I remember when I first start working as a discrete trial training therapist back in the 90's, the first goals for the children I worked with were teaching the child, "Look at me," "Sit down," "Stand up," "Come here," "Give me," and "Do this." Sure does sound like a I was training a dog instead of teaching a child social communication skills, doesn't it? So, 20 years later, what should the initial goals be for a young child with autism beginning an ABA intervention program? First, there is not one answer to that question. It would depend on the skills the child already has. However I will share some skills to assess and target at the initial stages of learning social communication skills that I believe are essential for building the foundational skills a child needs to communicate and engage with others. Here are some initial skills to target if the child doesn't already display these skills:
1: Point to request a desired item that is in close proximity to the child (Initially the child should touch the item with a point and then receive the item. Then increase the expectation to also making eye contact before, during, or after pointing. Then increase the expectation to naming the item and eventually using a simple sentence to request the item). The reason why pointing is so important is because it allows the child to learn how to request items in a socially appropriate manner instead of crying, whining, screaming, or grabbing.
2: Make a choice given a field of two items (hold up two items and teach the child to point to request one of the items). It's easier to teach this by first holding up an item that you know the child would want with one the child wouldn't want. Then teach the child to make a choice when it is two desirable items. The reason why teaching a child to choice given a field of two is to build the skills of listening, scanning, and communicating a selection to a communication partner. This skill is used throughout the lifespan to demonstrate knowledge and to engage in reciprocal interactions with others.
3: Imitate motor movements during playful activities (songs, simple games like Simon Says, with toys, during book sharing activities). The key is to teach the child to watch an adult or a peer and do what that person is doing not to memorize specific motor movements. So, it is important to vary the movements you use during the activities once the child is able to imitate some movements that were presented repeatedly. The purpose of focusing on this is to teach generalized imitation skills. Many children with autism have deficits in imitation. Imitation is a very important skill for developing relationships with peers and learning new skills.
4: Play independently with a variety of age and developmentally appropriate toys (You can start with shape sorters, nesting cups, peg puzzles, legos, etc.) This skill is important to teach because independent recreation increases the quality of life for all people. If a child with autism does not have independent recreation skills, the child may resort to engaging in self stimulatory behaviors or problem behaviors.
5: Allow an adult and/or a peer to join the child's play (when someone joins the child's play, the child remains calm and refrains from moving away or engaging in problem behavior). This is important to teach because it teaches children with autism early on that playing with others is something to view as enjoyable not something to avoid. It helps them deal with their social anxiety by beginning with just allowing others near them while they are playing (parallel play). Eventually this should be expanded to responding to initiations from others during play, maintaining joint play, and initiating play with others.
Of course, these are not the only goals that can be targeted when beginning an ABA intervention program, but they should certainly be considered as initial targets. This summer, I will be developing a website that has ABA lesson plans for these goals and many, many others. However, in the meantime, if you need an ABA lesson plan for teaching the above goals, let me know, and I will post it.
I am excited for the website! What a great idea. It is about time more teachers advocate for and implement goals that target typical development for young children with ASD that can be applied in natural settings.
ReplyDeleteGreat blog, and I really like the program ideas listed in this post. They are a good starting point for an ABA program.
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