AUTISM DIRECTIONS - 
Applied Behaviour Analysis

Lilian Saltel, PhD.    
Board Certified Behaviour Analyst       

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Dr. Lilian Saltel is the owner of Autism Directions. She completed her PhD, with major in Applied Behaviour Analysis (ABA). She is a Board Certified Behaviour Analyst and provides services that are in accordance with the professional and ethical standards of her licensing board.

Dr. Saltel has been working with children with autism and other disabilities for over eight years. Her expertise includes working with pre-school and school-age children.

Regarding pre-school children, she has trained staff and family members in ABA principles, programed for skill acquisition and developed behavioural plans. Dr. Saltel has also collaborated with daycares and pre-schools when necessary.

Regarding school-age children, she has worked collaboratively with schools in developing Individualized Educational Plans, trained teachers and educational assistants, and collaborated with other clinicians such as speech pathologist or occupational therapist to develop language and motor skills.

In her practice, Dr. Saltel has been teaching adaptive, academic, communication, and social skills. She has developed successful interventions to decrease problem behaviours. 

Dr. Saltel’s goal is to build functional skills that promote a better life quality for children with autism and their families.
    
Applied Behaviour Analysis (ABA)

ABA is an intervention that uses learning principles to teach socially important behaviours to children with autism. Some examples of socially important behaviours are: communication, play skills, self-help, and motor skills. Problem behaviours are assessed and managed in order to increase learning opportunities.

Children with autism are less likely than other children to learn socially important behaviours from their everyday experiences. ABA intervention tries to decrease the gap between children with autism and their peers by providing learning opportunities that are planned in a very structured way and using a lot of repetition.

ABA is considered by many researchers and clinicians the most effective and evidence-based intervention for children with autism.

Some Examples of Strategies used by Behaviour Analysts are:

  • Discrete Trial Training (DTT): Very structured way to teach skills. It is composed by clear instruction, clear response, and clear consequence.

  • Incidental Teaching: Uses natural settings to teach skills. It is less structured than DTT, however, does require some planning and contrived arrangements.

  • Pivotal Response Training (PRT): Teach skills that are important for many other skills. For example: imitation, verbal skills, and cooperation.   
 
  Communication
Skills
Stereotypic Behaviours
Social Interaction
Autism Spectrum Disorder

Autism is a developmental disability usually diagnosed between 18 and 36 months of age.

Autism diagnosis is usually based on impairment on communication and social interaction skills, as well as the presence of stereotypic behaviours. Autism impacts how individuals learn and function throughout their lives.
 
According to the Diagnostic and Statistical Manual of Mental Disorders: DSM V, individuals must display a total of six or more items from three categories in order to be diagnosed.

Qualitative impairment in social interaction as manifested by at least two of the following:
  • Marked impairment in the use of multiple non-verbal behaviours like eye-to-eye gaze, facial expression, postures and gestures normally used to regulate social interaction.
  • Failure to develop peer relationships appropriate to developmental level.
  • Lack of spontaneous seeking to share enjoyment, interests or achievement with other people.
  • Lack of social or emotional reciprocity.

Qualitative impairments in communication as manifested by at least one of the following:
  • Delay in or total lack of development of spoken language not accompanied by an attempt to compensate through alternative modes of communication
  • In individuals with adequate speech, marked impairment in the ability to initiate or sustain conversations.
  • Stereotyped and repetitive use of language or idiosyncratic language.
  • Lack of varied, spontaneous make-believe play or social imitative play appropriate to development level.

Restricted, repetitive and stereotyped patterns of behaviour, interests and activities as manifested by at least one of the following:
  • Encompassing preoccupation with one or more stereotyped and restrictive patterns of interest that is abnormal either in intensity or focus.
  • Apparently inflexible adherence to specific, non-functional routines or rituals.
  • Stereotyped and repetitive motor mannerisms (hand or finger flapping or twisting or complex whole-body movements)
  • Persistent preoccupation with parts of objects.

Individuals must also have delays or abnormal functioning in at least one of the following areas with onset prior to Age 3:
  • Social interaction
  • Language as used in social communication
  • Symbolic or imaginative play
 
  
    
Services
   
   
Assessment:
Child’s communication and other adaptive skills are assessed as well as any problem behaviours. This assessment will support the definition of the learning priorities and type of interventions.

Interventions:
The Behaviour Analyst will develop interventions using ABA principles such as: reinforcement, fading, prompting, shaping, chaining, pairing, discrete trials training (DTT), incidental teaching, and functional communication training (FCT). The Behaviour Analyst will provide continuous training on the interventions as well as assess the progress and fidelity of the intervention implementation.

Consultations:
Consultations will happen at the child's house or any other settings. All significant caregivers, especially the ones who are applying the interventions will be present during the consultations to assess progress and problem solve if there are challenges. During these consultations, the Behaviour Analyst will observe how the caregiver is applying the interventions and provide feedback. Goals will be consistently revisited.

School Consultations:
The Behaviour Analyst will work collaboratively with school staff and parents to develop Individualized Educational Plans. The Behaviour Analyst will develop interventions and train school staff on these goals.  

Behavioural Plans:
The Behaviour Analyst will prioritize any problem behaviours as they interfere with learning opportunities. The problem behaviour will be assessed through a functional behaviour assessment to identify the function. Afterwards, a behavioural plan will be designed and discussed with the parents and other significant caregivers. Parents will be required to sign the behavioural plan. 

Parental Involvement:
Parental involvement is crucial for the interventions’ success. Although training is provided by the Behaviour Analyst, parents are responsible for any intervention implementation, either by them or other significant caregivers. Parents are also required to provide all materials for the interventions designed.

Teaching Skills such as:
  • Compliance & Cooperation
  • Self-Help
  • Social Interaction
  • Community
  • Academics
  • Communication
  • Visual Performance
  • Self-Management
  • Daily routines
  • Eating
  • Play
    
Resources
   
Books for parents and caregivers: 

  • Applied Behavior Analysis and Autism: An Introduction by Suzanne M. Buchanan, Psy.D., BCBA & Mary Jane Weiss, Ph.D., BCBA 
  • Right from the Start Behavioral Intervention for Young Children with Autism by Sandra L. Harris, Ph.D. & Mary Jane Weiss, Ph.D.  
  • Understanding Applied Behavior Analysis: An Introduction to ABA for Parents, Teachers, and Other Professionals (JKP Essentials Series) by Albert J. Kearney 

Manuals:

  • The Verbal Behavior Approach: How to Teach Children with Autism and Related Disorders by Mary Barbera 
  • Self-Help Skills for People with Autism: A Systematic Teaching Approach (Topics in Autism) by Stephen R. Anderson 
  • A Work in Progress: Behaviour Management Strategies and a Curriculum for Intensive Behavioural Treatment for Autism by Ron Leaf & John McEachin
      
Helpful Sites:   

  • Association for Science in Autism Treatment: www.asatonline.org  
  • Association for Behaviour Analysis International: www.autismsig.org
  • Parent Professional Partnership - Association for Behaviour Analysis International: www.pppsig.org    
  • A Parent’s Help Guide: Helping Children with Autism www.helpguide.org/mental/autism_help.htm