Therapist/Aide Training Guide
Aide Training Week 1 (trainings are about 1 hr per day)
DAY 1:
What is autism: (15 min)
- Autism Spectrum Disorder
is a neurological disorder which according to the DSM 4:- A total of six (or more) items from (1), (2), and (3):
- Qualitative impairments in reciprocal social interaction, as manifested
by at least two of the following: - Marked impairment in the use of multiple nonverbal behaviors such as
eye-to-eye gaze, facial expression, body postures, and gestures to regulate
social interaction. - Failure to develop peer relationships appropriate to developmental level.
- A lack of spontaneous seeking to share enjoyment, interests, or achievements
with other people (e.g., by a lack of showing, bringing, or pointing out
objects of interest) - Lack of social or emotional reciprocity.
- Qualitative impairments in communication as manifested by at least one
of the following: - Delay in, or total lack of the development of spoken language (not accompanied
by an attempt to compensate through alternative modes of communication
such as gesture or mime). - In individuals with adequate speech, marked impairment in the ability
to initiate or sustain a conversation with others. - Stereotyped and repetitive use of language or idiosyncratic language.
- Lack of varied, spontaneous make-believe play or social imitative play
appropriate to developmental level. - Restricted, repetitive, and stereotyped patterns of behavior, interests,
and activities as manifested by at least one of the following: - Encompassing preoccupation with one or more stereotyped and restricted
patterns of interest, abnormal either in intensity or focus. - Apparently inflexible adherence to specific, nonfunctional routines
or rituals. - Stereotyped and repetitive motor mannerisms (e.g. hand or finger flapping,
or twisting, or complex whole body movements. - Persistent preoccupation with parts of objects.
- Delays or abnormal functioning in at least one of the following areas
with onset prior to age 3 years: (1) social interaction, (2) language
as used in social communication, or (3) symbolic or imaginative play. - The disturbance is not better accounted for by Rett's Disorder or Childhood
Disintegrative Disorder.
- The Good News:
Family-centered intensive (30-40 hr/wk) intervention strategies by trained/certified
providers can "recover" 35-47% of the children as shown by the research
of Ivar Lovaas and others.
Discuss Calvin's IFSP goals and Needs
to Learn/Knows (45 min) with question and answer
DAY 2:
#1 BUTTONS
#2 ABA procedures
#3 Components
#4 Transfer Procedures
#5 Behaviors
#6 What to do/not
#1 Buttons
Button #1 Sr- - Negative Stimulus Response (Unwanted response)
Button #2 Sr+ - Positive Stimulus Response (Good response)
Button #3 Sra - Stims (rolling car, ears/mouth, holes)
2 Worlds (not Tarzan)
1. Good things/good world/fun
2. Bad things/bad world/work/take away from fun
#2 ABA Procedures
What
are discrete trials?
Sd ----> R----->Sr
Sd
- discriminative stimulus - the instruction, question, relevant item
or materials, etc.
R - response
Sr - stimulus response - consequence - Consequences can increase
rates of behavior (reinforcement) or decrease
rates of behavior (punishers or extinction)
discriminating stimulus is a particular stimulus that evokes
a particular response
due to a history of reinforcement.
Antecedent
Behavior
Consequence
Instruction
Response
Consequence
FBA-Functional Behavior Assessment
Date/time A B . C
Dyslexia
Dyspraxia
Dysteachia
Prompt / Prompt dependence
Types of prompts
Reinforcers
Killing reinforcer
Pairing
1.People
BEFORE
LANGUAGE TRAINING SESSIONS START
What
is "pairing"? "Pairing" refers to associating
yourself with the delivery of reinforcing items and events. Through pairing
you establish yourself
as a reinforcer.
A
reinforcer is any item
or, event that increases the rate of a behavior when it is presented
following the behavior. Anything that is consistently a reinforcer will become
reinforcing itself (a conditioned
reinforcer).
How
do you pair yourself with reinforcement?
- have
a number of reinforcing items and activities that are currently effective
for your child - present
yourself or your words with or immediately before the delivery of reinforcement - offer
ways to access other reinforcers that your child could not access independently - ensure
that you are not associated with the termination of ongoing reinforcing activities
or other negative events - don't
place demands upon your child initially - gradually
increase demands once the training relationship has been established - set
up playing so that you are required to make things fun (car goes down slide,
you control car and don't give it to child until mand) - establish
yourself as a reinforcer - How do you know if trainers have paired
themselves effectively? Does
your child run to them or from them? - Giving up reinforcer doesn't mean its
gone forever. - Pairing should continue to occur at
the beginning of and during each session whenever instructors
interact with the student. - Pair every 20 minutes (per session)
or at least the first and last 20 minutes. - Gradually increase expectations.
- Give me beads (history of just touching)
-> then pick up for 1 second -> then hold -> then remove for longer
periods - PAIRING -> EASY TASK -> HARD TASK
-> EASY TASK -> HARD TASK -> EASY TASK -> PAIRING
| Do |
Don't |
|
natural language
yourself and words followed by reinforcer
engagement & interaction
for interaction before reinforcement (don't do a whole bunch of stuff)
Reinforcers
During Pairing
- Follow
child's motivation - Control
access to reinforcers (deliverable in small amounts, go away by themselves) - You
are critical for activity
Types
of reinforcers
- Edibles
- Tickles
- Praise
- Bubbles
- Squirt
guns - Wind
up toys - Videos
- Balloons
- Blankets/pillows
- Swinging
- Trampoline
No
demands - depends on child's capability - lots of reinforcement
Don't
turn reinforcer into task (read book "what's this?")
Be
silent, play next to child w/o engaging child
2.Pairing Items (table, chair, flashcards)
3.Pairing Actions (auto window in car)
Backwards chaining
To learn door lock combination number at Kindercare: 4641*
You enter 4641 and teach *
You enter 464 and teach 1*
You enter 46 and teach 41*
You enter 4 and teach 641*
You enter nothing and teach 4641*
EO-Establishing Operations->reinforcer
Data Taking P+ + - NR
| Program | Trial 1 | Trial 2 | Trial 3 | Trial 4 | Trial 5 | Trial 6 | Trial 7 | Trial 8 | Trial 9 | Trial 10 |
| NR | P+ | P+ | - | + | + | + | + | + | + |
Maintenance
%-90% over 2-3 days with 2 people
#3 Components
Components of Verbal Behavior
Motor Imitation
Echoic
Manding
Tacting (expressive)
RFFC (receptive feature, function, class)
TFFC (tacting feature, function, class)
Intraverbals
#4 Transfer Procedures
Transfer Procedures
1.Receptive/tacting
l
v
2.RFFC/TFFC
l
v
3.Intraverbal
l
v
4.No prompts/spontaneous
#5 Behaviors
SUMMARY OF THE PROCEDURES TO REDUCE
DISRUPTIVE BEHAVIOR
- HE/SHE WANTS SOMETHING AND THEY CAN'T
HAVE IT AT THIS TIME.- WALK AND PEEL PROCEUDRE (HOME
VERSION) - Say no and if accepts it reinforce
- If problem behavior occurs, walk
in opposite direction - DO NOT REDIRECT TO FUN ACTIVITY
- Return only to protect the child
or property with no talking, walk again - If child grabs you, peel and go
about your business - When child stops problem behavior
for 1 minute return and redirect. - Use Data sheet# 1 during practice
- WALK AND PEEL PROCEUDRE (HOME
- CHILD WANTS SOMETHING AND THEY CAN
HAVE IT BUT NOT FOR DISRUPTIVE BEHAVIOR.- COUNT AND MAND PROCEDURE
- Tell the child to stop behavior
or "quiet" and begin counting by showing fingers counting off to 10 at
first - If problem behavior continues during
count, re start the count. - If child runs off, stop count and
go about your business, don't follow the child. - When you reach 10 with no problem
behavior prompt child to request desired item or activity with acceptable
form of communication. - Deliver item for proper communication
and then use the motivation at the moment for that item to run mand trials. - Use data sheet #2 when practicing.
- CHILD IS INSTRUCTED TO DO SOMETHING
BUT REFUSES COMPLIANCE TEACHING PROCEDURE- After placing a demand allow about
3 seconds for compliance - When compliance occurs reinforce
and be prepared to do so. - If compliance does not occur guide
the child to complete the task - Do not give reinforcement for completion
if guided - In some cases you may want to use
the promise technique of showing a strong reinforcer before placing the
demand on the child to reduce the motivation to escape your request. - If the promise is ineffective than
remove the promise and physically guide with no reinforcer after physically
guidance. - When practicing this technique make
demands easy at first. - Use data sheet #3 when practicing.
- After placing a demand allow about
- HE/SHE WANTS SOMETHING AND THEY CAN'T
HAVE IT AND THE CHILD IS IN SCHOOL OR OUTSIDE THE HOME.- WALK AND PEEL OUTSIDE THE
HOME OR IN SCHOOL. - Say no and if accepts it reinforce
- If problem behavior occurs, place
a compliance demand on the child specific to the setting. If in school
direct to next activity or run some contrived compliance trials. Provide
no reinforcement for compliance within the trials. - DO NOT REDIRECT TO FUN ACTIVITY
- Use the promise procedure within
school and outside the home as well. - Use data sheet # 3 when practicing.
Be sure to mark that data sheeting indicating that the practice started
with the denial of a child request for something they could not have at
this time.
- WALK AND PEEL OUTSIDE THE
#6 What to do/not
TEACHING
COOPERATION DURING INTENSIVE TEACHING
- Do I need to change teaching procedures
to produce greater cooperation and a higher rate of responding in intensive
teaching situations? IF YES, CONTINUE TO ANSWER QUESTIONS BELOW. - Do I need to Identify Stronger reinforcers?
- Do I need to make a determination
as to how the child learned the task avoidance, e.g. function is socially
mediated positive, negative or automatic positive reinforcement? - Do all the teachers need to pair
themselves with reinforcers until my child is approaching them to receive
the reinforcers and their voice is paired with reinforcement? - Do we need to stop interrupting my
child's reinforcers to present demands? - Are we ready to begin requiring my
child to just mand reinforcers since we are paired with reinforcement sufficiently? - Are we ready to begin or should we
return to requiring very easy and infrequent demands that result in immediate
reinforcement before requiring more difficult tasks? - Are we prompting immediately to insure
successful responding so that correct responding contacts reinforcement? - Are we using the extinction procedure
based upon the function only if we moved the response requirement
up too soon and therefore the child becomes task avoidant or resistant to
the teaching? - After we use extinction are we re-adjusting
the instructional demands to prevent using extinction again? - If my child is now ready for intensive
teaching have we paired the intensive teaching situation (table) with reinforcement
so that my child comes to it readily because it is associated with receiving
of reinforcement and not removing of reinforcement? - During intensive teaching are we interspersi
mastered - new tasks at a high rate,e.g. 80-20%. - During intensive teaching are we using
errorless teaching procedures? - During intensive teaching are we mixing
and varying tasks across the skill areas, e.g, motor imitation, tacting,
intraverbals, RFFC, etc.? - During intensive teaching are we teaching
all skills to fluency ? - During intensive teaching are we maintaining
an appropriatel fast presentation of demands? - During intensive teaching are the
demands low, easy and infrequent at least initially? - During intensive teaching are arranging
for my child to mand at the end of each sequence of tasks? - How much direct teaching time will
be spread across intensive teaching and NET? - What skills will be targeted in Intensive
teaching sessions and what reinforcers will be used and how many responses
before a reinforcer? - What skills will be targeted in NET
situations: (Manding, VB Modules)? - In three (3) months what will my child
being doing differently, e.g number of responses per minute, number of responses
before a reinforcer, number of spontaneous mands per day?
DAY 3:
- General Classroom routines (show schedule
and discuss different activities Calvin will be involved in) - Motivators
- Stims
- Rewarding
- Pairing
- Prompting
- Prompt Fading
DAY 4:
Optional: HOW TO TEACH PIVOTAL BEHAVIORS
TO CHILDREN WITH AUTISM: A TRAINING MANUAL
DAY 5:
- Answer questions, do basic written test
Aide Training Week
2 (trainings are about 1 hr per day)
DAY 1:
- NET at table
DAY 2:
- NET at table
DAY 3:
- Model how to ID motivators & stims
in classroom and outside. Model prompting of teacher instructions and basic
classroom routines.
DAY 4:
- Model peer interaction
DAY 5:
- Model & have aide do some interacting
with child
Aide Training Week
2-3 (trainings are about 1 hr per day)
DAY 1-5:
- Have aide do work but with comments
on technique from modeler.