Blog article written by Dr. Charles Galyon
It can be helpful to think of the brain like a muscle: exercise makes it grow and improves its capabilities. There are plenty of commercial products that claim to improve brain power (memory, processing speed, attention...), but the actual evidence for these products indicates either no real benefit or a very specific benefit (that is, improvement in that specific task, but not other tasks). There are simply no shortcuts for a "supercharged brain." That does not mean that various brain challenges are without value though. For example, crossword puzzles appear to help maintain the strength of long-term memory later in life. This article discusses a little bit about early brain development and why diverse experiences are important for children's brains, and a few specific ideas to keep in mind when trying to help your child develop their abilities.
Immature and Slow to Develop
Humans have an unusually long period of development. Our children are largely helpless for a very long time and their brains will not "fully develop" until possibly early to mid-20's. However, you can clearly see a lot of differences in the abilities of very young children and adolescents, with adolescents capable of understanding more abstract concepts and engaging in more complex discussions (Piaget and his colleagues generally explored these ideas long ago). Because the period of development is so long, that leaves a lot of time to help build a child's abilities and improve on areas that they may be struggling in. Children's brains are also very adaptable (a concept called "plasticity"). One example of that is how young children are more able than adults to recover from brain trauma. On the other hand, some neurological differences do not appear likely to ever be fully addressed. It would be difficult to discuss all of the types of abilities and differences that are "plastic" and those that are not, but we can cover some important areas that parents can work on with their children.
Critical Periods/Sensitive Periods of Development
Sometimes you may hear the term "critical periods" of brain development. This concept means that certain abilities (such as the ability of the brain to process visual information) must develop within a certain time window or else it will never develop. It may be an overstatement for us to say with certainty that some abilities will never be able to develop, but there are certainly times during which it is easiest for a child to acquire a certain skill (such as language). These times during which it is easiest for the child to develop an ability or skill are often called, "sensitive periods" instead of critical periods to help emphasize that the window of opportunity is not necessarily completely shut. Usually these periods are for very specific abilities, such as the ability to process certain types of sensory information, or to develop motor skills or language skills. We are still learning more about human development, however, and there are many areas that are less clear (such as social skills).
Impulse Control and Emotional Regulation
The ability to inhibit a behavioral impulse or an emotional response is important for success in many areas of life (jobs, social interactions, relationships...). Our capacity to do this seems to reside heavily within the front part of the brain (the prefrontal cortex). Fortunately, this appears to be the last part of the brain to reach full maturity, which means there is a lot of time to exercise it. On the other hand, this also partly explains why children, adolescents, and even young adults can be extremely impulsive or make some very questionable decisions at times. The development of the prefrontal cortex also seems to coincide nicely with our "cognitive peak." You could say that we are, essentially, at our smartest in early adulthood (though the decline afterward is actually rather slow). This means that for children we should continually encourage them to practice impulse control and emotional regulation. We can do this most effectively by giving them mild "patience challenges" that push slightly at their limits and providing them with appropriate feedback, encouragement, and (if necessary) rewards for achieving their goals. I would not recommend doing this with an overly high frequency (such as multiple times per hour, every hour, every day) as it's likely to produce so much frustration that you'll get resistance from them in the future. However, if it can be made slightly playful, then the child is building an invaluable ability and also building confidence in their abilities.
An important thing to keep in mind is that emotional regulation and impulse control (or "behavioral regulation") appear to rely on basically the same neurology. To build greater emotional regulation, it is often helpful to teach the child to voluntarily withdraw from a situation when needed (by rewarding them for doing so if necessary). This can give their brain (prefrontal cortex actually) time to catch up and reassert its control over the situation. I've seen parents use many approaches to explaining this to their child, but I think my favorite has been the idea of an "overheating engine" that needs to cool off. Teaching the child how to recognize the signs of getting emotionally overwhelmed is a helpful (possibly critical) step in teaching them to self-regulate their emotions more effectively. A variety of physical cues can help, including their heart rate and breathing, as well as how impatient they're feeling.
Frustration Tolerance and Patience
Similar to building greater impulse control and emotional regulation, the capacity for frustration tolerance and greater patience are likely to be great contributors to a child's long-term success. Tolerance for frustration or setbacks increases the likelihood a child will persist at a challenging task and, as a result, learn more skills and ultimately enjoy more success. Explaining this to a child is not likely to convince them to keep working on a particularly frustrating homework assignment though. As the parent, you effectively coach your child by encouraging them to persist, giving them just enough help when they need it (called "scaffolding"), and showing them how their continued effort has paid off. Then celebrate their success with them! The more they do this (and enjoy the success that follows), the more likely they are to persist at challenging tasks again in the future.
Building patience may be more challenging because "having it now" is always more appealing than "having it later." Individuals who are unable to wait (called "delayed gratification") are less likely to enjoy bigger successes later in life. Those who are able to wait can develop more complex plans and enjoy bigger rewards as a result of their patience. One way to help is to require the child to do "just one more time" or wait "just one more minute" on a fairly frequent basis (ideally at least a few times per day if circumstances permit it). I would not recommend prompting them to do a second round (at least not at first), because they may just get too frustrated, doubt your sincerity in the future, and decide they'll just make it happen on their own (whether you agree or not). You can also offer them bigger rewards for their patience (though starting with praise and allowing them what they originally wanted is a good idea). For example, "Sure, I'll let you have a cookie, but if you can wait until we're done with this, I'll let you have two cookies instead."
Training with ADHD
All of this comes to one final point. While reading this far (good patience and persistence!), you may have thought several times that the skills discussed sounded kind of like what is lacking in a child with ADHD, and you would be right. The neurology of ADHD appears to primarily be underactivity of the area of the brain involved in impulse control, emotional regulation, frustration tolerance, and patience. These skills are important for helping a child to persist at challenging tasks, maintain focus on one thing for an extended time, develop a complex plan, and carry out that plan. They're also important for preventing the types of impulsive or hyperactive behaviors that often get kids in trouble when they have ADHD. Because of that, the exercises discussed here are especially important for children with ADHD (though helpful for all children). This doesn't mean that children with ADHD just needed to do these exercises more, or that their parents committed "bad parenting", which lead to the problems with ADHD (there is clearly a strong genetic component to neurological development and a difference in brain chemistry for individuals with ADHD). Many children with ADHD may have more difficulty with completing these exercises successfully as well, and therefore may need a combination of medication and behavior therapy (rather than just behavior therapy). Progress in developing these skills may also be very slow for a child with ADHD (which can frustrate the parent), but slow progress eventually produces significant progress, and the time is well-spent. Remember, the prefrontal cortex seems to be the last area of the brain to mature, which means that "exercising that muscle" may help to reduce the neurological difference by the time your child is much older.
Written by Dr. Charles Galyon
Parenting is one of the most rewarding and most challenging jobs I’ve ever had. As a parent/educator, one of the most important things that I’ve tried to be consistent with is using positive communication and following through with what I tell my own children as well as the children I teach. Before I had my own children, I used to think that positive communication should be a “given” and easy to practice on a day-to-day basis. However, having my own children made me quickly realize that parenting is a learning process and some days are simply easier/harder than others. We’ve all had the day when you’ve hit the snooze one too many times and now you are running around the house trying to get lunches ready for school and children dressed all while trying to get yourself ready. Bottom line, try to realize you are only human and try to have some humor in your day because “this too shall pass”. I have put together a list of “Say this/ Instead of this” language to help (maybe) make parenting a bit easier for you. In addition to these phrases, giving children choices is also a great option because it makes children feel like they have control (even though, you, as the parent, has come up with the acceptable options). Acceptable choices may be as follows: “Meghan, you have a choice. You may clean your room now or after we eat dinner.” By giving this choice, you are still making room cleaning a priority but you are giving your child the choice of when they can do it. If a child is protesting hand washing, you might say, “it’s time to wash your hands. You may wash them in the kitchen or the bathroom.” Try not to phrase the options as a question because that gives the child the option of saying “no”. Believe me, I am guilty of this as a parent and educator. My coworkers and I catch each other phrasing choices as a question sometimes and we laugh about it and learn from it!
Say this: Instead of this:
“Walk please” “Stop running”
“Use quiet voices inside please” “Stop yelling”
“You may yell when we go outside” “stop yelling”
“Please use gentle hands” “Don’t hit”
“You may spit in the sink after “Stop spitting”
you brush your teeth”
“Look with your eyes” “Don’t touch that vase”
“Please use your words to tell “Stop hitting your sister”
Meghan that you don’t like that”
“We draw on paper” “Don’t draw on the table”
“We build with blocks” “Don’t throw the blocks”
“Keep your feet on the floor please” “Don’t climb on the table”
“Keep you shoes on your feet please” “Stop taking your shoes off”
Blog post written by Katie Wood, RBT. Katie is an amazing mom, ABA therapist, and our preschool group teacher!
God loves to throw us curve balls, but He never abandons us…granted, He is probably laughing his holy pants off watching the beautiful chaos.
It has been one year since I moved from a small, downtown office within a cozy group of psychologists to opening the ABA Interventions center.
The ABA Interventions center is more than therapy sessions back to back, caffeinated therapists pretending standing in line at the office Keurig 3 times a day is normal (the machine takes 3 minutes so if we are 3 minutes late to the lobby this is why), it’s more than parent training while laughing and crying simultaneously when a kid says his first sentence or finally sits for an entire story, it’s more than teaching kids to communicate on an AAC device or PECS and finding out that the staff are in love with researching and learning every ounce of knowledge possible about functional communication training…ABA Interventions is a professional team of therapists that work as a beautiful unit.
This team IS ABA Interventions. I joke that I receive emails and questions about clients from the therapists 7 days a week and at all hours of the day and night, but it’s so true. These therapists share a passion that is unlike any passion I’ve seen in a workplace. Our one year anniversary of the center being open is a celebration of our staff and team we have created to help our clients.
With that being said….
Thank you Miss Mary (BCBA) for teaching the therapists how to create a natural environment for learning and setting such an outstanding example on how to make kids excited to learn. Thank you for your patience and flexibility when being faced with challenges in the field. Thank you for leading clinical meetings and facilitating discussions among the team.
Thank you Miss Katie (RBT) for being our preschool group leader, always coming to work with a smile and getting even the sleepiest therapist clapping and singing along in circle time. Thank you for teaching our clients that being messy is fun and being a shining example of how kids can learn through the natural environment.
Thank you Miss Crystal (RBT) for being the therapist that advocates for our older clients and refuses to let age stand in the way of an individual learning. Thank you for your commitment to drive all over town to make sure our older clients receive the services they need in an appropriate setting. Thank you for your commitment to parent training and always wanting to make sure that your clients generalize their skills.
Thank you Miss Melissa (RBT) for your constant desire to learn and to implement evidence based practices. Thank you for your incredible ability to balance school, a job, and a family as you work on your requirements to become a behavior analyst. Thank you for always pushing the others to become experts in their field!
Thank you Miss Cresanna (RBT) for being incredibly persistent and never accepting that a child can not learn something. Thank you for your desire to always research, learn, and implement plans to perfection. Thank you for being our go to therapist when it comes to assistive technology and DTT!
Thank you Miss Jenna (Office Manager) for your tireless hours of billing, scheduling, and answering phones and emails. Thank you for keeping us organized, in line, and busy. We have a horribly long wait list and you are always striving to get as many kids access to services as possible.
Thank you Dr. Charles Galyon (private practice psychologist) for all the time you take to join us for our weekly clinical meetings, trainings, and coordinating services! We have benefited so much with you being in our office and we most definitely think of you as part of the ABA Interventions team! We frequently hear schools and families report that “Dr.Galyon really took the time to get to know the child and he was amazing!” Well, we know you are amazing! Thank you!
We are so excited to begin another year and to always work on our goal to make sure that all individuals have access to services that they need.
written by Elizabeth Ginder, MSSW, BCBA; owner and clinical director of ABA Interventions, LLC
DTT, is discrete trial training, gets its name from its discrete beginning and ending. It is a highly structured therapy that occurs in rapid succession. Tasks are presented until they reach a pre-determined mastery criterion. DTT is started with a cue to respond or instruction, and the child’s response is followed by reinforcement or correction. Each time the task is presented, the same components are used in the same structured manner, as instructed by the BCBA. Because of its standardized format, DTT is easy for multiple therapists to use consistently between sessions and settings.
DTT is most commonly used for skills that require repetition or are not intrinsically motivating. It is also commonly used for new skills. This method, by its very nature, reduces environmental variables that may interfere with or take control over a child’s learning experience.
NET, or natural environment training is what we, as parents, do with our children on a daily basis. NET occurs, as said in the name, in the natural environment. Here, a therapist will follow a child’s lead, taking advantage of a child’s natural interests and motivation to create learning opportunities. This method has many advantages! It can be used anywhere and opportunities can be created for many skills; communication, pretend play, joint attention, turn taking.
There are a few drawbacks to NET because there is not always a specific protocol or step-by-step instructions like in DTT. It can be difficult to keep up with a child’s interests and keep goals functional and the interests of a child can often change frequently. In addition, there are less obvious roles of a stimulus, reinforcer and consequence and there can be areas targeted for implementation can be limited.
Article written by Melissa Roberts, RBT
Extinction is a method used in ABA therapy to discontinue reinforcement previously given to challenging behaviors. The way we react to problem behaviors can sometimes increase rather than decrease the behaviors. Often times, this is done unintentionally. By modifying our response to the challenging behavior, we can decrease its occurrence.
Extinction is never the ONLY part of a behavior plan. Plans for problem behaviors are created by the child's BCBA, and involve determining the function of the problem behavior, changing our response to that behavior when it occurs by not attending to it, and teaching the child an alternative, functional, and appropriate manner to achieve the desired outcome.
During extinction, we often see an extinction burst, or an increase in the occurrence of the problem behavior. Sometimes a child will even resort to more intense behaviors or try alternative inappropriate behaviors when the original problem behavior no longer results in what the child wants.
Hang on!! This too shall pass … because you will not attend to it! By doing so, the child will learn that they should follow your instruction and choose the alternative, appropriate, and functional behavior that you are reinforcing.
If you adhere to this behavior plan, as instructed by your therapist, you will begin to see the behavior decline and over time, stop altogether.
Please beware!!! What's the worst you can do? The worst thing you can do is to start an extinction plan but occasionally give in. By occasionally giving in, you are only teaching your child that their behavior must reach a certain intensity or duration before you will response. In a manner of speaking, this will only intensify and prolong the initial behavior you were hoping to decrease.
So, stay strong and stick to your extinction plan!! You can do it! And we will help you.
Blog article written by Melissa Roberts, RBT
4 easy steps to help you contrive simple situations which will require communication!
Step 1. HOLD BACK! Make sure most preferred things are not readily available all the time.Put preferred items in clear boxes or bags within sight, but out of reach; tall shelves work great as well
Step 2. ENTICE! Play with your child’s toys and prompt them to use words (or PECS or other communication modalities) to reqest to also play
Step 3. FOLLOW THROUGH and hold your child up to what they can do! Follow through with communication and make sure they are asking appropriately then provide access to what they are requesting.
Step 4. PRACTICE, PRACTICE, PRACTICE! Try to practice this everyday in order to enrich your child’s environment with communication opportunities.
Below are some pictures of opportunities we've created in our preschool room! Bolts for the toy drill set are sealed in containers, coins for the popular coin bank are out of reach, but visible in a zip lock bag, and the ALL TIME favorite sensory table is roped off. These created opportunities to: ask for help, identify a problem (what's wrong? "I can't reach/it won't open), gain an adult's attention, and request for an item!
What are some things you can do in your home to create amazing communication opportunities?
Blog article written by Crystal Wilson, RBT and Elizabeth Ginder, MSSW, BCBA.
Today is World Autism Awareness Day. There are many ways to raise awareness and acceptance: through conversations, actions, reaching out to other superhero parents (our name for parents of our amazing clients), or simply sharing this picture to remind people that our kids are amazing individuals that love to learn, especially if we teach the way they can learn.
"PECS was developed in 1985 as a unique augmentative/alternative communication intervention package for individuals with autism spectrum disorder and related developmental disabilities. First used at the Delaware Autistic Program, PECS has received worldwide recognition for focusing on the initiation component of communication. PECS does not require complex or expensive materials. It was created with families, educators, and resident care providers in mind, so is readily used in a range of settings." (PECS-Canada.com)
Frequently used to teach children with autism, this system works by allowing a child to view a field of two or more pictures, from which the child is allowed to select what they want or need. The child then picks a picture and gives it to a therapist or adult in exchange for the item.
Initially, the use of PECs is taught by teaching children to request highly preferred toys and activities. As the child’s knowledge expands and he or she becomes more comfortable communicating in this way, PECs can also be used to communicate varying needs, wants and instructions. These include things like locations, people, feelings, body parts, and common qualifiers and carrier phrases, such as “I want”, “Where’s the”, “I see”, etc.
Below is a wonderful step by step guide for PECS implementation.
Written by Melissa Roberts, RBT.
Flexibility (noun): The quality of bending easily without breaking
Flexibility is an important life skill. However, sometimes flexibility doesn’t come naturally and must be learned. Unlike other skills, flexibility isn’t something that can always be seen physically and is more abstract, sometimes making it challenging to know when and how to teach. Because of this, we need to make it a point to notice whenever our children are being flexible and provide consistent reinforcement! For example, a child might struggle with wanting pieces of a game set up the same way every time the game is played (i.e. all pieces in a straight line, lined up by color, etc.). As teachers and parents, we could start by prompting changes in routines/actions and reinforcing every time even the slightest hint of flexibility is detected, working to increase flexibility and gradually fade reinforcement. The end goal would be to have the child be okay with and not engage in challenging behaviors during changes that occur naturally or that another individual initiates. We want our children to have the delicate balance of being able to gracefully accept changes (bend) while still maintaining a sense of assertiveness for themselves (without breaking).
Written by Mary Hanks, M.Ed., BCBA
ABA is Functional. Unique. Natural.
Here's a great process to create a FUN ABA goal:
1. ABA goals are functional. This means goals are chosen because they are of importance to the child and the child's ability to be a part of the community. That is, within the family, school, at the grocery store, etc.
Sam (not an actual client!) is doing really well with his preschool peers and the teachers are excited to move him up to Kindergarten. Our goal is to work on Kindergarten readiness skills: playing with toys in a functional manner, reading grade level words/letter sounds, and identifying numbers.
2. Each child is unique. The first thing we have to do is find the appropriate motivation. Children don't fit into cookie cutter therapy programs. Every child is UNIQUE and will prefer different activities, experiences, foods, or toys. Identify a few of these highly preferred things your child enjoys.
Sam is pretty good at playing with a variety of toys, but ABSOLUTELY LOVES vehicles. In fact, this is the first thing he runs to during free play time and will sit for 15 minutes and play with airplanes and firetrucks. Sam will also consistently and quickly finish worksheets when told that he can play with vehicles after work.
3. Natural. A lot of people think that ABA only occurs at the table, but it actually occurs everywhere. ABA therapists may have to begin skill building at a table, but they will quickly work on generalizing skills to the natural environment. We want the child to be able to use all of that wonderful knowledge in all environments.
Time to piece it together! For Sam, we made a parking lot and filled in the parking spots with "targets." Programs covered during his therapy time included:
- Receptive and Expressive identification of words and numbers (park the airplane in spot 11, what is parked in the spot that says "that")
- Multiple step instructions (grap the red train, fill it up at the gas station, and park it in spot 20)
- Block imitation from a model (Vehicles need gas to go! build a gas station pump that looks like mine!)
- Following instructions (Parking lots need stores! Go get the pile of blocks and build your favorite store)
- Receptive and Expressive Categories (where are the numbers/words/vehicles, what vehicle do you want?)
- Math, Counting (how many empty spots do we have left? How many more vehicles need spots?)
- Positional words (put the airplane on top of the store)
- Yes/no/not (is this a firetruck? find the airplane that is NOT yellow)
- Answering questions (the kids on this bus are hungry...where should they go?)
Remember: It's important for children to play and have fun while they learn!
Written by: Elizabeth Ginder, MSSW, BCBA