RBT Study Guide: Essentials

RBT Study Guide What are the 3 domains of ASD? Social Communication Social Interaction Restrictive, repetitive patterns of behavior What are some red flags a child may be at risk for ASD? No big smiles or other warm, joyful expressions by 6 months or thereafter No babbling, back and forth sharing sounds, smiles, or expressions by 9 months Lack of response to name No back and forth gestures by 12 months (pointing, reaching, waving) No words by 16 months No two-word meaningful phrases (without imitating or repeating) by 24 months Any loss of speech, babbling, or social skills at any age Unusual Prosody (little variation in pitch, unusual voice quality) Explain the fundamental principle of ABA ABA - is a scientific approach, that uses the principles of learning to understand the relation of behaviors and the environment. -* Consequences that follow a behavior control whether that behavior will increase or decrease. What two components does a comprehensive ABA treatment program include? 1. Behavior Reduction - change antecedents and consequences to decrease inappropriate behavior: stereotypy, noncompliance, tantrums, aggression, SIB 2. Skill Repertoire Building - increase appropriate behavior Behavior management and Skill Acquisition -> DTT & NET 3 levels of BACB certification? 1. RBT - Registered Behavior Technician 2. BCABA - Board Certified Assistant Behavior Analyst 3. BCBA - Board Certified Behavior Analyst ABA treatment team consists of...? Supervisor, RBT, parents, caregivers, other professionals (Speech, OT...) Roles/responsibilities of RBT? - Direct implementation of skill acquisition and behavior reduction plans developed by the supervisor - Data collection- skill acquisition and behavior management - Assist with certain assessments (i.e. preference assessments) - Safety of the client Two roles of the BT in assisting with assessments? 1. Provide information about clients' current skill set 2. Assist with behavior management and motivation during a formal assessment. 3. Does preference assessments What activities do most therapy sessions include? Preparation and clean up Rapport building - "pairing with client" Skill acquisition tasks Behavior management Data collection 1. DTT - Discrete Trial Training - More formal instruction, repetition of instructions, often conducted sitting down with specific materiExplain the two types of formats that learning activities are per- als being presented. formed in? 2. NET - Natural Environment Training - Less formal instruction, variety of instructions, centered on naturally occurring activities, moving around in natural environment. What does a BT collect data on? 1. behavior reduction within the BIP & new behaviors 2. skill acquisition target 3 instances where a BT should call the supervisor on the case to relay information: 1. client is sick (sessions are being cancelled) 2. Behaviors have unexpectedly increased 3. Parent expresses concerns or has questions 4. Changes in environment that are affecting therapy sessions 5. Client is having difficulty with a particular task/lesson. - Model target skills and provide hands on support as parents learn to implement new producers with their child. 1/9 - May teach parents how to teach new skills and manage behaviors - Provide positive feedback and support during a behavior How can BT assist with parent training? Task avoidance (noncompliance) Tantrums What are some behaviors more commonly observed in individuals self-injurious behaviors (SIB) with autism? Aggression Stereotypy (self-stimulatory/repetitive body movements or behaviors) (hand flapping) What are the ABC's of behavior? A - Antecedent- what happens right before the behavior occurs B - Behavior - what specifically does the behavior look like C - Consequence - what happens right after or in response to the behavior What information in included in the Skills Acquisition Plan? specific instructions, expected correct response, specific target being taught, specific materials or stimuli being used, any other information related to the teaching of this skill. Define positive and negative reinforcement: positive reinforcement - technical term for getting good stuff when you do something correct. Negative reinforcement - escaping or taking away/removal of bad/negative stimuli *both increase or maintain behavior What are the 4 functions of problem behavior? 1. Attention - someone gives attention for problem behavior 2. Tangible - someone gives access to a tangible item or activity for problem behavior. (Toys, food, activity) (Julie wants a cookie, she screams, mom gives cookie to keep her quiet) 3. Escape/Avoidance - someone allows escape from an aversive task upon problem behavior - discontinuing a task or demand once bad behavior presents. 4. Automatic - feels good to do it, not socially mediated, sensory stimulation Antecedent vs. Acquisition Antecedent - thing or event that occurred before, what happened before behavior occurred. Acquisition -the learning or developing of a skill, habit, or quality. Example of an antecedent modification: - Task Modification - Still have to do the same amount/all of the problems but they get to choose what order they want to do them in. - Demand Fading - reduce the amount of tasks the child must do - Noncontingent Reinforcement (NCR) - time based schedule, they get it for free no matter what. The behavior feels good. (for attention - pat Melony on the back overtime you pass by her chair - Functional Communication Training (FCT) - teach child to request access to the reinforcer (can't stand at refrigerator and cry anymore, must show a picture of juice) - Behavioral Momentum - (High P Low P) High Probability Low Probability - 3 High P, 1 Low P. Other examples of antecedent considerations to utilize for aggressive/dangerous clients: - Potentially dangerous items are removed from environment (scissors, hot coffee...) - Dress Accordingly - long sleeves, pants, hair pulled back. - Avoid exposed skin, no jewelry Define Extinction: Breaking the relationship between the behavior and reinforcer that previously followed it. No longer give the reinforcer for a previously reinforced behavior. (planned ignoring - attention, tangible - don't give her the cookie, escape - make them finish the demand) What is an extinction burst and when would it occur? The behavior will get worse before it will get better when implementing Extinction. Dramatic but temporary increase in problem behavior. NEVER GIVE IN!!! Reinforcement of some behaviors and not others. The results is an increase in desired behaviors that are reinforced and an elim2/9 ination of problem behaviors that are not reinforced. (Reinforce desired behaviors AND don't reinforce (extinguish) undesired behavior) Explain Differential Reinforcement 1. Differential Reinforcement of Alternative Behavior (DRA) - has both antecedent and consequence component. A specific appropriate response is taught to replace an inappropriate response. (Like FCT) 2. Differential Reinforcement of Other Behavior (DRO) - presenting What are the three Differential Reinforcement (DR) procedures? a reinforcer contingent on the absence of a problem behavior for a specified period of time. (Whole interval/momentary interval) 3. Differential Reinforcement of Incompatible Behavior (DRI) - an incompatible behavior that is impossible to occur simultaneously with the problem behavior is reinforced. (ex: hand mouthing -> playing with toys) What components are included in the behavior intervention plan (BIP)? (6) 1. Operational definition - definition of the behavior in detail. 2. Hypothesize function - what behavior function 3. Antecedent Modifications 4. Replacement Behaviors 5. Consequence Modifications 6. Data Measurement What should you do if you observe a behavior that is not in the BIP? Take ABC data and extinction planned ignoring or which best fits the behavior. Let your supervisor know immediately Is designed to provide a set of skills and strategies that allow staff What is the Safety Care curriculum designed for? (Crisis Manage- in a variety of setting to safely and humanely provide support to ment) individuals who may sometimes exhibit disruptive or dangerous behavior. What behavioral instruction methods are incorporated into Safety Care? Errorless learning Task analysis Role-playing What are the three levels of safety care training? a. Level 1 Introduction b. Level 2 Specialist c. Level 3 Trainer Define Satiation: a. Consuming substantial amounts of a reinforce temporarily decrease reinforcing effectiveness b. Reduces the effectiveness of a reinforce ("I can't eat another hot dog") (Don't want to watch a movie later if you spent all day watching TV). What is Deprivation? a. Withholding a reinforce which increases reinforcing effectiveness b. Increases the effectiveness of a reinforce (Haven't had cookies all week!) Explain the three types of direct preference assessments: 1. MSWO- Multiple Stimulus Without Replacement- Present array of 5-7 items and instruct the child to "pick one". Once selected, allow the child to access that item for 30 seconds. After 30 seconds remove item from the array and lineup remaining items and instruct child to "pick one". Continue in this manner until all items have been chosen. The item chosen first is presumed to be the most preferred. The item chosen last is considered the least preferred. 2. MSW- Multiple Stimulus With replacement- Similar in setup to MSWO except after an item is selected it will be returned back to the array. Prior to the preference assessment allow the child to interact with each item. Line the items up so they are equidistant and instruct the individual to "pick one". Allow access to item for 30 seconds and then place the item back in the array. There will be as many trials as there are items. Continue in this manner until all trials are complete. 3. Paired Choice- Stimuli are presented in pairs until each stimulus has been presented with every other stimulus. The sequence of 3/9 the pairings is predetermined. Tell the individual what you are presenting and then ask him/her to make a choice (e.g. I have a ball and a sticker, pick one). Hold the stimuli on a table in front of the individual. Give the individual the item that he chooses for 30 seconds. If the individual attempts to take both, remove them both and represent them. What is pairing? The process by which a neutral stimulus (person, place, object) becomes a learned (i.e. conditioned) reinforcer List 2 suggestions for effective pairing: Identify as many things as possible that are reinforcing for the child Pick reinforcers that are easy to deliver (such as a cookie broken into bits, juice poured in a cup, etc) Have reinforcers immediately available during ABA sessions Approach child with reinforcer and make it obvious that you have something reinforcing Throughout the session give "freebies" without requiring the child to do anything Make sure you are not interrupting something that the child is doing to offer something that is less reinforcing Provide several opportunities for reinforcement to be delivered each minute Try to create new ways to interact with reinforcers so that your involvement increases the reinforcing value Be aware for the value altering effects/MO (if the child becomes satiated with the reinforcer, change reinforcer) What is Discrete Trial Training? is a 1:1 instructional approach utilizing the principles of ABA. Teaches new skills in a planned, controlled and systematic manner. Each trial has a definite beginning and end. Multiple trials. What are the 3 components of a discrete trial? 1. Stimulus (SD) Discriminative Stimulus - the question of instruction you are presenting the child with. 2. Response 3. Consequence a. The child will not respond consistently Why is it important not to repeat the SD without giving a conseb. We want the child to learn that every time we present an SD, that quence? a response is expected. What needs to be done before presenting the SD? a. Gain the child's attention before presenting the SD b. If you fail to gain attention first, child is unlikely to respond and you are setting them up for failure. What is the maximum amount of time that can elapse between the presentation of the SD and the response? 3 seconds What two possible consequences follow a response? 1. correct response 2. incorrect response When would reinforcement be given as a consequence? Immediately following the correct response What are the two categories of reinforcers? a. Unconditioned - primaries/unlearned - food, drinks b. Conditioned - secondary/learned - praise, rough-housing, toys, tokens, a break What is a prompt and how is it used to promote learning? - supplemental stimuli that control the target response but are not a part of the natural SD that will eventually control the behavior. - Additional cues that are given before, during, or after the SD to assist the learner give an appropriate response. - help the child respond correctly Stimulus prompt example: Present large picture of spoon and 2 smaller pictures then give the child a spoon to match. Provide an example of a response prompt: SD:"How old are you? +immediately following the SD the BT says, "Say four" 4/9 When the prompt has been eventually faded out, and then the child finally achieves the task on his own, transfer stimulus control has occurred. How can you transfer stimulus control using prompt fading: *important note: Most to least prompting on acquisition Least to most prompting on mastered (unless on otherwise specified instructions from supervisor) What is Errorless Learning? A teaching method that provides immediate and effective prompts to eliminate the child from making mistakes or errors in the learning process Reduce response errors What are the 4 steps of implementing Errorless Learning? 1. Cold Probe - conduct preference assessment first. For the first trial of every target within each program conduct a cold probe. Provide the SD then wait 2-3 seconds for the child to respond to see if they know the correct response or not. 2. Prompt - Correct response, no need to prompt. No Response, do not reissue the SD go in with more intrusive prompt (full physical). (Most intrusive to least intrusive) 3. Transfer Trial - From least intrusive prompt to individual correct response. 4. Reinforcement -Delivery of reinforcement for correct answers. Unprompted trials should be consequated with highly preferred reinforcers What is a transfer trial? When moving from a prompted response to an independent response. Explain the Prompt Hierarchy from most intrusive to least intrusive prompts: Physical, partial physical, verbal, gesture, model. What error correction procedure should be used when a child responds incorrectly to a known skill? no-no -prompt- repeat when you have to prompt after the second no, go to the LEAST intrusive prompt and then work your way up What is discrimination training? Procedure for teaching the learner to discriminate between two or more stimuli 1. Successive Discrimination - used when there is NO field of stimuli for the client to point, touch or pick up. (naming objects - acting, answering personal information questions - intraverbal) alternating using positive stimulus (includes reinforcer) and negExplain the two types of discrimination training and when they are ative stimulus (does not include reinforcer) (Stand up, what is it?, used: where do you live?) 2. Simultaneous Discrimination - There is a field of stimuli for the client to respond to by pointing, touching, or picking up an item from a field of items. Used for matching or receptive lessons. (touch nose, put with same, give me cup) What does it mean to maximize discrimination? To select acquisition targets wisely in order to facilitate learning and minimize confusion for the learner. Two examples of maximizing discrimination: 1. sound - consider how similar the stimuli sound. Avoid similar sounds (doll, ball, eyes, ears) 2. color - it is important to consider the color of the target object. Avoid placing targets with the same color it can confuse the child 3. shape (ball and orange) Define shaping? Reinforcing successive approximations of a target behavior while extinguishing previous approximations. example of shaping: Andy cannot say the sound "b". the BT's have no way to prompt Andy to make him say this sound, so they shape the "b"sound. Name the 3 types of chaining: 1. forward chaining 2. backward chaining 3. total task presentation 5/9 When is chaining used? When we want to combine two or more simple behaviors or responses into a more complex sequence. (brushing teeth) What is Natural Environment Training (NET)? ABA teaching procedures that can be used to teach learners in their natural environment (through play or other disguised activities) Advantages of using NET? - Motivation/EO provides best conditions for mand teaching - Generalization naturally occurs; elaborate generalization procedures are not necessary. - Reduced amount of negative behavior due to use of child's interest; specific reinforcement is naturally built in. - Verbal interaction is characteristic of natural environment - Verbal responses can be mixed together under environmental conditions that may evoke them later. What are the difference between NET and DTT? DTT - has lots of trials, much more structured NET- does not have a lot of trials the target items are chosen by the learner not the BT, the lessons can be more "functional" in nature. the learner typically Name 3 examples of indirect prompting strategies used in NET: Rephrase the question Asking leading questions/scaffolding Relating situation to previous event Drawing/using visual representation of situation Asking yes/no questions or giving a choice of responses Maintenance is continued performance of a response after it was first learned. What is the difference between maintenance and generalization? Generalization is the expansion of teaching beyond what was directly or intentionally taught. What three domains should generalization be demonstrated across? 1. Across people- demonstrates ability to respond to not only the person who trained the new skill, but across all the other various people. 2. Across Settings-demonstrates ability to apply the learned skill across untrained settings (i.e. home, school, community). 3. Across Stimuli- demonstrates ability to apply the learned skill across untrained materials/stimuli. List 4 strategies for promoting generalization: 1. teaching using multiple examples 2. Teaching across multiple people 3. Teaching using flexible/multiple instructions 4. Teach "functional" behaviors What are the two guidelines for collecting accurate data? 1. Data should be recorded immediately following the occurrence of behavior 2. Data should be complete and detailed including all relevant information of the behavior. What is the Daily Notes section in Catalyst used for? For own reminders, to a fellow BT, or your supervisor. behavior? updates? tips?question? parent updates? phase changes? Where in Catalyst can you find access to your supervisor's team meeting and overlap notes? In main menu select documents tab How can you correct an error in Catalyst? Click the red arrow in the upper right corner of the screen and you will be able to delete the data entered. (For some programs you will need to email your supervisor that the data was entered incorrectly and needs to be changed) How do you take ABC data using Catalyst? You can take it in the ABC update program, select behaviors, and add in a detailed documentation of the behavior. What is partial interval recording? You record whether the behavior occurred at all during the interval. Supervisor sets an observation time or an interval length. Divide observation time by interval length to get the number of intervals. What is momentary time sampling? When the behavior occurs at the end of the interval. 6/9 List 2 examples of permanent product data? Completed worksheet Written composition Written spelling words Homework assignments Art projects What are the 6 elements of a line graph? 1. an x-axis and y-axis 2. axis labels:brief descriptions of each axis written adjacent to the axis it represents 3. legend: lists the graphed targets and identifies the symbol that corresponds to each. 4. data points: The data points are plotted on the graph. Indicate numerical value 5. condition labels:brief description of the teaching procedure or intervention written along the top of the graph 6. condition change line: a thin, vertical line drawn on the graph at the corresponding point in time when the condition changed What two processes are done to indicate a large break in time when data on the behavior was not collected? first, the data points that precede and follow the break are not connected with a line. Second, an axis break symbol is drawn on the x-axis at the point where the break occurred. Define abuse: California - legal definitions vary from state to state, federal definition of abuse and neglect. Open hand and on bottom that doesn't leave a mark. Anyone responsible for the individual can be an abuser. Physical - threat, risk, and non-accidental physical abuse emotional - Injury to the psychological capacity or emotional stability. Rejection and ignoring, shame and humiliation, terrorizing, isolation. sexual - intercourse, sexual activity, inappropriate touching neglect - failure to provide food, clothing, supervision, shelter, or medical care. Name 3 common signs of abuse: Each type of abuse can result in physical and behavioral changes in the child these changes can provide reasonable cause to believe or suspect abuse or neglect Unexplained injuries - burns, broken bones, bites, black eyes, bruising - shape of objects, unconvincing explanations. Returning to earlier behaviors - thumb sucking, bed wetting. Fear of going to particular locations fear of particular people Changes in appetite/eating behaviors Changes in sleep behavior Lack of personal care/hygiene (neglect) - consistently dirty, body odor, lack of sufficient clothing. Inappropriate sexual behavior Individuals with Disabilities - make it harder to identify Unexplained injuries - self injurious behaviors, noncompliance with medical care, tolerance for pain Who is a mandated reporter -RBT's - Individuals that throughout their job come into contact with children, individuals with disabilities, dependent adults or senior citizens are legally required to report abuse. When should you report abuse? Report to: local child protection agency, local law enforcement agency. - 1-800-4-A-CHILD -Inform your supervisor and Director Andrea Macken immediately Telephone: within 24 hours Written report: within 36 hours 7/9 How can a BT treat a client with dignity: - incorporate client choice - respect personal space - ensure privacy when addressing adaptive care needs such as toileting. - don't speak negatively about client's behavior within earshot of client. What information about the client is considered Private Health Information and protected under HIPAA? Information regarding physical, mental or emotional health (past, present or future) Name Postal address Names of relatives Names of employers Date of birth Telephone number Fax number Email address Social security number Medical record numbers Account numbers License certificate numbers Health plan beneficiary numbers UCI numbers What are the only situations in which breeching client confidentiality is acceptable? - child abuse - neglect - suspected suicide - suspected homicide - Elderly abuse - Use acronyms whenever possible - When carrying documents around, ensure company name is not revealed How can a Behavior Technician avoid compromising confidential- - Use initials ity? - Remove company logo or anything else that may reveal the client's diagnosis - Store information in a locked box when transporting confidential documents to and from the office locations What is verbal behavior? verbal Behavior (VB) is an Applied behavior analytic approach to teaching language that is based on the work of B.F. Skinner What is considered verbal behavior? Any behavior for which the reinforcer is indicated by the behavior of another person. Verbal does NOT equal Vocal. Verbal behavior includes Non-verbal behavior. What are the four verbal operants we focus on in early intervention? Echoic Mand Tact Intraverbal What is an echoic? controlled by a verbal stimulus that matches the stimulus, the reinforcer for the echoic behavior is non-specific (i.e., does not match) you HEAR and you SAY the SAME What is a mand? a mand can be thought of as a request, controlled by a motivative variable, benefits the speaker, the reinforcer for the mand is specific for that motivation *prompting would make it IMPURE example: MO/EO:Hunger R" "cookie" SR:"gets cookie" You WANT it, you SAY it, you GET it! HIPAA Health Insurance Portability and Accountability Act 8/9 What does research tell us about the man repertoire? Children acquire language faster in mand training Teaching appropriate mands decreases inappropriate mands Teaching mands directly benefits the speaker Teaching the mand facilitates acquisition of other verbal operants What are some strategies that can be used for mand training? - Sabotage/manipulate the environment - capture opportunities across the session - contrive MANY throughout ABA session - control delivery of reinforcer-giving all vs. some - ex:lollipop:on lick vs. the whole lollipop - acting confused - don't make prefered items readily accessible What is a tact? after mand training,you can move to tact training tact training provides the listener with information about the environment What is an intraverbal? - with the intraverbal there is a verbal stimulus, then the other person responds with a verbal stimulus that is related but does not match that response. The reinforcer is non specific. (Basically conversation) example: "Who are you talking to?" "My boss" "Oh" - The intraverbal allows us to talk about things that aren't present - It also allows you to talk about private events that others aren't experiencing (i.e. "What can you see?") What is the difference between "pure" and "impure"? - Impure is a guided/prompted tact, "What is this?" - Pure is an independent tact without any prompts from BT. Child labels object independently. Capture- take advantage of a moment that is naturally occurring to target a program or mands (Ex- child reaches for cookie so you either prompt him to say cookie or he says cookie independently) In regards to mand training, what is the difference between "capContrive- manipulate the environment/situation to target a proture" and "contrive" gram or mands (Ex- child winds to play building blocks. You hoard all the blocks and have him mand for each block or prompt him to mand for each block) Define Dual Relationship Any relationship other than a therapeutic one between a practitioner and a client (Romantic, financial, social) Romantic- flirting, dating, sexual contact Social- connecting on social media, sharing casual photos, eating dinner with clients, spending time in community together Financial- private tutoring for pay, babysitting, making educational materials for a fee Why are dual relationships a problem? Relationships are dynamic and change over time (romantic relationships end, friends have arguments etc) Threats to confidentiality Threats to trust Threats to objectivity More hesitant to discuss difficult situations and provide critical feedback 9/9