Tuesday, April 7, 2015

The First 3 Months of Early Intervention

Numerous research studies show that the earlier the better when it comes to early intervention using applied behavior analysis in the treatment of autism.  What is not so often written about, is how exactly to begin an early intervention program and what are the critical first steps to take when a Behavior Analyst begins working with a child with autism.
At a recent ABAI conference an expert from Poland held a session on why the first 3 months of an early intervention ABA program are so critical. The presentation focused on quality of services and building a strong foundation, reminding us not to jump ahead too quickly, not to target all deficits but to prioritize deficits and skills to ensure quality. The presenter emphasized how important it was to develop a positive relationship with the client in the first month in order to obtain optimum results. This information probably seems intuitive to most Behavior Analysts yet so many of us go about our first treatment sessions the wrong way.
When a typical ABA program begins, a Behavior Analyst will gather information on problematic behavior and details surround that behavior - the frequency, where it occurs, when it occurs, etc. The Behavior Analyst will meet with important people in your child's life, such as friends, babysitters, teachers, and relatives to get an understanding of how they behave within a variety of relationships. Also, they will schedule a time to observe your child to personally witness the problematic behavior. Once they have gathered enough information, the Behavior Analyst will complete an entire behavioral assessment on your child's behavior and then begin to implement the plan in your child’s natural setting such as the home or classroom. A Behavior Therapist will typically show up with a bag of tricks (toys, games, motivators) and get to work. This is where, according to the presenter, some of us may be going wrong.
What she recommended was to use the first month to build motivation in the child by establishing a playful rapport. Do whatever it takes to win him over – jump on the couch, do fun activities or just be silly.  If a child knows that every time his therapist comes he/she will need to work, then a feeling of dread comes over the child when the therapist arrives. But if the first month is used to establish a positive foundation, the child will look forward to the arrival of his therapist and be more motivated to work.
Another recommendation was to take a step back in the beginning to identify the motivating factors that are already in the child’s home. If all the therapist uses to motivate the child are his special toys in the bag of tricks, it will be very difficult for the parents to replicate once the therapist leaves. If there are things in the household that motivate the child – special  DVD’s, one-on-one attention, preferred games – use these motivators rather than the toys that come and go with the therapist.      
And as we always say, consistency in the implementation of the treatment plan across people and time is paramount in the success of the intervention.
We at Total Education Solutions are committed to being at the forefront of the behavioral health services industry. We strive to keep up to date with all the latest research and trends in the industry. It is always our pleasure to pass along to our readers and clients the valuable information we learn.
Daniel Adatto

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