The Role and Importance of ABA inThe Role and Importance of ABA inEarly Childhood InterventionEarly Childhood Intervention

LandonLandon

• 19 months old

• Outcome: I want Landon to say words sothat he can communicate with mom and dadsaying, “mama”, “dada”, “all done”, “bye”,“more”, etc.

GracieGracie

• 31 months

• Outcome #1: I want Gracie to sit and playfor a longer period of time, starting at twominutes and then long enough to hear astory.

• Outcome #2: I want Gracie to play withtoys rather than put them in her mouth.

ComparisonComparison

ECI “Educational” Model

• Parent Involvement

• Basic Strategies

• Child’s response

Applied Behavior Analysis

• Parent Involvement

• Basic Strategies

• Child’s response

Jennifer Caffee, EISJennifer Caffee, EIS

• 13 years experience with Autism SpectrumDisorders

• Training: Applied Behavior Analysis(ABA) and Discrete Trial Teaching

• 2008 ECI of LifePath Systems

• Professional Expert, Sand Diego UnifiedSchool District

Jennifer Caffee, EISJennifer Caffee, EIS

• 2002 Case supervisor for a home basedprogram focusing on ABA and discrete trialprinciples

• 1998 Professional Expert, San DiegoUnified School District

• 1997 Dallas MHMR Behavior Specialist,implemented in-home ABA through UNT

Brooke Janacek, MaEd, EISBrooke Janacek, MaEd, EIS

• 14 years experience with Autism SpectrumDisorders

• 2005-Current Supervisor with ECI ofLifePath Systems

• 2001 Early Intervention Specialist with ECIof LifePath Systems

• 2000 Worked with family in-home ABAprogram

What is Applied BehavioralWhat is Applied BehavioralAnalysis (ABA)?Analysis (ABA)?

• Data-based strategy for teaching childrenwith intellectual disabilities

• Only treatment for children with AutisticSpectrum Disorders approved by the FDA(Food and Drug Administration)

• ABA identifies behaviors/skills to beextinguished or reinforced, how to identifywhat is reinforcing and how to providereinforcement

Seven Dimensions of ABASeven Dimensions of ABA

1. Applied: Interventions focus on changingsocially significant behavior

2. Behavioral: Behavior is measurable

3. Analytic: Objective demonstrations thatthe procedures caused the effect

4. Technological: Interventions are describedso they can be implemented by anyonewith training and resources

Seven Dimensions of ABASeven Dimensions of ABAcontinuedcontinued

5. Conceptually systematic: Interventions arespecific and identifiable

6. Effective: Interventions produce strong,significant change

7. Generality: Interventions, from thebeginning are intended to operate indifferent environments and continue afterformal treatment has ended

Steps in the ProcessSteps in the Process

1. Increase

2. Discuss

3. Refer

Option 1: Structured visits withOption 1: Structured visits withABA principlesABA principles

• Focus is on teaching caregiver when andhow to reinforce behavior

• Specific examples of prompting child

• Provide behavior modification strategiesand family goals

• Data collection to monitor effectiveness ofintervention

JackJack

• 24 months

• Outcome #1: I want Jack to respond to hisname that way I know he is paying attentionalong with watching where I point such as“There’s a dog.”

• Outcome #2: I want Jack to be able to askfor a particular food or say he wants to eator sleep. He will be able to ask for up,outside, and milk

Jack continued…Jack continued…

• Outcome #3: I want Jack to followdirections like “throw it in the trash”, “goget…”, “bring me…”, and “show me…”

• Outcome #4: I want Jack to playappropriately with toys rather than puttingthem in his mouth and licking them.

• Outcome #5: I want Jack to walk on flatfeet rather than on his toes.

Option 2: Systematic ProgramOption 2: Systematic ProgramDevelopmentDevelopment

• All aspects of Option 1

• Increase home visit hours

• Evaluation: Assessment of Basic Languageand Learning Skills (ABLLS)

• Follows discrete trial training methodology

• Data collection on specific targeted skills

• Family goals for generalization

CohenCohen

• Outcome #1: I want Cohen to play with toysthe way ther are intended to be played sothat he will color on paper rather than shredit, roll train around the track rather than pullthe track apart, and attempt to swing bat andhit ball off the tee, and engage in pretendplay consistently.

Cohen continued…Cohen continued…

• Outcome #2: I want Cohen to use words torequest his needs and wants and to labelobjects so that he begins to communicateverbally.

What is discrete trialWhat is discrete trialtraining/teaching (DTT)?training/teaching (DTT)?

• One-to-one instructional approach used toteach skills in a planned, controlled, andsystematic manner

• Used when a learner needs to learn a skill insmall, repeated steps

• Each trial has a definite beginning and end

How does DTT work?How does DTT work?

• Tasks are broken down into short andsimple trials

• Motivation for learner is built by rewardingperformance of desired behavior orcompleting of task by tangible or externalreinforcers

How does DTT work?How does DTT work?

• Stimuli presented in DTT is clear andrelatively consistent. Learner is onlyrewarded for performance of desiredbehavior under the specified stimuli

• DTT teaches skill/behaviors explicitly(cause-effect learning)

• Instructions are simple, concrete, and onlyprovide the most salient information

Parental Teaching ComponentParental Teaching Component

• Transition after ECI is part of the plan whenABA is being considered.

-- ECI can train volunteers in the principles

-- ECI trains family on instruction and datacollection to become the expert to continuehome program

• Consider the ability and personal preferenceof the family involved in intervention

Parent CommentsParent Comments

• Once ABA started, shehas improved so muchmore

• I am able to use ABAwithin my dailyroutines

• ABA strategies havehelped me teach mychild

• The therapists havegraciously helpedteach me strategies toadapt into our dailyroutines

• We have receivedABA on a weeklybasis. He isrequesting things dailylearned many newskills

IDEA Part CIDEA Part C

A statewide system described in sec. 633 shallinclude, at a minimum, the following components

Statute: Title I/C/635/a/2

(2) A State policy that is in effect and that ensuresthat appropriate early intervention services basedon scientifically based research, to the extentpracticable, are available to all infants and toddlerswith disabilities and their families…

Texas: ECI Policies andTexas: ECI Policies andProcedures ManualProcedures Manual

20.2 Service Delivery Accommodations

The contractor must design early interventionservices to accommodate the family by

• allowing variable degrees of familyinvolvement, as determined by the family

• not denying services based on the family’sdecision about their level of involvement.

Texas ECI HandbookTexas ECI Handbook

• Services can be provided in different ways,depending on how your child may benefitmost

• Your child’s need for any service can rangefrom less than an hour to several hours perweek

IDEA Part CIDEA Part C

A statewide system described in sec. 633 shallinclude, at a minimum, the following components

Statute: Title I/C/635/a/2

(2) A State policy that is in effect and that ensuresthat appropriate early intervention services basedon scientifically based research, to the extentpracticable, are available to all infants and toddlerswith disabilities and their families…

Where do we startWhere do we start

Autism Team

• Consists of a staff personfrom each discipline

• Hire or contract with aBCBA to develop programs

• Regular meetings toestablish procedures,training opportunities, shareinformation

BCBA and LCSW

• BCBA develops theprogram

• Designated staff membersbased on interest level toprovide the ABA services

• Autism training is focusedon these people

Who will teach me?Who will teach me?Support Groups, Conferences,Parents, Practice

ResearchResearch--based Methodologybased Methodology

• American Academy of Pediatrics

• The Mind Institute

• The American Academy of Intellectual andDevelopmental Disabilities

• National Institute of Mental Health

• Autism Speaks

• US Surgeon General

• Rethink Autism

Common Texas Resources forCommon Texas Resources forTrainingTraining

• Autismspot.com

• Texas State Conference on Autism

• www.woodallkids.org

• www.fhautism.com

• www.autism-society.org

• www.focussped.com