What the AUTISM?!

Welcome back to another episode on “what the AUTISM?!” This podcast is for anyone who is struggling with understanding what autism is and how we can better empower our autism community through research proven methods. In each episode, I will be sharing with you ground-breaking research and how the diagnosis of autism can often be misunderstood. If you are a new listener to our podcast, I highly recommend you start from episode 1 to catch you up to speed on various terminology and concepts! Now let’s get started…

Today’s episode will be covering the last part of our ABA 101 series. During the last 3 episodes, we talked about the ABCs of ABA, what behaviors are, the functions of behavior, reinforcement versus punishment, so today we’ll be talking about reinforcers and how we establish motivation in our children.

Let’s get started with a quick recap. Last week’s episode covered the difference between reinforcement and punishment in ABA terminology. Remember that reinforcement occurs when a behavior INCREASES because of a consequence of either adding or removing something from the environment.  By definition, a reinforcer INCREASES behavior and there are 2 types of reinforcements: positive and negative reinforcement. 

Positive Reinforcement: A behavior occurs. A stimulus such as a person, an object, etc is presented immediately following the behavior. The probability of that behavior occurring again in the future increases. 

Negative Reinforcement: A behavior occurs. A stimulus is removed immediately following the behavior. The probability of that behavior occurring again in the future increases. Let me remind you, that just because the word “negative” is present, it does not mean anything bad. 

What are some examples of reinforcers? Any items/access to activities such as electronics (tablets, video games, etc) or access to locations are all common examples of reinforcers.

What effects reinforcer effectiveness?

We must remember 4 different variables that effect reinforcer effectiveness. They are: deprivation/satiation, immediacy, size, and contingency.

1) Deprivation/Satiation: Often referred to as not enough or too much of a good thing!

Deprivation: Not having access to something that is highly desirable. Often this is used to increase the value of an item/activity to someone. 

Example:  

• I’ve been working all day and haven’t had a chance to eat. Because I haven’t eaten anything, I’m deprived of food, so my motivation to get food is higher. 
• If my child had access to their video games removed, their motivation to gain access to play their video games is higher. 

Satiation: This is the opposite of deprivation. Satiation refers to having too much. If the same reinforcer is used over and over again, it will lose it's reinforcing value.

Example:  

• Let's say you ate a cheeseburger for lunch today and for dinner, your friends want to go out to have burgers. Tomorrow, your co-worker suggests grabbing a burger for lunch again...no thank you! You are satiated with cheeseburgers.

2) Immediacy:  The item that is serving as the reinforcer needs to be delivered as quickly as possible as soon as the target behavior occurs. The longer the amount of time lapses between the behavior and the delivery of the reinforcer, the less effective the reinforcer will be. 

Example:

• Let’s say that Johnny was promised by his mom that he’ll get a lollipop if he’s behaves in the grocery store today. Johnny is on his best behavior, and on their way out of the store, mom promises that he gets his lollipop. However, on the way home, mom forgot that she has a...

Have you ever come across a situation where a child doesn’t listen to you, no matter what type of punishment or negative consequences you place on them? Or have you ever seen a child start losing interests in earning some of their most favorite activities, toys, or foods? Today we’re going to talk about reinforcements versus punishments and what type of strategy may be the most helpful for your child. Please note that I’m not a child psychologist nor a family therapist. I’m a board certified behavior analyst that is here to talk to you about behaviors and how we can shape and develop desirable behaviors in our children. If you enjoy our podcast, please make sure to follow our podcast channel and follow us on our Facebook page and Instagram @whattheautism. 

In today’s episode, there will be some technical language and vocabulary that is specific to ABA, but be patient with me, as I’ll be breaking down what each of these terms mean and present to you some everyday examples that may be helpful in you understanding a little more about ABA. 

Now let’s start with “what is reinforcement?”

Reinforcement occurs when a behavior INCREASES because of a consequence of either adding or removing something from the environment.  By definition, a reinforcer INCREASES behavior. Remember that consequences is not a negative association like a punishment. We talked about consequences in episode 6 where we described consequences as anything that occurs after a behavior takes place. So for example, let’s say that Jenny is instructed by the teacher to go to her desk to complete her worksheet. Jenny starts crying, whining, and throwing her toys around the classroom. Because the teacher is busy working with the other kids, she puts Jenny on a time-out until the teacher is ready to work with her. Now, based on all the things we talked about in previous episodes, what do you think will happen in the future when the teacher tells Jenny to complete worksheets? Jenny will continue to engage in tantrums and inappropriate behaviors in order to get out of completing her worksheets. So during the next couple days, she continues to exhibit these inappropriate behaviors. This “time out” now functions as a reinforcer in this situation. Why? Because these inappropriate tantrums and whining behaviors have increased.  If you need a couple seconds to digest this concept, I suggest you take a pause here before moving on.

Now digging a little further into reinforcements. There are 2 types of reinforcements: Positive and negative. Don’t let the word negative get you to think that it comes with a bad connotation. It’s simply referring to whether a stimulus has been presented or removed. 

1) Positive Reinforcement: A behavior occurs. A stimulus such as a person, an object, etc is presented immediately following the behavior. The probability of that behavior occurring again in the future increases. 

Examples: 

• Bob finishes his math homework and afterwards he gets a piece of gum. A piece of gum is the stimulus that is presented. And because Bob is motivated by gum, the probability of him completing his math homework to get more gum increases.
• George sits appropriately in circle time and exhibits listening skills by answering questions about the story. This earns him 10 minutes of his favorite activity: blowing bubbles. The activity of blowing bubbles is a stimulus that is presented and because George is motivated by this activity, the probability of him engaging in circle time in the future increases. 

2) Negative Reinforcement: A behavior occurs. A stimulus is removed immediately following the behavior. The probability of that behavior occurring again in the future increases. Let me remind you, that just because the word...

What are the 4 main functions of behavior:

1. Escape
2. Access to Tangible (activity, object, anything)
3. Attention
4. Automatic (behaviors that you engage in because the specific internal sensation/feeling that you get feels good)

Remember, a behavior is only a behavior when 1. The action is measurable and observable 2. Passes the dead man’s test. These are things that we reviewed last week in episode 6, so make sure to take a listen if you missed last week’s episode! 

So let’s start talking about autism. How does the identification of the functions of behavior help in treating those with autism? When children engage in socially inappropriate behaviors such as aggression and self-injurious behaviors...if we do not understand why the child is engaging in these behaviors, we can’t properly treat the behavior. This results in a treatment program that will never get to the root of the problem.

We also review a research article that was published in 2018 titled "The Big Four." The purpose of this article is to suggest that by adding prevention practices to early intervention guidelines for problem behavior, this would increase the effectiveness of a treatment. The article talks about how understanding the core functions that produce problem behavior teaches us how to arrange environments and how to teach skills that would prevent problems from occurring from the start. I’ll go ahead and link this study on our facebook page, but it’s extremely important that we focus on the reason why a child is engaging in a specific behavior rather than how the child is engaging in the behavior. 

I’m really excited for today’s episode because this is an episode that will benefit listeners of all backgrounds. So whether you are a parent (you don’t have to have an autistic child for ABA strategies to be beneficial to your parenting), a treatment provider, or even someone who’s just curious about ABA. I’ll tell you from the start, ABA does NOT always equate to autism therapy. ABA can be used for anything and anyone that engages in behavior...which is basically all living and breathing organisms. ABA has been proven to be an effective method of treatment for children with autism, but ABA has been an effective method for those that struggle with substance abuse, fitness coaches, nutritionists, life coaches, organizational behavior management (which focuses of the behavior of a company’s employees and the company itself). 

What is ABA? ABA is a therapy based on the science of an individual’s behaviors and how they learn. So in other words, behavior analysis helps us to understand how behavior works, how a person’s behavior is affected by the environment, and how their learning takes place.

The main goal of ABA is to increase behaviors that are helpful to an individual and decrease behaviors that are harmful or that can negatively impact learning. Ways that ABA therapy programs can help...is 1. Increase language and communication skills. 2. Improve attention, focus, social skills, memory, and academics 3. Decrease problem behaviors, such as intense tantrums, aggression, non-compliance, property destruction, and many more. ABA has been existing as a therapy treatment since the 1960s and since then the research behind ABA and its effectiveness has been thoroughly investigated and proven time and time again. During the last 3 episodes, I’ve touched on various research that proves the effectiveness of ABA and some common myths that have been debunked by research. Tune into episode 5 if you’re curious to hear more about other common myths on the topic of the autism diagnosis. 

But to dive into the topic of ABA treatment, I’m going to simply breakdown some very basic foundational principles of ABA. This is going to be extremely helpful to know for future episodes when we dive further into research that has more complex concepts and scientific terminology. 

In ABA, the surrounding environment is extremely important. When we first start services for our patients, what’s most important is that we control this environment to ensure that we create as successful of a learning opportunity as possible. In order to do this, we first need to understand how these environments are studied and how to effectively utilize these variables to control the environment.

First, we need to define what the word BEHAVIOR means.  We define behavior as anything a person says or does that involves movement and has an impact on the environment. A behavior needs to be able to be observed, described and recorded. It needs to be able to pass what we call the dead man’s test. Basically, the concept is that If a dead man can do it, then it is NOT a behavior! So for example, a child not paying attention, not a behavior. Why? Because a dead man can do that. A child being non-responsive is not a behavior. Why? Because a dead man can do that. A child working on their homework, running, playing with their friends are all examples of a behavior. 

Another common mistake that many people make is what we call circular reasoning. For example, some parents will come to me and say "Johnny doesn’t do his homework because he’s lazy?" So if I ask, "Why is Johnny lazy?" The parents will say "Because he doesn’t do his homework." There is no end to this circular reasoning. And this results in a behavior that can’t be observed. I can’t observe Johnny being lazy. What does lazy look like? How it looks for me might be different for someone else. If we can’t observe it, we can’t measure the behavior. And a behavior has

In today's episode, we talk about some common myths that people have about the autism diagnosis and how research has debunked them!

1. Autism only affects children. False!
2. Autism is just an issue with the brain. False! Co-morbidities (GI issues, sleeping problems, epilepsy, etc) are very common in children with ASD.
3. Autism is caused by bad parenting. FALSE!! Research has proven that there was no difference in parenting styles between parents of typically developing children and parents of children with autism/anxiety disorder.
4. Vaccinations causes autism. FALSE! We reviewed Andrew Wakefield's 1998 study that claimed that the MMR vaccine caused autism. This study was retracted in 2010, but in this episode we dive deeper into this study to examine issues with this research study.
5. All autistic people are extremely gifted/talented with memory skills, numbers, music, art. False! Although this may be true for SOME of our children, this doesn't accurately reflect across all children with autism.
6. ABA treatment turns children into robots! FALSE! A good ABA treatment provider ensures that their programming has variability and generalization. ABA treatment has been research proven to be the most effective in treating autism.

Go to our facebook page @whattheautism to find each perspective research articles and supporting studies to debunk every single one of these myths!

Unfortunately, we do not know all of the causes of ASD. However, through much research and time, we have learned that there are likely many causes for multiple types of ASD. As we’ve discussed in episode 2, there is quite a wide spectrum of children when we talk about ASD. There are children that are extremely gifted with numbers and academics but has a really difficult time socializing with others. You also have children that have extreme high levels of maladaptive behaviors such as aggression, property destructions, self injurious behaviors and have minimal or 0 level of vocal communication. Because there are so many different severity levels within the autism spectrum, it’s difficult to say that one factor impacts the severity of the diagnosis. The autism spectrum disorder affects children of all races and nationalities, but certain factors increase a child's risk.

• Most scientists agree that genes are one of the risk factors that can make a person more likely to develop ASD.
• A child's biological sex can also be a factor. Boys are about four times more likely to develop autism spectrum disorder than girls are.
• Family history. Families who have one child with ASD have an increased risk of having another child with the disorder. It's also not uncommon for parents or relatives of a child with ASD to have minor problems with social or communication skills themselves or to engage in certain behaviors typical of the disorder.
• Other disorders. Children with certain medical conditions have a higher than normal risk of ASD or autism-like symptoms. Some examples include fragile X syndrome and Rett syndrome
• Extremely preterm babies. Babies born before 26 weeks of gestation may have a greater risk of autism spectrum disorder.
• Parents' ages. There may be a connection between children born to older parents and autism spectrum disorder, but more research is necessary to establish this link.

Let me remind you that these are just some POTENTIAL factors that might increase the risk that a child may have autism, there are other speculations that are being researched and studied, so the autism research community will definitely be needing more time and data. 

ASD continues to be an important public health concern. Like the many families that have been impacted by autism, the CDC wants to find out exactly what causes the disorder. Understanding these different factors that make a person more likely to develop ASD will help identify more information about the causes. One of the largest U.S. studies to date is SEED (S-E-E-D): Study to Explore Early Development (SEED). SEED is currently looking at many possible risk factors for ASD, including genetic, environmental, pregnancy, and behavioral factors. SEED is a valuable resource for testing hypotheses regarding ASD characteristics and causes. I’ll link you guys to this research study and some helpful pdf documents on our facebook page, @whattheautism. 

Although there is much more research that needs to be conducted, it’s important that as a community of autism advocates, treatment providers, educators, and parents, we find ways to contribute to the future of autism research. One easy way is to stay informed on the current research that is happening. Even though there’s a long list of possible factors and variables that might contribute to a child being diagnosed with autism, it’s an extensive list of possibilities that research needs more time to continue to digging through in order to find more answers. There aren’t any research studies that solely identifies that THIS specific variable causes autism, as many of these possible factors are just possible risks factors for the diagnosis. But as a treatment...

A great way to make a quick observation of how your child is developing is...

1. Do a quick research of a timeline and understand the developmental milestones that your child should be meeting. At what age should my child be babbling sounds and trying to mimic words? Engaging in joint attention and be interested in playing with other children?  Crawling? Playing with toys? Etc.

2. Immediately set up those peer dates with anyone and everyone that you can possibly expose your child to. Seeing your child in the same environment as their peers will help you to see what is typical and what is not.

If you are in a place of thinking your child may need help but maybe you're afraid, confused, and unsure. I hear you. I may not have directly experienced what it’s felt like to receive the news that my child has an autism diagnosis and that they won’t develop like their neuro-typical peers, but what I do know is what can lie on the flip side of the timeline once your child begins receiving treatment. Every parent that I have worked with has experienced the same type of fear and uncertainty, but I have yet to have met a family that has EVER regretted their decision to get their child’s autism diagnosis treated. 

ABA treatment: Why is it the most effective? We cover research proving the effectiveness of ABA treatment. Applied Behavior Analysis (ABA) is a therapy treatment based on the science of learning and behavior. What we do as behavior analysts is take a look at an individual’s specific behavior and determine if this is this a behavior that we need to increase or decrease? If a child is aggressive or engages in excessive tantrums, that’s a behavior we want to decrease. Eye contact, functional language, social skills are all behaviors we want to increase in our children. This is where we begin to evaluate the environments that the child is in and determine what the child’s main motivators are in order for us to create a controlled environment that will also us to most successfully teach a child various skill sets and decrease undesired behaviors.

ABA has been proven in over 20 different research studies that intensive and long-term therapy using ABA principles improves outcomes for many children diagnosed with autism. The Kennedy Krieger Institute in Baltimore Maryland is an internationally recognized institution dedicated to improving the lives of children and young adults with pediatric developmental disabilities through patient care, special education, research, and professional training. I’ll be linking you to their website that discusses their stance on ABA treatment on our facebook page. But over the past 40 years, an extensive amount of research has documented the success of ABA-based treatment to reduce problem behavior and increase appropriate skills for individuals with intellectual disabilities (ID), autism, and related disorders.

Another study to note was published in September 2017. E Linstead, D R Dixon, E Hong, C O Burns, R French, M N Novack, and D Granpeesheh conducted a study to investigate how treatment intensity and duration impact learning across different treatment domains, including academic, adaptive, cognitive, executive function, language, motor, play, and social. The results indicated that treatment intensity and duration were both significant predictors of mastered learning objectives across all treatment domains .

So why ABA? Why and how is it effective in treating autism. In ABA, we study the child’s environments and determine how we can best increase and decrease behaviors. And this means everything and anything, and this can also include skills sets that involve speech and occupational therapy. It’s not to say that one treatment trumps over the others, but it’s to say that ABA can many times be the most effective in showing significant progress across areas that are more than just treating maladaptive behaviors. We focus on providing our...