7/28/2019 Association for Science in Autism Treatment - Integrating ABA and Speech Pathology

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Clinician's Corn... Integrating ABA ... ResourcesFAQClinician's CornerForumIntegrating ABA and Speech PathologyI am a speech language pathologist in a school-based program that relies heavilyon Applied Behavior Analysis (ABA). What is important to know about thisapproach and its implications for my role? In what ways can I support thisschool-based program?Barbara Esch, Ph.D., BCBA, CCC-SLP Esch Behavior Consultants, Inc.Elizabeth G. Dyer, M.A., CCC-SLPThese are important questions and indeed there is much to consider. We invitedtwo speech language pathologists to respond to your questions.What is important to know about this approach and its implications for my role?Answered by Barbara Esch, Ph.D., BCBA, CCC-SLPEsch Behavior Consultants, Inc.First, kudos to you for your interest in ABA and your desire to be supportive!Speech language pathologists are ideal professionals to be included on an ABAteam since its members are focused on providing effective and efficientinstruction, much of which is geared toward speech and language acquisition.Probably the most important issue is to understand what makes an applied

behavior analysis (ABA) approach different from more traditional instructionalapproach. Many people have heard the term ABA but arent sure what it means orwhat ABA involves.A breakdown of the terms is helpful. First, applied simply means that asbehavior analysts we select behaviors to teach that are socially significant(language, reading, play and leisure skills, following instructions, and so on)and that we use behavior analytic principles to teach those behaviors. The termbehavior refers to responses (teaching targets) that we can observe and measureso we can track when they occur. This way, we know if these important behaviorsare increasing as a result of our teaching. Its not possible to observe andmeasure fuzzy terms like communication or neatness unless we describe what wemean by these concepts. It IS possible, though, to observe and measure concretebehaviors such as when a child asked for juice or greeted 3 classmates by name

or put all toys in toy box so this is why were careful to define teachingtargets very specifically. Finally, in order to troubleshoot learningdifficulties, we use analysis to look at the effect of environmental conditionsthat occur around a particular target behavior. As behavior analysts, we look atevents before the response, such as instructions and prompts, and consequencesthat occur after the response such as praise, toys, edibles, or access toactivities. When we know what happens in the environment before and after thechild responds in some way, we have a better idea about how to strengthen thoseresponses wed like to increase. We also have more information about how toteach new, more appropriate behaviors to replace some that may be lessdesirable.The overall goal of a language-based ABA program is to equip students who are

not currently learning with specialized instruction (often 1:1) so they canacquire the skills necessary to be successful in more typical classroomsettings. Then the goal is to gradually reduce or eliminate the individualizedsupport. In other words, were teaching children the foundation skills they needto respond accurately and appropriately in a group setting, skills that mosttypically developing children already have by the time they enter kindergarten.How is an ABA program different from typical instruction? If theyre carefullydesigned, these language-based classrooms are unique in a number of ways:A commitment to evidence-based teaching means that providers are using methods

7/28/2019 Association for Science in Autism Treatment - Integrating ABA and Speech Pathology

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that have been shown to be effective through published scientific research.Data based decision making relies on daily data collection and analysis oflearning variables to guide teaching and new target selection.Errorless learning techniques are used to promote rapid skill acquisition.This involves prompting and reinforcing correct responses before errors occur.

For example, when teaching a child to name a picture of a horse, the therapist

might ask Whats this? and then prompt horse before the learner gives anincorrect response. Prompts can then be faded as appropriate.Intensive, individualized instruction provides opportunities for repeatedpractice and reinforcement of skills each day.Expressive language is taught across the 4 basic, all-important languagefunctions of requesting, labeling, repeating, and conversing.Generalization procedures are used to ensure that learned responses are usedbroadly across language functions, settings, situations, and people.Positive consequences, based on the students current motivation, aresystematically used to maximize learning.

Speech language pathologists who have expertise in these 7 areas are highlyvaluable to ABA programs. Whether working within the ABA classroom or in aseparate therapy setting, a therapist with these skills translates intodouble-benefit for a learner since all of his or her instruction will besimilarly focused in these highly effective areas.Often, speech language pathologists working in ABA programs are asked to weigh

in on decisions about selecting an appropriate communication mode for a learner.Although speech is by far the most desirable choice (its fast, easy,accessible, and cheap), some learners may not easily acquire vocal speech and soother communication systems must be considered. Two of the most commonalternatives are sign language and picture communication. From a behavioralperspective, there are pros and cons to each of these and neither system shouldbe recommended wholesale for entire classrooms but, rather, should be carefullydetermined according to their benefits for each individual learner. For anexcellent discussion of the advantages and disadvantages of sign language andpicture communication systems, I recommend Sundberg and Partingtons 1998teaching manual Teaching Language to Children With Autism or Other Developmental

Disabilities (chapter 4; see reference below).For behaviorally-oriented speech language pathologists, there are a number ofother resources to check out.For language-related curriculum assessment and teaching, I recommend:The Verbal Behavior Milestones Assessment and Placement Program: The VB-MAPP byMark L. SundbergTeaching Language to Children With Autism or Other Developmental Disabilities byMark L. Sundberg and James W. PartingtonAssessment of Basic Language and Learning Skills by James W. Partington and MarkL. SundbergThe Verbal Behavior Approach: How to Teach Children With Autism and

Related Disorders by Mary L. BarberaOther useful resources:Speech Pathology Special Interest Group (SPABA), Association for BehaviorAnalysis The Journal of Speech-Language Pathology and Applied Behavior AnalysisCambridge Center for Behavioral StudiesIn what ways can I support this school-based program?Answered by Elizabeth G. Dyer, M.A., CCC-SLPThis is an excellent question, and one which is asked frequently. Although somein my field may harbor some misconceptions about ABA, I believe this type ofprogramming meshes very well and rather easily into what we do as

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speech-language pathologists. Many people assume that ABA is only referring onlyto discrete trial instruction, when in fact it encompasses that plus otherteaching techniques which we tend to be much more familiar with, including (butnot limited to) incidental teaching, and, yes, promoting the generalization ofskills (across settings, people, etc.). Furthermore, the commitment to datacollection and analysis that we see within ABA should absolutely be embraced byall providers on a team.Your level of involvement can be what you and your team choose it to be. Giventhat the basis of the ABA programming is to develop receptive and expressivelanguage skills and to promote the use of those skills in social contexts, wecan be instrumental members of the team. Our training, knowledge and experiencelend themselves well to providing input on appropriate speech and languagetargets. For instance, when a child has an articulation or phonological disorderand he or she also works on Verbal Imitation and/or Phrase Imitation withinthe ABA program, it is important that we have input into thesounds/words/phrases being targeted. If the child is not yet ready to beproducing the /r/ sound, it would not make sense for words or phrases includingthat sound to be practiced. Other members of the team may not be as well-versedin sound acquisition and may not be able to make those determinations.Additionally, we can provide the appropriate targets which the child is readyand able to practice and thereby create a situation where the child is not onlyproducing the sounds/words/phrases on a daily basis, but data is being collected

on it for us to see across instructors! This is a win-win situation. Other areaswhere we can also be very helpful is identifying appropriate vocabularyselection, syntactical structures, determining appropriate mean length ofutterance (MLU) for sentence imitation, offering input into other expressivelanguage expectations, and generalization of skills across settings andcommunicative partners (after all, conversing with ABA instructors andconversing with same age peers is not necessarily the same skill set). Finally,we have much to offer with respect to assessment and training related toaugmentative communication systems.It is important to not overlook the benefits we receive from being a part ofthis type of team as well. Behavior management strategies derived from a

functional assessment, systematic approach to skill development, carefulselection of prompts and prompt fading procedures, detailed data collection andanalysis of said data all come to mind, along with a myriad of others. I wouldencourage you to learn as much as you can in those areas.It is essential that consultation and collaboration be included. Time must bespent discussing goals, progress, instructing and guiding providers so thatitems are targeted appropriately. It is invaluable having providers attendspeech-language therapy sessions, and, in turn, observing them during theirsessions. Consultation can also focus upon observing the student in the fullarray of school settings. Having a team of dedicated professionals all on thesame page is the key to successful programming. With this in place, the skysthe limit! Fall NewsletterNow Available Newsletter

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