Dr. Chris’ Autism Journal

Over the Memorial Day weekend, Dr. Chris Whalen and Dr. Shannon Cernich attended the Applied Behavior Analysis International conference in Chicago.  There were many exciting presentations and new developments in the field of ABA related to autism.

Of particular interest was a poster presentation entitled “An Analysis of Instructor Errors in Discrete-Trial Teaching of Children with Autism” by Daniel Mruzek, Tristram Smith, and colleagues at the University of Rochester.  They found that the largest proportion of instructor errors when delivering discrete trial training (DTT) occurred when delivering reinforcement.

These errors were of two types:  The instructor reinforced an incorrect child response or the instructor failed to reinforce a correct child response.  For example, instructor says “Show me the big one.”   Child points at small item but instructor thinks the child pointed at big item and says, Great job!”  Or the child points at the big item but the instructor is looking at her data sheet and thinks the child did not respond and says, “Try again.”  As reinforcement (often colloquially known as reward) is what increases the rate of a response, DTT can result in the wrong responses being increased, even with a trained instructor.

This is not to suggest that DTT is a flawed methodology.  All training methods as well as life often result in the wrong responses being reinforced.  Imagine the following scenario:  You meet someone new named Shelly; you mishear her name and call her Sally.  She responds when you call her Sally and does not correct you.  Your behavior of calling her by the wrong name is reinforced.

So the point is not to end your child’s DTT program in place of some other methodology, but to make sure it is being properly supervised.  Trained, good ABA therapists will regularly make the errors describe above (they’re only human), but a good supervisor will detect and correct these errors while supervising your child’s session.

More highlights from the ABA conference will follow in future blogs, but in conclusion, Dr. Chris and Dr. Shannon gave presentations at the conference on the use of TeachTown: Basics, a computer-assisted program that delivers concepts during the computer sessions in a DTT format.  Although computerized instruction is meant to supplement human instruction, not replace it, we are proud to state that TeachTown: Basics delivers errorless reinforcement.  There are some things that computers can do better than people.  If only your computer would help you the next time your child tantrums!

 There is no specific age that a child should start using the computer, but most people would agree that the child should be at least 2 years old. At this age, many children may be ready, but some will not, even at 3 or 4 years old. By the age of 5 years, most children are probably ready to start using the computer in one way or another. There is little research on when a child should begin using the computer, but there are a few signs that your child might be ready:

1. Your child is at least 2 years old
2. Your child is interested in visual stimuli such as the computer or television
3. Your child attends to visual stimuli for at least 5 minutes (with or without your help)
4. Your child is able to reach for items or point to desired items (so that they can touch the computer monitor or point to items on the screen) (not necessary for your child to use a computer mouse at first) (this one is not totally necessary as there are accommodations that can be made even for those children who cannot point to the screen)
5. Your child can attend to and follow brief, verbal instructions (e.g. “sit down”) (for this one, it is worth trying the computer briefly to see what happens, for some children, they respond better to the computer than to verbal instructions).

How can I get a child started using the computer?

The best way to get a child started on the computer is to introduce it gradually with little demand on the child. The focus at first should be on showing the child that the computer is fun!

1. Pick a stimulating program that your child is likely to love (this does NOT have to be educational – just fun for your child!) and have your child sit with you while you navigate through the program. If your child wants to grab the mouse or touch the monitor, let him, but do not give your child any instructions or place any demands on him or her.
2. Once your child begins to show interest (which could be the very first time!), start placing your child’s hand on the mouse occasionally and physically prompt them to move it around and click. If you have a touch screen monitor, you can have your child start touching the screen to see what will happen. For this step, you should again choose a program that is reinforcing for your child, not necessarily a learning program.
3. Now you can introduce a simple learning program (you will want to start with content that is relatively easy, but not boring, for the child). Begin with very short sessions such as 5 minutes and do several times throughout the day (2-3 times). Sit behind your child and provide extra reinforcement (e.g. praise, food, touch) to keep your child engaged. You may want to set a timer so the child knows how long they are expected to sit at the computer.
4. Increase the difficulty of the learning program and increase the time gradually that the child sits at the computer (no more than 20 minutes for a young child, up to an hour for an older child).
5. As your child gets more independent on the computer, you can fade your presence but it is recommended that you sit with your child for some of the computer sessions to work on expressive language and social interaction.
6. To make sure it is working, you should collect data on the skills you are trying to improve.

What should I look for in purchasing software for my child?

1. If only looking to entertain your child, not teach, pretty much anything will work – these kinds of programs are good rewards for your child to earn after using a learning program.
2. For teaching, look for programs that are specifically designed for your child’s needs. For instance, if you have a child with an Autism Spectrum Disorder, you may want to purchase a program that is designed specifically for this population. Also, be sure to look at the ages the program is designed to teach. If your child is older, you will want to choose a program with age ranges that match your child’s developmental level.
3. Look for programs that are based on science. Many programs claim to do this, so look at what “science” they are referring to.
4. Look for companies that have done and continue to do research on their products! This one is extremely important, claiming something is “evidence-based” or “effective” without any research is a false claim. At minimum, the companies should provide a scientific framework that their products are based on.
5. Identify programs that are visually interesting and have fun sounds – you will want your child to enjoy what they are doing! Most companies provide free demos of their products so that you can check out what the program looks and sounds like. Higher quality products are more engaging for most children.
6. Programs that claim to be effective should provide a data collection system in the software. Having frequent progress reports on how your child is doing will help you decide if the program is working or not.
7. One of the biggest issues with computer instruction is whether or not skills will generalize to off-computer activities. Programs that provide generalization solutions in the software and give suggestions for off-computer activities are ideal.
8. Last, but not least, try to identify programs that will grow with the child so that you are not replacing software every month or so (this gets costly, results in loss of data tracking, and can be frustrating for your child).

Written by:

Christina Whalen, PhD, BCBA

President and Chief Science Officer

TeachTown, Inc.

www.teachtown.com

Seattle, WA – TeachTown, a privately held autism research and technology company, was named a winner of the 2007 Tibbetts Awards for excellence in the Small Business Innovation Research (SBIR) programs. Individuals and companies selected for these national awards are recognized as having provided outstanding SBIR leadership.

Teach Town, founded in 2003, provides an education and language learning platform as well as services specifically designed and developed for children with autism and other cognitive impairments. It was conceptualized by Chief Scientist Dr. Christina Whalen, licensed psychologist, and certified behavior analyst, and developed with Eric Dallaire, and Lars Liden, Ph.D., cognitive and neural systems. Dr. Whalen will accept the award on October 10, 2007 in Washington, DC, and attend the congressional reception on Capitol Hill.

With recent increases in autism prevalence, estimates are now 1 out of 150 births, “We have a rapidly growing school-age autism population that is severely under-served.” says Dr. Chris Whalen, “Our goal is to provide affordable, available, and effective treatment.”

TeachTown received an SBIR (Department of Education) grant in 2004 to develop its first product TeachTown Basics, which was released to the market in March 2006. They also received a “Stepping Stone” grant in June 2007. The company has built up a science advisory board which includes some of the most prominent autism researchers in the US. The results of the first Teach Town: Basics study was published in the Journal of Speech and Language Pathology and Applied Behavior Analysis in March 2006.

SBIR support for product development and research has allowed Teach Town to become the only evidenced based autism treatment technology solution available which provides online synchronization and communication of the child’s activities and progress data. This addresses the main area of pain for service providers and parents which is the ability to; track, report and communicate on a child’s progress. The program includes both on and off computer activities using scientifically-based treatment approaches which are needed to be successful in teaching children with autism. TeachTown allows service providers to serve more children at one time and exceeds mandated education data reporting requirements in all 50 states.

TeachTown is now embarking on a 2 year project and will conduct research studies which will include children with autism or Asperger’s Syndrome, parents, and professionals from the autism community. This research will guide the development of a new education and treatment program targeted at grade levels 2^nd – 5^th. This innovative treatment will build on the success of TeachTown: Basics, which is now helping hundreds of younger children and being adopted by major school districts across the U.S.

Christina Whalen, PhD, BCBA

(206) 336-5585

chris@teachtown.com

About Teach Town

www.teachtown.com

TeachTown is a privately held company based in Seattle with offices in San Francisco, and is funded by the Washington Research Foundation and private investors led by Richard Fade, founder of the Autism Treatment Network.

For more information about the Tibbetts Award Click Here

If you are struggling with finding a quality service provider for your child, or if you are wondering if the ABA services you are receiving are appropriate, the ABA Autism Special Interest Group, with funding from the New Jersey Center for Outreach & Services for the Autism Community, have provided a set of guidelines that are extremely valuable:

ABAAutismSIG Gdlns 2007.pdf

In this document, they provide consumers with information about board certification for ABA providers and what other qualities to look for to increase the chances of receiving the quality services that your child deserves.  They note that certification is NECESSARY, but not SUFFICIENT for selecting a qualified professional.  In other words, someone who provides ABA services and who is not certified should be questioned regarding their education and ability to provide services.  However, just having that is not enough, you should look at the applicant’s experience with autism, and with the age group and functioning level of your child. 

This document was put together with a lot of expertise and thoughtfulness, I hope you find it helpful!

I recently had the pleasure of interviewing Krista Schultz, who works in Alberta, Canada with children with autism.  She is an ABA and developmental specialist and a frequent user of TeachTown with her clients.  I love her philosophy for teaching children and her passion for making a difference in the autism community.  I also really enjoyed her responses regarding technology and her feedback on TeachTown.  I hope you enjoy this as much as I did! 

Interview with Krista
May 2, 2007

1) Please provide us with a brief background about your education and credentials:

I am originally from Northern Alberta, Canada and received my first degree (Bachelor of Education) from the University of Alberta.  During teaching and then school counseling, I worked through a Master of Science degree in Educational Psychology with a Specialization in Developmental Psychology.  Since that time I have become a Registered Psychologist in the Province of Alberta and have continued to work in educational systems as well as home environments supporting children with special needs.

2) When and why did you start working with children with autism?

To be honest, it was quite unintentional.  Behavior has always been my key interest and I had been working with severe behavior disorders in children and adolescents. I am an avid proponent of the position that although we live in very rural areas, we should be providing children with services and professionals to the best of our abilities.  I received a call from a colleague who had a referral for an adolescent with autism and she asked if I would consult.  It was then that I realized that the area of autism and the families in our communities were sadly being under represented.  At that time, autism was not widely recognized.  Due to many factors, media included, I find there to be far more interest from the general public on the area of autism and thankfully, more recognition from service providers and educators to broaden their own knowledge of the diagnosis.

3) What positions have you had in the past and where do you work now?

I have been a teacher of many subjects, gifted students, educable mentally handicapped and those with severe behavioral disabilities.  As a Psychologist, I have a private practice and contract to school divisions, multidisciplinary teams and family agencies to provide assessment, support and programming for children with a variety of needs including those with medical conditions, FASD, severe behavioral disabilities, Autism Spectrum Disorders and learning disabilities.  I am also a workshop facilitator on several subjects surrounding special needs children and learning. 

4) What is the best part of your job?

Watching my clients successfully meet objectives and seeing the joy on the faces of parents.  AND, having clients whom other professionals cannot pick out of the classroom as the child who has the autism diagnosis!

5) What part of your job is most difficult?

Supporting families while waiting for services to be put in place.

6) What is your approach to using ABA? 

I believe that ABA incorporates many different teaching methods.  It is flexible and transitions between developmental stages as well as changes that a child presents during the course of their programming.  It is that flexibility - and the knowledge and openness to accept and embrace those times - that allows ABA programs to meet the needs of the individual child and address behavioral teaching.  Generalizing to natural settings and a comprehensive interventionist program that eventually fosters the fading of reinforcers is my key approach with my primary work being in school settings.

7) Other than ABA, what other treatment approaches do you incorporate into your practice?

My treatment practices in my work with autism have largely been guided by the science of ABA and the writings of Lovaas, Fenske, etc. 

8) Do you find that many children you work with benefit from using visual strategies?

Absolutely.  Given the difficulties with self regulation and auditory “overload”, many of the children I work with can build increased independent and functional skills from incorporating the visual modality.

9) How do you think that computers can help children with autism?

Computers are tools in our society.  Working with children with autism and using computers allows behavioral teaching and independence with skill building.  While the face to face, social component of interactions is certainly important, there are many aspects of teaching that can be completed by the use of computers.

10) Do you think computers can help parents, in what way?

Often the parents with whom I consult are eager, interested and motivated but they are not therapists or teachers.  They are not autism specialists or experts.  Having the technology and support of a good program that is effectively addressing the unique needs of their child(ren) with autism is empowering and motivating.  It also allows parents to be parents and not have the worry of appropriate programming or seeking out multidisciplinary teams to do, essentially, similar work.  Given our shortage of professionals in many areas and the factor of rural living, computers also “shrink” and sometimes eliminate barriers to effective programming.

11) How can computers help schools?

In our province, technology in schools is priority and for children with autism we find that while teachers want to offer similar experiences, they are often at a loss to make these times meaningful and functional.  In several situations this year, I have been exploring the use of TeachTown in a variety of settings in schools.  Again, non-expert facilitation and the preparation time that computers offer teaching professionals has been invaluable.

12) How do you use computers in your position and how can other clinicians benefit from technology?

I have been far more open to using technology and computers as tools for increasing functionality, independence and skillstreaming.  We are fortunate in this day and age that assistive technology devices and technology such as TeachTown has vastly reduced barriers that would have otherwise made appropriate and beneficial teaching very difficult or unrealistic.

13) What aspects of TeachTown: Basics are most helpful for you?

The non-expert model has been very motivating for those unfamiliar with autism.  The ease of setting the program up and moving parents and para-professionals through the trials has been excellent.  As an educational psychologist working with Individual Program Plans, the data, ease of collection and simplicity of results (graphs, etc.) have provided solid evidence of progress for clients.  Teachers have been thrilled with the explanations of objectives for sessions as it has allowed more meaningful short and long term goals to be added into the child’s program plan.

14) If you were on the design team at TeachTown, what would you do next to improve or enhance TeachTown: Basics?

Expand the developmental levels to promote additional training for older children!

15) What future directions should TeachTown take for developing other products?

I would like to see TeachTown work with assistive technology professionals to address the needs of children with autism who may present with additional impairments such as hearing impairments, visual problems or severe fine motor skill deficits.