Association for Behavior Analysis International

When trying to provide the most effective ABA Therapy to children with Autism Spectrum Disorder (ASD), what happens outside of the session is often as important as what happens within. Sleep deprivation, school environment, and general home environment need to be considered and addressed by the BCBA to create the most conducive environment for behavior change. In this symposium, two case studies are presented in which the BCBA advocated for schedule changes that, in turn, produced significant behavioral benefits for their clients. The first presents a case of insomnia in a child with ASD. When a sleep study was conducted, the sleep experts claimed that nothing could be done. An ABA intervention provided relief for the parents and produced a normal sleep pattern in the child. The second case study presents a child with ASD who changed from a school with an Autism program plus twelve hours of outside ABA Therapy to home schooling with forty hours of ABA Therapy. This move produced a notable change within the first two weeks and other behavioral results that might not have been achieved had the child been kept in the former program.

Sleep deprivation can have a detrimental effect on a wide range of social and academic behaviors and can severely impede learning. Often, childrens sleep patterns impact entire families, making sleep problems that much more important to address. Delayed sleep onset, night awakenings, and early awakenings combined with other issues presented by ASD can be especially difficult for families to manage. Piazza and Fisher (1991) found a lack of methodologically rigorous solutions in the literature that addressed insomnia in children. They effectively approached sleep problems using a protocol of faded bedtime with a response cost. A case study will be presented which used a protocol partly based on Piazza and Fishers with a child with ASD. However, in the present protocol, no response cost was used. Over a four-month period, nightly sleep increased and the time of sleep onset was reduced. In addition to the development of the current protocol, various impediments to the protocol, including parent compliance and addressing sleep as a non-operant, will be discussed.

Insurance companies often restrict the authorized number of hours of ABA Therapy based on the other activities in a childs schedule: school, other therapies, etc. Parents are also known to make such arguments. This and other arbitrary limiting of ABA Therapy seriously impede the progress that can be made with target behaviors not just in the short term, but perhaps at all. A case study will be presented of a child with ASD whose ABA Therapy had been restricted to twelve hours per week due to school and related activities for several years. The parents decided to home school the child so that ABA Therapy hours could be increased to forty. This increase in weekly ABA hours had a dramatic effect on targeted academic behaviors, articulation of speech, independent play skills, and the frequency and duration of tantrums in just a short period of time. It is questionable if the child would have ever reached the current level of responding if ABA Therapy hours had continued to be restricted. That the school environment might have also been hindering some of the target behaviors will also be discussed.