應用行為分析治療(ABA) Q&A

henryfok

怎樣小組時或課堂上都以不出位,thx!

原帖由 earlyeducation 於 11-9-11 18:38 發表
在一對一過程中學生會學習各種的日常生活指令，這些指令會幫其他老師及家長去指示學生在平時上課的行為。到適合的時候，一對一的形式亦會有所改變，會慢慢變成學校上課形式，而且在治療內容亦會加上小組學習，令學生能在一對一 ...

conconma

ABA Strategies

ABA therapists work with applied behavior analysis techniques in order to teach children with autism through intensive one-on-one therapy sessions. ABA can help children with any level of autism spectrum disorder. ABA therapy works on communication, academic, social and behavioral skills or any other deficits that a child might have. Specific targets of the interventions are chosen based on the child's individual problems and disorder. Children with autism often exhibit behaviors such as their unwillingness and a reduction in these behaviors is often the first intervention target. After behavior problems are controlled, the intervention aim can shift to dealing with other aspects of autism, such as improving communication and social interaction. Goals in an intensive behavioral intervention program will also change as the child improves or when there is a change in the environment.

Treatment is based heavily on functional assessment, information, and family input.

Basic principles of behavioral and educational intervention approaches

Behavioral therapies include specific approaches to help individuals acquire or change behaviors. All behavioral therapies are based upon some common concepts about how humans learn behaviors. At the most basic level, operant conditioning involves presenting a stimulus (request) to a child, and then providing a consequence (a "reinforce" or a "punisher") based on the child's response.

•        A reinforce is anything that, when presented as a consequence of a response, increases the probability or frequency of that response. Examples of possible reinforcers for young children may include verbal praise, or offering the child a desired toy.

•       A punisher is a consequence that decreases the probability or frequency of that response. Possible punishers for young children may include verbal disapproval or withholding a desired object or activity. The term "punisher" is a technical term used in behavioral therapy and does not imply the use of physical abuse such as hitting, slapping, spanking, or pinching.

ABA Therapy Approaches

A default in social motivation is a characteristic in autism. Children with autism typically lack the motivation to learn new tasks and participate in their social environment. Some traits you may observe when placed in soc
al situations are temper tantrums, crying, noncompliance, inattention, fidgeting, staring, attempting to leave, or unwillingness. The use of ABA therapy can increase the desire in children with autism, therefore, significantly enhancing the effectiveness of the teaching environment.


[ 本帖最後由 conconma 於 11-9-11 22:17 編輯 ]

conconma

ABA needs to follow the fomula of ABC method.

A is Anecdotal observation, what environment factors trigger this behavior. 什麼環境因素引致該行為.  B is the Target Behavior which we want to change. 針對什麼行為需要去改變 In your case it is 離開位. C is the Consequence, what is the feedback to make the child willing to change his behavior gradually? 什麼反饋令他願意改變現有的行為...Therefore, at first, you and your therapist need to work together to observe and find out what factors trigger this behavior. Without finding out the cause, how can you motivate the child with consequence in order to change his behavior?

analyse分析-->find out the reason/cause, how to motivate with consequence to change the behavior-->apply應用good behavior to life (應用行為分析)

分析問題行為的前事-行為-結果（A-B-C）路徑圖，製定對抗行為路徑圖，改變A或C進而改變問題行為

OR

A - Antecedent  
A directive or request for the child to perform    an action.
                        
B - Behavior  
A behavior, or response from the child - successful performance, noncompliance, or no response.
                        
C - Consequence     
A consequence, defined as the reaction from the therapist, which can range from strong positive reinforcement (ie. a special treat, verbal praise) to a strong negative response, “No!”            


另一方面, 教導+訓練學生去類化環境也是重要...舉例說, 在家他會用匙羹吃飯, 而無論出外, 在學校也一樣(要用匙羹吃飯)-->行為不會因環境變化而改變...

又譬如: 在家訓練要坐好專注, 在學校亦需要一樣...同樣地,  在學校要留心上堂及投入訓練, 在家亦需要

再舉個例子, 小朋友被同學欺負而不懂回應 A=面對其他小朋友欺負, B=不懂說出適當回應, C=激發他講出 :[停手!]motivate him say "Stop!" or "You are not nice!". You can use movie/cartoon and role playing to explain to him.

再舉一個實例, 我個仔試過一排突然間唔肯去任何廁所 (但之前巳經toilet trained), 后來經過一段時間的觀察+記錄, 發現原來佢愛上"玩"廁所(沖廁), 因為他也經常邀請我一齊去"玩"沖廁,每次見到沖廁他也很雀躍, 既然佢當了廁所係玩具, 誰也不會在玩具piss...A: 突然間唔肯去任何廁所, 當廁所係玩具 B: 唔肯去廁所 C: 解釋及示範廁所不是玩具, 廁所的真正用途

[ 本帖最後由 conconma 於 11-9-12 00:47 編輯 ]

cheungsm1

請問如小朋友有簡單嘅語言，但他不時自言自語講太空話自我刺激，應該怎辦？
Thanks

conconma

不少自閉兒都有自我刺激行為, 反映著感統的失衡, 坦白講不是一個容易處理的問題, 因為當一樣行為消失, 好快可能又出現另一個行為去取替...不過都可嘗試去減輕程度, LPYdad提議的也非常好...

1. 治本...感統失衡+將刺激行為變得比較正常

跳彈床(以半小時為一個單位)也是不錯的感統運動, 可訓練語言區, 消耗多餘體力, 我個人比較喜歡手拖手跳, 一齊跳, 一齊唱, 數, 增加互動, 目光接觸

另外, 有些自我刺激喜歡fing 手, 自轉, 不停跳...將它們化為跳彈床, 都係跳, 不過看來很正常...鍾意licking人, 牆, 就lick糖 (不含庶糖, 不然會過動)
http://www.littlegianthk.com/b5_product1.php?all=y&fid=1&sid=16


2. Redirect his attention

玩手, 咁隻手得閒, 就畫下圖, 剪紙, 穿珠,砌圖, 玩練力胶, 做rdi一起摺手巾, 摺衫...在街上, 可問他問題或形容見到0既東西(要他跟你講or fill in sentence);叫他摸摸身體部份; 一起唱歌+做動作, 分散其注意力, 仲知令佢唔專注於自我刺激及講太空話...

3. 嘗試搵出及記錄引致刺激的環境及源頭及次數,會否 燈光, 某些聲音, 物件刺激到佢, 令佢很緊張, 需要自我刺激來安撫及平靜自己...我小朋友每次聽到冷氣機低沉的頻率, 便會失控, 打頭...但夏天四處都有冷氣機...在家我會播放輕音樂, 蓋過冷氣機聲...出街就讓他聽mp5...

4. 身體過敏或治療引發自我刺激

原來某些自閉兒對一些食物, 如: 旦, 牛奶有過敏, 食后好像身體內有蟻咬一樣(我小朋友這麼形容)...在街外用膳(食過味精食品), 情況非常嚴重...另外, 每次排毒期間或針炙療程過后, 自我刺激也嚴重了, 要做大量感統+按摩去平伏...因為他們表達能力比較弱, 所以可能用行為表達自己身體的不適...

5.還有假如小朋友比較大, 認知能力亦可以, 家長就需要當他每次有刺激行為時, 講出你對佢的感受+表情, 告訴他:[this is not good唔好睇, 我唔鍾意你咁做], 然後替他搵一個取替品去代替自我刺激...情況如許可, 拍下他的行為及別人的目光, 反應...讓他明白這樣也會令自己及家人感到embarrassed

[ 本帖最後由 conconma 於 11-9-12 10:23 編輯 ]

conconma

U too...

overcomer

咁ABA在訓練孩童社交互動方面有什麼方法? 除了"背對白式"的方法外, 有冇類似RDI的理念, 希望孩童有動態智能, 主動分享意見? 如果小朋友係高功能, 智力等冇問題, 係差社交, 有什麼方法? 社交係最惡搞的, 其他小朋友係唔會就你, 對方會回答什麼不能完全預測。又會有暗示、諷刺等。

ABA在心智解讀方面又如何TRAIN? 如何訓練他們解讀別人的想法?

conconma

Actually, Asperger is also weak in social skill, in order to enhance their social skill) first, we have to do the foundational work. step by step...學社交也等同學語言, 認知...都是要先打好基礎, 再逐步去提昇...所以, 最初prompting 是有需要的, 等於一個小孩最初學講說話,都要家長經常在旁提點著...但等他掌握了技巧, 一定要基礎上巳純熟, 穩固, 才可以再提昇...

For ABA, normally it divides into age groups with similar ability in order to train their social skill...

The art of social interaction is a combination of responses to both verbal and non-verbal social bids.  

During the training, we focus on beginning social initiations and reciprocations, dramatic play skills, turn taking, and age-appropriate games.

For examples:4-6 year-olds

To enhances creativity, themed play, and cooperation with peers.  Additional skills include listening, following group instructions, and playing games with rules.  Role playing and compliments enhance self esteem.

children may need additional teaching in cooperation, teamwork, and adding novelty to group play themes.  Group topics include self regulation, theory of mind, and advanced conversational skills.

More dramatic play to the next level.  there might be different themes every 2 weeks to encourage the use of imagination, taking on a character role, and teaching children to plan their play.  

For the elder kids, incorporates the acquisition of social skills concepts, such as making and keeping friends, conversation, expressing feelings, self regulation, and self confidence through special activities.  

Anger management is also very important.  Some of the ASD child, they are hard to control their temper, e.g will cry or feel mad if they lose in the game. Thus, they have to learn and practice coping strategies, relaxation techniques, and effective strategies for self management to enhance social relationships and daily functioning.

For adolescence can be tough, it addresses common challenges for teens and teaches strategies to establish lasting friendships, deal with peer issues and solve social problems in positive ways.

還有, rdi 在動態智能訓練也是非常好...所以我也經常鼓勵家長們去上rdi 家長學堂, 將會得益不淺...無論TEACCH, aba, RDI, floortime etc每種訓練也有其優點, 能集大成者會是最好...

今晚眼睛很累, 其實有補充的, 遲些再加...各位中秋節快樂!!

[ 本帖最後由 conconma 於 11-9-13 11:56 編輯 ]

conconma

在小朋友的社交模式多出現在遊戲中, 但自閉兒在遊戲過程中缺乏与他人的经验分享，主要表现在三个方面，缺乏唤起别人注意的交流性语言、缺乏共同注意和缺乏共同活動行為

在語言、視線和活動，這三个方面都表现了自閉兒与人經驗分享能力的不足。据此推测，自閉兒可能就因此很難通過对對人的態度和情感知覺，而獲得他人给某一特定对象物有个约定俗成的象征符号能力，从而使他们難以進行假想遊戲。

有共同注意力的小孩特徵:

1. 從后面叫孩子的名字，他会回頭望, 甚至報以微笑或點頭。
2. 大人對孩子说话时，孩子会注意大人的眼睛或面部表情。
3. 孩子想要的東西拿不到時，會用手指指着東西要人幫忙。
4. 孩子想要的東西拿不到時，他会看看東西、看看人，要人幫忙。
5. 孩子有東西覺得好玩或有趣時，会拿给别人看。
6. 孩子看到有趣的東西時，会用手指指给别人看。
7. 叫孩子+指着遠處令他感興趣的東西叫他看時，他会往手指指的方向看去（不是只看着手）。
8. （沿上题）這時他会看看人、看看東西，看别人在看什麼

共同注意力可用來引導注意力，以便分享接触一件物品或与他人共處的經驗。它包括以下幾方面：

1. 將某物拿给某人看+觀察此人的反應

2.看别人所指或正在看的東西，并且
指着某樣東西讓别人看一件物品或者件事，目标就是看那个東西（這井不是说一个孩子指着糖要糖，而是像评論一个话题那樣指着，並與同伴共享這一評論）。

共同注意力之所以重要是因為它是非言语性的社交技能，或语言發展前的技能...

的確, rdi在提高共同注意力有很大成效...

<待續>

conconma

首先, 社交能力與智力是不掛鉤...但有影響性

曾有學者將一班智力正常自閉兒與另一班弱智的小朋友在實驗, 讓他們去玩社交或假想遊戲...結果令人感意外, 自閉兒的分數竟然比弱智的小朋友低很多很多...

故此,我是贊同家長去聽RDI家長學堂, 但是在實行RDI前, 必須搞清楚你的小朋友在verbal behavior intervention 基礎是否穩固(the functional roles between speaker and listerner)

不然, RDI也比較難去運用得好

conconma

首先, 社交能力與智力是不掛鉤...但有影響性

曾有學者將一班智力正常自閉兒與另一班弱智的小朋友在實驗, 讓他們去玩社交或假想遊戲...結果令人感意外, 自閉兒的分數竟然比弱智的小朋友低很多很多...

故此,我是贊同家長去聽RDI家長學堂, 但是在實行RDI前, 必須搞清楚你的小朋友在verbal behavior intervention 基礎是否穩固(the functional roles between speaker and listerner)

不然, RDI也比較難去運用得好...假如有智力問題, 在實行RDI同時請先打好VBI基礎, 這是非常重要的...VBI是ABA一個重要元素, 但坊間不是很多公司有實行

overcomer

什麼是VBI, 謝謝你耐心解答。

LPYdad1

Dear conconm, earlyeducation & overcomer,
Yr passage are extremely gd. Learnt a lot from yr explanation in ABA & social skills,