Updated : ABA parents - give me your thoughts on this

[PuddleJumper1]

Ds has ABA both at home and in clinic. One of his tasks is getting dressed (shorts, shirt and shoes on). At home he does that in the morning or whenever he needs to be changed in the normal course of the day. At clinic or therapy at home they practice by having him undress and redress. 

 

Last week at clinic it took him almost 20 minutes to undress and redress. Redress is longer. Lots of looking around, getting distracted or just simply not moving. The next morning at home I handed him shorts (on in less than a minute) then his shirt (also on in less than a minute) and we went about our day. Today in clinic undress and redress again took nearly 20 minutes. I think he's bored with being asked to do something he knows he can do.

 

At this point I feel like we're training me to have patience and not him dressing skills.  :willy_nilly:

 

ETA - there is still work to be done on this task. Shoes are emergent and we haven't even begun with pants yet. 

[Crimson Wife]

Sounds like a compliance issue rather than a not knowing what to do issue. The therapist(s) should be baselining tasks before deciding what to add to the program. I'd talk to the supervising BCBA about it.

[Lecka]

I would also bring it up.  

 

If it is mastered, it is mastered.  

 

Motivation is also very important.  Either natural motivation (like -- getting dressed to go somewhere, or getting dressed to be warm, or getting dressed as the thing to do before breakfast) or with the therapist providing reinforcement.  

 

The therapist might need to provide more reinforcement.  Also -- what is the therapist doing during the lollygagging?  Just letting him lollygag?  This would possibly (probably) be seen as escape behavior with my son, and the therapist (or me) would step in with more re-directing or prompting, like handing him his shorts or something.  

 

I would totally ask.  Share what you know he can/can't do at home.  You do not want them to think pants/shoes is a compliance issue, when you know he doesn't know how to do it.  It could also just be generalizing, though.  We have things with my son, where he can do it in his usual place, but it is hard when he first does it in a new place.  So -- for a lot of goals he is supposed to master them with some things different (not in his room, with a different person asking him to do it, that kind of thing).  So -- it is not considered totally mastered if he only does it at home with me, but he doesn't do it at another place or with another person.  

 

If he is just undressing and redressing one time, at the clinic, and yesterday was their baseline ----- then it does make sense.  If they are taking baseline data -- they do just give the direction (the s d) and then do not get involved.  If the baseline was that he took 20 minutes -- then it may be a good goal for him to get dressed just with being asked, not necessarily when it is in order to do something he wants to do (my son can be like this with getting dressed).  If he ever needs to change clothes b/c an accident or spill, then it is reasonable for the teacher to say "change clothes" and he just does it.  Maybe.  

 

I think you should tell them, if it was baseline, always tell you if it is baseline.  Baseline can be really irritating -- b/c you are not supposed to help, or even give positive/negative feedback.  Whenever a program is designed and they are doing a program -- it should be better I think. 

 

I got the most helpful information for understanding ABA from a book called The Verbal Behavior Approach by Mary Barbera.  My son was doing Verbal Behavior, so some is specific to that, but there is a lot in there just about the way they do things.  It might be worth a check-out from the library.  Also from asking questions and seeing more.  

 

Edit:  for example, if you did go swimming and want him to change clothes, you would ultimately hope he could do that the same in a swimming pool bathroom as at home -- and that is not always the case with all kids.  or, my son I am hoping will go to a day camp next summer, and he will need to change into his swimsuit.  He will be 6, and it will be okay if he needs help ---- but sometimes it helps to think of a real reason you might want a skill, when it seems like a kind-of pointless skill b/c he can do it at home.  If that makes sense.  If he has that kind of issue with generalizing.  My son is a lot better about it, but I have been surprised by him not doing something that he does do at home.  It is just a thing with him.  It is a lot better than it used to be, though :)

 

But, I can get behind wanting him to be able to change clothes so he can be independent when he goes to day camp next summer and they take them swimming in the afternoon.  That is motivating to me!  Just having him dress and undress for the therapist -- not so much.  But if it is moving from Point A to Point B -- I like it.  

 

It might be something like that.  Or ------ it really might not be.  It might turn out to make some kind of sense, I hope!  But it also sounds like -- hmmmm.  

 

I can also think of times it might be a good skill, if my sister took him swimming, or if he spent the night with his grandparents and needed to put on pajamas.  If you know he does well with things like this ---- then I would tell them.  If not, and these are things he might do, then those might be other things that he is moving towards if they do this as a program, that might seem desirable to you.  

 

(I am hoping it turns out to be baseline data -- b/c then it would make sense.... AND if it was baseline data, when he starts a program, you will not just be sitting there and watching him!  If it was not baseline -- maybe there is another explanation, but I think there is a need for an explanation that does make sense.)  

[PuddleJumper1]

Sounds like a compliance issue rather than a not knowing what to do issue. The therapist(s) should be baselining tasks before deciding what to add to the program. I'd talk to the supervising BCBA about it.

 

Totally agree with it being compliance rather than knowing the task.  We're still pretty new to ABA so I'm still working on understanding all that is going on in these tasks. I know for me - if I know how to do something but someone repeatedly asked me to redo it just to see that I can I'd be bored and frustrated too. We're far from done with the task but he's got parts of it. I'm going to ask for some clarification at next session. 

[PuddleJumper1]

I would also bring it up.  

 

If it is mastered, it is mastered.  

 

I'm wondering if they want mastery of compliance to task as well. We're far from finished with the task. We've still got socks, tied shoes, pants and outerwear to tackle but he does know these first two pretty well. 

 

Motivation is also very important.  Either natural motivation (like -- getting dressed to go somewhere, or getting dressed to be warm, or getting dressed as the thing to do before breakfast) or with the therapist providing reinforcement.  

 

I think this may be a big part of our issue. At home he's getting dressed to start the day - at therapy he's getting undressed/dressed simply because he's being asked to. There is always a reward (book or video) but I'm thinking that's not working for him anymore.

 

The therapist might need to provide more reinforcement.  Also -- what is the therapist doing during the lollygagging?  Just letting him lollygag?  This would possibly (probably) be seen as escape behavior with my son, and the therapist (or me) would step in with more re-directing or prompting, like handing him his shorts or something.  

 

At the moment we're ignoring the behavior. Therapist thinks some of it is attention seeking. I agree with you on escape but I think it's escape due to boredom or even frustration that he knows how to do this and does it every morning at home.

 

I would totally ask.  Share what you know he can/can't do at home.  You do not want them to think pants/shoes is a compliance issue, when you know he doesn't know how to do it.  It could also just be generalizing, though.  We have things with my son, where he can do it in his usual place, but it is hard when he first does it in a new place.  So -- for a lot of goals he is supposed to master them with some things different (not in his room, with a different person asking him to do it, that kind of thing).  So -- it is not considered totally mastered if he only does it at home with me, but he doesn't do it at another place or with another person.  

 

Good point!

 

If he is just undressing and redressing one time, at the clinic, and yesterday was their baseline ----- then it does make sense.  If they are taking baseline data -- they do just give the direction (the s d) and then do not get involved.  If the baseline was that he took 20 minutes -- then it may be a good goal for him to get dressed just with being asked, not necessarily when it is in order to do something he wants to do (my son can be like this with getting dressed).  If he ever needs to change clothes b/c an accident or spill, then it is reasonable for the teacher to say "change clothes" and he just does it.  Maybe.

 

Another good point. I'm sure this comes into play in this. However, I feel like he's actually working backward. He can and has done this faster in therapy. We've been at this for months. At first he was actually learning the steps to dressing. Then he could do it (not perfect but he can get shorts and shirt on) Now we're just checking things off on a list. 

 

I think you should tell them, if it was baseline, always tell you if it is baseline.  Baseline can be really irritating -- b/c you are not supposed to help, or even give positive/negative feedback.  Whenever a program is designed and they are doing a program -- it should be better I think. 

 

I got the most helpful information for understanding ABA from a book called The Verbal Behavior Approach by Mary Barbera.  My son was doing Verbal Behavior, so some is specific to that, but there is a lot in there just about the way they do things.  It might be worth a check-out from the library.  Also from asking questions and seeing more.  

 

That book is sitting in my need to read pile :) Thanks for the reminder. 

 

Edit:  for example, if you did go swimming and want him to change clothes, you would ultimately hope he could do that the same in a swimming pool bathroom as at home -- and that is not always the case with all kids.  or, my son I am hoping will go to a day camp next summer, and he will need to change into his swimsuit.  He will be 6, and it will be okay if he needs help ---- but sometimes it helps to think of a real reason you might want a skill, when it seems like a kind-of pointless skill b/c he can do it at home.  If that makes sense.  If he has that kind of issue with generalizing.  My son is a lot better about it, but I have been surprised by him not doing something that he does do at home.  It is just a thing with him.  It is a lot better than it used to be, though :)

 

But, I can get behind wanting him to be able to change clothes so he can be independent when he goes to day camp next summer and they take them swimming in the afternoon.  That is motivating to me!  Just having him dress and undress for the therapist -- not so much.  But if it is moving from Point A to Point B -- I like it.  

 

It might be something like that.  Or ------ it really might not be.  It might turn out to make some kind of sense, I hope!  But it also sounds like -- hmmmm.  

 

I can also think of times it might be a good skill, if my sister took him swimming, or if he spent the night with his grandparents and needed to put on pajamas.  If you know he does well with things like this ---- then I would tell them.  If not, and these are things he might do, then those might be other things that he is moving towards if they do this as a program, that might seem desirable to you.  

 

(I am hoping it turns out to be baseline data -- b/c then it would make sense.... AND if it was baseline data, when he starts a program, you will not just be sitting there and watching him!  If it was not baseline -- maybe there is another explanation, but I think there is a need for an explanation that does make sense.)  

 

Thanks for walking through that with me Lecka! Lots to think through and ponder. Definitely going to ask about this task on Monday. 

[Crimson Wife]

Totally agree with it being compliance rather than knowing the task.  We're still pretty new to ABA so I'm still working on understanding all that is going on in these tasks. I know for me - if I know how to do something but someone repeatedly asked me to redo it just to see that I can I'd be bored and frustrated too. 

 

Our ABA team is pretty good about speeding up the program when it's clear that DD can do the task & is just bored. I was just in a team meeting last week where the case manager asked the therapists to baseline DD on the 3rd level of some task even though she hadn't quite "mastered" the 2nd level according to the data graph. DD was supposed to do the task 4 times correctly but what was happening was she'd do it quickly the first time, reluctantly the 2nd and/or 3rd time, and then be non-compliant after that. So the case manager decided to go to the next level in the program.

[albeto.]

He can and has done this faster in therapy. We've been at this for months. At first he was actually learning the steps to dressing. Then he could do it (not perfect but he can get shorts and shirt on) Now we're just checking things off on a list. 

 

What does the drill look like? What are the specifics? When is mastery determined?

 

I would suspect secondary rewards are more powerful than primary rewards at this point. If the primary reward is video or book, it might be less rewarding than the secondary reward of stalling. Perhaps he's developing some sense of modesty and is uncomfortable undressing in front of others. Perhaps he feels he is being patronized. Perhaps he's simply bored of doing this again and again and again. In any case, there's something he's getting out of it - his stalling serves a purpose. Find out what that is, and brainstorm a more effective solution.

 

Our drills were very specific. The were very detailed. A drill like this would look something like "Ds will put on one item of clothing within 60 seconds (or whatever would ensure success)." Once that was done without prompt or protest three trials in a row, that particular skill would be considered mastered. The next might be, "Ds will put on two items of clothing within 2 min." Again, three trials in a row without prompt or protest would consider this particular skill mastered. The rest of it, every other item of clothing, would be handed to him to move along. Only when he did them all within the time allotted would they start reducing the time. Waiting for the entire skill to be mastered before moving on seems counterproductive to me, but then, it's been a while. 

[PuddleJumper1]

What does the drill look like? What are the specifics? When is mastery determined?

 

I would suspect secondary rewards are more powerful than primary rewards at this point. If the primary reward is video or book, it might be less rewarding than the secondary reward of stalling. Perhaps he's developing some sense of modesty and is uncomfortable undressing in front of others. Perhaps he feels he is being patronized. Perhaps he's simply bored of doing this again and again and again. In any case, there's something he's getting out of it - his stalling serves a purpose. Find out what that is, and brainstorm a more effective solution.

 

Our drills were very specific. The were very detailed. A drill like this would look something like "Ds will put on one item of clothing within 60 seconds (or whatever would ensure success)." Once that was done without prompt or protest three trials in a row, that particular skill would be considered mastered. The next might be, "Ds will put on two items of clothing within 2 min." Again, three trials in a row without prompt or protest would consider this particular skill mastered. The rest of it, every other item of clothing, would be handed to him to move along. Only when he did them all within the time allotted would they start reducing the time. Waiting for the entire skill to be mastered before moving on seems counterproductive to me, but then, it's been a while. 

 

The drill is he removes all clothing items (which right now are sandels, shorts and t-shirt). Then is handed each item to put back on. I'm not sure how they are determining mastery. I'm going clarify that on Monday. 

 

Very interesting point on the secondary reward!  In any case, there's something he's getting out of it - his stalling serves a purpose. Find out what that is, and brainstorm a more effective solution.  

 

Thanks Albeto! 

[Lecka]

Personally -- I would ask to think about -- if there is work needing to be done on shoes, just work on shoes.  He doesn't have to totally dress and undress to work on shoes. 

 

In addition -- I have an issue with my son ------ he wants to take off his shirt every time he takes off his pants/shorts.  This is not the end of the world or anything, but ----- it would be nice if he could just do one or the other at times. 

 

They could also change from handing it to him.  My son actually does better if things are set on the floor for him, sometimes.  He also always does MUCH better if he can pick a choice of shirts.  That would be something that would engage him a lot. 

 

Even if they have some compelling reason to keep this program -- it doesn't mean they couldn't try to do things to make it more interesting and fun (intrinsic to the task).  My son has some cartoon shirts he likes, that could be like that, if someone goes "oh, you picked Yoda this time," that kind of thing could be more interesting to him. 

 

I also wonder if it is attention-seeking.  Did they say why attention-seeking and not escape?  Does it make sense?  Could be a little of both, too.  I know the hard way ----- if I ignore a behavior, thinking it is attention-seeking, but it is really escape, then whoops, I have just totally reinforced an escape behavior.  But sometimes my son's therapist says ---- it can be hard to tell until you collect some data or whatever. 

 

If you have a feeling like they are just going down a list and this is next on the list, I would consider asking more about why they really want to do it right now. 

 

The book I recommended is really good (imo).  If it is in your stack anyway -- totally read it. 

[albeto.]

The drill is he removes all clothing items (which right now are sandels, shorts and t-shirt). Then is handed each item to put back on. I'm not sure how they are determining mastery. I'm going clarify that on Monday. 

 

Very interesting point on the secondary reward!  In any case, there's something he's getting out of it - his stalling serves a purpose. Find out what that is, and brainstorm a more effective solution.  

 

Thanks Albeto! 

 

You're welcome. :)

 

I would only add that when you find out what that stalling serves and you find a more effective solution, I would encourage you to resist the temptation to focus on compliance. You could give him a more valuable reward, but see, he's identified and is trying to solve a problem. He's kind of solving it, but it's creating more problems, therefore, it's not an effective solution. So when you find out what he wants, try and help him solve it more effectively (in a way that is also socially appropriate and doesn't create more problems for him or others). 

[PuddleJumper1]

 I also wonder if it is attention-seeking.  Did they say why attention-seeking and not escape?  Does it make sense?  Could be a little of both, too.  I know the hard way ----- if I ignore a behavior, thinking it is attention-seeking, but it is really escape, then whoops, I have just totally reinforced an escape behavior.  But sometimes my son's therapist says ---- it can be hard to tell until you collect some data or whatever. 

 

 

I honestly don't think it is attention seeking. It doesn't feel like that at all to me. I think he simply doesn't see the point or is bored with the exercise. I think it falls under the escape mode. So much with him is nuance and guess work (he is a non-verbal pre-teen functioning at a toddler level) but I really think he's trying to express his boredom with the task. 

[PuddleJumper1]

I would only add that when you find out what that stalling serves and you find a more effective solution, I would encourage you to resist the temptation to focus on compliance. You could give him a more valuable reward, but see, he's identified and is trying to solve a problem. He's kind of solving it, but it's creating more problems, therefore, it's not an effective solution. So when you find out what he wants, try and help him solve it more effectively (in a way that is also socially appropriate and doesn't create more problems for him or others). 

 

Great input! I think you are spot on. Much to think about. Again - thanks :)

[Lecka]

Did I understand that the therapist thinks he is attention-seeking, and you think it is escape? 

 

You have got to talk to her.  We do the opposite approaches for attention and escape -- if I ignore escape, with no re-directing or helping or trying to make it fun or anything at all ------ I am making it worse.  But sometimes I am supposed to ignore attention.  I have (on occasion) made the mistake of *thinking* something was escape, and then paying attention to it, and then afterwards realized it was attention, so I had then reinforced an attention-seeking behavior.  My son has also used behaviors that started as escape, and morphed them to attention, b/c he knows he will get attention (a lot we can then ignore or whatever, but bolting was like this for a while, and it was so hard, I couldn't just let him run away, ugh). 

 

My son is also starting to be able to request breaks and to say he doesn't want to do something -- and at various times his requests can be honored.  Like - maybe he has some choices, and can choose not to do something, but the other thing might be required. But building in choice and letting him choose not to do certain things or letting him choose not to do it a certain way (vs another way) are things that we can do sometimes. 

 

I read a really interesting book excerpt (I think... or did I buy it on my Kindle lol) called Stop That Seemingly Senseless Behavior.... I think this book, it may not have been.  But -- it was talking about a lot of skills for kids to learn, and one was about asking for breaks and being taught to protest things they do not like.  We are building that in with my son.  Even though we do not always honor his protests fully, a lot of times maybe we can honor them in some way.  Sometimes we just say "oh, you don't like that, okay, we won't do it" too.  B/c it is so good for him to have a way to communicate that he doesn't want to do something. 

 

I agree a lot with what albeto said, also. 

 

You are your child's advocate and if you think it is not a good program -- you can bring it up.  You can see what they say.  Maybe they convince you it is a worthwhile thing (by convincing you with a thoughtful discussion, not just saying it is what they do).  If they are just going down a list of goals and just doing things very dryly, I would want to see if they could not adjust the program to make it more interesting or not include every step, or something.  Or make it a game in some way.  If anything like that would work. 

 

Edit: does she time how long it takes him?  Is she graphing the amount of time?  Is the amount of time decreasing with her chosen intervention of "ignore it b/c it is attention-seeking."  If the time is not decreasing, and it does not appear to be an extinction burst (and it doesn't sound like it is) ---- then what is her explanation for why the time is not decreasing?  If that sounds like how it works -- that is how it has been with my son, but he has always been with one agency. 

 

You are his mom and your family knows him best, too. 

[MomOfABunch]

Can you take a (tasteful) video of how fluently he does it at home and show them? Or time him for a few days and show them how long it's taking him at home? See what they say. If he's doing it in one setting but not another, it's not an ability problem it's likely a generalization problem.

[PuddleJumper1]

Came back to give this a happy update  :thumbup:

 

We talked through his skills both at home and clinic and we re-evaluated everything (not just the clothes dressing). He has new goals and we refined the goals he's still working on. 

 

As for dressing - that one became 'check on it occasionally but not necc. to do all the time'. We've even added shoe tying to his list. That is something I never thought I'd say!!!

 

Thanks again for talking it through with me. 

[Lecka]

Good news :)

 

[msjones]

Glad they changed things up for him.  

 

I work with special needs kids in a developmental preschool, and the best information come from the parents.  We are always glad to hear what's going on at home and happy to adjust accordingly.  School is such an artificial environment -- the home stuff is the real thing.  

 

It's especially helpful to see videos of home behavior.  Helps us really understand what the child is capable of!  

 

 

[Elisabet1]

I would not want them doing that with my child. I would not want my child dressing and undressing on command in front of others like that. Are you okay with it? I would say no more.

[Lecka]

I am going to respond as someone who has had my son dress and undress with a therapist. 

 

He has problems with his motor skills, and he needs to practice and learn this vital self-help skill.  This is reality.  

 

I am aware that a child with communication deficits is at risk for abuse of all kinds.  I take steps.  I am very fortunate -- my son has a lot of communication skills now.  

 

There is a lot to watch out for, and I think it is always good to be reminded about safeguarding our children and the possibility of abuse, and how we look for signs and check up on things.  

 

But -- I think it is acceptable.  

 

I get it -- my children did not go to childcare when they were young, and I used to be concerned about people letting childcare people be involved with them and with hearing that they would do things like be told to sit on the toilet with their entire class..... my sister's kids went to a daycare where in one room, they had a bathroom with six little potties, and they all pulled down their pants and sat on the toilet at the same time.  

 

I used to have a problem with that and think "not my kids."  

 

My sister had a relationship of trust with the daycare, though, and they potty trained easily that way.  She was fine with it.  

 

Anyway -- I think it is good to mention, and I share concerns.

 

But -- if someone is needing help, they they need help.  

 

And, what is the way to become independent in dressing skills across settings?  Imo it is to practice these skills across settings.  So that down the road -- it will be an independent, generalized skill, and there will be no need for help.  

 

My son is going to day camp next year (for special needs), and he will need to change from his regular clothes into swim trunks, and then from swim trunks back into regular clothes.  Either he is able to do it by himself, or he is going to get help.  At this point -- I am confident he will do it on his own, with maybe a little help the first time or two as he is used to the routine and new place.  But ----- I would not keep him out of it, just b/c he would be told to take off his clothes and put on his swimsuit.  (And if this was a problem, a program would be needed.  And -- I think it is kinder to start a program in a lower-stress environment and then move on to a higher-stress environment -- which the day camp setting may be for him, I don't know -- but I want for him to be able to easily put on his swim trunks and then put on his clothes.)  

 

So I agree with the concern, and I think it is important, but I am just sharing that there are reasons that it makes sense to me.  

 

My son is also one where he can do a lot of skills at home or with me (me specifically, lol) but may not be able to do that same skill in another place or with another person.  So if I want him to have some independent skills, he has to practice them with other people -- I cannot help him generalize a skill to the point that he does it without my presence.  

 

But anyway -- the OP came back and said she talked to the clinic and they have updated all his skills, so I think it sounds like a non-issue now.