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August 17, 2019

7/6/2019 7:30:00 AM
'Understanding Why & How Behavior Changes,' a workshop giving hope for every child with autism
Kimberly Drake
Special to the Lakeland Times

Autism is the disorder with two-degrees of separation, meaning if you don't personally know someone with autism spectrum disorder (ASD), most likely you know someone else who does.

According to the Centers for Disease Control, this developmental disability is defined by diagnostic criteria which include "deficits in social communication and social interaction, and the presence of restricted, repetitive patterns of behavior, interests, or activities that can persist throughout life."

Like the roots of a tree, autism is spreading throughout humanity at an alarming rate, with about 1 in 59 children afflicted with ASD in the U.S. As the numbers rise, so does the need for autism-specific therapies and interventions, specialized education, and tools for parents and caregivers to help navigate the still mysterious world of autism-related behaviors.

These autism-related behaviors are often maladaptive, which leaves parents, caregivers and educators at a loss as to how to help their loved one or student learn appropriate alternatives. Undesirable behaviors are sometimes challenging to understand, even by parents who have been with their child since birth. Deciphering why maladaptive behavior occurs is the key to guiding it in the appropriate direction.

On Monday, Jennifer Hartman, M.A., BCBA, presented a free workshop, "Understanding Why & How Behavior Changes," at the Howard Young Medical Center in Woodruff, to help those who work closely with individuals on the autism spectrum learn the basics of Applied Behavioral Analysis (ABA.)

This free workshop, sponsored by Therapy and Beyond, an autism treatment provider based in Texas, Oklahoma and Colorado, was one of the organization's Community Giveback events to offer interactive learning opportunities for parents, caregivers, educators and any person who wants to learn more about why certain behaviors occur and what to do to change them.

Hartman is the daughter of longtime area residents, Dr. Charles and Eileen Lonsdorf, and was born and raised in Northern Wisconsin. She has been a Board-Certified Behavior Analyst (BCBA) since 2009, earning her master's degree in behavior analysis at Western Michigan University. She has 14 years of experience in the field of ABA, 10 years as a BCBA, and has taught college-level courses, presented research at conferences, and has been involved in teacher and staff training and development.

Her work has also involved collaborating with other service providers, parent training and education, and conducting individualized evaluations, assessments and treatment and behavior intervention plans for children diagnosed with ASD. Hartman supervises treatment teams providing individualized behavior therapy to those with autism spectrum disorder and other developmental disabilities through in-home, school and clinic-based programs.

BCBAs like Hartman have a master's degree, typically in behavior analysis or a related field. They also must pass the licensure exam through the Behavior Analyst Certification Board and are upheld to ethical and practice standards, with continuing education required on a regular basis. BCBAs are also utilized in other venues, such as businesses looking to improve organizational behavior management.



'Autism is not a mental illness'

Hartman began her journey into the world of autism treatment after switching college majors from marine science to psychology and taking classes in learning and behavior. It is at that point she began to realize if the environment changes, behavior can also change.

"Some of the courses involved pairing with a family with a child with autism, observing and working with ABA technicians and supervisors implementing this therapy in the home," Hartman explained. "I observed how not only did the child's skills progress and maladaptive behavior decreased, but the family now had the ability to take the child out to McDonald's, the grocery store or even the gas station. We take that ability for granted. But that's something that is challenging for children on the spectrum."

According to Hartman, "everyone, including those not on the spectrum, engages in behaviors for a reason."

"Applied behavior analysis breaks down behavior incidences into observable and measurable events, looking at what happens before and after the behavior so that we can better understand why it is occurring, and then work towards changing the behavior by modifying the contingencies surrounding it, implementing specific interventions that are science-driven, and taking data to ensure these interventions are effective," she said.

Hartman said ABA therapy starts as soon as children receive a diagnosis, which can be as young as 18 months. Insurance companies do pay for these interventions, but according to Hartman, "funding typically changes from insurance-based to private-pay or alternative funding sources for families looking to continue services past the age of 19."

Therapists work towards the ultimate goal of independence for the person with ASD.

"Autism is not a mental illness and does not result from bad parenting. Actually, these children can have very high IQs," Hartman stated.

In ABA therapy, technicians teach children different strategies to escape a demand more appropriately, such as asking for a break, as well as other behavior strategies like tolerating denial.

"We also plug in antecedent strategies to prevent that problem behavior from ever occurring. We may use timers or visual supports, or we implement fixed time schedule reinforcement or non-contingent reinforcement, so children with ASD are not as motivated to engage in problem behavior to escape demands," Hartman explained. "Strategies are implemented based on the function of the undesirable behavior. If we're not analyzing the function thoroughly, then we can't treat that behavior appropriately."

Because ABA is data-driven, another big piece of the behavior puzzle is analysis.

"We accumulate a lot of data, and that helps us know if the interventions and strategies are effective," Hartman explained. "If we discover they are not working, we can make the changes necessary and that's an important aspect of ABA. It's individualized to the patient or the child, and then it's always changing based on their individual needs."

"One of the things skilled ABA therapists do, and we do at Therapy and Beyond, is use naturalistic teaching strategies, getting away from things like flashcards at a table because that doesn't generalize skills for the real world," Hartman stated. "We embed opportunities for generalization from the very beginning to focus on those age-appropriate areas of development, so we're better set up for success. A program will look at the whole child to ensure these newly developed skills are exhibited across a variety of people in different settings, and they're also meaningful for the child and their needs."

The attendees of the workshop were a mix of 28 educators, paraprofessionals, parents, caregivers, and grandparents from all over the region. The room was full of highly inquisitive people seeking more information on how to best help their loved ones and students learn more appropriate behavior.

When asked, many attendees identified undesirable behaviors such as hitting, biting, throwing things, no eye contact, inappropriate emotional responses, repetitive behaviors, refusal to try new things and elopement. One parent asked how to get therapy like ABA for her teenage child and relayed to the group how challenging it is to find services in rural areas such as the Northwoods.

"The vision of ABA therapy is that there is hope for every child," Hartman said. For the parents, grandparents and educators, who live and work with children on the spectrum, educating themselves in workshops such as this, help make that vision into a reality.

Kimberly Drake can be reached at kimberlydrake21@gmail.com.





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