ABA Therapy  For Children two to twelve          in  New york and New Jersey

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Implementation



ABA is considered by many researchers and  clinicians to be the most effective evidence-based therapeutic approach demonstrated thus far for children with autism. According to the U.S. Surgeon General, thirty years of research on the ABA approach have shown very positive outcomes when it is used as an early intervention tool for autism. The studies show about 50% of children with autism who were treated with the ABA approach before the age of four had significant increases in IQ, verbal ability, and social functioning. Even those who did not show as good results still had significantly better improvement than children who did not receive the intervention. In addition, some children who received ABA therapy were eventually able to attend normal schools.  (U.S. Department of Health and Human Services, 1999)


Once the assessment and planning of curriculum have been  completed, it's time to implement .



Steps for implementation



1) Therapists will identify goals for the target skill/behavior and identify the criteria that will be used                                              to evaluate whether positive reinforcement is effective.Performance criteria also are established for each                           target skill/behavior so that teachers/practitioners can monitor learner progress and adjust reinforcement strategies as
learners gain mastery of target skills/behaviors. The initial criterion should be easily attained so                                              that learners can be successful without much effort and can acquire the identified reinforcer more easily.                               This also helps the learner establish a clear connection between the target skill/behavior and subsequent                         reinforcement. For example, a therapist might decide that an initial criterion for “keeping hands down” is 2 minutes for three consecutive days. The therapist  would then collect duration data to monitor learner progress. When the learner with
 meets this criterion, the therapist  gradually increases the amount of time that the learner is
required to keep hands down until the program goal is acquired. As the learner  gradually masters                                              the target skill/behavior, the criteria are adjusted so that reinforcement is thinned and can become generalized in the natural environment
.


2) Part of implementation of an ABA program includes having many strong reinforcers on  hand. The                                 therapist will observe the learner in natural settings along with conducting an interviewing of  the parent                                    to identify:activities, objects, and foods that the learner selects when allowed free choice.Because many learners                     with autism have not yet learned the value of social reinforcers, therapists must teach them to like these types of                  reinforcers by initially pairing a social reinforcer with a secondary reinforcer. As learners become more motivated by
social reinforcers, therapists should fade the use of other secondary reinforcers (e.g.,edible, sensory)


3)  Schedules of reinforcement refer to the frequency or timing of the delivery of reinforcement following a target skill/behavior. For example, a reinforcer can be delivered either on a continuous or on an intermittent schedule. A continuous reinforcement schedule is used when learners  are reinforced each and every time they use the target skill/behavior.
Continuous reinforcement schedules are best used when a learner is first learning a target skill/behavior and has not yet made a clear association between the target skill/behavior and the reinforcement. CRF may occur in DTT or natural environments.
Once this has occurred the schedule can be thinned to intermittent. There are basically 4 intermittent schedules of reinforcement. : Fixed-Ratio (FR) Schedule, Fixed Interval (FI) Schedule. Variable-Ratio (VR) schedule.
Variable-Interval (VI) schedule.


4) Therapists focus on preventing satiation so that the identified reinforcers do not lose their effectiveness.                            Reinforcers often become less effective when the same reinforcer is used too frequently. It is also important to note that a particular reinforcer may be reinforcing one day and not the next day. To prevent satiation therapists will provide a variety of reinforcers for the learner to choose from.


5) As a final step in implementing the ABA program  the skill or behavior needs to be generalized and maintained. It must occur across various settings, people and stimuli as well as over time. This is a crucial component of skill acquisition and if it is not occurring then a skill should not be considered mastered. Response maintenance means that the learner has learned a skill and continues to demonstrate this skill after teaching has been discontinued. Various strategies that should be followed to ensure that generalization is a focus of the program include the following:                                                                                Aim for natural contingencies of reinforcement – It is important to address behaviors that can be maintained by the natural environment.  Behaviors that are naturally reinforcing for the child to exhibit are more likely to be maintained and generalized.
Teach with Multiple  Exemplars – It is important to teach with many examples of targeted stimuli. For example, if a student is being taught to label a “car" there should be varied materials should be  used.  These could include pictures in a book, 3D objects, and pictures of various types of cars. This will help ensure that the student can label any ‘car’ that he/she observes. As part of this category, a student should be taught with many different instructors as well as settings.
Program Common Stimuli - Common stimuli refer to materials that can be found in the natural environment and are similar to those that will be observed. The more that the stimuli resemble something a student would witness, the more likely that they will be able to display the same response they were taught.
Train loosely -This strategy refers to varying any dimension of the program/target that is not critical to the teaching of the skill  For example: varying the tone of voice when presenting the instruction, varying the choice of words, presenting the stimuli from different angles, perhaps using a whiteboard or on the table.
Use Indiscriminable Contingencies - This strategy refers to the schedule of reinforcement that is used to teach a skill. If a skill is taught only using a continuous reinforcement schedule (CRF) once that reinforcement is removed, the skill will most likely falter. It is important to use an intermittent schedule of reinforcement to help maintain the skill. In the natural environment behaviors do not receive continuous reinforcement.
Teach Self-Management Techniques  -If a child is able to learn when and how to use their learned skills in the natural environment then it is likely those behaviors will continue. It is not enough to teach a child various phrases to request an item without teaching them when they should request the item versus obtaining it independently.