What is behavior therapy?
Behavior therapy is the application of evidence-based practices in applied behavior analysis (ABA) to help people live better lives. It focuses on behavior that is important to you. This includes teaching new behaviors, increasing the frequency and fluency of desired behaviors, decreasing the frequency of excessive behavior, and helping the client to no longer engage in problem behavior. What behavior do you want your child to do more? What behavior do you want him or her to do less? What new behavior would you like to learn to help your child and your family? As your child develops self-advocacy skills, what behavior does he or she want to learn?
Serving: Individuals with autism, developmental delays, and ADD/ADHD
Ages Served: Toddlers to teens and young adults (1 to 26 years)
Locations: Serving the San Francisco Bay Area, where the therapist travels to you in your home, your child's school and/or community!
Skill Acquisition: As part of your child's assessment, an experienced Board Certified Behavior Analyst (BCBA) will collaborate with you to create goals to address your child's behavioral deficits. These are developmentally appropriate behaviors that your child does not independently engage in often or at all. Some of the new skills may function as replacement behaviors for problem behaviors. The goal is to teach your child new behaviors that are more adaptive and which allow him or her to access a wider variety of reinforcing environments. Your child may learn new skills in the following areas:
Pretend play helps children develop theory of mind.
Behavior Reduction: As part of your child's assessment, the behavior analyst will collaborate with you to create goals to address your child's behavioral excesses and problem behaviors. These are behaviors that impair your child's quality of life, because your child is engaging in them too often or because your child should not engage in them at all. Behavior reduction programs may be implemented for any of the following relevant excesses and problem behaviors:
Self-injurious behavior (SIB)
Aggression toward others
Screaming, crying, or whining
Behavior therapy teaches new behaviors to you in parent training, or coaching, so that both you and your child become more and more independent of the therapist. You will learn to apply principles and methods of ABA on your own. Caregiver coaching is also offered for your regular nanny, grandparent, or other family member who supervises your child during sessions. In addition, sibling coaching extends perspective taking and care toward your child's siblings, who may benefit from guidance about how to interact with your child. Behavior happens in response to the environment, and your child's family is a part of his or her environment. This means that your own behavior is also a part of your child's environment, and when you make changes in your own behavior, you will see your child's behavior change, too!
Natural Environment Teaching (NET): Your child will participate in naturalistic and incidental learning opportunities, which are child-initiated. These opportunities occur when he or she is already engaged in an activity. This type of learning helps your child achieve independence in using new skills in the actual environments in which he or she needs them. Pivotal Response Training (PRT) is a type of naturalistic learning.
Discrete Trial Teaching (DTT): Your child may receive structured learning opportunities, which are adult-initiated. These opportunities have a distinct beginning, middle, and end, usually in an environment relatively free of distractions. Once your child masters goals in a structured setting, he or she will participate in naturalistic learning opportunities for the same skills.
Verbal Behavior (VB): Your child's services may focus on developing communication skills, using a functional approach to language. This approach focuses on the function, or reason, for using language, based on the consequences. It begins with emphasis on your child communicating his or her wants and needs and progresses to your child commenting, conversing, and using language in other ways. Skinner coined the term verbal behavior to refer to behavior that is reinforced by other people, and it includes both vocal verbal behavior (speech) and non-vocal verbal behavior (such as exchanging pictures or using signs). Teaching non-vocal verbal behavior may be a bridge to vocal verbal behavior.
Motivation is essential to every treatment method. You can create motivation! When you are currently deprived of something, this can increase the likelihood that you'll engage in behavior that results in you gaining access to that item or activity, and this is what we call motivation. Instead of giving access to toys and activities freely, you can make access to toys and activities contingent on the desired behavior. Programs to teach your child to speak create the motivation to speak. Here are some examples of creating motivation:
If your child is about to color and has crayons but no paper, the therapist prompts your child to communicate that he wants paper or waits for him to independently request it.
If you give your child small portions of her favorite snack at a time, this creates the motivation to ask for more.
For potty training, the therapist offers your child lots of water to drink to create the motivation to use the toilet and to communicate the private sensation of a need to use the toilet.
At Inspire, the voices of autism self-advocates are heard. Some adults with autism who received ABA therapy from other companies as children speak of feeling that their behavior therapists and parents were forcing them to change who they are, to "normalize" them, and not just teaching them new skills. A theme in autism self-advocacy is respect for diversity. Here at Inspire, the behavior analyst does not assume that all of your child's behavior needs to be changed to mirror everyone else's. The approach is to appreciate individuals as they are, while also helping them to improve in areas of genuine need.
At Inspire, many of the new behaviors your child will learn are behavioral cusps. These behaviors create additional changes, like exposing your child to new environments that your child would not experience if he or she hadn't learned the behavior. Learning to imitate, speak, play with peers, and read are examples. If you imagine your child's life before and after learning these behaviors, you see that these behaviors result in major changes. Bosch and Fuqua (2001) described the characteristics of a behavioral cusp, which include:
The new behavior allows the learner to experience new environments and new reinforcement.
The new behavior is "generative," meaning that it leads to other new behaviors that are not taught.
The new behavior is incompatible with a problem behavior, or it makes another behavior cease.
The new behavior affects other individuals in the learner's verbal community.
For example, when your child learns to speak by requesting items and activities, she can now join her peers and family in a wider variety of social and play environments that involve speaking. Learning to speak a couple of words may result in your child echoing other words that people in her environment say, without anyone directly teaching her to copy their model. It can lead to a "language explosion." When your child learns to speak, she may also stop whining, screaming, or crying for her favorite toys. Why? Because she now asks for items and activities that she wants, asks for more time, and asks for another toy when she can't have the first one she requested. Her words replaced her problem behavior! Lastly, your child learning to speak affects others in her verbal community by allowing them to hold spoken conversations with her.
Reference: Bosch, S., & Fuqua, R.W. (2001). Behavioral cusps: A model for selecting target behaviors. Journal of Applied Behavior Analysis, 34, 123-125.
Pivotal behavior is behavior that leads to the emergence of new behaviors that don't have to be taught. This actually overlaps with the meaning of a behavioral cusp.
Thinking, Feeling, and Sensing
ABA focuses on public behavior, i.e., actions that can be observed by others in the external environment. This is because we can identify progress as we implement our teaching techniques. At Inspire, the behavior analyst also respects that everyone engages in private behavior, i.e., actions that can only be observed by oneself, such as one's own thoughts and feelings. In addition, everyone experiences private events, such as their senses (what they see, hear, taste, etc.). These private behaviors and private events can manifest in public behavior. For example, emotions like happiness and sadness manifest in facial expressions and other body language. Therapy can teach your child to identify emotions and express empathy. Therapy can also help your child develop "theory of mind," or perspective taking, which is the skill of inferring other people's senses, thoughts, and feelings. At Inspire, the whole person is also respected by teaching problem solving, which involves your child thinking aloud or acting in novel ways to prompt himself or herself to explore solutions.
Eye contact, joint attention, imitation, turn taking, sharing, initiating and responding to social interactions, perspective taking, empathy, jokes, idioms, voice volume, personal space, etc.
Potty training, self-feeding, eating a variety of healthy foods, dressing, hand washing, tooth brushing, hair brushing and other self-care skills, crossing the street and other safety skills, doing chores, cooking, managing money, taking the bus or driving, working at a job, etc.
Self-management skills in which your child learns to act as his or her own therapist, coach, teacher, or "executive" by making choices, identifying new skills to learn, setting goals, planning, organizing, self-monitoring (i.e., observing one's own behavior), waiting (also called "delayed gratification" or "impulse control"), regulating emotions, starting tasks and sustaining attention to them until completion, transitioning, showing flexibility, problem-solving, using checklists, using token systems and other positive reinforcement that your child learns to implement for himself or herself.
Communicating with vocal verbal behavior (speech) and non-vocal verbal behavior (picture exchange, signs, gestures, AAC devices), requests, comments, conversations, listener responding, etc.
Independent play and leisure activities, such as arts and crafts, building with blocks, writing, and reading; gross motor play, such as running, jumping, and swimming; cooperative and interactive play, such as games with peers, siblings, and family; pretend play, such as symbolic and role play, etc.
Alternative behaviors that your child emits instead of engaging in problem behaviors, such as the following: speak to request preferred items and activities, instead of whining, crying, or screaming to get them; select an alternative item to play, when denied access to a requested item, instead of grabbing the requested item; ask for a break, when engaged in a non-preferred task, instead of throwing the task items on the floor or running away, etc. These alternative behaviors are functionally equivalent to the problem behaviors, meaning that they get the same results, but they are appropriate alternatives.
Regional Center, Insurance, and Private Pay
Inspire Behavioral Learning, LLC provides services through the regional center, insurance, and private pay. Services may be provided with the following regional centers and insurance in network:
Regional Center of the East Bay (RCEB)
Optum/United Healthcare/United Behavioral Health
Anthem Blue Cross Cross Medi-Cal
We can also request a single-case agreement with other insurance carriers to provide services to you and your child.
Contact Inspire Behavioral Learning to see if behavior therapy is right for you and your child!
FREE 30-minute initial consultation