Friday, June 29, 2012

Developmental Readiness and Learning

     I am not the parent of or an individual with developmental differences. Albeit, I did have fairly interfering ADHD as a child, and still have unmistakable ADD. It interfered with a lot of learning, and I am probably what would be considered a "late bloomer." I may be all the better for it, and I wouldn't change anything. Enough about me.

     I have recently been really into reading blogs authored by individuals with an ASD and parents of children with different abilities. Their stories are always heartwarming and, not surprisingly, always as "human" and empathetic as any of the other blogs I frequent. There is, however, a common stream I have been coming across about "patience" and "developmental readiness." The quality of patience and the understanding of developmental readiness is key for professionals who help treat children, especially young learners, with barriers. However, there is an additional argument that typically accompanies these opinions about avoiding early intervention. I cannot disagree more.

     The argument goes something like this, we need to respect developmental readiness and be patient and not try to "rush" along progress. Here is the enormous problem with this argument. Learners who present with developmental delays typically also have atypical learning histories. And the longer they "practice" the wrong thing, the harder it is to teach the right things. Forget teaching replacement, more socially valid behaviors to counteract, when we do not intervene early to teach these learners how to learn, we risk profound issues in the future.

     When we look at developmental milestones, there are definite learner readiness and listener responding skills that should be acquired by a certain age. When we do not directly teach them to individuals who lack them, a whole array of other barriers arise. If I present a learner with three toy hammers -- one red, one blue, and one yellow -- and ask "Give me the yellow hammer," and the learner hands me all of the hammers, this is a problem of discrimination that carriers over across environments, and social and academic tasks. When a 4 year old is still in diapers, his preschool-mates are going to notice the abnormality, and may avoid that child, thereby risking socialization issues. Additionally, social differences are already going to be present, so why exacerbate the issue by not teaching potty training, and getting the child out of diapers. There are multiple efficacious protocols for potty training -- some by way of aversive over-corrective, others positive practice, some both. Why does the child who is already clearly "different" need to be more ostracized by their peers? What service is it to respect their developmental readiness at a young age and risk their developmental inappropriateness later in life? What good is it to be patient while they are young, and risk not only abnormal, but deficient learning repertoires? And when that happens, some may ask, "Why isn't my child's school doing more to educate my child?" Unfortunately, sometimes, the answer is because the child does not know how to learn. I worked extensively with a high school Sophomore who was able to sit at a desk for <.1% of his academic day. And I did the math on this; frequency tally of out of seat and engaging in maladaptive behavior / amount of hours in IEP for academic instruction * 60 [minutes in an hour] = __%. It didn't matter how fully we accommodated and modified, how powerful the extrinsic motivators were, this learner did not know how to learn, because he did not know how to sit at a desk. And this is because he did not want to and because no one had taught him how to sit an receive instruction.

     We always want to meet learners where they're at. But as they fall behind crucial developmental milestones, we need to teach these skills in isolation. We are the adults and we need to make it better for them to be engaging with peers than hand-flapping. It needs to be more awesome to be on a swing with friends than spinning in a corner.

     The most motivating note I have to offer on all of this, is that we can teach skills to overcome barriers and deficiencies, and we have 40+ years of empirical evidence to prove that. Patience and respect for development is absolutely important, but it is hazardous to be cautious or hold back or think that we are "rushing" a child who has developmental and learning-based barriers, when we are actually creating future opportunities for a better, more positive development. 

Saturday, June 16, 2012

Great news for ABA!

Happy Saturday!

Just received this email from ABAI:


'The Presidents of the Association for Behavior Analysis International (ABAI), the Association of Professional Behavior Analysts (APBA), and the Behavior Analyst Certification Board (BACB) met on December 11, 2011 to discuss how these organizations can best serve and advance the field of behavior analysis. The discussion covered the aims and efforts of the three organizations in approaching that overall goal, the relationships among the organizations, and the role each plays in our discipline. This constructive meeting reinforced the importance of cooperating to advance our field, and resulted in the following affirmation:
ABAI, APBA, and the BACB pledge to work together to support and advance the interests of the field of behavior analysis. We acknowledge the importance of each organization’s role, and agree to move forward in a cooperative and collegial manner.
Approved by the Behavior Analyst Certification Board, March 7, 2012
Approved by the Association of Professional Behavior Analysts Board of Directors, March 15, 2012
Approved by the Executive Council of the Association for Behavior Analysis International, May 25, 2012'


At a recent meeting of IL-ABA there was some discussion on the split between ABAI and APBA, so I am glad to hear that some reconciliation is happening.

This is really going to go a long way in ensuring that the profession stays the cohesive and cutting edge.


Friday, June 8, 2012

Wednesday, May 23, 2012

Technology Disintegration


     Technological disintegration is when an augmentative communication device loses its efficacy and function to assist the user with communication. Sometimes, there is an unseen barrier when providing AAC interventions where we misunderstand what appears to be a lack of communicative intent for technology disintegration. 

     When a child is throwing their PECS book, rather than using it appropriately. When the Dynavox sits on the counter for days on end without being used. Imagine if you were unable to ask for water when you were very parched, or if you did not have the opportunity to ask to do a different task than the one you were currently engaged in. This is a major contributor to technological distintegration. A breakdown in the ability to use AAC devices to mand (request). A few things happen at this stage. The worst and most crucial, is that you give up asking. In turn, this destroys the motivation to want to ask in the first place, and then the child is in a vacuum, devoid of motivation to get needs met. Secondly, you continue to mand, but you do so through negative or dangerous non-vocal behavior to get your needs and wants met. Lastly, other possible AAC interventions become increasingly difficult to implement because of a suboptimal, previous history with other AAC. 

     One of the most unfortunate, yet most avoidable, causal factors of technology disintegration, especially with electronic AAC devices, is that they don’t get charged, or PECS books get left at home! AAC is not something we only use when we are in school, or are dinner time. Making the device available, and having the child learn that it is always available, is the first step in avoiding technology disintegration. The device should be with the child about at all times, just as we can call upon our vocal speech at any time to engage in a vocal, verbal episode. 

     The other thing about AAC is that there needs to be training for all parties involved in the intervention. It is not simple enough to place a bunch of pictures in front of a child and expect them to know what to do with them. Furthermore, it is not simple enough to assume that consistency across people and contexts are implemented. Of course, we want the child to be able to use their AAC with anyone, anywhere, at any time, but in the beginning, we need to make sure that all people are implementing the intervention the with the same techniques. It is not so much that everyone in the child’s life needs to have intensive training on working with the AAC device, but it is very important that all parties are consequating the device’s use in a similar way. So if mom requires a sentence strip for PECS (e.g. icon for “I,” icon for “want,” icon for item on a sentence strip and handed to her) but dad only requires the icon for the item, then we are reinforcing two different uses of the device. Sure the function is the same, but the intensity of the training waxes and wanes. Later on, this may be OK, but in the beginning, when teaching how to appropriately use the device, it’s important for everyone to be on the same page with what constitutes an appropriate mand and therein produces delivery of the item. 

     One major note to keep in mind, is that AAC devices are a child’s words. The child’s brother should not be playing with PECS icons, or listening to music on their friend’s iPad that is for communication. There is a certain amount of respect and care that needs to go into managing AAC devices. 

     Technology disintegration can occur for many reasons. Sometimes it may be that non-vocal communication has worked for so long, that why should I bother using this “new-fangled” thing. When we see technology disintegration setting in, it is time to intensify the training and usage of the device. It is, however, a balance between making the device functional vs. aversive. 

     As I always say, as teachers and parents, we need to know our kiddos inside and out, and create meaningful interventions and curriculum to supplement their deficits and accentuate their abilities.

Monday, April 9, 2012

Published!

My piece, Dignity, Function, & Choice: Ethical and practical considerations on best practices for educating learners with developmental delays, has appeared in the April 2012 edition of the National Association of Special Education Teachers The Practical Teacher series. Read it here!

Friday, February 17, 2012

Restraint

     There is a lot of buzz recently around restraint and seclusion. With bills in and out of Congress, parents and advocacy groups are being more outspoken as a result. I thought I would weigh in on the subject of restraint specifically. I would also add that I consider myself a very A-type personality and have unfortunately been involved in more instances of physical restraint than I care to recall. Thankfully, in my new position as an ABA therapist, it virtually never arises.

     I have a few opinions on the matter. The first is that immobilizing an out of control child, regardless of if they present with any barriers, stinks. Some of my worst days, both professionally and personally, were days where I needed to help in a restraint situation. They are physically and mentally taxing, they damage rapport with students, and from a person-first perspective they make me uneasy.

     Second. Restraints should be exclusionary. They should not be done in the middle of a classroom where all other students can see. They should not be done in hallways. If you are in one of those areas, then the proper staff should be called to remove the student to a safe environment set-up for the purpose. We need to give children the dignity they deserve -- this is especially true in the times when they are in the most distress. An individual's dangerous behavior is telling us that something is wrong. We need to teach self-management and communication skills to avoid situations where students are speaking to us through their dangerous behavior

     In terms of training people in restraint, once you train them, they are probably going to use the techniques. As sad as it is to say, once you have "empowered" an individual to make the decision to restrain, in my personal experience, a restraint becomes almost self-fulfilling prophecy. In this same token be weary of people who "like restraint trainings." I once heard a colleague say "I like restraints." This is clearly a person who should NOT be trained to use restraint, and should be placed in a different setting where using restraint is minimized. To be glib, they cannot restrain themselves from using restraint on others.

     It takes a very specific type of person who should be trained in restraint systems. The type of person who recognizes the value of the embedded deescalation techniques that are to be used prior to engaging in restrain. Obviously, there are situations that warrant restrain immediately, but those are far and few between, and I cannot think of one good example from my experience. People who do not fit this mold, should not be trained in restraint, or working with students who may require restraint.

Friday, February 3, 2012

Dolch Sight Words Resource

     I have just finished creating a PowerPoint and data sheets for fluency and accuracy that contains all of the Dolch sight words by grade level and (almost) alphabetical order -- words that were similar such as "them" and "then" are separated by a word to avoid confusion and a false negative during assessment/teaching.

It is available for download here. You will need a GoogleDocs account to access the *.zip file.

Enjoy!