Intensive ABA Services
Back to School 2010
By Vincent LaMarca, BCBA
Lovaas Institute – Indianapolis
Here's a common school myth: providing a child with an aide in school leads to prompt dependency. In fact, research suggests the opposite is true. An aide in school can lead to greater independence. Consider that children in the best outcome groups of Lovaas 1987, Sallows 2005, and Cohen 2006 started in school with an aide who had been active in the home program (see www.lovaas.com/research.php for references). These aides were eventually faded so that the children continued in a general education classroom on their own.
Not all children reach a level at which an aide can be completely faded. Finding the balance between providing the help a child needs to be successful and allowing the space a child needs to be more independent requires constant evaluation. Prompting and fading are some of the most difficult tasks to plan for because there are so many variations of what might happen. However, over the years I have collected a number of guidelines that have proven helpful, particularly if an aide is demonstrating difficulty knowing when and where to fade. I've included these guidelines as well as an example data sheet below.
Prompting and fading are as much an art as they are a science. Hopefully, these suggestions will help you refine your clinical judgment and capture pertinent data that shows progress in fading a school aide when appropriate.
1. Write down the current skill level of the child when the aide is present. What does the child do well when the aide is present? You can write this in narrative format or in bullet format. For example, for a sewing class, you might say:
This narrative/bullets helps remind us of the level she is capable of when the aide is next to her and can quickly and easily prompt.
2. Determine on which behaviors you will immediately intervene, regardless of trying to fade the aide. For example, the aide will immediately intervene if:
Part of allowing for more independence means you also allow for more mistakes. However, we want to be clear what behaviors or skill loss is not acceptable.
3. Write down a basic prompt hierarchy from the least to most intrusive prompts (i.e., what's the minimal prompt you might be able to give her). One prompt may sometimes be more intrusive than another, but there is an overall progression from what results in the most intrusion by you to what results in the least intrusion. In my experience, the following prompt hierarchy is common:
4. No longer implement most-to-least prompting (i.e., keeping the child successful). Instead, implement least-to-most prompting (i.e., giving a chance for the child to try on her own and possibly make a mistake, deal with consequences, have others help, and figure things out on her own). Her success may decrease somewhat as a result.
5. Before prompting the child, count to 15. Give that long for things to work themselves out without you.
6. Everyday ask, "Was the child successful at least 80% of the time?" If so, then you MUST do less to help out the next day.
7. Collect data on how much prompting is occurring and how well she is doing on her own. Some potential data collection includes:
8. Don't worry about day-to-day data when looking for trends because there can be so many variations in the activity. Instead, look at the data from week to week and see if there is gradual improvement.
9. Every two weeks to a month, reassess what her current skill was prior to starting to fade the aide, what she is doing now and how involved the aide currently is.
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The names of all children in this newsletter have been changed in respect for family confidentiality.