ABA methodology/courses for adults with LD , in Don Orione Care Center

The Care Center Don Orione from Voluntari, Ilfov is a residential center for children and adults with a wide range of severe disabilities, as well as  LD ( learning disabilities), abandoned children and adults coming from the social institutes that can’t support them anymore.

A big part of the adults are persons with learning difficulties such as : intellectual disabilities, ADD/ADHD, autism spectrum disorders, social phobia, speech disorders, dyslexia and other form of functional variations.

One of the most important Don Orione’s activity is focused on teenagers, adults starting from 18 years old and adults with LD difficulties. Thus, Don Orione created a day centre dedicated for teaching and working with the children and adults. The families can bring here their children or adults that require special treatment and approach in learning. The target people of the courses are those who present the following:

• intellectual disabilities
• ADD/ADHD, autism spectrum disorders
• social phobia and sensory processing disorders (SPD)
• speech disorders
• dyslexia and other form of functional variations.
• anxiety disorders
• different degrees of delay in neuro-psycho-motor development

An important detail is the fact that Don Orione is organizing day courses for children and adults with learning difficulties of autism spectrum disorder that want to learn a foreign language in order for them to adapt into society and become members of it. Don Orione has specialised teachers that are prepared and qualified to work with LD people.

The best practice presented is the implementation of ABA methodology ( applied behavior analysis) for children and adults with a large spectrum of learning difficulties.

The methodology used (ABA) is based on 28 methods in the treatment for different kind of disorder.

In Don Orione are used used the following methods in order to apply ABA methodology:

• Discrete Trial Training (DTT) – Discrete Trials
• LOVAAS Methos
• Picture exchange communication system
• TEACCH method
• Pivotal Response Training (PRT)
• Incidental Teaching
• Reinforcement of positive behavior
• Verbal Analysis Behavior

The other methods underlying the ABA methodology are the following:

• Discrete Trial Training (DTT) – Discrete Trials
• Pivotal Response Training (PRT)
• TEACCH Structured Teaching
• Incidental Teaching
• Positive Behavior Supports
• Verbal Behavior Analysis (VBA)
• Intervention strategies in accordance with the principles of Applied Behavioral Analysis:
• Proactive Strategies
• Visual / Physical Structure – Physical /
• Social Stories
• Skills Teaching Strategies
• Errorless Learning
• Task Analyzes
• Video Modeling – Video Modeling
• Consequence Based Strategies
• Differential Reinforcement
• Planned Ignoring
• Token Systems – Token Systems
• Response Cost Systems
• Time out Overcorrection
• Guided Compliance

The ABA methods are being used daily to children, young teenagers and adults with LD difficulties. At the daily center, everybody who comes here starting from children, young teenagers and adults with LD difficulties have courses during all day, with breaks in between, taken place in special classrooms, arrange properly for them in order to understand better what they are taught to learn.

There a lot of visual images and pictograms.

There are also training courses with those who are hospitalized at the Center in order for them to manage their LD difficulties easier and try to adapt to a normal lifestyle.

The special classroom is prepared and arranged in conformity with what they are learning in a specific day, through which they will have a final result at the end of the day. The special classroom includes:

• lots of images for the sensory stimulation;
• specific objects in order to develop some skills;
• practical applications;

The bench and chairs are placed in order to create a team working strategy.

ABA therapy programs helps to:

• Increase language and communication skills;
• Improve attention, focus, social skills, memory, and academics;
• Decrease problem behaviors.

Positive reinforcement is one of the main strategies used in ABA. When a behavior is followed by something that is valued (a reward), a person is more likely to repeat that behavior. Over time, this encourages positive behavior change. First, the therapist identifies a goal behavior. Each time the person uses the behavior or skill successfully, they get a reward. The reward is meaningful to the individual – examples include praise, a toy or book, watching a video, access to playground or other location, and more. Positive rewards encourage the person to continue using the skill. Over time this leads to meaningful behavior change.

Understanding antecedents (what happens before a behavior occurs) and consequences (what happens after the behavior) is another important part of any ABA program.

The following three steps – the “A-B-Cs” – help us teach and understand behavior:

1. An antecedent: this is what occurs right before the target behavior. It can be verbal, such as a command or request. It can also be physical, such a toy or object, or a light, sound, or something else in the environment. An antecedent may come from the environment, from another person, or be internal (such as a thought or feeling).
2. A resulting behavior: this is the person’s response or lack of response to the antecedent. It can be an action, a verbal response, or something else.
3. A consequence: this is what comes directly after the behavior. It can include positive reinforcement of the desired behavior, or no reaction for incorrect/inappropriate responses.

Good ABA programs for learning disabilities are not “one size fits all.”

Rather, each program is written to meet the needs of the individual learner. The goal of any ABA program is to help each person work on skills that will help them become more independent and successful in the short term as well as in the future.

A qualified and trained behavior analyst (BCBA) designs and directly oversees the program. They customize the ABA program to each learner’s skills, needs, interests, preferences and family situation.

The BCBA will start by doing a detailed assessment of each person’s skills and preferences. They will use this to write specific treatment goals. Family goals and preferences may be included, too. Treatment goals are written based on the age and ability level of the person with ASD. Goals can include many different skill areas, such as:

• Communication and language
• Social skills
• Self-care (such as showering and toileting)
• Play and leisure
• Learning and academic skills

ABA is considered an evidence-based best practice treatment by the US Surgeon General and by the American Psychological Association.

In the Don Orione Bucharest Center are also presented, well implemented and used another good practices for L.D people, such us:

1. PECS methodology
2. Supporting living
3. Share stories
4. Promoting religion

It is held in the Care Center of Don Orione, Voluntari, in the day center opend for everybody and the internal health acre center, for the children and adults living there.

Through the ABA methods and continuous training from professional personnel, adults with LD difficulties are getting a skill that can help them work and have a job.

Some of the LD adults also learn a foreign language that helps them to have a more wide area of jobs. There is no qualification, the LD adults develop specific skills and competence.

At the end of the course a participation certificate is issued.

Length of course that good practice is part of; If different type of setting brief description of what it is; Are there any prerequisites for entry to the course?

Generally, professional personnel works all day long with LD adults in order to have a sooner and good results ( from 09.00 to 13.00 and then from 14.00 to 17.00 ). At theory sesssions there are common group session all day long, only little breaks, such as for lunch, snacks. The learning and teaching is continuously – also in theory but also in practice. After 5 o clock there are free activities that are chosen by themselves in which they discover new skills.

In conformity with the final objective of the course, the participants are identified.

The novelty is the organization of such courses, applying the same methodology, for learning a foreign language. Until now only one course of this kind has been organized.

The courses could also be individuals.

To take part to this course the LD should be demonstrated.

There are also individual lesson (at request), but also group lesson for a minimum period of 1 week until to 2 years, for the external persons. It depends very much on the level of L.D.

The teaching principles embedded in this programme are structured in conformity with ABA methodology described above, in conformity with the level of understanding of the LD adults.

Each children or adult with LD is evaluated and it will follow the proposed program for him in conformity with his specific LD and with the final desired objective to be reached.

The initial evaluation is made by the teacher psychologist.

For this best practice the type of learner that is supported is a lifelong learning, because it starts from early ages till adult period, and never stops. In a period of 2 years, it is considered that LD adults can reach their specific goals in gaining the targeted competence.

The LD adults are being evaluated through the surveillance part at the end of the programme, for at minimum 1 year period.

With the help of a multisensory course, methods and practices, the children and teenager adults develop their visual, speaking and vocabulary skills resulting in better future learning in all areas.

The main resources used are:

• Human resource – being the most important one in the methods used;
• Material resource – using all the materials that were at the center in order to apply the methods used;
• Financial resource – that is common to the Human resource – being the training of the qualified personnel in order to implement the specific methods;
• The newest methods and best practice

http://www.asociatiadonorione.ro/gradinita-don-orione

The main purpose – that teenager adults would acquire a series of learning and behaviour skills through methods that will help them develop their competence/skills to its maximum potential.

Main objectives of the best practice:

• Exercise and empowering the valuable skills needed in society
• Helping students to work on self-awareness
• Learning to take a part on different activities
• Learning how to take care of yourself and others
• Increase of the sensory
• A more improved communication
• Getting employed on companies
• Learning a foreign language

We considered ABA method / Multisensory classrooms/ courses for adults with LD ( learning difficulties), in Don Orione Care Center as a Good Practice because we can have proofs of results and real evidence of the process, such as:

• Integration of adults with LD difficulties into society;
• Feeback from learners and also employers;
• Getting jobs on companies, such as factories, embassy working labour;
• Learning a foreign language in order to expand their skills.

ABA is considered an evidence-based best practice treatment by the US Surgeon General and by the American Psychological Association.

“Evidence based” means that ABA has passed scientific tests of its usefulness, quality, and effectiveness. ABA therapy includes many different techniques.  All of these techniques focus on antecedents (what happens before a behavior occurs) and on consequences (what happens after the behavior).

More than 20 studies have established that intensive and long-term therapy using ABA principles improves outcomes for many but not all children with autism. “Intensive” and “long term” refer to programs that provide 25 to 40 hours a week of therapy for 1 to 3 years. These studies show gains in intellectual functioning, language development, daily living skills and social functioning. Studies with adults using ABA principles, though fewer in number, show similar benefits.

1. Discrete Trial Training (DTT) – Discrete Trials
2. LOVAAS Methos
3. Picture exchange communication system
4. TEACCH method
5. Pivotal Response Training (PRT)
6. Incidental Teaching
7. Reinforcement of positive behavior
8. Verbal Analysis Behavior

and others

All this principles are working by creating an enjoyable environment that motivates to discovering and learning, with multi- sensory classrooms with use of images and specific ones for the children and adults.

We focused on teaching to adults with autism spectrum diseases, but the ABA methodology process and methods can be applied on a large scale. Such a specific course can also be used as a successful tool of teaching to the adults with attention deficit disorder (ADHD), dyslexia, speaking disorder and other forms of functional variations.

The LD adult will gain confidence and the most very important – skills- in order for him to have a life and become aware of normal things like a normal person does.

The ABA therapy services is provided only by a board-certified behavior analyst (BCBA). To become a BCBA, the following is needed:

• Earn a master’s degree or PhD in psychology or behavior analysis
• Pass a national certification exam
• Seek a state license to practice (in some states)

ABA therapy programs also involve therapists, or registered behavior technicians (RBTs). These therapists are trained and supervised by the BCBA. They work directly with children and adults with autism to practice skills and work toward the individual goals written by the BCBA. You may hear them referred to by a few different names: behavioral therapists, line therapists, behavior tech, etc.

As a ABA specialist, a special insurance is needed.