For over fifty years, research has demonstrated the efficacy of applied behavioral methods in reducing inappropriate behavior and in increasing communication and appropriate behavior. According to the Association for Science in Autism Treatments (ASAT), ABA is the only scientifically validated treatment shown to be effective to teach individuals with ASD. A number of studies also indicate that, when implemented intensively for more than 20 hours per week, ABA may produce large gains in development and reductions in the need for special services (Reichow, 2012). However, there is great variation between public school programs in how they use the principles of ABA to teach students with autism and the amount of support provided to the teaching staff.
Checklist for Parents Checklist for Professionals
Key Indicators of a Quality Autism Program
In an effort to identify the components needed to teach children with autism effectively in schools, many state Departments of Education and private organizations have created key indicators of quality autism programs in schools (Librera, W. L., Bryant, I., Gantwerk, B., & Tkach, B., 2004; National Professional Development Center on Autism Spectrum Disorder, 2011). All indicators generally fall into one of four areas: 1) staff experience and knowledge; 2) curriculum that can be individualized; 3) teaching procedures that are considered evidenced-based practices and that are shown in the research to be effective for teaching individuals with ASD; and 4) specific procedures for generalizing skills to the community and family.
Megan Miller, MA, BCBA, NJEMT
Cara Graham, MA, BCBA
Teaching Procedures – As we said earlier, ABA is the only scientifically validated treatment shown to be effective to teach individuals with ASD. However, there are many different procedures that are part of an ABA program. One important distinction that needs to be made is that doing just one of these does not meet the requirement of a quality ABA program. ABA is a methodology and a teaching procedure that needs to be utilized across the entire school day. The recommendation for ABA therapy is often between 25 and 40 hours a week in order for an individual to make significant gains.
Staff Experience and Knowledge – In order for students to receive a curriculum based in ABA, the teaching staff must have expertise in behavior analysis. Unfortunately, there is not a lot of integration of ABA principles or how to run a classroom based on the principles of ABA in special education teacher training programs. There are also no requirements for special education teachers to be knowledgeable about ABA in order to teach students with autism.
Curriculum and Learner Goals – It is essential that the student’s IEP be individualized to target deficits in all areas of functioning including language, social skills, academics, and reduction of problem behavior. Curriculum that is in place for students in a self-contained classroom must be appropriate for their developmental level, including school readiness skills which may not specifically align with the core curriculum content standards.
Community Collaboration – Community collaboration and in particular parent collaboration is a crucial component to having students make as much progress as possible. This includes regular trainings for parents and ongoing feedback so parents can see how their children are progressing in their IEP goals. Effective programs take into account the school community and enlist community support to maximize use of all resources available to address student needs.
ABA in all Educational Placements
It is important to note that these recommendations for a quality program are not limited to self-contained classrooms. Regardless of educational placement – self-contained, inclusion, or general education – it is important to provide individuals with autism spectrum disorders the proper level of support to be successful. While most self-contained classrooms provide individualized instruction using the principles of ABA with well trained staff and community collaboration, that is not always the case in inclusion or general education classrooms. In these other settings it is equally important to have a Board-Certified Behavior Analyst (BCBA) consulting with teachers and staff. In order to effectively support students in this environment, BCBAs need to allocate time with the one or two classroom teachers to understand where and when the BCBA’s help is needed and provide the training and support in a really individualized manner. This can include setting up Peer Mediated Instruction (Carter, E., 2013, Cushing, L.S. and Kennedy, C.H., 1997) or class wide behavior modification systems like the Good Behavior Game (Joslyn, P.R., Donaldson, J.M., Austin, J.L. and Vollmer, T.R, 2019). BCBAs can assist teachers with this process by using BST, structuring feedback training with students, and facilitating peer mediated support strategies.
BACB Recommendations on Ratios
Many of the recommendations for a quality school program for students with autism include high levels of technical support and knowledge which can only be provided by someone with extensive knowledge of Applied Behavior Analysis such as a BCBA. While schools are increasingly employing BCBAs as consultants or full-time staff they are often overburdened and expected to manage extremely large caseloads. There are currently no recommendations for BCBA caseload sizes specific to school settings. However, the Behavior Analysis Certification Board (BACB) has outlined caseload recommendations for Healthcare Funders and Managers. The recommended caseload size for one BCBA working with students receiving 10-25 hours per week of ABA therapy services is 10-15 students and for students receiving 30-40 hours per week of ABA is 6-12 students (The Council of Autism Service Providers, 2014).
What if Someone Asks to Implement a Non-Evidence-Based Practice?
Do your job well and people will see the value of evidence-based practices. BCBAs have an ethical responsibility to provide effective treatment and an “obligation to advocate for and educate the client about scientifically supported, most-effective treatment procedures” (BACB, 2014). However, a lot of these practices are marketed extremely well, play on people’s emotions and desires, and are fun. But while many non-evidence-based treatments may be harmless, like music, play, or dolphin therapy, others can be extremely harmful and even abusive, such as having individuals drink chlorine to cure their autism.
A big risk of trying non-evidence-based practices is that it takes time away from effective treatment. It may also create challenges that hadn’t existed prior, like introducing a variety of new foods following an unsuccessful attempt to remove gluten. If staff or family recommends a non-evidence-based practice, your first question should be, “How will this affect the child’s behavior?” Ask the professional if you could take some baseline data prior to them implementing the intervention. Then compare the effects behavior analytically (Cicoria & Olive, 2019). The Code specifically states in element 2.09(d): “Behavior analysts review and appraise the effects of any treatments about which they are aware that might impact the goals of the behavior-change program, and their possible impact on the behavior change program, to the extent possible” (BACB, 2014).
Building a Successful Collaboration
In order to use ABA to help individuals achieve meaningful, socially significant progress, collaboration is key. It takes a village to educate a child and every member of the IEP team, from paraprofessional to parents, needs to work together. Navigating these delicate relationships requires specific skills and empathetic behaviors (Taylor, LeBlanc, Nosik, 2018). It also involves an understanding of culture and interventions that have already been implemented. School staff may have a better understanding of the student, the environment, and strategies that may not work. Parents will always be the expert on their child. We created checklists to guide both parents and professionals in helping the student achieve success in their school-based ABA program.
A Checklist for Parents
Checklist for ParentsA parent’s job is the hardest and best job in the world. To help your child achieve success in school, strive to:
- Schedule in self-care. If you are feeling overwhelmed, save this list. Try to find activities that you enjoy that are just for you. It will enable you to spend more quality time with your child, which is more important than anything else on this list. When you are in a good place, come back to this list.
- Ask thoughtful questions that will help you identify quality ABA programming that will benefit your child. We compiled a list of questions for you here.
- Develop and maintain positive relationships with the entire IEP staff.
- Find out the teacher’s preferred mode of communication. It’s easier for them to keep you regularly informed if you communicate via their preferred mode.
- Offer to help the teacher with something you’re good at. Ask if they can use any materials or reinforcers. Offer to volunteer your time during school or to prep things after hours. Teachers appreciate all parent attempts to make a difference in the classroom which will benefit your child in multiple ways.
- Communicate any changes at home that may impact the child during school. Let staff know about strategies that have helped your child achieve success at home. Keep the teacher in the loop about what went on at home over the weekend or the night/morning before school or of changes to medication.
- Become a member of a parent support group. Start by searching “Parent Training and Information Center” or contacting your district’s special education supervisor.
- Be wary of support from social media groups. They can be a great place to ask for resources but remember that anyone can take screenshots to share with the whole world. Even if your child shares a diagnosis with someone else’s child, your experiences are likely to be worlds different.
- Join professional organizations for recent research and support. Not sure which ones? Try Council for Exceptional Children, Autism NJ, or ASAT (Association for Science in Autism Treatment). Sometimes local parent support groups like POAC in New Jersey provide not only parental support and trainings but also events for individuals with autism and their families.
- Subscribe to media publications to get up to date information. Podcasts! Books! Blogs! Autism Spectrum News is a great place to start. Just make sure you always check your source and look for any bias that went into preparing the material.
- Listen to the IEP team’s feedback throughout the year.
- Collaborate with the IEP team to get the best possible outcome for your child. Remember the old adage, “You get more bees with honey than you do with vinegar.” Arguing will ensure that goals are addressed but collaboration and support will help your child exceed expectations.
- Maintain documentation and organize it into categories (i.e. year, setting, provider). This will help you easily reference documentation should you need it in the future. A good rule of thumb is to keep all initial evaluations and the most recent three years’ worth of documents.
IEP Meeting Tips
Before:
- Review the updated documents sent to you. Make notes in the margins. They are your copies.
- Prepare questions. We even made you a list!
- Prioritize which goals are the most important for your child.
- Decide whether or not you want to sign the IEP at the meeting. We always recommend taking the IEP home to review it before signing.
During:
- Take notes. You also have the right to record.
- Listen to the team’s feedback.
- Collaborate to prepare for your child’s success.
- Stick with your signing plan.
After:
- Review notes and documents.
- Contact any IEP team member for clarification.
- Prioritize your requests and collaborate.
- Combine requests into one email so that the team can respond efficiently.
- To sign or not to sign?
How to advocate for your child if you see that they are not making progress:
- Reach out to the IEP team via email.
- Give the traditional 24-hour response time when you reach out to school staff.
- If you still don’t get a response, follow the chain of command in order to maintain positive relationships: teacher first then case manager is the typical hierarchy schools follow.
- If relationships start going south and you feel your child is having a difficult time or not making progress, it’s always easier to understand everyone’s point of view with an in-person meeting or phone conversation. Remember that you can ask for an IEP meeting at any time, it’s the law.
- Reserve reaching out to the principal and special education director or supervisor until after an IEP meeting if the IEP team is unable to address your child’s barriers to making adequate progress.
A Checklist for Professionals
Checklist for ProfessionalsSchool professionals should work towards:
- Collaborating with other members of the IEP team.
- Demonstrating an awareness of and respect for the culture, language, values, and parenting styles of the families they serve.
- Evaluating the school environment they create. Are behavior analytic principles applied throughout the school day? Are methods of instruction varied and individualized to the student? Do motivational systems generalize outside of one setting? If you’re not sure, seek out professional development.
- Observing other professionals who run similar programs to incorporate great ideas into your own.
- Setting goals and timelines for the school year. Decide when you will reevaluate what has worked and what hasn’t.
- Providing parents with information about child development, fostering coordination of efforts between school and home, supporting the family in reducing challenging behavior, and enabling parents to acquire their own skills to support their child’s IEP goals and to teach their child new skills. (APQI)
- Evaluating their own progress and needs.
BCBAs consulting in a school setting should remember to:
- Articulate their role at the outset. Understanding who the client is, the reason consultation is necessary, their specific responsibilities, and that their primary ethical obligation is to the student first will help guide the relationship. Setting these guidelines from the beginning will avoid difficult conversations later.
- Be upfront about their scope of competence.
- Navigate delicate professional relationships using empathetic behaviors (Taylor, LeBlanc, Nosik, 2018).
- “Condition yourself as a reinforcer.” Become either positive reinforcement because you’re fun, bring snacks, and solve problems or negative reinforcement because when everyone follows the plan, the BCBA won’t bug them anymore (Mumford and Theroux, 2014).
- Find something in the classroom to compliment – the more the better. Teachers and school staff work hard to create their classroom resources, programs, and structures. They will appreciate you noticing.
- Deliver reports and subsequent interventions in a timely manner. When BCBAs are called, staff is in crisis mode. Many times student placement and sometimes even presence in school depends on these evaluations. Be thorough but as efficient as possible.
- Use language that people can understand – avoid the jargon. Less response effort in the long run, more efficient. And ethically, it’s in the code. It’s enticing to make yourself look more professional but do that instead by creating awesome plans.
- Recognize school staff as local experts. “Affirm the teacher’s role as the expert in the classroom and discover helpful, respectful ways to influence teacher and para behavior. Rely on teachers’ feedback. Build collaborative relationships” (Mumford and Theroux, 2014).
- Be flexible whenever you can. Seek team input on goals, strategies, measurement, mastery – there is more than one way to achieve goals. Figure out in which aspects of your plans you can accommodate other people’s suggestions.
- Teach staff how to become the students’ reinforcers and how to foster independence.
- Make themselves available for consultation and schedule regular visits.
- Understand the school district’s policies, school culture, hierarchy, and union practices (Luiselli 2002, Mumford and Theroux 2014).
- Discuss with administration what they should do if staff members won’t collaborate or follow plans.
- Engage in frequent, ongoing discussions with supervisor about caseload, priorities, and progress.
- “Be honest, be humble, be human,” but also be nice. Talk to people, listen to their answers, when you ask them how they are doing, care enough to focus on, listen to, and remember their answer. As BCBAs, we are so apprehensive to make personal connections because we don’t want to violate the ethical code but we forget that we are human first. And human connections are what drives buy in which helps staff set up environments that will help the learner meet success more quickly.
Creating positive, collaborative relationships will benefit the student. Anecdotally speaking, when the parents are on the same page as the teacher, the students acquire skills more quickly and maintain them better over time. Think big, plan long term, collaborate, and capitalize on the systems set in place to ensure that we set everyone – the student, the staff, peers, families – up for success.
Cara Graham, MA, BCBA, is Owner & Executive Director and Megan Miller, MA, BCBA, NJEMT, is Clinical Supervisor at Graham Behavior Services.
If you would like more information on how to successfully implement an ABA program in a school, please reach out to the authors via email cara@grahambehavior.com or meganm@grahambehavior.com or visit their website www.grahambehaviorservices.com. Graham Behavior Services frequently posts blogs for both professionals and parents on their website as well as fun and informative content on their social media accounts.
References
Behavior Analyst Certification Board. (2014). Professional and ethical compliance code for behavior analysts. Littleton, CO: Author.
Carter, E. (2013). Peer-Mediated Support Strategies. Tennessee Department of Education, Vanderbilt University.
Cicoria, M. J. & Olive, M. (Host and Guest). (2019, November 22). The Ethics of School Consultation for BCBAs: Session 101 with Missy Olive (101) [Audio podcast episode]. In the Behavioral Observations Podcast. https://behavioralobservations.com/the-ethics-of-school-consultation-for-bcbas-session-101-with-missy-olive/
Cushing, L.S. and Kennedy, C.H. (1997), Academic effects of providing peer support in general education classrooms on students without disabilities. Journal of Applied Behavior Analysis, 30: 139-151. doi:10.1901/jaba.1997.30-139
Joslyn, P.R., Donaldson, J.M., Austin, J.L. and Vollmer, T.R. (2019), The good behavior game: A brief review. Journal of Applied Behavior Analysis, 52: 811-815. doi:10.1002/jaba.572
Librera, W. L., Bryant, I., Gantwerk, B., & Tkach, B. (2004). Autism program quality indicators: A self-review and quality improvement guide for programs serving young students with autism spectrum disorders (PTM No. 1504.65). Trenton: New Jersey Department of Education.
Luiselli, J. K. (2002). Focus, scope, and practice of behavioral consultation to public schools. Child & Family Behavior Therapy, 24(1-2), 5–21. doi:10.1300/j019v24n01_02
Mumford, L. & Theroux, K. (2014). Ethical considerations in school consultation: Problems, responsibilities, & solutions. BC-ABA Annual Conference. https://bc-aba.org/wp-content/uploads/2014/03/Ethics-of-School-Consultation-BC-ABA-March-15-2014-FINAL.pdf
National Professional Development Center on Autism Spectrum Disorder. (2011). Autism program environment rating scale (Preschool/ Elementary and Middle/High School). Chapel Hill, NC: Author
Reichow, B. (2012). Overview of meta-analyses on early intensive behavioral intervention for young children with autism spectrum disorders. Journal of Autism and Developmental Disorders, 42, 512-520.
Taylor, B. A., LeBlanc, L. A., & Nosik, M. R. (2018). Compassionate care in behavior analytic treatment: Can outcomes be enhanced by attending to relationships with caregivers? Behavior Analysis in Practice, 12, 654–666. doi: https://doi.org/10.1007/s40617-018-00289-3
The Council of Autism Service Providers. (2014). Applied Behavior Analysis Treatment of Autism Spectrum Disorder: Practice Guidelines for Healthcare Funders and Managers. Retrieved from https://casproviders.org/wp-content/uploads/2020/03/ABA-ASD-Practice-Guidelines.pdf
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