August 26, 2015

I have been working with children with autism and their families since 1999 implementing a treatment that is based on the principles of Applied Behaviour Analysis or ABA.  ABA is something that I am very passionate about and I have seen first hand the power that it can have in improving the quality of life for children and youth with autism and their families.

There would never be enough room in a single post to convey all of the reasons why.  So when I was asked to write a series of posts on ABA I was delighted!  Because an ABA program works on teaching new skills and helps children and/youth with autism learn new ways to get their needs met, we are often in a position of power with a vulnerable little person or youth in front of us, working with a family that is trusting us to do right by his/her child/youth.  In this post I want to review why a treatment that is based on ABA teaches kids and/or youth with autism to follow instructions.

We are surrounded by different kinds of instructions and come into contact with them on a regular basis.   Instructions can be simple, and include one step like being asked to turn on a light, or more complex and have a number of steps associated with them like when my sons teacher declares that everyone should 1. go and get their lunch from their backpack, 2.  go to the table and 3. start eating.   Instructions can be specific like kick the soccer ballor less specific like go play.  They can be delivered with words or verbally by a person, or they can be presented in text like the lego ship instructions that my son built the other day or through a device like an iPad touch the dog.  These examples illustrate just some of the things we need to consider when deciding what and how to teach new skills.  

Here are some of the very important reasons that we should teach children and youth with autism to follow instructions:

1 Because it will lead to more learning

Teaching someone to follow instructions is not about controlling them, but rather about maximizing learning potential.  A program that is based on ABA will assess each unique learners skills and determine where to start that works best for them.  The ability to follow simple instructions like show me the dogis a pre-requisite to following more complex instructions like find the dog in the picture and colour it brown.  

The ability to follow instructions can lead to to the acquisition of more and more complex skills and as such leads to increased independence.  In some instances there is a lack of what I might call readiness to learnskills, such that the child or youth has a difficult time sitting and attending for long periods of time.  In this instance we look at each unique learner and start where they are at.  If a child or youth is unable to attend we teach them to do that by breaking that complex skill down into its component parts. For more info on how to do that read a blog I wrote about that here.   Being able to follow instructions and attend to a teacher is a building block or prerequisite to learning new skills.  But as always, and why ABA is such an important treatment, we look at each individual learners profile and teach them how they learn best.

2. Because it can lead to empowerment

I do not advocate for blatant compliance and rule following.  In many instances there comes a time in ABA programming when we teach when it is ok to question authority figures or at least when it is ok to say noto an adult.  This is something that I wrote about in a recent blog about sexual abuse prevention.  Children and youth with autism are potentially more vulnerable to predators because they may follow instructions from anyone.  

It is critical to empower them with the skills that they can use to keep themselves safe.  The important caveat here though, is that I cannot teach them those safety skills if they are unable to follow instructions.  The literature is clear on this, in order to teach safety skills like what to do if someone tries to abduct them, or what to do if they are lost or separated, or how to know if someone is safe requires being able to attend to some instructions and the ability to imitate because the best way to teach these skills is by showing them what to do and providing opportunities to practice.   For example if we want to teach them what to do if they are lost or separated we would teach them that they can shout out for the person they are with, look for and walk over to a community helper like a cashier, and tell the cashier they are lost.  

Check out the references included at the end of this article for the research in this area.   Ultimately I am an advocate for teaching important skills to each person at his/her level, in the best way that they learn and building on those skills such that we improve his or her quality of life.  I would rather empower each of my clients with skills that will improve his or her quality of life and set up the environment such that they are kept as safe as possible until they can advocate for themselves.

3. Because there is a difference between a cant dovs. a wont do

If you are working with a child or youth with special needs and they are engaging in non-compliance or challenging behaviour, it is because they are trying to tell you something.  As a teacher or ABA therapist, it is our job to figure out why.  

Are they engaging in the problem behaviour because they cant do the task we are asking of them or are they doing it because they would rather do something else altogether.  The way to help them will be informed by the why.  If they are doing it because it is too difficult then as the teacher I need to break the skill down and figure out what I am doing to contribute to the difficulty.  I would empower them with a better way to communicate this to me as well.  Perhaps I would teach them to ask for help or I would make sure that I have assessed their skill level appropriately.  Perhaps they are missing a pre-requisite and I need to go back and teach that first.  If they are engaging in the problem behaviour because they dont want to do what I have asked them  I would want to teach them to communicate that to me in a more functional way, perhaps I would teach them to ask for breaks, or I might start with shorter intervals or smaller expectations and gradually increase the expectation.  

No matter what it is imperative that we get to the bottom of why this is happening and teach them a better way to communicate their needs.  Regardless of the why if is interfering with their ability to learn new and important skills that will improve his or her quality of life and a program that is based on ABA would empower them with those really important skills.

It is such a privilege to be able to work with children and youth with autism and his/her family.  It is not something that a Behaviour Analyst takes lightly.  In fact, this Behaviour Analyst is constantly striving to ensure that I am doing right by my clients.  

This means ensuring that I am always current on the best practices and research on how to teach new skills and deal with challenging behaviour as well as conducting myself with the utmost integrity and ensuring that all my interactions align with the Behavior Analyst Certification Boards (BACB) code of ethics.  Many of the tips I mention here were adapted from the work of other Behaviour Analysts.  

For the research check out the reference list below:

Bergstrom, R., Najdowski, A.C., & Tarbox, J. (2012). Teaching children with autism to seek help when lost in public. Journal of Applied Behaviour Analysis, 45, 191-195.
Gunby, K. V., Carr, J. E., LeBlanc, L. A. (2010). Teaching abduction prevention skills to children with autism. Journal of Applied Behavior Analysis, 43, 107-112.
Pan-Skadden, J., Wilder, D.A., Sparling, J., Severtson, E., Donaldson, J., Postma, N., Beavers,
G. & Neidert, P. (2009) The use of behavioral skills training and in-situ training to teach children to solicit help when lost: A preliminary investigation. Education and Treatment of Children, 32 (3), 359-370.
Taylor, B.A., Hughes, C.E., & Richard, E. (2004). Teaching teenagers with autism to seek assistance when lost. Journal of Applied Behavior Analysis, 37, 79-82.


Editor’s Note:  Opinions expressed by Autism Daily Newscast Contributors are their own.

About the author 

Sarah Kupferschmidt

Sarah is a Board Certified Behaviour Analyst who and Co-Founder of Special Appucations. She is a professor, TEDx Speaker as well as a top safety writer for Autism Parenting Magazine. Sarah has worked with hundreds of children and youth with autism and their families and has clinically supervised and trained staff on how to implement treatment strategies that are based on Applied Behavior Analysis (ABA). Her mission is to empower parents and educators who work with children with special needs with skills that will improve his/her quality of life. You can follow here on Twitter.

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