and are making an effort to move forward. The goal of a support group is to do just that, offer support, offer different perspectives on how to handle issues as they happen. You want to be able to get insight from parents that have been where you are so that they can offer tips on how to get through the phase you are in.

You also want to be careful of people who tell you that they have the “cure” for autism. At this moment in time, there isn’t a cure for autism. There are therapies available that if done properly can help minimize certain behaviors. There are people on the spectrum whose symptoms are so subtle that if you didn’t know they were diagnosed with autism, you wouldn’t know they had autism.

Autism is not a battle that one can do alone. Autism is pervasive within the child and it is pervasive within the family. Support groups and support networks are important. Your doctor should be able to offer you a list of local support groups.

How can I learn all I can about autism to help my child? There is so much information on the internet these days, what are some trusted sources?

While it is impossible for any individual to know about all the content on the internet or have a list of every reliable source out there, there are a few sources that are credible that your doctor should be able to direct you to. These reliable sources will undoubtedly lead you to other trusted sites.

If you were to sit down and type in “autism” into Google you are going to get more than 76 million results. Out of the first 100, a third of them are going to do one of two things: selling you something or offering you a cure.

The most reliable websites are those that are government sites or educational sites. For example, PubMed Health and Autism Society are credible sites that offer resources to parents and people with autism.

How can I keep everyone that is involved in my child’s care on the same page?

Communication is important, because it is very much a team effort when it comes to making sure that the therapists, doctors and educators are all working together. There are websites out there that allow parents to set up an account and have the doctors, therapists, teachers, caregivers all logon to talk about the child. You can also keep a journal. You can also ask one of the persons involved to be the “case manager” but make sure you chose someone that understands your child’s condition and treatment plan and is respected by the other people on the “team.”

How do I help my other children understand their sibling who has autism?

Your doctor should encourage you to have your child’s siblings be a part of the therapy sessions. Often times resentment or anger can build because your other child/children does/do not understand the behavior of their sibling who has autism. This is normal. The way that you can help all of your children is to seek out therapy that involves all of your kids. This will help your child with autism learn appropriate social cues through the example of their sibling(s) and it helps your other children feel as though they are a part of child’s care.

Introduction

ABA stands for applied behavior analysis. It’s a form of therapy that’s based on the principles of behavioral psychology. It’s one of the most common therapies used to treat autism and it’s endorsed by the surgeon general. ABA is widely popular due to its proven effectiveness in improving the lives of individuals with autism. An ABA center is where individuals with autism can go to receive ABA therapy.

Customized Therapy Programs

No two children are exactly the same, right? Since this is true, it makes sense that no two children will have exactly the same therapy needs. They will have different behavior problems and will be behind in different developmental milestones. Therefore, ABA centers should never be offering cookie-cutter therapy programs.

In designing a therapy program, the ABA center should be performing a deep assessment of your child’s needs. An analysis of your child’s current skills will be produced from this assessment. Then, a board certified professional will design a therapy program tailored to your child and their current skills. Additionally, the ABA center should be asking for the parent’s input in the initial and ongoing assessment. Parents add value to the assessment by providing information about behaviors the child is having and skills they are lacking. This is also a chance for parents to communicate the goals they have for their child. Goals can range from basic life skills like toilet-training to more sophisticated skills like vocal communication.

Any worthwhile ABA center should be willing to create a unique therapy program to meet your child’s and families needs.

Formal Assessment Tools

Formal assessment tools, such as the VB-MAPP and AFLS should be used to evaluate the skill sets of an individual diagnosed with autism. They should be part of the foundation and structure of any great ABA curriculum.

The VB-MAPP is an assessment tool used to determine an individual’s social and early learner skills. VB-MAPP stands for Verbal Behavior Milestones Assessment and Placement Program. Quality ABA centers use the VB-MAPP, or something similar, to assess a child’s skills and then guide the design of that child’s goals.

The AFLS is another assessment tool that could be used by an ABA center to assess your child’s needs. AFLS stands for Assessment of Functional Living Skills. AFLS assesses the more practical, functional skills like toileting, dressing, basic communication and self-management.

There are even more tools that ABA centers could be using like the ABLLS and the Essentials for Living. These tools not only allow the therapy team to do an initial assessment of a child, but they are also designed for continued monitoring and measurement of your child’s progress. The therapy team uses these tools to re-evaluate the effectiveness of the therapy program.

Consider asking an ABA center if they are using these tools to initially evaluate and continually monitor their children. Without these tools and the data they provide, an ABA center would have far less visibility into your child’s needs and progress.

Based on Data

Data is the lifeblood of any quality ABA program and guides the decision-making about your child’s therapy programs.

For example, when your child first comes to a center, they may spend 60 minutes of every day flopping on the floor and screaming. A proper ABA center should be tracking the amount of time your child engages in this behavior. Over time, it will become possible to see a trend in the frequency of problem behaviors from one day to the next. The therapy program supervisors will then use this daily/weekly trend to decide how well the intervention is working. Eventually, they’ll want to see the 60 minutes of daily tantrums become 30 or 15 minutes. This declining trend in tantrums could indicate that the program is working. On the flip side, if that 60 minutes of daily tantrums consistently stayed at 60 minutes over the course of several months, this might indicate that something about the therapy program wasn’t working. In the case of a program not working, the program supervisors should be able to re-examine the child’s behavior and shift the therapy program accordingly.

Consider asking the ABA center “what kind of data do you use to track my child’s progress?” and “can I see the data?”

Social Skills, Natural Environment Training and Table Work.

Every ABA therapy program should be based on 3 different components of ABA.

1.) Social Skills – The child should be learning social skills by communicating with the therapist, working on eye contact improvements and socializing with other children at the center. To make sure your child is getting the right social skills training, you want to know that they will have appropriate peer groups of the same age. A 10 year old will not gain as many social skills interacting with only 5 year old children as opposed to if they were interacting with children of their own age.

2.) Natural Environment Training – Natural environment training involves using the principles of ABA therapy in natural environments or “the real world”. If your child only learned at a table in a therapy room, then they would have a harder time applying their teachings to other situations. By integrating therapy into “natural environments” like a kitchen, a bathroom, or even a playroom, your child becomes more equipped to use their new skills in the rest of the world and in your home.

3.) Table Work – Table work is the initial teaching arm of the therapy program. Table work provides an environment that is engineered to reduce distractions. The reduced-distractions environment of table work creates focused learning experiences for your child.Through table work, they will become more accustomed to the kind of setting they will experience in a regular classroom as well as at a desk job.

One-on-One Therapy

An intense ABA therapy program means there will be a lower ratio between therapists and children. Additionally, an intensive ABA therapy program should strive for a 1:1 ratio between therapists and children as much as it can.

A 1:1 ratio has a positive impact on teaching the therapy. With a 1:1 ratio, the therapist can be fully aware of all your child’s behaviors, struggles, triumphs and skills.

Furthermore, the 1:1 ratio also has benefits beyond the learning part of the therapy program and impacts the general operation of the center. Even small amounts of time where therapists must manage multiple children can result in behaviors going unnoticed and safety becoming increasingly at risk.

Ask the ABA center how often your child will be 1:1 with a therapist. If it’s possible, try to find a center that provides 100% 1 on 1 ABA therapy. This means that at NO point during the therapy program will your child be without a 1 on 1 setting with a therapist.

Contact Lighthouse Autism Center to learn more about finding a quality ABA center for your child.