Welcome back to a day in the life of a Registered Behavior Technician (RBT). We continue our three-part series as we observe the second of two Applied Behavior Analysis (ABA) sessions. For the afternoon session, I followed Lead RBT Kaitlyn Gilbert, who is also studying to become a Board-Certified Behavior Analyst (BCBA). She, like Tamia, starts her session by speaking with the client’s caregiver. It is crucial for Kaitlyn to communicate with the caregiver before an ABA session. By speaking with the caregiver, Kaitlyn can gather valuable insight into the child’s specific needs, preferences, and any challenges they may be facing. This information allows Kaitlyn to tailor the ABA session accordingly, ensuring that it aligns with the child’s individual goals and targets their specific areas of improvement. Moreover, by understanding the caregiver’s perspective and concerns, Kaitlyn can establish a collaborative approach that fosters trust and cooperation between all parties involved, ultimately enhancing the effectiveness of the ABA program.
While transitioning into the clinic, Kaitlyn notices that her client is getting frustrated. She reminds the client to ask for help. Kaitlyn plays a significant role in encouraging her client’s independence by promoting the act of asking for help. By teaching and reinforcing this skill, Kaitlyn empowers her client to communicate their needs and seek support when necessary. Encouraging the child to ask for help not only enhances their ability to express their concerns effectively but also fosters a sense of self-advocacy and confidence. This promotes the child’s overall development and equips them with essential life skills that will greatly benefit them beyond the ABA sessions in various aspects of their daily life.
Once in the clinic, the client asks to go to the restroom. A line has already formed and the client must wait their turn. In assisting her client to wait patiently, Kaitlyn employs various strategies to ensure a positive and productive experience. One approach she employs is singing to the client, which serves to engage their attention and distract them from potential impatience or restlessness. The soothing effect of music can help create a calming atmosphere, reducing anxiety and promoting relaxation. Additionally, by allowing the client to hold her hand, Kaitlyn provides a comforting and reassuring presence, reinforcing a sense of safety and security. By implementing these techniques, Kaitlyn helps her client build patience and resilience while fostering a supportive and nurturing environment during waiting periods.
Kaitlyn informs me that the client has new daily living goals. She plays a crucial role in helping her client learn daily living skills. These skills are essential for individuals with autism as they enable them to become more independent and capable of navigating their daily routines. By teaching her client skills such as personal hygiene and household chores, Kaitlyn is not only providing practical support but also fostering a sense of empowerment and confidence within her client. Ultimately, the development of these skills allows individuals with autism to have a greater sense of control over their lives, enhance their quality of life, and increase their inclusion in society.
When in the therapy room, Kaitlyn shows me a visual tool she has been using to help the client know the appropriate times to be quiet and loud. Visual cues hold significant importance for children with autism as they often face challenges in understanding and processing verbal instructions or social cues. Visual cues, such as pictures, symbols, or gestures, provide a structured and consistent way of communication that appeals to the visual strengths of individuals with autism. These cues help the client to comprehend and follow instructions, understand expectations, and navigate their environment more effectively. By utilizing visual cues, Kaitlyn can enhance communication, reduce frustration, and improve engagement and learning outcomes for her client, promoting their overall development and inclusion.
Assisting her client with their LAMP (Language Acquisition through Motor Planning) device is a crucial part of Kaitlyn’s support. For individuals with limited verbal communication abilities, a LAMP device serves as a powerful tool for augmentative and alternative communication (AAC). By assisting her client in using the LAMP device, Kaitlyn enables them to express their needs, thoughts, and desires, thus enhancing their ability to communicate effectively. This communication support not only enables her client to interact more meaningfully with others but also promotes their independence, self-advocacy, and participation in daily activities. By guiding her client in navigating and utilizing their LAMP device, Kaitlyn plays a valuable role in facilitating their communication and overall development.
During Discrete Trail Training (DTT), Kaitlyn demonstrates remarkable effectiveness in her use of modeling to support her client in successfully utilizing his LAMP device. Recognizing his tendency to answer too quickly and become frustrated, she sets a positive example by deliberately slowing down her own response and providing clear and concise communication through the device. Her deliberate and patient approach encourages her client to adopt a similar strategy, helping him to focus his attention and consolidate his thoughts before providing a response. Kaitlyn’s modeling also extends to addressing his tendency to scroll when frustrated. By demonstrating appropriate device navigation skills and offering gentle reminders, she assists her client in developing alternative coping strategies, such as taking breaks or using other communication methods. Kaitlyn’s expertise in modeling proves instrumental in fostering a more efficient and successful use of the LAMP device for her client.
After completing DTT, Kaitlyn transitions her client into the playroom. She is a skilled therapist who effectively utilizes Natural Environment Teaching (NET) while working with her client. She understands the significance of implementing this teaching method to promote learning and growth in a natural setting. With NET, Kaitlyn provides her client with opportunities to practice skills in real-life situations, allowing for generalization and transferability. However, Kaitlyn’s client is not responding to her attempts to communicate. Still, she understands that even if her client does not respond in the preferred way, it is crucial to continue employing NET. By consistently providing opportunities, she believes her client will gradually develop the desired responses. Moreover, she recognizes that every small step and effort her client makes in response to the teaching is valuable and contributes to their overall progress. With her patience and commitment, Kaitlyn ensures that her client receives the best possible support for their development.
About halfway through the session, Kaitlyn is joined by her Board-Certified Behavior Analyst (BCBA), Anna. Kaitlyn and Anna commence a PEAK assessment session with their client. As they prepare for the task ahead, Kaitlyn and Anna review the goals and objectives to ensure a personalized and effective evaluation. With the PEAK assessment, their primary focus is on the client’s language and cognitive development, aiming to identify strengths and areas that require further support. Anna expertly guides Kaitlyn through the process, explaining each step and providing necessary instructions. Kaitlyn and Anna foster a supportive and engaging environment, adapting the assessment to the client’s specific needs and abilities, ensuring their comfort and participation. Together, Kaitlyn and Anna work to administer the assessment, continuously observing and recording data to gather comprehensive information about the client’s progress, which will allow them to adjust the client’s intervention strategies accordingly. Through their collaborative efforts, Kaitlyn and Anna aim to empower their client by uncovering areas for growth and tailoring interventions that will promote further progress on their developmental journey.
After the therapy session with the client, Kaitlyn takes time to debrief the client’s caregiver in order to provide them with a comprehensive understanding of what transpired during the session. Kaitlyn starts by recapitulating the main topics discussed, ensuring that the caregiver is made aware of the progress made in the assessment process and any concerns that arose during the session. She patiently listens to the caregiver’s perspective, acknowledging their observations and answering their questions. By debriefing the caregiver, Kaitlyn aims to establish a collaborative and supportive relationship, enabling them to work together in the best interest of the client’s well-being.
For more information on augmentative and alternative communication (AAC), check out this information from Autism Speaks:
