Back to The Arc of Loudoun Logo

DONATE    WORK WITH US

Menu

admin

About admin

https://abc.thearcofloudoun.org

Posts by Justin Whedon:

what-is-autism

What is Autism?

“Autism, or autism spectrum disorder (ASD), refers to a broad range of conditions characterized by challenges with social skills, repetitive behaviors, speech, and nonverbal communication. According to the Centers for Disease Control, autism affects an estimated 1 in 44 children in the Unite States today” (Speaks, 2022a).

Autism is truly a spectrum. Child’s abilities and challenges vary based on a combination of genetic and environmental factors. There are several subtypes of Autism, and it can range from a child requiring immense support in daily living, to a child able to live independently. Autism is typically accompanied by medical issues including sensory sensitivities, gastrointestinal issues, seizures, sleep disorders and occasionally depression and/or anxiety. 

Signs of Autism

Typically, Autism is screened for at ages 2-3 years old. However, it is extremely crucial to be educated in signs/symptoms so you can observe your child throughout the early years.

6 months

  • Limited eye contact
  • Decreased smiles/limited engagement with familiar faces

9 months

  • Decreased back/forth sounds (ooh, ahh)

12 months

  • Little to no babbling
  • Decreased or no responding to their name
  • Little to no waving, pointing, showing of interest/back-forth

16 months

  • Very few to no words

24 months

  • Very few to no meaningful 2-word phrases (does not include imitating or repeating)

At any age

  • Decreased eye contact
  • Limited understanding of other’s feelings
  • Preferring solitude
  • Restricted interests
  • Resistance to minor changes
  • Repetitive behaviors (flapping, rocking, spinning)
  • Unusual and/or intense reactions to sounds, smells, tastes, textures, lights, colors

“If you have concerns, get your child screened and contact your healthcare provider. The M-CHAT (Modified Checklist for Autism in Toddlers ™) can help you determine if a professional should evaluate your child. This simple online autism screen, available on our website, takes only a few minutes. If the answers suggest your child has a high probability for autism, please consult with your child’s doctor. Likewise, if you have any other concerns about your child’s development, don’t wait. Speak to your doctor now about screening your child for autism” (Speaks, 2022b)

Autism & Different Approaches

Autism is a lifelong disorder; however, with different treatment approaches, children can feel reduced symptoms and improve quality of life. All treatment approaches are individualized to the child, as each child with Autism has a different set of strengths and challenges.

  • Behavioral Approaches
    • These focus on changing behaviors, which lends itself to finding out what happens before and after the behavior.
    • Behavioral approaches are rooted in evidence and have the most effective evidence for treatment of ASD. An excellent behavioral environment is Applied Behavioral Analysis (ABA)
      • ABA utilizes Discrete Trial Training (DTT) and Pivotal Response Training (PRT)
        • DTT utilizes a step-by-step teaching approach. With this model, activities are broken down into a simpler form to teach appropriate behaviors and responses. Typically, undesired behaviors are ignored using this model.
        • PRT is more of a natural approach to behavior. This approach focuses on teaching “pivotal” skills that will allow the child to develop other skills such as initiating communication.

  • Developmental Approaches
    • These focus on developing the skills children with ASD typically have difficulty developing on their own. These developments include physical, sensory and language skills.
    • Occupational therapy teaches the child skills for daily living, to encourage living as independently as possible. These skills include eating, bathing, and relating to others.
      • Occupational therapy can also include sensory integration therapy, which aids in improving responses to sensory input that could be restricting and/or overwhelming.
          • Speech and Language Therapy aids in improving a person’s understanding and use of speech and language. Some people with ASD may communicate verbally or nonverbally, using gestures or communication devices. (CDC, 2022)

Great news – Aurora Behavior Clinic offers all 3 of these approaches to treatment of ASD! Peruse our website to find out more information!

CDC. (2022, March 9). Treatment and intervention services for autism spectrum disorder. Centers for Disease Control and Prevention. Retrieved January 6, 2023, from https://www.cdc.gov/ncbddd/autism/treatment.html#:~:text=The%20most%20common%20developmental%20therapy,people%20with%20ASD%20communicate%20verbally.

Speaks, A. (2022a). What is autism? Autism Speaks. Retrieved January 6, 2023, from

https://www.autismspeaks.org/what-autism

Speaks, A. (2022b). Learn the Signs of Autism Autism Speaks. Retrieved January 6, 2023, from

https://www.autismspeaks.org/signs-autism

The-Importance-of-Play

The Importance of Play

, ,

Play is crucial to a child’s development, as it enriches their cognitive, physical, social, and emotional well-being. Not only does play aid children in comprehensive development, but it also allows parents to connect with their little one at the child’s level, creating a bond throughout childhood. Play is largely based in interaction. As a child plays, they are interacting with the people and environment around them. They can learn how objects work and how others may react to certain activities. As the interaction grows and develops, a child’s confidence and resiliency also build as they are beginning to master their environment.

Although it is immensely important for a parent to play with their child, it is equally, if not more important for children to play with other children. When children play with others, they can maintain creativity and leadership, while with parents some of this is lost as the child begins to accept the adult role within play structure.

Play is crucial throughout life. As the child enters a school setting, play becomes important in developing their social and emotional well-being. Additionally, when play is utilized in a school setting, it aids in the child’s readiness for learning and their problem-solving skills.

Different types of play to consider:

  • Unstructured play is unplanned play that naturally occurs in the environment. It will typically take place and is important when a child is younger, so they can utilize their imagination, combined with their interests to create a play scheme.
    • Examples of unstructured play
      • Creative play including musical or artistic games
      • Exploring new spaces such as backyards, playgrounds, etc.
      • Imaginative games such as make believe or dress-up
  • Structured play is organized play that occurs in a fixed setting and at a specific time. Typically, it is led by a grown-up, and it is more beneficial towards older children, as they develop and can understand multistep directions.
    • Examples of structured play
      • Outdoor ball games such as shooting a basketball
      • Swimming lessons
      • Storytelling at the local library
      • Dance or music classes
      • Board or card games
Picture1-1024x685

What is Occupational Therapy (OT)?

,

Occupational therapy (OT) is an evidenced-based profession utilizing a holistic approach to consider all components of the individual and their goals. OT focuses on increasing an individual’s capacity and/or modifies the environment and activities for greater participation. OT utilizes direct observation, assessment conducting and analysis of results between the child’s development and the environment.

Occupational therapy provides family-centered services to incorporate support and to strengthen satisfaction, well-being, child performance and caregiver carryover/skills. The practice utilizes modeling, play-based activities, cognitive-behavioral strategies, and social toys to improve cooperative play and promote social outcomes.

Practitioners work with children and their families to promote active participation in their environment and additional meaningful occupations. A child’s occupation is to play and learn, develop life skills, be creative and to thrive. Recommended interventions are based on a thorough understanding of typical development, the child’s environment, and the impact of the disability on their development and overall occupational performance.

Occupational therapy is an appropriate approach for children with developmental disabilities. OT programs assist in targeting concerns such as…

  • Daily living skills
  • Fine & gross motor skills
  • Praxis difficulties
  • Play skills
  • Social sills
  • Sensory difficulties
What-is-a-Speech-Language-Pathologist

What is a Speech Language Pathologist?

A speech-language-pathologist (SLP) is a trained professional certified to provide speech/language therapy services by having obtained the Certificate of Clinical Competence (CCC). A CCC-SLP evaluates and treats children and adults who have difficulty with communication.

An SLP can treat many types of speech and language disorders. A speech disorder is a condition in which a person has difficulty creating or forming the speech sounds needed to communicate with others. Types of speech disorders include articulation and phonological disorder, stuttering and Apraxia. A language disorder is impaired comprehension or the use of spoken, and written language systems. Types of language disorders include receptive, expressive, and pragmatic language disorders. An SLP may also evaluate and treat children and adults who have a swallowing disorder, an oral-motor disorder or require the use of Augmentative alternative communication devices (AAC).

Speech and language therapy is an evidenced based profession utilizing a holistic approach. Our facility offers various treatment approaches and sensory based activities that help promote language development in children. Therapy is tailored for an individual’s specific needs and can treat a variety of disorders such as receptive and expressive language disorders, developmental delays, speech sound disorders, social communication disorders, and feeding/swallowing disorders. SLPs provide family-centered services to treat individuals at all levels of severity from 18 months to 21 years old.

An SLPs main priority is to address improving communication in an individual. Communication is the active process of exchanging information and ideas. The two ways we communicate are verbally and nonverbally. Verbal communication consists of spoken language. Nonverbal communicators communicate in other non-vocal ways such as using gestures or eye contact or their body language to help us understand their wants and needs and their emotions. Some nonverbal communicators also use AAC which stands for alternative and augmentative communication; Augmentative means to add to someone’s speech and Alternative means to be used instead of speech. People of all ages can use AAC if they have trouble with speech or language skills. Some people use AAC throughout their life. Others may use AAC only for a short time, like when they have surgery and can’t produce speech. There are two types of AAC. One type of AAC is low tech or no tech AAC which requires something external to the person using it that is non-electronic or a very simple electronic device. For example, Picture Exchange Communication (PECs), or communication books. High tech AAC is a complex electronic device that permits the storage and retrieval of messages, which allows speech output such as using an app or an iPad/tablet with a “voice” to communicate known as a Speech generating device.

SLP-and-ABA-Collaboration

SLP and ABA Collaboration

,

Speech therapists can play a major role in helping individuals with Autism learn to communicate and engage with other people. They can help the individual with autism build communication and social skills in different settings like home, school, and work. SLPs may work with the person alone or in small groups.

Although the fields of SLP and ABA each address a wide range of different concerns, we share an interest in supporting individuals with communication impairments, including reducing problem behaviors that stem from inadequate communication skills. Teamwork can also better teach our students to develop and use functional communication skills across a variety of instructors and environments. As SLP and behavioral analysts overlap in the teaching of communication skills, each profession contributes unique expertise. Behavior analysts have strengths in measuring communication skills, especially related to functionally-defined verbal operants, whereas speech-language pathologists have a deep understanding of speech and language development. 

It takes a village to support our clients and all members of the village are important.

Some ways SLPs initiate and maintain a collaborative process with behavior analysts:

  1. Give input on functional communication by helping develop phrases or words the student can use to communicate how they feel when working with the RBT—or anyone on the team.
  2. Develop shareable communication goals.If we can teach team members to implement communication-based goals, students will get more opportunities to practice these skills throughout their day. These opportunities outside the speech room can help students become more independent and effective communicators.
  3. Share approaches you think will be better for the student. This will help determine the best way to target goals for our students.
  4. Discuss progress with each other. It is important to discuss progress on goals so the team is up to date on goals and new goals can be discussed.
pexels-samer-daboul-1815257-1024x682

Functional Communication Training (FCT)

0

Functional Communication Training (FCT) teaches children to replace undesirable behaviors with more appropriate responses. The purpose of FCT is to teach an acceptable response that serves the same function as the problem behavior with the goal of decreasing the problem behavior. These responses can be in the form of vocalizations, sign language, gestures, or responses from a communication device. Caregivers, teachers, and service providers can use this strategy across settings to promote generalization of skills.

The first step in creating a FCT program is to identify the function of a target behavior (e.g. attention, escape, access, or automatic). Once the function has been identified, an alternative behavior that possesses the same reinforcing properties as the problem behavior can be taught as a replacement behavior. For example, a behavior technician places a demand during a session. The client engages in a vocal tantrum. In FCT, a more appropriate response would be the client requesting a break. This could be in the form of saying, “I need a break”, signing “take a break”, or presenting a “break” card. This replacement behavior serves the same function as the tantrum, but it is a more socially acceptable behavior.

Replacement behaviors should be presented in a way that is most appropriate to the child. For example, if a child does not communicate vocally, a replacement behavior could be in the form of a sign or gesture. FCT is an antecedent intervention, so it is important to prompt the learner to demonstrate the replacement behavior before the problem behavior occurs. The replacement behavior should be consistently reinforced while the problem behavior is ignored. FCT can be used in conjunction with other behavior change strategies to teach more acceptable behaviors and decrease problem behaviors.

pexels-pixabay-265076-1024x685

ABC Data

, , 0

The term “ABC” refers to the antecedent, behavior, and consequence that describe a behavioral event. ABC data collection allows us to better understand the function of a behavior and identify any behavior patterns. ABC data can be collected by caregivers, teachers, and service providers in the child’s natural environment.

An antecedent is what occurs immediately before the behavior of interest. Common antecedents that can produce an undesirable behavior include demands, transitions, or denied access to a preferred item or activity. The behavior is anything that the individual does. It is important to describe behaviors in observable and measurable terms. In other words, clearly describe what the behavior looks like. The consequence is what occurs immediately after the behavior of interest. Common consequences that may follow a behavior include attention, escape from a task, or access to a preferred item or activity.

Example:

            Antecedent: A parent places a demand on a child to put on their jacket

            Behavior: Child shouts, “No!” and throws the jacket across the room

            Consequence: Parent gives a verbal reprimand to the child           

            While collecting ABC data, avoid using subjective terms such as “felt upset” or “was frustrated”, as these terms can have different meanings. For example, “throwing a jacket across the room” is a more objective description compared to “felt upset”. Describing events objectively provides a clear understanding of what each antecedent, behavior, and consequence looks like. ABC data should be recorded as soon as possible for the most accurate description of the event. ABC data collection is a very useful tool that helps us better understand the “why” of behavior.

kids-1093758_1280-1024x682

Token Boards

, 0

A token economy, or a token board, is an effective behavior change system that has been applied to various settings. This system uses positive reinforcement to increase the future frequency of a desirable behavior. A token board consists of three components: (a) target behaviors; (b) tokens that are earned for demonstrating the target behaviors; and (c) back-up reinforcers. Token boards can be used across settings (e.g. school, home, or clinic) to promote generalization of skills.

            The first step in designing a token board is to identify a list of target behaviors. These behaviors need to be measurable and observable with a clear understanding of what the behaviors look like. Then, tokens and back-up reinforcers can be selected. Tokens can be in the form of points, checkmarks, tally marks, or stickers. Back-up reinforcers, or preferred items or activities, are obtained by exchanging the earned tokens. These back-up reinforcers can include games, toys, snacks, or special privileges. For example, a child earns a sticker every time he picks up his toys. Once the child earns 5 stickers, he may have access to the iPad. It is important that the ratio of tokens earned and the value of the back-up reinforcer “match” to maintain motivation. The flexibility of a token board allows you to reinforce any behavior, use as many, or as few, tokens that are appropriate, and choose tokens that are of interest to the child.

            There are several advantages to implementing a token board. It is important to provide immediate reinforcement when a child demonstrates a target behavior. Tokens can serve as this immediate reinforcement while the back-up reinforcer is not readily available. This maintains the child’s motivation to demonstrate the target behavior and earn more tokens. Token boards are also highly structured and consistent. Once a criteria is established, tokens are delivered and behaviors are consistently reinforced. Lastly, a token board can keep a child engaged if the token board is individualized to their interests and they have the opportunity to choose their back-up reinforcer.

            The ultimate goal of any behavior change system is to experience naturally occurring reinforcement. Tokens can be paired with verbal praise to increase the reinforcing effect to maintain behaviors after the removal of a token board. It is also important to gradually increase the token requirement in order to receive the back-up reinforcer. Overall, a token board is an effective strategy that reinforces appropriate behavior with the goal of accessing reinforcement in the natural environment.

kindergarten-2204239_1280-1024x682

What is Applied Behavior Analysis?

0

Applied Behavior Analysis (ABA) is a well-developed, research-based, scientific discipline among the helping professions that focuses on the analysis, design, implementation, and evaluation of social and other environmental modifications to produce meaningful changes in human behavior. ABA includes the use of direct observation, measurement, and functional analysis of the relations between environment and behavior.  The practice of ABA is rooted in data, which serves as a fidelity check for the effectiveness of recommended strategies and procedures.  This ensures that the client’s ABA program is dynamic, never-stagnant, objective and, most importantly, effective.  It utilizes changes in environmental events, including antecedent stimuli (what happens before a behavior) and consequences (what happens after a behavior); to create programming that produces practical and significant changes in behavior. These relevant environmental events are usually identified through a variety of specialized assessment methods.  

ABA is based on the fact that a client’s behavior is determined by past and current environmental events, or contingencies, in conjunction with other genetic and/or environmental variables.  ABA focuses on treating the problems of the disorder by determining functions and maintaining variables in order to support the learning or appropriate and functional behaviors instead of maladaptive, or inappropriate,, ones.  ABA is not only an evidence-based practice for people diagnosed with Autism, it is also proven to be effective for other diagnoses such as ADHD and Depression.  It may surprise you to know that ABA may also be beneficial for neuro-typical, or “typically-developing”, individuals as well.  Behavior is all around us—which means ABA can be applied to almost anything or anyone who demonstrates observable and measurable behavior. 

ABA can be provided in various forms: Direct, or “1-on-1” therapy sessions is when where a client receives services from a R/BT.   Group therapy sessions (e.g. social skills) where a client receives services in a group with services provided by an R/BT or BCBA/BcaBA.  Caregiver Training is provided to caregivers only, without the client present, with services provided by a BCBA/BcaBA.  These sessions are perfect to review the client’s progress, discuss concerns and learn how to implement strategies and procedures at home.  ABA is an appropriate approach for children with ASD and children with other developmental disabilities. ABA programs may include targets to address concerns such as:  

  • Maladaptive Behavior
  • Conversation and pre-conversational skills
  • Adaptive, daily living skills
  • Attending skills
  • Fine & gross motor skills
  • Play skills
  • Social skills
  • Communication skills
  • Imitative skills
  • Functional Academic skills

Team Members 

ABA should be a team approach. This team includes the child, caregivers, program manager, and behavior technician(s).  It may also involve other stakeholders, or individuals who may support or benefit from the client’s progress.  Examples of stakeholders are: client’s siblings, teachers, aides, etc.  Below are commonly used terms to define roles within the client’s ABA team:

Behavior Technician (BT): BTs are dedicated to providing one-on-one services to clients receiving ABA treatment. Behavior Technicians are responsible for implementing the treatment plans and protocols developed by Program Managers. Depending on a client’s level of needs and frequency of services, your family may have more than one BT assigned to your case.  A BT is a paraprofessional who practices under the close, ongoing supervision of a program manager. The BT is primarily responsible for the direct implementation of behavior analytic services.

Registered Behavior Technician (RBT): RBTs receive a internationally-recognized credential through the Behavior Analyst Certification Board (BACB).  In order to apply for the credential, the applicant must: complete a 40-hour, intensive training on ABA; pass a competency assessment administered by a BCBA/BcaBA, and pass a certification exam.  Once the credential is earned, the BT practices under the close, ongoing supervision of a program manager. The BT is primarily responsible for the direct implementation of behavior analytic services. Further information regarding certifications can be found at https://bacb.com.  

Program Manager/ Board Certified Behavior Analyst or Assistant Behavior Analyst (BCBA/BCaBA): The program manager is responsible for coordinating services, conducting assessments, treatment plan development, and supervising Behavior Technicians (BT). A program manager may also conduct one-on-one sessions. Your program manager will be the main contact person throughout the client’s therapy.  The BCBA/BCaBA certifications are delivered through the Behavior Analyst Certification Board (BACB). A BCBA is a therapist with an expertise in the field of behavior analysis. All BCBAs are required to possess a Master’s Degree in ABA or another closely related field while BCaBA’s are required to possess at least a Bachelor’s Degree. A BCBA/BCaBA receives specialized training, including coursework and practical experience, in behavior analysis.  The program manager works closely with the family, administers assessments, develops intervention plans, and supervises the behavior technician. 

Costs?

In some cases, ABA is covered by insurance.  It is always important to be aware of your insurance coverage including deductibles and copayments.  Typically, an ASD diagnosis is required in order for private insurances to provide an authorization to cover the costs of ABA therapy.  To be eligible, diagnostic testing must be completed by a physician such as a developmental pediatrician or psychologist.  However, as mentioned above, ABA is proven to be effective for those diagnosed with other conditions.  In these cases, ABA costs may be funded by private pay and/or scholarships/additional funding. 

If you’d like to learn more about receiving ABA at The Aurora Behavior Clinic at The Arc of Loudoun please contact us directly by submitting an inquiry form.