Introducing CBS Social Skills Groups for Autism!

We’re excited to announce our newest service for CBS clients:  Social Skills Groups for Autism!    Our group sessions are happening now, in our Main Irvine OfficeMastering social skills can profoundly improve life for those with social deficits—particularly in the ability to make and maintain friendships, and to participate in school and the workforce. 

Our social skills groups for autism typically last between two and four hours, and take place by appointment only (depending on staff and client availability) on weekdays between 9:00 a.m. and 6:00 p.m.  Group sessions are a great way to have fun and interact while learning social skills in a supervised, controlled setting.

A functional behavior assessment is usually a prerequisite, to confirm whether the program fits each client’s needs and goals.  So before you begin, please contact us to speak with one of our supervising Board Certified Behavior Analysts to discuss your situation.  Or to learn more about whether this service might be right for you or your loved one, you can also check out our social skills groups for autism page!  


 

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ABA Must Not Overlook Adolescents and Adults

By Shaji Haq, Ph.D., BCBA-D

 

Over the past twenty years, applied behavior analysis (ABA) treatment providers for children with developmental disabilities—particularly autism spectrum disorder (ASD)—have multiplied exponentially.  But ABA treatment facilities for adults are sparse.  This is a tragedy; we’re often stopping short when treatment is still critical, and in some cases, even more so.

Many factors may have contributed to the increase in children’s ABA providers (e.g., Lovaas’ seminal study on the effectiveness of early intensive behavioral intervention in 1987, mandated insurance coverage, and funding and research for ASD treatment), but this increase addresses only part of the issue.  Students with ASD often “age-out” of school systems or ABA agencies, leaving families with limited options—limited in terms of effective treatment, and limited in helping loved ones access services which are critical to independent, adult functioning.

Adult clients may lack the skill to participate in vocational or community integration programs.  For example, adults with ASD who cannot successfully participate in community programs might have severely limited communication skills, difficulty managing personal hygiene, or display severe behavioral inflexibility (e.g., insistence on sameness of routines) that can be barriers to those programs.  Many of these individuals also display problem behavior, such as aggression and self-injury, which often excludes them from participation.

Without ABA services to improve skills and treat behavior problems, the situation may seem bleak.  But it doesn’t have to be.  The key to ABA treatment is always identifying the cause of behavior.  Experimental functional analyses (Iwata et al., 1982/1994), also commonly referred to as Functional Analysis Assessments (FAAs), are the gold standard for identifying the function, or purpose, of problem behavior for individuals (regardless of age) with developmental disabilities.

FAAs are an area of service CBS has begun to provide, which is not commonly found in Southern California.  Our FAAs use rigorous data collection systems and research-based experimental design.  Since 2004, Center for Behavioral Sciences has emphasized teaching individuals of all ages with developmental disabilities to reach greater levels of independence, and our new FAA program is a great step forward.

While an FAA and any behavior intervention translates to vastly different outcomes across individuals, at Center for Behavioral Sciences, we believe that older clients must be recognized as an equally-important population to children with ASD.  Adult treatment goals may range from basic activities of daily living to more advanced skills, such as time management, decision making, how to use public transportation, and vocational training.

If you are interested in finding out about our FAA program, our Intensive Treatment Center or our other services, you can follow the menu above or contact us to learn more!

 

References

Iwata, B. A., Dorsey, M. F., Slifer, K. J., Bauman, K. E., & Richman, G. S. (1994). Toward a functional analysis of self-injury. Journal of Applied Behavior Analysis, 27, 197-209. doi: 10.1901/jaba.1994.27-197 (Reprinted from Analysis and Intervention in Developmental Disabilities, 2, 3-20, 1982).

Lovaas, O. I. (1987). Behavioral treatment and normal educational and intellectual functioning in young children with autism. Journal of Consultation and Clinical Psychology, 55, 3-9. doi: 10.1037/0022-006X.55.1.

 


Disclaimer: This article is for general information only, and is not intended (nor should it be relied upon) as health care or other advice regarding your specific circumstances. Individual circumstances and outcomes vary, and the statements or recommendations in this article may not apply to you. Please contact your health care provider regarding any specific issue or problem.  The opinions expressed in this post are the opinions of the individual author and may not reflect the opinions of CBS.

©2018 by Center for Behavioral Sciences, Inc.  All rights reserved.

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A Behavior Analyst’s Tips for Picky Eaters

By Dr. Joyce Tu, Ed.D., BCBA-D

Overview

Caring for a loved one with developmental disabilities can pose unique challenges, which are not always adequately addressed by conventional methods. We have covered how to tackle toilet troubles and chronic sleeping issues. Below, Dr. Joyce Tu, Ed.D, BCBA-D, shares one program to help parents and caretakers introduce new foods to picky eaters.  From a behavior analyst’s perspective, eating may be addressed using the following framework:

  • The Premack principle (the principle that more likely behaviors, can be used to reinforce less likely behaviors);
  • Shaping (reinforcement of behavior resembling a target behavior);
  • Fading (gradually reducing prompts or reinforcers); and
  • Positive reinforcement (presenting a reinforcer to make behavior more likely).

If this seems too technical, don’t be discouraged; the program itself is fairly simple!  Your child (or other “picky eater”) will be introduced to various types/shapes/sizes of food throughout the day by using these principles, and can gradually expand her daily menu.

Program

First, you’ll need to identify a reinforcer—a favorite food that your “picky eater” already likes.  Then, choose a new food which you would like to introduce to her diet.  Next, for each bite of new food that your “picky eater” eats, immediately give her a bite of her favorite food.  This is “positive reinforcement.”  (See, it isn’t so hard!)

Alternatively, you can start more slowly and present a bite of her favorite food when she first touches the new food.  Then, when your “picky eater” gradually brings the new food closer and closer to her mouth, give her a bite of her favorite food.  This is called “shaping.”

Gradually increase the ratio of new food to a favorite food, to 2:1.  In other words, when your “picky eater” eats two bites of new food, present one piece of her favorite food.  Later, increase the ratio to  3:1, then 4:1. By changing the ratio this way, you are using a “fading” procedure.  When the ratio of new food vs. favorite food has increased to 5:1, you can then introduce a second new food.

When introducing the second new food, have your “picky eater” take a bite of the second new food, then a bite of first new food, then five bites of her favorite food. The ratio of the second new food, to the first new food, to a favorite food should be gradually increased to 2:5:1 (i.e. two bites of the second new food, five bites of the first new food, and one bite of a favorite food).

Gradually increase this ratio of the second new food vs. the first new food, vs a favorite food, to 3:5:1, 4:5:1, etc.—until your “picky eater” begins eating both new foods without your help. Using the same procedure, you can then introduce other new foods.

 


Disclaimer: This article is for general information only, and is not intended (nor should it be relied upon) as health care or other advice regarding your specific circumstances. Individual circumstances and outcomes vary, and the statements or recommendations in this article may not apply to you. Please contact your health care provider regarding any specific issue or problem.  The opinions expressed in this post are the opinions of the individual author and may not reflect the opinions of CBS.
 
©2017 by Center for Behavioral Sciences, Inc.  All rights reserved.

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Help Your Child Sleep through the Night Using these Simple ABA Techniques

We’ve posted our tips on tackling toilet troubles. Another common issue for parents and caretakers of children with developmental disabilities is their child’s interrupted or irregular sleep pattern. Below, Dr. Joyce Tu, Ed.D, BCBA-D shares systematic shaping and fading strategies, designed to help regulate your child’s bedtime routine.  Please note that this program is best suited to children with chronic sleeping issues (such as sleeping only 2-4 hours daily for a prolonged period). It is not intended for children who may have experienced only a few sleepless nights.

Before you begin, limit your child’s sugar and caffeine intake before bedtime. Your child should not eat foods that contain sugar or caffeine at least four hours before bedtime.  Implement at least ½ hour of daily exercise in conjunction with this sleeping program.

On the first night, begin with a 12:00 a.m. bedtime. Prompt your child to perform “getting ready for bed” tasks such as brushing her teeth, using the restroom, changing into pajamas, getting into her own bed, and listening to a bedtime story.

Keeping your child awake until 12:00 a.m. might be the most difficult part of the program. Parents who complete this program successfully often report that they engage their children with activities such as taking walks, playing games, etc., to keep the children awake during the first few weeks.  If your child gets up between 12:00 a.m. and 6:00 a.m., prompt her to return to bed with no additional verbal interactions. In other words, do not scold or acknowledge the behavior excessively.

When your child can stay in bed from 12:00 a.m. to 6:00 a.m. for one week:  Move her bedtime to 11:30 p.m. the next night. Then, when she can stay in bed from this time, move bedtime to 11:00 p.m., then to 10:30 p.m., then 9:00 p.m.  Following these procedures, gradually shape your child’s bedtime to suit your household schedule.

 


Disclaimer: This article is for general information only, and is not intended (nor should it be relied upon) as health care or other advice regarding your specific circumstances. Individual circumstances and outcomes vary, and the statements or recommendations in this article may not apply to you. Please contact your health care provider regarding any specific issue or problem.  The opinions expressed in this post are the opinions of the individual author and may not reflect the opinions of CBS.
 
©2017 by Center for Behavioral Sciences, Inc.  All rights reserved.

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Toilet Training Made Easy

Introduction

 

Caring for a child, potty accidents come with the territory, especially for those with developmental disabilities such as autism. As common these issues are, the good news is that they are also highly manageable. Our step-by-step guide below aims to tackle even the trickiest of toilet troubles. Let’s dive right in!

The goals here are two-fold.  First, we’ll aim for seven days in a row with no more than one accident.  The long-term goal is for your child to use the toilet for every elimination with no assistance.  This program requires that your child be able to walk, sit for approximately 2-3 minutes, and grasp with her hands.  You will also need the following:

  • Training pants (preferably regular underwear).
  • Simple clothing: no pants/elastic waistband pants, or short shirts for girls.
  • A child-size toilet seat, or child’s potty chair if your child is uncomfortable on the adult toilet. (If you use a potty chair, keep it in the bathroom at all times.)
  • A variety of your child’s favorite drinks.
  • A variety of small food treats that your child likes. (Note: be sure to only make these food treats available as a reward for dry pants! Do not use these treats for anything else.)
  • A variety of your child’s favorite toys and activities.
  • Two or three days of free time with minimal disruption for training.

 

Understanding the Two Basic Procedures

 

Procedure 1: Toileting

 
Using the toilet is a chain of many small steps. Your child must be taught each of the following steps to help her learn these habits effectively:

a.  Come up with a signal for your child to use to tell you she needs to go to the toilet:

Ask, “where do you go potty?” and vocally prompt the answer “toilet” or “bathroom.” Have your child imitate “toilet” or “bathroom” aloud if necessary. Praise your child for answering “toilet” or “bathroom.” If your child cannot talk, have her use a gesture or a picture.

b.  Have your child walk to the bathroom in front of you. Physically prompt your child to do so if necessary.

c.  Have your child take down her pants and sit on the toilet.

d.  Give your child 2-3 minutes to use the bathroom. Encourage her to do so by stating “go potty.”

If your child eliminates, praise her and provide food treats (or other reinforcers of their choice). If your child does not eliminate, ignore it. Do not scold or express disappointment. Go to the next step.

e.  Flush the toilet (or empty the portable potty) only if your child eliminates.

f.  Say “Get down” and have your child pull up her pants.

g.  If this was performed during a wet version of the “dry pants check” (Procedure 2 below), have your child walk back to the place she wet herself and change to dry pants

h.  Continue with the toileting schedule.

 

Procedure 2: Dry Pants Check

 
This is a way to teach your child that you want her pants to be dry all the time.  The procedure is as follows:

a.  Ask your child “Are you dry?” Help your child place her hand on the crotch area of her pants so that she can feel for wetness.

b.  If your child is dry:

Praise her for being dry (e.g., “Nice dry pants”), and give her lots of social reinforcers (e.g., hugs, kisses). Then give your child a small piece of the food treat or a sip of a drink.

c.  If your child is wet:

Tell her “No wet pants.” Take her immediately to the toilet (using Procedure 1 above). Have your child do as many of the steps as possible and use hand-over-hand prompting for those steps your child does not know.

d.  For the steps your child can partially perform:

*Pair every step in this procedure with the actual instruction (e.g., “walk to the bathroom”).

*Do not talk to or praise your child during this procedure; only give those verbal instructions to complete the step(s) involved. Your voice should be calm but firm.

*Do not scold or reinforce behavior (such as with a drink or affection) during this procedure.

 

Day One

 

Step 1. Change & Drink:

After a small breakfast (no starches) change your child’s diaper to training pants. At breakfast have your child drink at least 1 ½ cups (6 oz.) of her favorite drink.

Step 2. Perform Procedures 1 & 2:

Five minutes after breakfast perform a dry pants check (Procedure 2).

If your child is dry, praise her and give her a small piece of her food treat. Then ask, “What do you need to do?” Verbally prompt your child to state, “Go potty.” Proceed to performing toileting (Procedure 1). If your child eliminates, give her lots of praise and a reinforcer of her choice. If your child does not eliminate, say “nice try” and continue with the toileting schedule below.

Step 3. Toileting Schedule One:

After performing the above procedures, repeat the following cycles:

a.  Every 10 minutes: Dry pants check (Procedure 2).

b.  Every 20 minutes: Toileting (Procedure 1). Do this approximately 10 minutes before your child has a bowel movement (BM).  The BM schedule is based on what you recorded on the original toileting data sheet prior to training. Record whether your child was dry, wet, and/or had a BM.

c.  Every 1 hour:  Have your child drink a ½ to 1 cup of her favorite drink.

Step 4. Toileting Schedule Two:

When your child is eliminating in the toilet with no accidents for at least three hours:

a.  Every 15 minutes: Dry pants check (Procedure 2).

b.  Every 30 minutes: Toileting (Procedure 1).

c.  Every 90 minutes: Have your child drink a glass of liquid.

If your child has four or more accidents in a row, have your child repeat the toileting procedure after each accident two times and decrease consumption of the drink to a ½ cup.
 

Final Steps:

 
For every three-hour interval your child goes without any accidents:

    a. Increase the intervals between dry pants checks and toileting procedures by 5 to 10 minutes.

    b. Increase the intervals between liquid consumption by 30 minutes.

Diapers should only be worn when your child is asleep.  Eating schedules should be kept the same, but prepare lighter meals with fewer starches.

 

Day Two and Beyond

 

Continue with the same toileting schedule you ended with on Day 1. When your child is eliminating every two to three hours, stop giving liquids on a scheduled basis and slowly thin out (decrease) reinforcers for eliminating in the toilet.  By continuing to follow this procedure, you and your child will be on the way to success!

 


Adapted from Toilet Training in Less Than a Day by Nathan H. Azrin and Richard M. Foxx

Disclaimer: This article is for general information only, and is not intended (nor should it be relied upon) as health care or other advice regarding your specific circumstances. Individual circumstances and outcomes vary, and the statements or recommendations in this article may not apply to you. Please contact your health care provider regarding any specific issue or problem.  The opinions expressed in this post are the opinions of the individual author and may not reflect the opinions of CBS.

©2017 by Center for Behavioral Sciences, Inc.  All rights reserved.

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Conference

CBS Presents Its Research at the Bucharest International ABA Conference

In April, 2017, Dr. Joyce Tu, Ed.D, BCBA-D traveled to Romania on behalf of Center for Behavioral Sciences, along with other invited speakers from all over the world for the Bucharest International ABA Conference.  Ten international lectors attended from Great Britain, the United States, Norway, and Spain to present the newest theories and practices in Applied Behavior Analysis. Dr. Tu presented CBS’ original research on the following topics: “The Role of Joint Control in Manded Selection Responses and Generative Responding,” and “Teaching Social Verbal and Non-Verbal Behavior to Children with Autism.”

The Bucharest ABA International Conference is Romania’s main event dedicated to research and theory in Applied Behavior Analysis. The conference is accredited at the international level by Behavior Analyst Certification Board, and at the national level by the Romanian College of Psychologists and College of Physicians.

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No School….What to Do?

No School….What to Do?

A Few Simple Ways to Beat Boredom and Prevent Behavior Problems

 

Now that the excitement of the holidays has subsided, it is now December 26th and you, or rather, the kids have at least one week of NO SCHOOL! The thought of entertaining the kids throughout an entire day can be daunting. The best way to combat this stress is to arm yourself with a bag full of activities. This may mean you need to fight the crowds and head to your local craft store, or limit play with the new toys that Santa has delivered so they can be incorporated as a new activity during the week. As you would plan out your meals if you were on a diet, you can plan your activities for the days ahead and be prepared.

Here are a few simple suggestions that can help you beat “no school boredom” and prevent behavior problems.

  • Use a schedule board to show your child a list of activities for the day ahead. If your child does not read, use pictures of each activity to indicate what is next. Your child probably has a visual schedule board at school, and one for her home program. Therefore, creating a schedule board for the day at home can provide familiar prompts and a sense of structure for the day. For neuro-typical kids, this can help reduce the incessant asking, “what are we going to do?  I’m bored.”
  • Plan activities. Incorporate activities that require both interactive and independent work. Be sure to alternate or evenly space out the time for an interactive activity and an independent activity. Independent activities can be taken from mastered programs in your home program. This includes, for example, puzzles or games that your child was taught to do on her own.
  • Go outside as an activity. Take advantage of the beautiful California weather. Schedule your activities so that you are outside in the afternoon, go to the park, or play in the backyard. Kids typically run around quite a bit at school and they need the same amount of exercise (if not more) when they are not in school.
  • Try a community outing. For you locals, Disneyland, Knot’s Berry Farms, and the Long Beach Aquarium are all community outings that can entertain. On a budget? As we know, all of those amusement parks could get pricey. Instead of the aquarium, consider your local fish store. The kids will be able to look at the fish for free and will likely still get the same excitement.
  • Schedule a play date. It’s always nice to get the kids together, but it’s also nice to be able to commiserate with a fellow caregiver!

We hope these suggestions are helpful for you. It is also important to remember that it is vacation, so a day of non-structure and snuggling in front of the television with your little ones is more than okay.

 


Disclaimer: This article is for general information only, and is not intended (nor should it be relied upon) as health care or other advice regarding your specific circumstances. Individual circumstances and outcomes vary, and the statements or recommendations in this article may not apply to you. Please contact your health care provider regarding any specific issue or problem.  The opinions expressed in this post are the opinions of the individual author and may not reflect the opinions of CBS.

©2016 by Center for Behavioral Sciences, Inc.  All rights reserved.

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Reduce Stress This Holiday Season

Reduce Stress and Enjoy Yourself More

The holidays are filled with excitement and joy. With all of the excitement comes the stress of juggling multiple holiday activities. While you may be excited, you also may be feeling stress from the unknown. Several questions may run through your mind: Will my child have a behavior problem? Will I get to enjoy myself? Or, will I spend the entire time worrying about my child’s behavior?

Here are a few simple strategies to help you get through the holidays, and even to enjoy them!

Set Your Expectations

Set your expectations for your child and for yourself. How long do you want to be at the holiday event? How long can your child really be there? We all have limits regardless of any disability.  Expecting any child to behave and stay longer than they really can, will only lead to anxiety and stress on your part.

If it helps, call the host prior to the party and explain that you will attend, but only be for a certain time. This way, if and when you have to abruptly leave, the host will understand. And this can help reduce your anxiety and stress.

Prevention

Prevention is key.  This means not waiting for a problem to happen, but trying to prevent it from happening.  It can be easier to prevent than to react in the heat of the moment. There are several things you can do to prepare yourself, your child, and your family for the a holiday event.

  • Bring reinforcers (i.e., items that motivate your child’s good behavior, such as their favorite snacks or toys). If your child is on a token system, bring your token system.  Having reinforcers available can help you to remember to praise good behavior. We often get distracted at parties and ignore children while they are being “good.”  But if a child is going to continue to exhibit good behavior, she has to remain motivated. By having reinforcers available to present according to your child’s program, it is more likely that everyone will be happy and you will actually have more time to enjoy yourself.
  • Bring games and activities that your child can do independently. Often, we expect children to be good, but a holiday party may not necessarily be child-friendly. This can make it difficult for you and your child to relax. If your child enjoys coloring, puzzles, or a particular game, bring it with you. Set your child in an area with her own space to play with her toys or an activity that she can do on her own. If you child only enjoys watching videos bring your iPad, etc. Give yourself the night to enjoy, and just let your child watch videos if that is going to reduce your stress. Every once in a while, it’s ok.
  • Reactive Strategies. Plan for the worst.  You need to know before a holiday activity what you will do if a behavior problem occurs. Knowing the right response will reduce your stress level, even if it means leaving the holiday activity.

Ultimately, it is better to be over-prepared then overwhelmed. While the preparation may be stressful, you will feel relieved knowing that you have a plan. You may even be able to enjoy yourself knowing your strategies are in place, and they can buy you time to enjoy yourself — even if only for a short while.

We hope that you’ll find these tips helpful during the holiday season.

Happy Holidays!

 


Disclaimer: This article is for general information only, and is not intended (nor should it be relied upon) as health care or other advice regarding your specific circumstances. Individual circumstances and outcomes vary, and the statements or recommendations in this article may not apply to you. Please contact your health care provider or attorney regarding any specific issue or problem.  The opinions expressed in this post are the opinions of the individual author and may not reflect the opinions of CBS.

©2015 by Center for Behavioral Sciences, Inc.  All rights reserved.

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New Year’s Resolution Tips

Here’s to a New Year and a New Resolution!

Hello 2012! The start of a new year always brings the excitement and hope of many possibilities for the next 365 days. We come up with resolutions that tend to be more focused on the things we are NOT going to do this year. I’d like to offer you an alternate view of your resolutions.

Rather than focusing on the “not,” let’s look at what you “are” going to do in the new year. With our children, we often focus on what they are “not doing” when compared to their typical peers. In behavioral programs, you will find the complete opposite. Reinforcement (such as praise) is given for successive approximations of the ultimate behavior, thus shaping the behavior we desire.

This can be applied to your New Year’s resolution. Let’s take exercise as an example. Your ultimate goal may be to exercise five days a week. If you’re not exercising at all, this could be an unattainable goal. Rather than not meeting your goal and giving up by February, look at the number of times you have exercised thus far. Praise yourself and reinforce the smaller accomplishments. Even if you have exercised only once this week, give yourself a pat on the back, a special treat. Acknowledge the step you made towards your ultimate goal.

Then the next week, focus on increasing the number of times you exercise, compared to the previous week and so forth. You will see that reinforcing your desired behavior along the way to your ultimate goal is much more satisfying; and, it will increase your chances of actually reaching your goal and fulfilling your New Year’s resolution.

You can do the same thing when viewing your child’s program. Is there one program that you want to learn to implement, or you want your child to master? Remember, these short tips and you will be well on your way to achieving your goals:

1.  Determine the ultimate goal:  Decide what it is that you want to do.

2.  Clearly define the ultimate goal:  Create a description of what you want to achieve. This should be specific, observable and measurable. The goal should be so clear that you can visually picture it with your eyes closed.

3. Break the ultimate goal into smaller steps:  By breaking the goal down, it will be attainable.

4.  Determine your reward schedule:  From the onset, decide when you are going to give yourself that special treat. In the beginning, the rewards should be fairly frequent to increase your chances at maintaining a new behavior; and as you get closer to your goal, the rewards should be less frequent since you are closer to achieving the ultimate reward of accomplishing your goal and meeting your New Year’s resolution.

These tips offer an alternate way of viewing any new year’s resolution!  Happy New Year!

 


Disclaimer: This article is for general information only, and is not intended (nor should it be relied upon) as health care or other advice regarding your specific circumstances. Individual circumstances and outcomes vary, and the statements or recommendations in this article may not apply to you. Please contact your health care provider regarding any specific issue or problem.  The opinions expressed in this post are the opinions of the individual author and may not reflect the opinions of CBS.

©2012 by Center for Behavioral Sciences, Inc.  All rights reserved.

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