What are the areas of professional practice that capture my interest (this might be a disorder, anything relating to treatment or diagnosis, etc.)? With respect to this general topic, what would an essential question for me be? What do I already know about this topic? What don't I know about this topic?

As I had mentioned before (somewhere I’m sure), I am fairly sure that I want to work with children. I am particularly interested in autism and the autistic population. It’s hard for me to choose just one question that I would ask, because it seems as though I have formed many in my head. I have been asking questions regarding what we can do as SLP’s to manage the behaviors of our autistic clients (what is in our scope of practice and what behavior management programs are out there for us to implement in Tx). I have further refined this question, and am now asking what we as SLP’s can do to manage the aggressive behaviors of our autistic clients.

As some of you may know, I work with an autistic child who is just absolutely wonderful. His family has implemented a program, with the help of a psychologist in CA who has written a book on his particular method, which is called “Discrete Trial Training”. It’s a method used to manage as well as to try and lessen the behaviors of autistic individuals (particularly children). It is a very interesting concept, and as I have found out through correspondence with the owner of my list (the one we were supposed to subscribe to for this class), Discrete Trial is similar to a technique called ABA (stands for “Applied Behavior Analysis”). I hope to find more out in the future about this particular technique, as I am sure it will be beneficial to my research. I am currently receiving quite a bit of help from my professional mailing list and my client’s mother.

I feel that I know some about this topic, but I don’t think that I could ever know a lot. There’s just so much information out there on the different types of behavioral management programs that are being used by parents, teachers, psychologists, and therapists that it would be impossible to know everything or even to think that one may know a lot. However, I am so willing to learn more about this. In regards to the ABA/Discrete Trial Training, I know the basic logistics of the program. The key to this program is when giving an autistic individual an instruction, you must always follow through with that. For instance (and perhaps I will not explain myself well), if I told an autistic client to sit at the table and the client became non-compliant, I could say “Too slow. Sit at the table please.” If the client was still non-compliant, then I would say, “No”, in a firm yet non-threatening tone. If at this point the client is still non-compliant, I may begin to physically maneuver them over to the table. If aggressive behavior follows, then I have some choices. I could ignore the behavior (if it is not going to harm property or others), I could take away any reinforcers that the child has accumulated, or I could start engaging the client in imitation where I give simple commands, such as “touch you arm”, “clap your hands”, “jump up and down”. This gives me the upperhand in the situation and gives me the momentum I need to get the client to comply.

It has been my experience that the simple imitation commands work well in getting an autistic child to comply and works well in managing behaviors. However, it does depend on the client and at what stage the behavior has advanced to. Another way that the Discrete Trail Training works is in teaching new skills. For instance, I work with my client on various things (language, articulation, and various cognitive tasks). What my job is to try and elicit certain responses. For example, in a receptive language drill I my say “Show me school” and the client would point to the picture of the school. However, if he didn’t and let’s say he pointed to a house, I would then have to say “No. Show me school”. If the client then pointed to the correct card, I would verbally reinforce him. If he did not point to the correct card, I would then prompt the correct answer and then bring this particular card back later.

Generally, when my client does drills, he is “working” for something that is highly reinforcing for him. For instance, he will ask to go outside. Then I say, “You can work to go outside”. I will then ask him to come to the table. Before beginning the drill, I ask him if he would like to work to go outside (just to make sure). When he says yes, we begin the drill. Sometimes if he mentions multiple reinforcers I tell him that he will have to work multiple times (e.g. three times) for the three things that he wants.

There is way more to Discrete Trial Training that I’m sure I haven’t included but there is just so much to the entire program that it would take forever for me to write about. I’m also sure that I have left out some important points and for that I apologize. I hope I explained it well.

What I don’t know about my topic is what other methods and techniques are out there to implement into therapy. I’m not even sure if the technique is used by SLP’s or just parents of autistic children. I’m very interested in seeing what other methods are out there in regards to managing the aggressive behaviors of autistic individuals. I may also be interested in what SLP’s can do (if anything) to improve upon the pragmatics of an autistic child or client. Pragmatic deficits are among the main characteristics of autistic individuals and it would be interesting to know what SLP’s can do in therapy to work on pragmatics and if it would actually make a difference. I’m sure there’s more that I do not know about this topic, but as of right now, I cannot think of anything else. Perhaps with further research I will find new things that I want to know more about.

Heather