One obvious difference is the physical environment. In one-to-one setting, teaching is typically carried out at a children’s desk while the child is sitting next to or across the therapist. The level of distractions, such as noise and preferred items, is usually suppressed to a low level to allow children to focus to the teaching easily. In contrast, in natural settings like classroom, there are many physical factors potentially affecting their attention: teacher standing up and pacing around the classroom while students are sitting down, noise and movement produced by peers and distracting items like electronic devices and decorations. To minimize the difference of the two settings, in one-on-one therapy, therapist should actively and systematically de-structure the physical environment to simulate common natural settings. Some examples are changing locations where teaching is carried out, varying distance and positions of therapist and student, utilizing teaching materials typically found at home and in school and keeping distracting items, both visual and auditory, in the environment.
When the physical environment starts to simulate natural settings, in other words, when there are more attractions surrounding a student, it is not surprising for a student to pay less attention, causing more inaccurate responses. The increase in failures will create more opportunities to receive corrective feedback, redo the same trial and be assisted on familiar tasks, and potentially lead to disruptive behaviors like temper tantrum, crying or even aggression. To tackle inattentiveness and related disruptive behaviors, we should adopt a proactive strategy by teaching replacement skills to learn effectively in natural settings and increasing student’s tolerance to distractions and undesired events that come after inattentiveness. Some crucial replacement skills are responding to teacher under distractions, completing multiple-step task without teacher’s supervision, and repairing strategies like observing others after missing an instruction and seeking help from teacher.
Beside changing the physical features in the learning environment, therapist should also look into the intangible qualities found in the teaching process. One important feature is how instructions are delivered. Teaching instructions in classroom are usually less clear and wordier, and often assisted with different types of teaching tools, like writing on the white board, story books and textbooks, props and tools, etc. Therefore, therapists in one-to-one therapy should not be shy away from teaching like how school teachers do by systematically varying instructions and utilizing different teaching materials. It is common that some children with ASD do not understand complex instructions or find it hard to sustain their attention to long instructions, therefore we should also address these learning difficulties by teaching necessary replacement skills to help them to focus and learn effectively.
While de-structuring a therapy environment, therapist should also consider common settings that we would like learning to occur other than classroom. For young children, learning also happens at home, on playground, and in typical places in the community, such as park, library, restaurant and grocery store. To save the time and the cost spent on making a therapy room to look like one natural setting, probably the most efficient and effective way to destruct therapy is to conduct training in the real environment. We should identify and prioritize target settings based on a child’s needs, ability and potential learning environment in the future.
Information provided by Autism Partnership
Autism Partnership (AP) is one of the most established Applied Behavior Analysis (ABA) service providers for Autism Spectrum Disorders (ASD) in the world. Formed in 1994 in the United States, AP is run by professional clinicians and specializes in providing one-on-one therapy, group interventions and overseas consultation for children with ASD and their families.
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[:zh]很多父母都發現雖然孩子在一對一訓練中變得專注，他們仍然很難在家庭和教室等自然環境中專心學習。其實如果我們比較一對一和自然環境中的教學方式，就不難發現這種差異的原因。只有通過在一對一治療中直接和積極地解決這些教學環境的差異，我們的孩子才有可能在不同的地方跟不同的人成功學習。一個明顯的區別是實體環境。在一對一的環境中，教學通常在小書桌上進行，而孩子則坐在治療師旁邊或對面。還有為了讓兒童能夠輕鬆地專注於教學，干擾元素例如吸引學生的事物及噪音通常被移除或抑壓至最低程度。相比之下，在自然環境如教室中，有許多元素可能會影響專注力，包括老師會邊踱步邊教學，同學會產生噪音和動作，以及教室中設置了電子設備和裝飾等令人分心的物品。為了減少治療環境及自然環境的差異，在一對一訓練中，治療師應積極和有系統地解構教學環境，直至能夠模擬常見的自然環境。一般解構環境的方法包括改變進行教學的地點，改變治療師和學生的距離和位置，利用在家裡和學校中常用到的教具及物品，並在環境中保留在視覺和聽覺上令人分心的物品。
當訓練的實體環境接近自然環境時，換句話說，當學生周圍有更多干擾元素時，學生分心及反應錯誤的狀況會相應增加。同時，多次的失敗令學生有更多機會被老師批評，被要求重做任務及被輔助，最終導致發脾氣，哭泣甚至攻擊等滋擾行為。為了解決不專注和相關的滋擾行為，我們應該採取積極主動的策略，通過教授替代技巧，在自然環境中有效地學習，並提高學生對令他們分心的事物和不集中的後果的容忍度。一些關鍵的替代技巧是在多干擾的情況下對指令作出回應，在沒有老師監督下完成多步任務，以及在錯過教學後觀察他人和尋求老師幫助等補救策略。
除了改變學習環境中的實質元素外，治療師還應該探討教學過程中的無形元素。一個重要的元素是如何傳遞指令。學校課堂的指令通常不太清晰和冗長，並且經常以不同類型的教學工具輔助訊息傳遞，如白板上的文字，故事書和教科書，道具和工具等。因此，治療師應該有系統地改變指令及採用不同媒體輔助教學，直至像學校教師那樣發出指令。不理解複雜的指示或者不能持續專注長時間的教學是大部分自閉症兒童遇到的問題，因此我們應該通過教授必要的替代技巧來幫助他們有效地參與和學習，從而解決這些學習困難。
在解構治療環境時，治療師還應該考慮除了學校教室之外還應模擬甚麼環境。對於年幼的孩子來說，學習也發生在家裡，遊樂場上，以及社區中常去的地方，如公園，圖書館，餐廳和超給市埸。為了節省使治療室看起來像一個自然環境的時間和成本，可能最有效的解構方法是在真實的環境中教學。那麼治療師應根據兒童的需求，能力和未來潛在的學習環境確定訓練的目標環境並確定其優先次序。
資訊由Autism Partnership提供
Autism Partnership （AP）於1994年在美國成立，是全球最具規模為自閉症患者提供『應用行為分析』(ABA) 治療的專業機構。AP是由多位專業臨床心理學家、應用行為分析治療顧問及治療師管理，為患有自閉症譜系障礙（ASD）的兒童及其家庭提供一對一治療、行為干預小組訓練及海外諮詢服務。
請分享，讓更多人了解自閉症及學習更多應用行為分析（ ABA）的治療技巧。
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