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Behavior Advice for Parents, Tutors, and Providers

This issue concentrates on a topic with which all parents are concerned:

How do I know my child is really making progress?

Send  your questions as well as your answers to 
AskHeather@butterflyeffects.com
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Welcome to the third entry of Ask Heather. I'm Heather, Morton, Butterfly Effects Professional Development Coordinator. With each entry I share some interesting and very practical things that I've learned about behavioral training as well as take some questions. If you want to read previous columns scroll to the page bottom

If you have any questions for me, email them to askheather@butterflyeffects.com. Also, don't hesitate to share things you've learned from your own experiences. We will be printing some readers' suggestions as well as my own.

What you need to know about your child’s progress

Dear Heather,
My child has been receiving ABA services for several months, but I am not sure he is actually making progress. Maybe, I am too close to the situation, but I have a hard time seeing any progress in terms of problem behaviors getting better.
Thank you,
Anxious Mom

This is a question that frequently comes up with parents: How do I know that my child is making adequate progress?

It’s important to understand that not all ABA providers are the same!
At Butterfly Effects, we do sometimes see children who were receiving services elsewhere but have come to us because their parents are worried that they are not seeing progress. As we often tell parents, sometimes it's a matter of perspective. Progress can be hard to see when you are close to a situation, but there are times when progress isn't what it should be.

It's easy to simply say that it is just a question of personality, but a well trained experienced tutor or consultant should be able to adapt and have the ability to work with almost any child. 
As a parent, you always want to make certain that you have a Board Certified Behavior Analyst (BCBA) overseeing if not providing your child’s treatment. The BCBA should be the one to draw up your child’s treatment plan based on empirically proven scientific principles and should also be the one to measure and evaluate results using objective data.

When parents and ABA specialists look for ways to measure progress, what constitutes that progress can differ greatly from one child to the next.
However, progress is not something that we should have to imagine. All children should exhibit growth and the rate of that growth should increase as the child matures and develops better communication skills.

If you are concerned that your child is not making adequate progress, go ahead and ask the analyst. They should be able to show you tangible data that either confirms or denies your sense of things.

After that, if you are still not happy, talk with your analyst’s supervisor.

Ultimately, most parents can recognize progress when they see it.
You may recognize it as a heightened moment of connection and communication experienced with your child. You might see that progress in the way your child engages the world or shows off a new skill. Or you may even recognize that progress passively as the lessening of tantrums or the curbing of aggressiveness.

However, while we want parents and children to achieve that sense of success, when I look to measure progress, I want to record those things that are concrete and measurable.
Initiation and length of eye contact are measurable, as are hugs, as well as the length of a tantrum. Good consultants will record these details that should be the result of effective behavioral interventions and be able to define that progress on paper.

However, do keep in mind that there are no set formulas for progress or learning schedules that you can depend upon.
Development is a continuum with one skill building upon another. The rate at which children with autism spectrum disorder and related developmental disabilities acquire skills varies from child to child as all learning does with all children. And while similar things can be measured from child to child, our tracking is never rote.

We also have to appreciate that the order in which children learn various skills can also differ from one child to the next.
If you attended Butterfly Effects’ live webinar last month on selecting targets, you would better understand how building skills is a rigorous and scientific discipline, and always very individualized. A number of factors have to be considered when deciding if a new skill has been learned and is ready to be built upon. Our goal is to always build on strengths and to create success early on that will encourage future effort.

Rather than focus on one skill, in most cases, it is best to target a variety of skills simultaneously.
Furthermore, it’s ideal to teach new skills that can easily be transferred to multiple tasks. One of the most important aspects that the behavior consultant must focus on is teaching the child the mechanisms or what we call teaching contingencies that will foster learning. When that is accomplished, the rate of learning grows exponentially. As spoken about in a previous column, once a child learns how to greet someone entering his or her house, the child can be taught to generalize the application of a warm greeting to other times and places among family and in the community.

What happens if the learner gets stuck?
Roadblocks are no fun when they happen, but they aren’t all bad news. While the child had been readily learning new skills, suddenly, you may hit an impasse and this latest skill being taught seems impossible for him or her to master. This should be expected from time to time. In fact, it’s how we deal with the most resistant challenges that often define the depth of our ability to learn. It also helps to define the therapist.

If a child is not making progress on a particular skill, it is important that rather than keep trying the same approach over and over, that the Behavior Analyst alters the program by either presenting new ways to teach the skill or by changing the target. It’s never productive to keep at something in the same way without success. Repetition does not cure all issues.

Sometimes, we may even need to go backwards to move forward.
As we talked about in the last Ask Heather, behavioral momentum is a valuable tool to use with more challenging tasks. By building success with less challenging material, we can help the child build the momentum that allows him or her to more easily transition into difficult tasks. 

Parents should ask their child’s Behavior Analyst to more formally review their child’s progress on a monthly basis.
Ideally, the parent is involved day-to-day in watching his or her child progress. And when questions arise, they should be addressed immediately. However, it is still important to schedule time at least once a month to step back and take a broader view and determine what ‘s working, what’s not, and what should be changed.

Documentation
At Butterfly Effects, we like to encourage families to make use of the our user friendly online platform to keep current with progress notes and to post concerns and questions so they are not forgotten. It’s always good to have a permanent record to fall back on as it allows one to identify patterns and avoid the repetition of already failed approaches.

If a parent does not feel that his or her child is making adequate progress, it is important to discuss this issue with either the tutor or the supervisor.
While we seek to build many quick successes early on, as the child progresses in therapy, some skills can take days instead of hours to acquire. There will be times when the child absorbs things quickly and hungrily and other times when resistance seems to shut the door. While it is absolutely essential to  the learning process to celebrate our successes, we should not allow ourselves to get too disappointed by failures. In a webinar this past week, one of our BCBA's presented an excellent discussion on toilet training. That's a skill that is definitely taught with lots of praise and celebration and best accomplished without dwelling on incidental failures.

At Butterfly Effects, one advantage that we have as a large organization is our ability to switch up therapists if that is required, but more often than not when the child isn't progressing, there's usually other factors that come into play when progress slows. .I can't say that personality never comes into play, but fortunately, the tutors and consultants I've had the pleasure to work with have been highly professional and skilled, as well as creative and flexible when necessary within the bounds of ABA principles and techniques. If a problem persists, we typically get to the bottom of it quicker by performing a functional analysis, than switching therapists. When we do that analysis, we inevitably uncover an antecedent or consequence that is fortifying rather than fixing the problem.

That said, while ABA therapy is above all else based on scientific research and accumulated evidence, each therapeutic relationship is very individual and very personal. Not only is it important that your therapist be well educated in the principles of ABA and their application (always ask to see his or her certification), but he or she must also have the ability and the desire to understand the logic behind the child’s behavior and must also understand that behavior in the context of that child’s life and family.

Building rapport makes all the difference
Children respond to the correct stimuli, but they also need that stimuli delivered by someone who is attentive and connected. Regardless of an individual’s ability to communicate, it is important that that the child believes that he or she is truly being listened to before positive learning can take hold.  That's why good tutors will spend time playing and interacting with the child in order to build rapport.  This allows them to gain instructional control, slowly introducing demands and developing appropriate responde mechanisms through the play. 

As I mentioned earlier, you will recognize progress when you see it and you have the right to ask questions when that progress seems absent.
Sometimes it can be a matter of perspective. Go back every now and again and read progress notes and treatment plans from six months ago or a year. Often that will help you appreciate how far your child has come and just how much growth he or she is capable of achieving. Either way, it is important that you feel good about your child’s progress because ultimately, the greatest successes are achieved by those children whose parents become involved not just in monitoring their children’s progress, but who do whatever it takes to promote that progress throughout the course of everyday life.

If you are looking for an ABA, provider download our guide which includes the questions that need to be asked answered during your search.

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Back issues of Ask Heather

Volume 2:

• When do I use behavior momentum?

• When do I use planned ignore?
  and the example of  Johnny who is the master of getting attention:
  good or bad

• ... and a teacher needs help learning the ABC's of understanding aggressive behavior

:

Send  your questions as well as your comments and answers to  AskHeather@butterflyeffects.com

About Heather Morton, MA, BCBA
Working in the field of Applied Behavior Analysis for seven years, Heather's experience opened her eyes to the importance of excellent staff training and supervision to ensure the delivery of quality care. Heather is constantly in the search and development of new activities and strategies for training parents and supporting Butterfly Effects' professional development programs. Heather received her Bachelors degree in Communication Sciences and Disorders from Rockhurst University in 2007 and completed her Masters degree in Applied Behavior Analysis from the University of South Florida in 2009. She became a Board Certified Behavior Analyst in May 2010.

More Opportunities for Learning

You can learn a lot of useful tips by visiting the Butterfly Effects YouTube Channel. where you will find more than two dozen short videos offering solutions to very specific behavioral concerns.

Also make sure to take a look at our various online training courses.
These courses for  ABA specialists, teachers, and parents, allow you to learn at your own pace and convenience.

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