First Steps, receiving a diagnosis:
If you have concerns that your child is not reaching the developmental milestones for his or her age, use an autism screener and share your concerns with your pediatrician. Ask for a full diagnostic evaluation. A medical diagnosis will help open doors for services through the Regional Center and through your insurance to receive ABA services. There may be a lengthy waiting list to be evaluated by the Regional Center or by the doctor, clinical psychologist or neurologist so the sooner you request an appointment for evaluation the better. Let your doctor know that you would like a referral for ABA services.
After the diagnosis:
Receiving a diagnosis is an emotional process and may be scary. We are here to support you through this process. We care deeply about parents and caregivers and want you to know you don’t have to go through this process alone.
Understanding Autism:
Autism is a lifelong neurological condition that can be identified in early childhood. ASD is characterized by difficulties with social interaction and communication and by restricted or repetitive patterns of thought and behavior. In 2021, the CDC reported that 1 in 44 children in the US is diagnosed with ASD. It is more common in boys than girls (1 in 27 boys, 1 in 116 girls).
People with ASD may display a spectrum of behavioral symptomatology, from failure to establish friendships to a delay in speech or a total lack of ability to produce spoken language. For children who have language, they may have a challenge to maintain conversations or may have repetitive language or scripting. Children with autism may also display difficulty with joint attention, waiting for preferred items, maintaining eye contact, responding to their name, impulsivity and may be easily frustrated and display challenging behavior such as, aggression, self injurious behavior, tantrums or elopement, for example.
ABA therapy advances the development of social and communication skills while reducing challenging behaviors that interfere with daily functioning and learning.
Intensive, consistent, ABA therapy can increase a child’s ability to acquire language, learn, increase his /her ability to tolerate less preferred activities and in turn increase the activities they are able to experience to lead to a happy fulfilling life.
The Diagnostic and Statistical Manual of Mental Disorders (DSM) is the handbook used by healthcare professionals in the United States and much of the world as the authoritative guide to the diagnosis of mental disorders . The most recent edition (DSM-5; American Psychiatric Association, 2013), redefined the diagnostic criteria for ASD, which was previously regarded as three distinct diagnoses (i.e., autistic disorder, pervasive developmental disorder—not otherwise specified, and Asperger’s disorder). The DSM-5, however, classifies ASD as a single disorder.
Early Intervention:
Why is it so important? Research shows that the earlier a child receives intervention the greater his or her outcomes.
Insurance Accepted:
Getting started with a medical diagnosis from a medical doctor or licenced health care professional.
Determine what type of insurance you have (HMO, PPO, EPO). Find out the exact name of your plan.
Understanding your financial obligation (co-pays, deductibles, out of pocket maximums)
Finding the right ABA provider for your family
Community Resources:
Glossary of ABA Terms:
A-B-C Data
A description of a behavior in terms of the Antecedent (A) to the behavior, the Behavior (B), and the Consequence (C) of the behavior. The antecedent is what happened immediately before the behavior, such as being ignored, wanting an item, wanting to escape a demand. The behavior is a detailed description of what the behavior looks like, for instance “tantrum” can be described as kicking, throwing objects, etc. The consequence is what was the immediate response to the behavior. This may include ignoring the behavior, giving the item to the learner, etc.
Applied Behavior Analysis (ABA)
The application of the science of learning to socially significant human behavior.
Augmentative and Alternative Communication (AAC)
AAC covers a huge range of techniques that support or replace spoken communication. These include gestures, signing, symbols, word boards, communication boards and books, as well as Voice Output Communication Aids (VOCAs).
BCBA / BCBA-D
Board Certified Behavior Analyst. Requirements for this certification include completing a prescribed number of University Master’s level coursework, completing 1500 hours of clinical work under the supervision of a Board Certified Behavior Analyst, and passing the required written board exam. Continuing education credits are required for recertification every 2 years. The BCBA’s include but are not limited to conducting assessments, writing behavior plans and treatment programs, training staff and parents.
Behavior
To be called a behavior, it must be observable and/or measurable. In the field we refer to something called the "Dead Man's Test": If a dead man can do it, it ain't behavior. So "being quiet" is not a behavior because a dead person can "be quiet".
Chaining
Used to teach multi-step skills in which the steps involved are defined through task analysis, and each separate step is taught to link together the total "chain". Can be either done by backward, forward, or total task analyses.
Chronological Age / Developmental Age
Chronological age is the actual age calculated by birthdate. A developmental age is based on level of functioning/cognitive ability, and adaptive skills. For example a 7 year old child diagnosed with Autism could have the developmental age of a 3 year old. A Pediatrician or Developmental Psychologist can help you determine your child's developmental age, or if you work with a BCBA they can assess your child to help determine developmental age.
Co-Morbidity
This means having multiple diagnoses as the same time, such as being diagnosed with Autism, OCD, and an Anxiety Disorder. Autism often co-occurs with other diagnoses.
Self Contained Classroom / Special Day Class (SDC)
A contained, or self -contained, classroom is a classroom that has children with special needs. These classrooms have a smaller teacher to student ratio than an inclusive classroom. Typically these classes are taught by Special Education teachers and include 3 specially trained paraprofessionals.
Developmentally Delayed
A child or infant may be given a diagnosis of DD when they are not progressing as they should be and aren’t meeting developmental milestones such as crawling, sitting up, using a pincer grasp, talking/babbling, etc. However, adolescents or adults sometimes receive this diagnosis far later in life than they should have received it.
Discrete Trial Training (DTT)
A specific method of instruction in which a task is isolated and taught to an individual across multiple trials (repetition teaching). A specific opportunity to respond is presented, and a specific response from the learner is expected (Teacher: "Stand up". Learner: (stands up). Teacher: "Nice standing!").
Discriminative Stimulus (SD)
This can be a demand/question or directive given to obtain a specific response, or a naturally occurring signal that reinforcement is available. For example, if you are waiting for an important phone call about a bonus at work then every time your phone rings it becomes a potential SD of reinforcement (your bonus).
DSM
The Diagnostic & Statistical Manual of Mental Disorders is used by a variety of professionals across the world to diagnose or treat individuals. The DSM is basically a handy manual that catalogs all mental conditions, disorders, and syndromes and explains how to diagnose each one. It is regularly updated, and professionals reference the newest version when discussing, explaining, or understanding diagnoses.
Echoic
Repeating a modeled heard utterance, sound or word. This is an essential skill in learning verbal operant behavior.
Echolalia
Consistent repetition of vocalizations made by another individual. This may be immediate or delayed. Echolalia may not be productive or meaningful in learning verbal behavior but is more productive than not making any sounds at all.
Extinction
The process of withholding reinforcement from a previously reinforced behavior to decrease the probability of the behavior occurring in the future. It is essential to know the function of the behavior for extinction to be an effective strategy. For example, if a learner tantrums to get his/her parents attention, then no attention should be given to the tantrum. Tantrums will eventually fade out. Ethically, it is important to teach an acceptable, functional replacement behavior such as functional communication (i.e. asking for a hug).
Extinction Burst
This almost always occurs during an extinction process; the behavior will “get worse, before it gets better”. The behavior will temporarily increase in intensity and/or frequency and variability. If the behavior is deemed to be dangerous to the learner, others or property then an extinction process should not be used.
FBA
Functional Behavior Assessment. This is the process by which behavioral interventions are created. An FBA is intended to determine the function (or the reason) for a behavior, and then create an intervention based on that function. A Functional Analysis (FA) involves manipulating the environment to understand the behavior, while a Functional Behavior Assessment involves things like observation, interview, and collecting ABC data.
Fine Motor Skills
These are the activities that require the coordination and movement of the smaller muscles of the body, especially those of the hand.
Filed Size (teaching term)
During a teaching trial, this refers to how much stimuli to have presented in an array. E.g. "Teach the animal 'cat' in a field size of 2-3". This example means that the target stimuli ("cat" flashcard or photo) would be presented in an array of 2-3 other cards, during a teaching trial.
Generalization
Term used to describe the ability to learn a skill in one situation and be able to demonstrate the skill across other settings, across people and across situations not previously associated with teaching.
Gross Motor Skills
These are the activities we do using our larger muscle groups; like sitting, walking & jumping.
HoH Prompting
Hand over hand prompting is a physical prompt where you place your hands over the learner's hand to assist them with completing a motor demand or instruction.
Hypersensitivity
Acute reaction to sensory input (i.e. overly sensitive).
Hyposensitivity
Little or no reaction to sensory input (i.e. under-sensitive).
IEP
An Individual Education Plan is the individualized curriculum plan that children, adolescents, or adults (usually up to 22) have if they are in special education. An IEP is a legal document, and the IEP process should be taken very seriously and with much consideration for the learner's future. If the child is under 3 years old and receiving services they may have an IFSP, which is an Individual Family Services Plan.
Individuals With Disabilities Act (IDEA)
This law guarantees a free and appropriate public education (FAPE) and related services for children with special needs to prepare them for independent living and employment across their life span.
Incidental Teaching
Teaching that follows the learner’s lead in a naturally occurring way. Incidental teaching is used to program for generalization and maintenance and promote enhanced speech.
Individualized Family Service Plan (IFSP)
This is a document that serves learners aged 0-3yrs. who require early intervention services. Similar to an IEP, and also guaranteed through IDEA , the IFSP identifies and describes the services necessary for the individual learner to achieve developmental objectives. Family members and service providers, together, determine how best to plan, implement and assess services and progress.
Intermittent Reinforcement
Reinforcing a specific behavior some of the time, but not each time the behavior occurs. This can lead to strengthening a behavior and leads to extinction resistance. Everyone involved with the learner should be on the same schedule of reinforcement to either increase skill acquisition or decrease problem behavior.
Intraverbal
The basis of social verbal exchange/conversation. The learner’s verbal response is controlled by the verbal responses of others. Fill-ins are an example of a simple intraverbal “Twinkle, twinkle, little _______”. The learner would fill in “star”.
Least Restrictive Environment (LRE)
This is an educational term that refers to the most typical environment in which a learner can make academic and social progress. The environment(s) where the learner spends his time is determined in the IEP during the ARD process. The least restrictive environment is the ultimate goal of every educational program.
MAND
A verbal behavior term that means “request”. One of the first verbal skills that is taught. If a learner can request an item, person, and/or need then the request can replace challenging, problem behavior.
Manifestation Determination Hearing
Within 10 school days of any decision to change the placement of a learner eligible for special education because of a violation of a code of student conduct, the school district, the parent, and relevant members of the student’s IEP team (as determined by the parent and the school district) must review all relevant information to determine if the conduct in question was caused by, or had a direct, substantial relationship to, the student’s disability; or if the conduct in question was the direct result of the district’s failure to implement the IEP. If it is determined the behavior was due to the learner’s disability, then the learner may not be held accountable.
Natural Environment Teaching (NET)
This is basically the opposite of discrete trial teaching. The learner’s current activities and interests determine the teaching strategies. It differs from Incidental Teaching in that Incidental Teaching is a type of discrete trial methodology that is taught within generalized settings. NET follows the child’s lead and learning can occur anywhere and everywhere.
Pairing
In ABA, pairing is the act of an instructor bonding with a learner to become a reinforcer for that learner. This can take anywhere from 10 minutes to 10 days. Pairing is a continuous activity; a few minutes of the beginning of every therapy session should be spent pairing with the learner to increase instructional control.
P.E.C.S.
The acronym for Picture Exchange Communication System developed by Lori Frost and Andy Bondy. This is a simple, popular form of augmentative communication.
Probe
A procedure used to “test” a skill, or part of a skill, to assess if a specific step is already in the learner’s repertoire. Probes are also used to assess for generalization of skills or to determine functioning levels during baseline to program at the appropriate level. Probe may also refer to data that is collected only for a student’s first response to a specific stimulus/instruction.
Prompt
An added antecedent stimulus that brings about a specific behavior. Prompts can be thought of as “hints”. For example, a learner may not greet a friend passing by; the instructor may wave or mouth the word “hi” to occasion the learner to greet his friend. It is critical that prompts be faded quickly so the natural “cue” (the friend in the hallway) sets the occasion for a greeting.
Reinforcement
Any consequence that increases the probability of a specific behavior occurring again in the future. Positive reinforcement is something added, such as a paycheck, to increase the probability of continuing to go to work. Negative reinforcement removes an aversive, such as the dinging reminder in your car to put your seat belt on. Wearing the seat belt removes the annoying sound and increases the probability that you will increase your seat belt usage.
Shaping
A process used to teach a new behavior by reinforcing successive approximations to the target behavior. For example, if a learner won’t use a spoon, shaping may begin by tolerating the presence of the spoon on the table, then next to the plate, the on the plate, the touching the spoon and so on until the learner is eating with the spoon.
Spontaneous Recovery
A phenomenon that may occur after a successful extinction procedure whereby the behavior reappears again in situations that are similar to those in which the behavior originally occurred. Spontaneous recovery is short-lived and limited if the extinction procedure remains in effect. It is important to be aware of this phenomenon so that the behavior is not inadvertently reinforced.
Stereotypic Behavior
Repetitive movements of objects or motor mannerisms which may include rocking, hand flapping, clapping or laughing out of context. This is sometimes referred to as “stimming” which suggests a sensory function. This may or may not be accurate; many of these behaviors may actually serve as attention-seeking, avoidance, or communication functions.
Task Analysis
A step-by-step list of actions necessary to complete a specific behavior. The behavior is broken down into its component parts and then the learner is asked to engage in the behavior, for instance, “brush teeth”. Depending on their skill level the task analysis may be 10 steps or 40 steps. A task analysis may be in text or picture form. As the learner becomes more fluent with the task, the task analysis is shortened until the learner can perform the skill independently.
VB-MAPP
The Verbal Behavior Milestones Assessment and Placement Program is a language and social skills assessment, developed by Mark L. Sundberg, for learners with autism and developmental disabilities.
Vineland Adaptive Behavior Scale (VABS)
An assessment tool used to determine skill levels in the following areas: language, daily living, social skills, gross and fine motor skills. Parents/caregivers are typically interviewed with a structured questionnaire regarding the above skill levels.