Embedded Teaching- Reinforcing

Over the last dew days you have learned about creating opportunities to teach, waiting for the correct response, and giving prompts if you child isn’t picking up on the sublet hints. In our final blog series of embedded teaching, we aim to teach you on how to use positive consequences or natural actions to encourage appropriate behavior. Often, we call this positive reinforcement. We don’t always have to use extrinsic or outside rewards like candy, screen time, or tokens. Instead, we can more natural reinforcers to encourage your children to appropriately communicate.

For example, maybe, you are trying to teach your child to use “please” when they ask for items they want. First, you create and wait, by pointing to a toy that is out of your child’s reach. You count in your head for at least 3 seconds, and then you remind or prompt your child what they need to do. This can be accomplished by saying “Remember to say please when you ask your mom or dad for toys.” Once your child states, “Can I have the toy, please?” Immediately acknowledge this communication and reinforce this by giving the child the toy quickly. Always try to associate this this natural, positive consequence with your affirmation, encouragement, and acknowledgement. Natural reinforcers may include verbal praise, such as, “Wow! I’m so proud you are using manners!” Always try to very specific when giving acknowledgement to your child. This allows your child to learn what they did correctly and be motivated to repeat the behavior again.

Some children may struggle communicating vocally, and that’s okay. We can still use embedded teaching for them to learn appropriate ways to meet their needs. If your child is nonverbal (that is, does not talk to communicate his/her needs), we may want to teach them to point to items they may need. If a toy is out of reach, you would still create and wait  and prompt(remind) the child to point to what they need. Once your child points or you help them point to what they want, you can reinforce their nonverbal communication with giving them the toy. Remember to always tell your child what they did correctly “Nice pointing to what you needed!” to encourage them to continue to point to items.

Embedded teaching (or sometimes called naturalistic or incidental teaching) is an excellent technique that our faculty and graduate clinicians use all the time at the Husky ABA clinic. We capitalize on learning opportunities in real-world contexts to teach your child to communicate appropriately. Embedded teaching is a fantastic way to teach new behaviors in your everyday life!

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Embedded Teaching- Prompts

In our last post, we outlined about the “create and wait” technique of embedded teaching.   This is when you create a situation that would require a specific response from your child and wait for them to engage in the correct behavior. What happens if your child does not respond (stares at you blankly) or responds incorrectly? It may be necessary to remind, model, or prompt your child what they need to do! For example, you may give hints to your child about what you are expecting them to do.

For example, when you are the grocery store, you allow your child to pick a snack they like for the week. Perhaps, the goldfish are on the top shelf and they cannot reach it. Rather then grabbing the item, create and wait.Count to three in your head to see if they will ask for your help. If they don’t ask, try to prompt or give hints to what your child needs to do to get the gold fish. First, you point at the goldfish. Second, you may say, “What do we say when we need help from mom or dad?” Finally, you may prompt or remind your child to say, “Say ‘I need help, please.”

By prompting or reminding,this gives your child to understand and figure out what you want them to do. Often, you may notice your child needs lots of prompts.Over time, you will start to notice the number of hints, reminders, or prompts will decrease.  You will notice your child is communicating more and relying less on your prompts. Remember with embedded teaching, the goal is to encourage more communication. At the Husky ABA clinic, graduate and faculty clinicians want to promote language by embedding earning opportunities at any given moment.

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Embedded Teaching- Create and Wait

Teaching your child new skills can be difficult. One way to teach your child new skills, without them even realizing it, is through embedded teaching (sometimes called naturalistic teaching or incidental teaching). The first step in embedded teaching iscreate and wait.” This is when you create opportunities for your child to practice a skill (like asking for something they need) and wait for your child to do what is needed.  

Embedded teaching can be done anywhere! Often embedded teaching is a fantastic way for your child to learn to request for their wants and needs. For example, your child may be at the table during breakfast with a dry bowl of cereal. This would be a terrific opportunity to for your child to request for some milk! Instead of just pouring the milk, wait for your child to ask for it! When you notice your child may need something (like milk or spoon), create and wait by counting in your head to three. This allows your child time to notice what they need. Those three seconds allows them some time to identify what is missing.  

Clinicians at the Husky ABA clinic use embedded teaching every time we work with your child, and we hope to teach you, as a parent, to create these small, meaningful opportunities for your child to practice communicating, requesting, and using manners in your home, at the park, or at the store!  

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Second Year Feature- Samantha

Meet Samantha! 

Samantha is in her second year here at St. Cloud State. She comes from Minnesota State University Moorhead, but ended up finishing her bachelor’s degree at SCSU. She received a degree in Community Psychology with a minor in Communication studies in 2018 and was accepted into the ABA program right after. Her parents are also alumni of SCSU, and she has been coming to campus since she was young and started off her experience at the college in the Lindgren child center. While she didn’t originally decide to come to SCSU she is happy she’s here and loves learning from the professors who are all very knowledgeable in their subjects. 

Samantha previously worked with high functioning preschool-aged children in a day treatment environment that was designed to emulate a classroom. She currently works in a level four special education classroom in a general education middle school. The students are lower functioning and engage in high rates of physical aggression, verbal aggression, elopement, and property destruction. While she enjoys working with children of all ages, she thinks found her niche in middle school. 

Something interesting about Sam is that she had a heart attack during her first year of college and acquired two neurological disorders. The primary symptoms include sudden loss of consciousness, vertigo, migraines, and chronic fatigue. To aide in her disability, she received a medical alert and mobility assist dog from the local organization, Can Do Canines (they are located in New Hope, MN). Her dog Obie helped her regain her independence and ensured that she could safely attend classes on campus again. After five years as a team, Obie is now retired and spends his days sleeping in the sun next to Luna, his kitty best friend. Obie and Samantha are now featured on a vehicle that was donated to Can Do Canines by Subaru.  

Applied Behavior Analysis and Autism

Although behavior analysts can help anyone with behavioral challenges, we often work with children and adults diagnosed with autism spectrum disorder (ASD) Interventions based in ABA can be very beneficial to people with autism. Not only is it backed by decades of research, it has become widespread in popular culture.  

Children and adults with ASD are very intelligent. Often, they may have a hard time communicating their feelings to others and why they may behave in way that is confusing. Since BCBAs based their interventions on what actions a client does, a child or adult who cannot communicate is not something BCBAs worry about. Instead, we outline actions we want to see the client do more, and we measure how well our interventions work on increasing the appropriate behavior. 

Interventions in ABA are effective for those with ASD because we know each person is a unique individual. No two children are the same. Clinicians in ABA prioritize getting to know the child and make their treatments fit their needs. We recognize that those with ASD may engage in actions that are confusing to teachers, parents, community members, and siblings. This can lead to frustration, and we, clinicians from the Husky ABA clinic, want to help!  

At the Husky ABA clinic, we are experts in producing meaningful behavior change. This may create an individualized plan to teaching a child to independently toilet. Or teaching a child to recognize their frustration and ask for help! In addition, we work with families, teachers, and other important people in the child’s life to create positive environments.  

For more information check out Autism Speaks

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Second Year Feature- Kelsey

Meet Kelsey! 

She is another second year student at St. Cloud State in the ABA program. Kelsey received her undergraduate Psychology degree at University of Wisconsin- River Falls. She has also worked at a center for children with Autism Spectrem Disorder (ASD) for three years. While working at this clinic she started to show an interest in the field of ABA. She is currently doing in-home therapy for children diagnosed with ASD while working towards her master’s degree. 

Kelsey chose to come to St. Cloud State because her coworkers encouraged her to check out the master’s program. She says that she thought the program would be easier than it is, but she could not be happier at SCSU and is also learning so much more than she ever imagined. All the professors want students from the ABA program to come out of it with as much knowledge and experience as possible, and because of this all the class work can be challenging at times, which is why Kelsey says one of her biggest accomplishments so far has been making it through the first year of the program. 

A not-so-fun fact about Kelsey is that her laptop crashed during finals her first semester in the program, so now she prints all her work or has it on one of many flash drives, so she never loses it again. She also prints out every article from class (which can be up to 10 a week) and loves to use highlighters to pick out the most important information. 

 

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What is a Preference Assessment? 

Photo by: Vanessa Bucceri

When a board certified behavior analyst (BCBA) first meets their client, they prioritize in building a positive relationship with the child. They want to know what their client likes and is motivated for.  BCBAs are all about reinforcing good behaviorBCBAs often receive information from caregivers and people who have worked with children in the past on what they like. We know that preferences change frequentlyso a BCBA will take time to systematically assess the child’s preferences after receiving recommendations from a parent.  

The most common way a BCBA finds out what a child likes is through a preference assessment. Most preference assessments contain 5-10 items that may include toys, snacks, or activities. The first set of choices that are used are often picked based on information from caregivers and what is available to the BCBA at the time. Some common things that children work for are crackers, breaks (just having time to lay down or sit), electronic devices, toys, and time in the gym or on the playground.  

The preference assessment included at the top of this post is called a Multiple Stimulus Without Replacement (MSWO). In this assessment the child is presented with multiple items (7 were used in the example) and they are asked to pick on item at a time, after they pick an item they get to spend time playing with it or eating it, and then that choice is no long available to them. This process repeats until the child has picked each of the items once, and the order in which they chose is recorded. Then the order in which the items are lined up is changed and the process starts over. At the end of the assessment items that a child chose first most often are identified at the high preference items. 

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What is a BCBA?

Photo retrieved from BCBA.com

 Within the field of applied behavior analysis (ABA), there are many titles a clinician can have. BCBA stands for Board Certified Behavior Analyst. Clinicians who hold this title have received a master’s degree, completed at least 1,500 hours of supervised work with implementation of behavior-analytic work, and taken an international certification exam. At the Husky ABA clinic, we have four faculty advisors who are BCBA-Ds, meaning that they have a doctorate degree in ABA or related behavior.  

You may have noticed another title, the BCaBA, Board Certified assistant Behavior Analyst. BCaBA have undergraduate degree, completed at least 1, 000 hours of supervised works, and have passed an international certification exam. BCaBA’s  

practice under the supervision of a BCBA, monitoring front-line clinicians that are implementing the individualized interventions the BCBA has created.  

Finally, front-line clinicians in ABA, are often Registered Behavior Technicians (RBT). RBTs hands-on with the clients, directly implementing structured programming to help the child to be successful. RBTs work with clients every day to implement the interventions written by the BCBAs. RBTs are heavily supervised by both the BCaBA and BCBA to ensure treatments are implemented with fidelity.  

Overall, in ABA, we aim to identify the changes we need to make in the environment to enhance the lives of clients AND the individuals around them like their parents, teachers, classmates, and siblings.  

  For more information about Applied Behavior Analysis check out https://www.bacb.com  

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Using Choice Outside of the Clinic

Studies have shown that giving clients the opportunity to make choices in matters regarding their treatment can actually make treatment more effective! You might be asking yourself, “What does this look like outside of the clinic? How does choice align with me getting my child to do the things they need to do, but hate to do?” When a BCBA, like those found at our clinic, encourage caregivers to incorporate choice, we are not suggesting that the child gets to do anything and everything they want. Choice can be added naturally to your caregiving, without disrupting your ability to care for your child. You may find that adding choice may actually make it easier to get your child to do the things they don’t want to do, but are important…like tooth brushing!

Some children find toothbrushing to be a particularly aversive activity, but it’s important to their health and should be done. If your child hates brushing their teeth, choice can be incorporated to increase toothbrushing and/or decrease problem behavior during toothbrushing. One way to add choice to their tooth brushing time is to allow them to pick which toothbrush they would like to use each time they brush their teeth. Provide your child with two different toothbrushes that are theirs, and allow them to pick which one they would like to use each time they brush their teeth. As the caregiver, you probably know which toothbrush they will pick each time. However, still allowing the child to pick which brush they will use will give the child some autonomy and personal investment in the activity. If you can occupy the child with deciding on a toothbrush, you may find that they spend less time flat out refusing to do the activity. It’s also important to make sure there aren’t so many options that the client becomes overwhelmed. Choice could also be incorporated to this activity by allowing the child to pick between mint toothpaste, cinnamon, or bubblegum flavored toothpaste. If you are struggling to help the child brush for long enough, try asking the child, “Would you like to brush for two minutes or two-and-a-half minutes?” These are a few small steps that any caregiver can take to increase compliance for necessary tasks, without having to significantly disrupt your normal routine.

Another example of where choice can be used is with breaks. If you see that your child is getting upset and they need to take some time away from an activity, you should to give them a choice on whether or not they take a break. You can let them choose what they want to do during their break (draw vs nap), how long they want their break to be (three minutes vs five minutes), or where they take their break (at their desk vs on the floor). For example, you can ask them if they want to be away from their toys for four or five minutes. This will not only give them some control over their environment and themselves, but will also provide them with an opportunity to evaluate what they are feeling, how they are feeling, and what they need to feel better. Caretakers tend to be familiar with the cues that precede problem behavior, something that your child might not. Gently intervening when your child begins to exhibit signs of distress and offering them a choice about what you believe they might need to feel better is a great way to teach them to be aware of when they need to pay more attention to regulating their behaviors and how to do in a healthy way.

Our team is focused on providing assistance to caregivers and clients in a way that will foster independence, autonomy, and self-advocacy in clients. Providing small choices, throughout every day, is an excellent place to start teaching clients how to be more independent while continuing to pursue their therapeutic goals. Choice is not a cure-all and will not fix every problem behavior under the sun; however, choice is a powerful tool to foster independence in your loved one and help you and your child tackle those problem behaviors more effectively and efficiently.

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