Helping your child understand the good and the bad.

Holidays are an amazing time. You spend a ton of time with family, eat good food, laugh, dance and really not worry about all the calories you are consuming. You also are busy and your children may get away with some things.

For the holidays this year, I got to spend time in Dubai with my amazing family. My cousin has two little boys and her oldest is 4 years old. He is an amazing, intelligent, handsome, and a very smart little boy. He recently welcomed a little brother and has been engaging in behaviors that may be attention seeking. In addition, his routine has changed. There are people visiting, his meal times have shifted, all these people are giving him so much attention and even more attention to his brother. It's very hard for a little kid to understand that his little brother is still a baby. Even harder for him to understand that he is not the only little kid in the home anymore. So what are parents to do? My cousin actually designed a motivational system for her son. It has the seven planets on it, and when he displays "good attitude" the planets moved closer to earth. Once it lands on earth, he gets access to his favorite movie "The Avengers!! ".

This is exactly what a child needs.
1) A visual
2) A set contingency: when you display good behavior you get something you like
3) following through.

In this scenario, the three term contingency is very clear: Antecedent ( He sees a toy that he likes) ------> Behavior ( He asks for it appropriately)---------> Consequence ( You displayed awesome attitude, your planet gets moved closer to earth)

On the contrary, if he/she displayed inappropriate behavior, the planet moves down and he loses access to the avengers movie and does not get access to the toy.

Things to remember and consider when using a motivational system especially for a younger child:

1) First things first, understand the function of the behaviors that are being displayed ( please refer to the previous blog for more information on this). 

 2) Make sure the visual is very clear. It should be kid friendly with very minimal distractors as possible so your child easily sees when he gains or loses something. Visuals are very important.

3)  When your child displays inappropriate behavior and he loses a spot on the motivational system, remember the very next time he displays good behavior, move the planet all the way up so he gets reinforcement for the good behavior he did display. This is because you want the motivational system to be meaningful to him and want that motivational system to be more reinforcing than punishing.

 4) Always magnify learning and shape good behavior in small steps. So if this is the first time your child is using a motivational system, get him access to the preferred item that same day. You are teaching your child an incentive. Therefore, to teach this and in order for them to make a connection with that motivational system, they have to value it. Eventually, once he/she starts learning the set contingencies, you can start fading when he/she gets access to the preferred choices.

5) It's always great to give your child choices. Give him/her three preferred choices to choose from. Display these choices on the motivational system itself.

6) Follow through and be consistent. This is the most important component of using a motivational system. Remember, if you are inconsistent, it will make the inappropriate behavior even stronger. This is because your child will be confused and is learning that at times he is getting access to things he likes by acting out. When this happens, he/she is going to try everything and anything to get access to the things that they like again. So be consistent. When your child displays inappropriate behavior, give them clear consequences. Black and white. There should never be grey areas.

 7) Last but not least. Celebrate success in a big way ! go all out ! make your child the happiest person ever !! :) Here's an example of a visual for a motivational system.

Here's an example of a visual for your child:

As always, please email me if you have any questions :) and wishing everyone a very happy 2013 !!!

Why do we do what we do?

"The function of a behavior refers to the source of environmental reinforcement for it."

Tarbox et al (2009, p. 494)

Everyday and in the very beginning of life, as an infant, we have learned to do things because of the consequences that were put in place. These consequences were put in place based on the environment that we were in. For example: A baby has learned to cry when hungry so he/she will be fed, cleaned or picked up.

Therefore, in applied behavior analysis, behavior is maintained by several functions. In other words, behavior happens for certain reasons and understanding the reason why certain behaviors occur, will help us understand why a person does what he/she does. Behavior could be maintained by the following functions: attention, escape/avoidance,  tangible/activities or automatically maintained. Sometimes, behavior can serve multiple functions. For example, a child might learn to hurt themselves during class to get out of having to complete academic tasks and then also hurt themselves in the playground to get attention from the teachers.


Attention

You tell a joke and your friends laugh. You love your friends laughing at your joke because you absolutely love the attention, so you tell another joke. This joke telling behavior, is maintained by attention. You are more likely to tell a joke in their presence again because you love the attention.

Another example, your child kicks his sibling and his mother gives him attention for this. The child continues to kick his sibling because every time he kicks his sibling, his mother takes away attention from the sibling and giver her attention to the child kicking. His kicking behavior then is maintained by his mother's attention.

It may seem weird that a person would engage in a behavior to deliberately have someone scold them. However, it can occur because for some people it’s better to obtain “bad” attention than no attention at all (Cooper, Heron & Heward, 2007). 

Escape/Avoidance

Not all behaviors occur so the person can “get access” to something. Some behaviors occur because the person wants to get away from something or avoid something (Miltenberger, 2008).

For example, You see a cop on the road while you are speeding, you slow down. The reason why you slow down is because you want to avoid a speeding ticket.

Another great example is that you keep putting off your dentist appointment even though your teeth needs attention because going to the dentist is aversive and you want to avoid going as much as possible. 

Tangible/Activities

Your child cries or screams whenever they want a specific toy (tangible) in the store until you buy it for your child or your child kicks and cries every time he wants to go to the pool (activities) because every time he does this, you take him to the pool.

Automatic

Some behaviors, have no particular environment function. Some behaviors we only do because it feels good when we do it.  It is pleasing to us internally or in other words, they are “self-stimulating” (O’Neill, Horner, Albin, Sprague, Storey, & Newton, 1997) For example, rocking back and forth and twirling our hair while we read a book.


Behaviors always occur for a reason and it is very important to understand the reasons as to why these behaviors occur. Understanding the reasons, will help us determine how to improve a behavior or decrease an undesired behavior.

If you wish to learn more, please sign up for the following workshop on functions of behavior.

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Shaping workshop in December in full gear !

We got the place confirmed and the workshop is in full swing !!! We are so excited about this workshop because shaping is a procedure that is very important in teaching any skills that you would like to teach your child in order to make them more independent or introduce them to something that may be aversive to them. Shaping is a great tool and we at Littlesteps are so excited to share all our knowledge with you.  Hands on training will be provided on the day of the workshop, articles on current research will be shared and most importantly we will be able to exchange some ideas on how to teach your child or student skills that are important to their development.

Please fill out the form below to register and payment will be made the day of



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Little Steps Malaysia & Workshop

Hey everyone !! it's getting very close to the early bird price which is MYR 100. So if you are  attending please email me at littlestepsmalaysia@gmail.com in order to sign up for the special price, that will be great.

Wanted to give everyone an idea of the services Little Steps Malaysia provides to children with autism:

1) Individualized programming and consultation based on your child's needs
2) Provide training to parents using the science of ABA
3) Setting up the individualized programs at home for your child
4) Help parents troubleshoot behaviors of concern
5) Improving behaviors
6) Creating a positive and fun learning environment for children
7) Increasing independence at home

The services we provide are all individualized and tailored to your child's needs. Our objective at Little Steps is to give parents the relevant tools to help parents help their child achieve their full potential. We follow the seven dimensions of Applied Behavior Analysis in order to make programming at home effective.

Little Steps Malaysia is dedicated to all the children diagnosed with autism. We believe that every child diagnosed with autism deserves the chance to grow into their full potential. We believe children with autism can do anything they set their heart to do and most importantly we always operate by having the child's best interest in mind.

If you are interested to learn more, please call me at 010-221 4028, email me at: littlestepsmalaysia@gmail.com or come to the workshop ! :) Hope to hear from you soon !!

The way we operate

During my time in Malaysia, I have been asked this question " What ABA model do you operate from?- is it Lovaas? is it the UCLA model?  is it the early autism partnership model?"

I am very confused by this. I guess my confusion lies here: Applied Behavior Analysis is a science, shouldn't a form of science be the same thing? Shouldn't we all operate from the same model just like any other form of science?

Of course I understand having worked at a PCDI dissemination site, we utilized the technology of activity schedules widely ( the founders of the school created the technology of activity schedules.)  However, we still operate from the science of Applied Behavior Analysis. We still operate from a technology that has shown reliable, valid and evidence based results that are effective.

Lovaas, Sunberg, Jack Michael, Brian Iwata, and Thomas Freeman are all scientist that have studied the literature extensively, conducted research, published research and reported their findings. All of them have contributed to the field of ABA widely. Just like any other scientist that studies specific things in molecular biology , these scientist have also concentrated in the research of specific things as well. For example, Dr. Ivar Lovaas he was an amazing and knowledgeable man, the Lovaas approach states clearly that it is based on the science of Applied Behavior Analysis.  Dr Lovaas, focused more on incidental teaching in the child's natural environment and discrete trial teaching. But if you go on the website and read more, he envelopes the science of applied behavior analysis in his implementation of ABA. The Lovaas approach does use prompting strategies, functional communications, etc.Another example, Jack Michael, he concentrates his research on verbal behavior and Iwata researches on the functions of behavior. This does not mean we primary should follow their model of reported findings and just do what they do specifically. This means, we learn from what they have learned and try to replicate their findings if need be, using all the technology that we have in place based on ABA. Lovaas has contributed so much to the the field and his work is being replicated everywhere in great ABA programs. So what does this all mean? What should an ABA program look like? A great ABA program does not follow any specific model, it does not use just some strategies, and it must be individualized to the child's current needs. A good ABA program follows the science of Applied Behavior Analysis.

Therefore, when asked these days what model I follow, I try to be respectful enough and say I don't. However, we do follow the science of Applied Behavior Analysis and any program implementing teaching procedures using ABA should follow and be committed to the 'Seven dimensions of Applied Behavior Analysis' ( Baer, Wolf, and Risley, 1968).

The dimensions are:

1) Applied: this means that when choosing a behavior, the behavior chosen should be socially significant and have socially valid importance to the individual

2) Behavioral: behavior that is chosen should be measurable and documents that is was the individual behavior that was changed.

3) Analytic: a functional relation should be demonstrated. In other words, the intervention chosen should show experimental control over the occurrence and non-occurrence of the behavior.

4) Technological: the written procedures in the individualized program for the child or the written description of the procedures in a study should be written clearly so that others can understand it and replicate it.

5) Conceptually systematic: all the interventions that are being used should be derived from the basic principles of behavior.

6) Effective: The intervention chosen  or the program chosen for your child should improve behavior to produce pratical results for your child.

7) Generality: the intervention produces behavior that we can see across different environments and spread to other behaviors. Your child behavior should generalize to different settings, people and materials.


The seven dimensions should serve as the primary "model" when evaluating a good ABA program.
There should not be any other "model". There should always be great science in ABA and only then will your child benefit fully.

I hope this helps you pick a good ABA program for your child.

As usual, email me with questions if any :)

One step at a time...

Before starting any ABA intervention with your child, it's good to have a mind set. It's good to have a mantra to tell yourself in order to be grounded and in order to never give up. It's always good to hold on to a set of rules for yourself.

The first rule:

1)  Learning always has to be magnified

Autism affects each child differently. Each child learns differently. Therefore, based on your child's skills, learning should always be magnified. All those little steps you teach should be reinforced leading up to the final step of learning. For example: If your child can only say a few sounds, don't teach your child a sentence. First teach him sounds that you think would be important for him to know in order for him to communicate. Then, build on those sounds to eventually make words. Once he has words in his repertoire, build up to a two word sentence, a three word sentence and so on. With any skill you teach your child, you want your child to be motivated to learn. If you are teaching too much too soon, the teaching interaction might become punishing, and your child would not be motivated to learn.

2) We have to build on behavior that is already in the child's repertoire

Just like the previous example, don't teach your child to talk in sentences, when your child is finding it challenging to produce a sound or even imitate what you model. First build on imitation of sounds he knows, then build those sounds into words, sentences and so on. Shaping procedures are great for this and I will write more on shaping soon !

3) Only teach observable behavior

During my time in Malaysia, I have heard many say "it boosted his confidence" or "it makes him happy, that's why he flaps his hands". These opinions are merely assumptions. We do not know if it really makes him happy or if it does boost his confidence. It may, but we can't measure happiness and certainly can't measure confidence. What you can measure is the duration your child is engaged independently in his schedule, the number of times your child engaged in head banging, the variety of awesome food your child is consuming and because you have taught him appropriate social interaction, the number of times your child initiates for hugs. This is the hardest task for a parent. I can't imagine because I do not have kids of my own. But if I did, I imagine this part will be the hardest and the most difficult emotionally. However, seeing behavior in observable terms, helps you become a better teacher for your child. It helps you make good decisions and teach appropriate behavior so your child can become more independent and look more like his/her peers.

Now finally, the mantra that a parent should follow is this "Magnify and teach observable behavior so learning is fun".

Key words: Magnify, Teach, Observable = FUN.

Teaching your child should be a really fun process. It should be a time where you and your child spend together and learn things from each other. Your child should be motivated to learn, and you should be motivated to teach. Teaching should never be a struggle. It should always be a shaping process. It should always be little steps at a time...

What is Autism?

Autism is defined behaviorally by symptoms that appear prior to age 3. According to the Diagnostic Statistical Manual ( IV) the criteria for diagnosing Autism are abnormal or delayed development in 3 areas:

1) Impairment and delays in Social Interaction (Social Skills)
2) Qualitative impairment and delays in communication ( Language)
3) Restrictive, repetitive and stereotyped patterns in behavior ( Behavior Repertoire)

Under these three categories there are sub categories as described below. In order to meet the criteria for autism, there has to be a total of of six (or more) items from (1), (2), and
(3), with at least two from (1), and one each from (2) and (3):

A total of 6 or more items is required to meet the criteria for Autism in

 1) Impairment and delays in Social Interaction (Social Skills) ( at least 2 from this category)

(a) 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 (e.g., not reponding to name everytime her/his name is called, does not make eye contact)

(b) failure to develop peer relationships appropriate to developmental level. (e.g., your child tends to play by himself/herself in a situation where there are other children present or engage in tantrum behavior when peers initiate play)

(c) a lack of spontaneous seeking to share enjoyment, interests, or achievements with other
people (e.g., by a lack of showing, bringing,lack in joint attention, or pointing out objects of interest)

(d) lack of social or emotional reciprocity (e.g., does not like hug, tickles, or show empathy when another child is crying)


 2) Qualitative impairment and delays in communication ( Language) (at least 1 from this category)

(a) 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)

(b) in individuals with adequate speech, marked impairment in the ability to initiate or sustain a
conversation with others

(c) stereotyped and repetitive use of language or idiosyncratic language (e.g., saying the same word, scripting from movies, making unusual sounds)

(d) lack of varied, spontaneous make-believe play or social imitative play appropriate to
developmental level


3) Restrictive, repetitive and stereotyped patterns in behavior ( Behavior Repertoire) (at least 1 from this category)

(a) encompassing preoccupation with one or more stereotyped and restricted patterns of interest that
is abnormal either in intensity or focus (e.g., lining up objects, spinning object in the same way, not playing with toys appropriately)

(b) apparently inflexible adherence to specific, nonfunctional routines or rituals (e.g., engages in tantrum behavior when going from one place to the next)

(c) stereotyped and repetitive motor mannerisms (e.g., hand or finger flapping or twisting or complex
whole-body movements)

(d) persistent preoccupation with parts of objects (e.g., constantly playing with the same toy in the same way)

If you read this and think your child has autism, please contact your local pediatrician immediately. Your pediatrician can refer you to someone who can conduct a formal assessment and refer you to a provider that can provide effective treatment. The earlier intervention is sought, the more likely your child will improve. There is no cure for autism but with effective treatment and intervention, your child's autism can improve and in some cases the diagnosis can be taken away.

In choosing a treatment, feel empowered as a parent to take your time and do some research to see what is out there. Like I always say, the best treatments are the ones that report all their outcomes and evidence. Some treatments do report outcomes and evidence but they may not be socially valid, reliable or make any behavior improvements over time.

Please make yourself aware and be aware of fad treatments. Fad treatments claim to "Cure" autism and make your child better. Till date, there is no known cause for autism. There is no cure for autism. Choosing an effective program that is based on improving behavior is they way to go. I hope you feel empowered as a parent to make valid and reliable decisions on a treatment.

Here are two great links to help you think about some treatments out there and also links to help you with your questions on vaccinations, gluten free diets, etc

A Parent's Guide to Autism Spectrum Disorders

Suggested Links to Research Studies 

Vaccinations and Autism

Gluten and Casein Free Diets & Autism

Malaysian Parent Support Group

Autism Workshop Folks !

Hi Everyone!

I have been asked to do a small informational autism workshop for parents here in Subang Jaya.

Below are the details !

	Autism Workshop Helping my child with Autism.
	Topics that will be covered:  l  Brief Introduction to Applied Behavior Analysis (A.B.A) l  Relationship Building l  Managing Contingencies using Applied Behavior Analysis l  Increasing your child's independence at home

Autism affects 1:600 children in Malaysia. Autism Spectrum Disorder (ASD) affects over tens of millions worldwide. Applied Behaviour Analysis (ABA) has been much supported and is widely used in many parts of the world. In general, ABA involves breaking down teaching objectives into the smallest unit and teaching these units one by one.

This workshop will cover topics in the science of Applied Behaviour Analysis and help parents learn more about how they can become effective teachers for their children. Tina Dass is obtaining her M.A in Applied Behaviour Analysis from the United States and has worked with children diagnosed with autism in the United States for 6 years under the guidance of Dr. Kevin Brothers and PhD Candidate Sandra Gomes.

This workshop will be useful for therapists, teachers, caretakers and parents with children with autism.

Workshop Details:

Date:     13^th October 2012
Time:    9 am to 12 pm
Venue:                  1^st Floor, D'Tandoor Restaurant Subang Jaya, No. 7, Jalan SS 15/5A, Subang Jaya 47500 Selangor.

Price:

Early bird price is MYR 100 per person ( by September 25th)
Regular price MYR 130

Prices includes: Coffee/tea with snacks & a workshop packet.

Registration and payment may be made in the following ways: 

1. Scan/Email registration form along with payment receipt to littlestepsmalaysia@gmail.com
2. Payment can be made via transfer/cash/cheque deposit made payable to “Sheila Dass A/P Ranjit Dass” Maybank Account : 112308038289

Please do not hesitate to contact Tina/Sheila by phone 010-221 4028/016 283 7529 or by email littlestepsmalaysia@gmail.com for enquiries.

Registration forms and payment must be received by October 5^th 2012 

 

You can do anything you set your heart to.

Autism affects 1:600 children in Malaysia. 

Autism is a lifelong disability.

By way of comparison, more children are diagnosed with autism each year than with juvenile diabetes, AIDS or cancer, combined. ASD affects over tens of millions worldwide. This is such an alarming statistic. We have to do more for our children here in Malaysia.What can you do if you are a parent?

Educate yourself. Educate yourself about all the services available for your child. Unfortunately in Malaysia there are no government funding and no school systems that support the needs for a child diagnosed with autism. The best way to reach out is through research and empirical evidence.

After spending four beautiful years at Somerset Hills Learning Institute, my director told me to be proud of myself. And I looked at him with tears in my eyes and a breaking heart to leave all my kiddies that I love, and smiled. He added, "It's true, for the past for years, you have made a measurable difference in children's life. And that is something you should be very proud of". My director is a wonderful man. He started his school in the basement of a church with 4 children, 4 teachers and him. From a school of 4 children, he built a school with 30 children, with amazing, wonderful teachers. I realize this, a great program makes measurable differences in a child's life. This means that change is evident through data, observation and in a child's smile. He built a great school with a great mission, to "change the face of autism" and it continues. He is truly an inspiration.

Before I left my life in America, I had the opportunity to see one of our students graduate. He is 21, he is working and he is a tax paying citizen. How wonderful. Below is the link, so please check it out and let us all be inspired to increase autism awareness in Malaysia.

http://www.somerset-hills.org/home.html

Having fun is Important.

When a child is new to intervention, the first thing we do is play with them.

We follow them around the school for 2 weeks and observe what they like, chase them around, hug them, kiss them, tickle them and do things they like with them. This is called relationship building.

Relationship building is a very important aspect to treatment. I can't stress this enough.

Here are some ways to help relationship building.

1. Write down the 5 top favorite activity that your child prefers.

2. Choose a time of day where you can play with your child 1:1 without any distractions.

3. Bring out all the fun activities that you want to do with your child and play with him/her.

4. If your child seems more engrossed in the activity, you can take away the activity, expect eye contact and when he/she give you eye contact give him/her the tangible reward paired with lots of tickles and social praise  What you are doing here is, teaching social consequences by pairing tangible rewards. He/she is learning to appropriately interact with you and not just the item that they like.

5. It is important to pair social interactions. Even if your child's favorite activity is the TV, you can feel free to pause the tv or turn it off , wait for your child to look at you and then give him/her access to the TV once eye contact is given.

6. What if he/she does not look? What can you do? You can use your hands, gently guide his/her head to you and leave your hands there until he/she gives you eye contact. Immediately deliver the tangible reward (e.g., tv, candy, etc.) and pair that with tickles and lots of hugs.

The social component is so important. Many parents say that their children diagnosed with autism don't prefer hugs or tickles. And this may be true. Autism is diagnosed based on social deficits. Therefore, pairing social consequences with those preferred activities, will teach your child to love social consequences. In return, you will be signal for reinforcement (availability for fun stuff) and successfully built a meaningful relationship with your child.

The last component of relationship building  is this: HAVE LOADS OF FUN ! BE A CHILD AGAIN! ENJOY YOUR CHILD'S COMPANY ! :)

What is ABA?

Applied Behavior Analysis (ABA) is a science that is committed to understanding and improving behavior in the environment. How is Applied Behavior Analysis different from the rest of psychology? The field of ABA focuses on objectively defining behavior and is continuous in discovering variables in the environment that reliably influence behavior. Based on the observation, the results are quantified and described in order to make a socially significant change to the individual's behavior.

When a parent asks me what is ABA?

This is what I say " Our environment is constantly improving and changing our behavior. We eat because we are hungry, we drink when we are thirsty, we work to get our paycheck at the end of the month so we are able to buy all the things we love and we slow down when we see a cop to avoid a ticket. These things in the environment either motivate us to behave or make us avoid punishment  in order for us to live a better life. That in a nutshell is ABA"

This is how we look at behavior:

Antecedent ( What happens before the behavior occurs) 






Behavior ( What is the behavior that is occurring)






Consequences ( What happens after the behavior has occurred)

These is called the three term contingency or the ABC's of a behavior.

How is iABA applied to autism?

Children with autism take time to learn different tasks. Based on the environment, the instructor will help them learn each task (which will be objectively defined) by using little steps at a time and provide reinforcement ( a tangible thing they love) for each step completed correctly and independently. Over time, as the child gets more independent, the tangible reward is faded out and the learner will be able to do the task that is being measure all by himself/herself. This is just a glimpse into how it is applied. There are other ways to teach behavior. All the strategies that are used are derived from the literature that has shown statistically significant improvement of a behavior over time.

There are many treatments out there that claim to "cure" autism. Autism has no cure.  A good treatment should report all it's outcomes and evidence so parents are able to see significant behavior improvement. With good treatment, the diagnosis of autism can be taken away. A great website that I always refer parents to the Association for Science in Autism Treatment. They have great suggestions and amazing resources for any treatment you choose for your child. The most important thing is to be aware and always make evidence based decisions in regards to the treatment you choose.

I hope this was helpful. Email me anytime with questions !!