What Does In-Home ABA Therapy Look Like?

What Does In-Home ABA Therapy Look Like?

Many ABA therapy programs take place in-home. The comfortable setting makes in-home treatment more conducive to the needs of some children with ASD. In-home ABA therapy may differ from the therapy held in a clinical setting but what do those differences look like?

Family Involvement

Some children with ASD may require in-home ABA therapy to address issues with family members. This also allows family members to interact and learn how to use some of the ABA methods when treatment is over.

Other at-home issues may also require specific in-home therapy. Learning to properly use or interact with integral appliances, routines, and schedules may require the expertise of an in-home ABA therapist.

ABA Therapy Space

In-home ABA therapy usually requires designated spaces to be used. Each program is different and may use different spaces. All or most of the therapy programs will be conducted in these spaces, so be ready to slightly alter your daily routine if a specific room is off-limits for any amount of time (unless required to be there).

Being comfortable with a space may be beneficial to an ABA treatment program, so be sure to talk to your child’s therapist about therapy spaces. 

In-Home ABA Therapy Scheduling

In-home ABA therapy is usually recommended to be conducted with a schedule that will be used during weekends & holidays. Creating a matching schedule for therapy and non-therapy hours can make transitions easier.

Talking to your child’s therapist can help you make a great schedule your child can follow. Be sure to include times, as moving times around can cause issues. Activities, free time, playtime, errand time, sleep schedules, meal times, and any other important family needs should be factored into both the therapy and regular home schedules.

Parents at Home

ABA therapists are not babysitters and should not be used in that capacity. Having a parent or guardian home is imperative during in-home ABA therapy sessions. If you are unable to be there for a specific time or something unmissable comes up, be sure to have a guardian take your place and not an unrelated babysitter.

Talking to your therapist about needs and duties as a parent can help you understand why you need to be home during therapy and what your role may require. Be sure to take any important notes and schedule any new activities.

ABA Therapy from IABA Consultants

If you have questions regarding autism treatment, education, or plans using ABA therapy, we are here for you! Our goal is to make sure no family is turned away due to financial constraints. Our therapy team would love to talk to you. Find the location closest to you and give us a call. We’re here for you.

Underneath the Bursts

Underneath the Bursts

This past week I wrote to you about setting boundaries with our children. In my blog, I wrote about the importance of boundaries for the emotional development of children. I also wrote to you about my own struggles in setting boundaries as a mama. One of the main reasons I struggle with setting boundaries for my own children is the (out)bursts that come with it.

It just so happens that as a clinician one of my primary areas of specialization is problem behaviors (the bursts). It’s what I went to graduate school to study over a decade ago. Over 10 years later and I can tell you the science of reducing problematic behaviors hasn’t changed. My own journey applying clinical skills at home, of course, has not (well, not totally). Today I’d like to write to you about both.

ABA & Bursts

Let’s start at the beginning with ‘burst science.’ Applied Behavior Analysis teaches us that social behaviors, both positive and negative, can be broken into units that can be studied. In studying units of behavior, BCBAs are able to identify the function of behaviors (why behaviors occur) and missing skills in the child they are studying. When it comes to reducing problem behaviors, behavior analysts are looking for why the behavior is occurring. This involves looking at what is happening before the behavior and what happens after the behavior.

While studying the environment before bursts occur, BCBAs look for a deficit in the child’s environment. What are they missing? Studying environments after bursts allow BCBAs to see if the child’s problem behaviors filled the deficit. If they did, the child is successfully using the problem behavior to get their needs met. This means the problem behaviors are being reinforced and will continue to occur. Magic I’m telling you. Magic.

You see, by studying what a child is seeking in a specific environment you can create interventions that fill the child up with what they are seeking to immediately decrease the problem behaviors. This isn’t a long-term solution, but it creates a short-term solution to make the days easier for the child and their families. While the child is being satiated BCBAs work on teaching new skills surrounding the child’s needs. This always looks like teaching functional communication skills, how to ask for exactly what you need.

Sometimes teaching specific skills can look like teaching patience and tolerance to ‘no’ when what the child wants isn’t good for them to have all the time. For example, if a child is throwing tantrums to get access to candy it’s damaging to have non-contingent candy all of the time. But if a child is tantruming for positive attention, we can fill them up without having to teach tolerance to no. Though we might have to teach waiting because sometimes mama (or papa) is busy.

The key to this remedy is to also remove reinforcement when a child is using their problem behavior to get their needs/desires met. If, in the scenarios above, the BCBA is providing candy (one piece) every 30 minutes and within 15 minutes the child hits to get access to the candy the BCBA cannot give the child the candy. If they do they will reinforce the hitting and take the motivation away from using words. It is here, in this little sweet spot of the behavior intervention, that bursts occur. Let’s talk about that.

Why Do Bursts Occur?

Underneath the bursts for children (and adults… more on that later) is fear that their needs/desires won’t be met. The bursts occur because, in the child’s mind, that very thing they want could become unattainable, their need won’t be met, and they will have to experience negative emotions. Dealing with both the fear of a need/desire not being met alongside psychologically negative emotions is tough stuff for a child. This right here? This is the hard part for parents and the sweet spot for teaching emotional resilience and intelligence.  

As a mama, I know firsthand how easy it is to give in. To not want to deal with the temper tantrum, the screaming, and the crying. We are human beings and crying children is not comfortable. When we give in as parents at a given moment it provides immediate relief to ourselves and our children. It also perpetuates the very behaviors we don’t want to see more of and does not teach our children how to deal with the big emotions. 

About a year ago Henry and I were at Dametrius’s football game and Henry wanted candy from the concession stand. I had packed snacks and knew sugar was on the menu later so I didn’t want him to have extra candy. I leaned down and told my little son, “no, not now we’ll have dessert at dinner”. Of course, in public, a full-on tantrum occurred. At that moment I thought how perfectly aligned this example was. You see at that moment I could have made a concession at the concession stand by just giving in. If I gave in Henry would happily watch the game and I wouldn’t have to be teaching Henry to breathe and tell me how he feels. But giving in also meant teaching my son to numb his emotions with food and that screaming works. So I stood my ground and worked with Henry.

You see under the bursts, as we are teaching boundaries. As children burst, their hearts need to know they can ride through negative emotions and still be safe on the other side. That nothing bad comes from feelings and that needs can be met in new ways. To me, as a clinician, I know that working through the bursts creates long-lasting, positive, change. As a mama, teaching my children to ride what is underneath the bursts is more valuable than any concession I could make at any given moment.

Xoxo,

Jessie

What Does ABA Therapy Look Like?

What Does ABA Therapy Look Like?

Applied behavior analysis (ABA) is such a broad ASD therapy approach making it difficult to define what a typical program will look like. The amount of therapy and level of parent involvement varies, often according to the specific needs of the child. 

ABA skills training programs and techniques can require several hours each day. While skills training programs are usually implemented by behavior therapists or teachers, parents are often taught critical skills to help their children transfer what they have learned in therapy to everyday life, especially at home.

ABA skills training programs for young children are often based in the home and require special materials and a dedicated area for working. ABA behavior modification therapy may include 1-2 hours of parent training per week with the parents using strategies they learn in between visits. An ABA therapist may also consult with teachers to help support positive behaviors in the classroom. 

Strong ABA Therapy Programs

Strong ABA programs will all be different, as they should be tailored to the individual needs of each client. That said, all strong programs will also have some similarities on a general level.

Supervision

The program should be designed and monitored by a Board Certified Behavior Analyst (BCBA) or someone with similar credentials. Supervisors should have extensive experience working with children with autism. 

Training

All participants should be fully trained, with supervisors providing support, monitoring, and ongoing training for the duration of the program. 

Programming

The program should be created after a detailed assessment has been conducted and tailored to the child’s specific deficits and skills. Family and learner preferences should be given consideration in determining treatment goals. Generalization tasks should be built into the program to ensure the performance of skills in multiple environments. 

Functional Programming

The goals selected should be beneficial and functional to the individual and increase or enhance his/her quality of life. A mix of behavior analytic therapies should be used so that the child has an opportunity to learn in different ways. 

Data Collection

Data on skill acquisition and behavior reduction should be recorded and analyzed regularly. This data should be reviewed by the supervisor and used to measure the progress of the individual and provide information for program planning. 

Family Training

Family members should be trained in order to teach and reinforce skills. They should be involved in both the planning and review process. 

Who Provides the Actual ABA Services?

The top certification board for an ABA therapist is a Board Certified Behavior Analyst (BCBA) and comes from the Behavior Analyst Certification Board. Further certification can be issued in the form of a BCBA-D, indicating the therapist has a doctoral degree. Another license is the BCABA, which means having an ABA education at the level of a bachelor’s degree.

Some ABA therapists may indicate they have several years of experience but are not BCBAs. Individuals in this position should not be providing services unsupervised. Only board-certified BCBAs should be overseeing programs and implementing therapy methods.

ABA Therapy from IABA Consultants

If you have questions regarding autism treatment, education, or plans using ABA therapy, we are here for you! Our goal is to make sure no family is turned away due to financial constraints. Our therapy team would love to talk to you. Find the location closest to you and give us a call. We’re here for you.

Sources

Autism Speaks

Boundaries on the Home Front

Boundaries on the Home Front

Last week I wrote to you about my own journey in boundary-setting as a business owner and woman. This week I’d like to dive deeper into boundaries and talk to you as both a mama and a clinician about boundaries on the home front.

As a clinician, not only do I have extensive knowledge about early childhood development but one of my areas of expertise is reducing disruptive and dangerous behaviors. I spent the first five years of my career in Applied Behavior Analysis working in early intervention and on crisis cases.

I can see my young self now, rested for the day, walking into a therapy session and teaching things like how to work through a tantrum. I worked with each family on their own values and expectations of their child, observed the needs the child was trying to get through their tantrums, and taught consistent consequences to the family as well as adaptive skills to the child. In the range of adaptive skills I often taught language (use your words), patience, tolerance to hearing ‘no,’ disappointment tolerance, and expression of feelings. Each family and child was unique but the structure of the treatment was similar and based on boundary setting.

Learning Boundary Setting as a Mom

Fast forward about 8 years to when I became a mama and my son Henry became a toddler. Henry was (and is) a strong-willed child. I remember writing in his baby journal “I didn’t know babies came out like you…” because Henry was (and is) so vocal about how he sees things and how he wants things done. As a mama, I tried to also be a BCBA and use the same tried and true treatment structure with Henry. State a boundary, follow through with the boundary, use your words, and teach new skills. Easy right? No. Hard no.

Throughout my journey into motherhood, while I love my boys above all else, I have struggled with both postpartum depression (Henry) and a toxic home environment because of domestic abuse.  Toss in three boys who all have varied needs, wants, desires, and voices and the stress of setting boundaries felt impossible. You see, the thing with setting boundaries is that when you first set them children tend to resist them. Boundaries feel like a “no” to children (often they are) and the “no” feels like something for them to rebel against. As a parent, you have to be ready for the explosion as you set expectations. I’m going to be honest here; I could not weather the explosions so I became a, “yes mama”. Ugh.

Boundaries by Example

A year ago when I left domestic abuse my children & me. We were living in a psychologically frightening environment and I knew, no matter how much I wanted their dad to get help, that I couldn’t stay any longer. I set the boundary that I would not live in an abusive environment and modeled this incredibly important boundary for my children. 

Yet as the last year passed my small children had so much change in their little worlds. While some of my “yes mama” tendencies went away, some remained. Want a new toy? Sure. One more piece of candy? OK. TV time? You got it. This also worked the other way and when my children behaved in ways I didn’t love (not staying in bed, dumping their food on the floor, screaming for things) I would spend time making empty threats (one more time and then…) and eventually give in. While home life was much calmer as a single mama and my children were happy with me, I knew I had to reset, buckle in, and teach boundaries.

You see, without boundaries children don’t know which behaviors are OK and which ones are not. Without boundaries, they don’t learn how to navigate unpleasant emotions and what to do with their unpleasant emotions. They also don’t learn how to behave in social situations and can become impolite, spoiled, and disruptive.

Keep in mind that little children are still children. It’s basically their job to overreact while testing boundaries early on. It’s our job as parents, however, to shape their behaviors in positive ways. Yes of course I want my children to be happy but I also want them to know how to navigate their own inner and outer worlds. Boundaries are the way to teach this.

Maintaining Boundaries

As the fall came so did a new peace in our home. I set some simple boundaries for the boys I knew I could follow through with and continued to teach them how to navigate their emotions. I spent time making sure the values I set were in alignment with my values and that I was ready for tantrums when they came. The boundaries I set were for good listening, respect, kindness, and understanding “no.” 

My children have become calmer overall after the initial, “holy crap” boundary bursts. Boundaries tell them what is OK and what is not so they don’t have to guess or use tantrums to figure a given situation out. When they don’t like the answer they know we can hold space for them to be sad or mad. It’s a win-win. 

Me? I have a ton of compassion for the woman I was in early motherhood and know I was doing the very best I could at the time. I also am incredibly grateful that I’m in a space to apply my clinical skills to mommyhood. One day (and boundary) at a time.

Xoxo,

Jessie 

What Does ABA Therapy Look Like?

The Differences Between ASD and Social Anxiety

On the surface, social anxiety disorder and autism spectrum disorder (ASD) may look the same. Both people with autism and those with social anxiety can experience social situations differently than others.

While social anxiety and ASD can occur together, they are very different conditions. In some cases doctors even get the two mixed up, leading to misdiagnosis.

Let’s take a look at both the similarities and differences between ASD and social anxiety.

Similarities of ASD & Social Anxiety

A major similarity between social anxiety disorder and ASD is that both conditions look different in every person. With that said, there are plenty of similarities, including symptoms and treatment services offered. It’s also important to understand that social anxiety is not a form of autism and vice versa.

Similar Symptoms

One reason social anxiety and autism are sometimes confused is that some symptoms appear the same.

According to some educational psychologists, overlapping symptoms of autism and social anxiety disorder can include:

  • Limited social communication
  • Nervousness
  • Difficulty adapting to changing plans
  • Lack of eye contact

ASD & Social Anxiety Diagnosis

A psychologist can diagnose autism and/or social anxiety disorder using the Diagnostic and Statistical Manual of Mental Health Disorders 5th Edition (DSM-5). The DSM-5 is a handbook published by the American Psychiatric Association that helps healthcare professionals make diagnoses.

A healthcare professional will ask about symptoms and may observe a person in social situations before making a diagnosis. Sometimes a pediatrician or physician will recommend seeing a healthcare professional who can properly diagnose ASD, social anxiety, or other specific mental conditions. Ask your doctor for more information.

The DSM-5 diagnostic criteria for autism include:

  • Persistent differences in social communication, including but not limited to lack of back-and-forth conversations and differences in eye contact
  • Repetitive patterns of behaviors, such as lining up toys
  • Symptoms were present in early development, even if they went unnoticed
  • Symptoms interfere with daily functioning, such as schoolwork

The DSM-5 diagnostic criteria for social anxiety disorder include:

  • Fear of judgment in social situations
  • Consistent anxiety in social situations that does not fit the context
  • Avoidance of social interaction
  • Fear of social interaction that impedes day-to-day life
  • Having fear for at least 6 months (and the fear cannot be attributed to another mental health condition, such as panic or substance use disorder, or a disease like Parkinson’s)

Note that social anxiety can develop in children or adults.

ASD & Social Anxiety: Brain Functions

The amygdala, which affects the brain’s response to fear, may play a role in both ASD and social anxiety disorder. Research is still ongoing. Ultimately, however, brain functioning is very different in social anxiety and ASD. The neurological causes of autism aren’t yet fully understood.

Treatment for ASD & Social Anxiety

There’s no cure for social anxiety or autism. In addition, not everyone wants to “manage” or “fix” characteristics associated with autism. People can live fulfilling lives with customized support and treatment tailored to their goals.

Treatment and support options for ASD include:

  • Applied behavioral analysis (ABA) therapy
  • Occupational therapy
  • Social skills training
  • Cognitive behavioral therapy
  • Occupational therapy*

*Occupational therapy is often a first-line service for autism. It may also be used to help people cope with social anxiety in some cases.

High-Functioning Autism Vs. Social Anxiety Disorder

The current diagnostic process for ASD involves three potential levels of support needed:

level 1: requiring some support

level 2: requiring substantial support

level 3: requiring very substantial support

Autism is neurologically based, which makes it different from social anxiety disorder, regardless of communication abilities or any overlap in symptoms.

Differences Between ASD & Social Anxiety

The main difference between ASD and social anxiety is that autism is a neurodevelopmental condition, while social anxiety is a mental health condition. Experts say it’s essential to get the diagnosis correct.

Though a formal diagnosis is best made by a licensed professional, understanding the differences between social anxiety and autism can empower parents to seek an evaluation. Because autism and social anxiety are distinct conditions, they have nuanced symptoms and diagnostic criteria.

ASD & Social Anxiety Symptoms

People with autism and those with social anxiety alike may seem to avoid eye contact. Importantly, however, autistic people aren’t necessarily “avoiding” eye contact out of nervousness or fear. They’re simply not making eye contact in the first place, which is a distinct difference.

Researchers have suggested that individuals with autism look toward a person more slowly, while people with social anxiety look away faster. ASD is a spectrum, meaning people may communicate in different ways. Some may not speak at all, while others may engage in one-sided conversations or miss social cues.

On the other hand, people with social anxiety intentionally avoid conversations because of fear.

Social anxiety can be the result of trauma. A brain dealing with social anxiety may be compensating for something that happened or trying to prevent something from happening reoccurring. Social anxiety is different from autism because autism isn’t triggered by an event, experience, or trauma.

ASD & Social Anxiety Brain Functions

The amygdala may be implicated in both autism and social anxiety disorder, but current research supports the idea that autism is neurodevelopmental. There are comprehensive conclusions available concerning what causes ASD, but research is ongoing.

Social anxiety, on the other hand, is mental-emotional.

Please note that all of this information is for reference only. If you are concerned about your child, please contact your pediatrician or a mental healthcare specialist.

ABA Therapy from IABA Consultants

If you have questions regarding autism treatment, education, or plans using ABA therapy, we are here for you! Our goal is to make sure no family is turned away due to financial constraints. Our therapy team would love to talk to you. Find the location closest to you and give us a call. We’re here for you.

Originally Posted as How to Tell the Difference Between Social Anxiety and Autism at Healthline.com