Wednesday, March 25. 2009

Four Fundamental Mistakes to Watch for in ABA Therapy

Posted under: Research

One of my favorite ABA comments is the following, "It doesn't take a rocket scientist to implement ABA therapy...It's much more difficult than that!" Rocket scientists get to work with numbers and formulas that stay constant. 2+2 always equals 4. Behavior therapists get to work with children whose attitudes and desires vary from day to day. The rewards and prompts a child needs today may not be the same rewards and prompts he needs tomorrow, let alone a month from now. Still, like any science, I've found some basic guidelines that I return to frequently when behavioral treatment isn't going as well as planned.

Here they are:

The Four Fundamental Mistakes to Watch for in ABA Therapy
(in order of importance, #1 being most important)

1) Not reinforcing a behavior
a. Reinforcement increases a behavior. It's not simply a reward we think a child will like. If the behavior doesn't increase, adequate reinforcement wasn't present. One of the reasons a reward we think a child will like doesn't serve as reinforcement is because it gets overused. A child can only be tickled, spun around, or given a piece of cookie so many times. Reinforcement must be continually varied.

2) Allowing a child to be non-responsive
a. When questions or instructions are repeated over and over, a child learns, "I don't have to answer the first time. I can sit here and do nothing while you continue to repeat the question or give me a direction."

3) Not prompting frequently enough
a. A child should remain successful at least 80% of the time. Note that non-response is also considered an unsuccessful response. People must ask themselves, "Am I 80-100% certain the child can respond correctly on his own?" If not, enough help should be given so that the child does respond correctly.

4) Prompting too much
a. Ironically, it's also important to remember to fade prompts when a child is successful. This doesn't necessarily mean a prompt has to be completely removed immediately. There are limitless ways to gradually fade prompts so that less and less help is given while a child remains successful. Note that NOT prompting frequently is a bigger mistake to watch out for than prompting too much.

Does anyone else have some fundamental guidelines they turn to when behavioral treatment isn't going well? Feel free to share.

Comments

I think these are great points to reiterate with your ABA team. Another reminder I also find myself giving often involves consistency: with less-experienced therapists, it refers more to reviewing SD's and protocols; with my more experienced therapists it refers more to sticking to the protocol for a particular length of time before attempting change (probing different strategies if one sitting doesn't go well): if the student could learn and maintain the task after 1-2 sessions he probably would not need us! (Then, of course, the other side of that is not letting a target go on too long, but that is more up to the supervisor so not so much of a fundamental to point out with instsructors).


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