I Love ABA!

Welcome to my Blog!

This blog is about my experiences, thoughts, and opinions on ABA. My career as an ABA provider is definitely a passion and a joy, and I love what I do.

This is a personal blog: The views and opinions expressed here represent my own and not those of the people, institutions, or organizations that I may be affiliated with.

Saturday, January 24, 2015

Point Of View (P.O.V.)

*Recommended reading: ABA Haters, Choice

Happy New Year, blog readers! 

Yes I know, it’s been 2015 for quite a while now but I haven’t posted since 2014 so I can still say Happy New Year. Did you miss me? :-)

Well, today's post is one I have been sitting on for a while. I wanted to post it some time ago, but kept hesitating. I’m not a lover of controversy and this topic is pretty controversial in certain circles. The topic I am referring to is the divide between people who think Autism should be treated and those who do not. There are passionate arguments on both sides, and valid points on both sides.

 I thought about why I was hesitating to talk about this issue, and realized it’s because I don’t want to offend anyone. But just by having a blog about ABA, I am offending someone. So there’s kind of no way around it, even though that isn’t my intention. 

If you are unaware or not very informed about this “to treat or not to treat” issue, do me a favor: Go to Netflix, look for the movie “Sounding the Alarm”, and then just sit and read through the comments. That should bring you up to speed.

I watched the documentary (as I try to watch most documentaries about Autism that come out) and yes, there were moments in the film where I cringed or where I thought “wow, that is really some offensive language”. Yes, I agree as others have pointed out that the film was heavily slanted towards one type of Autism, and only briefly showed the variability of Autism. 

Autism is a spectrum. There is absolutely nothing monochromatic about Autism. It impacts different people differently, to different degrees. As a professional in this field, I have worked with individuals who are greatly impacted by their Autism, and others who are only mildly impacted. Quite understandably, the way you perceive Autism treatment will vary depending on your experiences with Autism. Or, your point of view gives you a different perspective. 

When I think of Autism treatment, I think about:

  •          A 5 year old girl who when I first met her, she was completely unable to communicate or use a toilet, and would stay up all night repeatedly jumping off of counters, furniture, or anything she could climb. Now she is talking, toilet trained, and doing well in 4th grade.
  •     A 3 year old boy who when I first met him, tantrummed all day, had cyclic meltdowns that lasted off and on for hours, and would run away from adults any chance he got. Now he is calm, he participates in his classroom setting, and every time I see him he gives me huge bear hugs.
  • A 2 year old client who when I first met her, would not keep her clothing on (she immediately took off any clothing that was put on her), did not respond to adult demands (“come here”), and only ate about 3-5 foods. Now she stays dressed throughout the day, responds promptly to demands, and she not only eats her food but will try to eat your food too if you let her.

Basically I think about kids I have helped, or have seen get the help they need.  I don’t know what would have happened in the lives of those families if their children didn’t get any services. Yes, I am very aware that for some individuals with Autism they don’t need intensive services, or therapists in their home, or visual schedules, or anything else I post about on this blog. I know that because I have also worked with clients where I discharged them from services because they didn’t need me, some of whom were quite upset about that. The parents wanted services to continue, the child loved therapy time, but I did not see a true need for intensive services based on the functioning of the child. 

I am no door- to- door salesman trying to talk someone into buying an encyclopedia set. What I offer as an ABA professional is a service; its treatment. If your child doesn’t need that treatment, okay. Great. I will go work with someone who does. There are families who need treatment, but can’t afford it or can’t access it. There are also families who have treatment or someone else’s expectations of normal “forced” on their child in an unethical manner.  Both of those scenarios are unacceptable. So whether your point of view is that ALL individuals with Autism should receive treatment or that NO individuals with Autism should receive treatment, can you see that it’s not that black and white? 

As a newbie in this field doing direct therapy, every time I met a new client they opened up my mind to what Autism is. I remember very clearly the first time I worked with a girl with Autism, a child with Autism who could read, a child with Autism who loved hugs, etc. I had to adjust my understanding of Autism to fit the new knowledge. Just like when I started reading books by Temple Grandin, I realized Autism was much bigger than my handful of clients who couldn't communicate. So for that expansion of understanding I think its great when Autistic individuals speak out publicly and say "Hey, I have Autism and I don't need to be fixed or treated". Just please remember that your experience with Autism is not everyone's experience with Autism.

For some individuals with Autism, they have jobs, they are married, they raise children, they open businesses, and they have a high quality of life. Which is amazing, and that’s what we all want is to have a high quality of life. Then you have other individuals with Autism, whose families don’t even dare to dream that maybe, hopefully, one day their child might be able to hold a job, get married, and be a parent. This isn’t an issue where one side is right and one side is wrong, it all depends on your perspective.

Friday, December 19, 2014

Quote of The Day

So today's QOTD is pulled from an open letter written by a parent, to her son's Autism therapists. I think its a beautiful letter, and you should go here and read it now.

There are so many wonderful quotes I couldn't choose just one. So here are a few:

"This is your job, but this is very, very personal to me."

" I’ll tell you that as a parent, it is tough to get your head around the fact that you have a child you can’t help."

 "I wonder if you know that placing this responsibility in someone else’s hands is terrifying. You are tasked with seeing my child’s potential, and reaching through thorns and brambles, through cuts and scratches, and bringing all that potential to the surface. You are tasked with nothing less than changing my son’s life. This might be the most important thing you ever do."

To the parents/caregivers who are in the scary position of allowing a professional to impact the life of your child: You are rock stars. We do what we do to help you, to support you, and to encourage you. We are not here to embarrass, irritate, or condescend to you. If you are working with someone who makes you feel that way, that isn't ABA. That isn't helping, and that is not ok.

To the educators and professionals who are in the scary position of being the professional who chooses to daily help impact a child's life: You are amazing. You work hard and tirelessly, you motivate and cheer families on regardless of your own emotions, issues, or job stresses. You root for your clients/students and you believe in them. By doing your job with excellence you are changing mindsets about how people perceive ABA.

I think it is so important for professionals in this field to remember that more than our expertise or clinical recommendations, what parents need from us is understanding. Demonstrating patience and remaining non-judgmental is huge for a parent who is struggling to learn in a session what it took you years of college and multiple clients to learn. Remember that every consumer you interact with, you have an opportunity to help their life in some way or to make their life harder.

To all my wonderful blog readers, I wont be posting again until well after the holidays. After the New Year I will be traveling the entire month of January, so I wish all of you a happy & blessed Christmas! To keep you company while I am gone, I am leaving you with my favorite Christmas movie: A Christmas Story :-)

Saturday, December 13, 2014

Are You a Great Supervisor?

*In this post I will mainly reference BCBAs, although non - BCBAs can, and do, fill supervisory roles.

As many of you in the field (should) know, the BACB recently added an 8 hour CEU requirement that teaches supervisors how to be supervisors.
You would think a field full of behavioral experts and data geeks would just be brimming with the most amazing, efficient, and effective supervisors/managers ever. No, not really.

I have worked with multiple colleagues over the years who openly admit that BCBA’s make some of the worst bosses. What is that about? Also, how can we improve this perception?

I have mentioned before on my blog that with my certification and new title came multiple experiences where I would meet new staff, new clients, or interact with school systems who would assume before even meeting me that I would be an arrogant so-and-so just because I'm a BCBA. If you aren’t sure what I mean, see my Bedside Manner post.

Over the years I have worked for varying types of supervisors. Maybe you have met some of them:

There is the super busy, stressed out, and preoccupied supervisor who you barely ever see. They make you feel like your questions are stupid, and rarely respond to your emails. They clearly know a lot about the science of ABA, they are just always too busy to actually share it with you.

There is the super fun and “Let’s be buddies” type of supervisor who likes to spend supervision sessions chatting and talking about what they did last weekend, and never has any feedback for you. You’re always “doing great”, and never really grow or mature as a professional working with this person. They want to be liked, not respected.

There is the very formal and somewhat rigid supervisor who prefers to stay all in their own head. They silently watch your session, taking copious notes (that they don’t share with you), and when you ask them a question they refer you to a research article or textbook, instead of answering the question. They also tend to speak almost entirely in jargon.

The good thing about having such varying experiences is it makes the great ones really stand out. Like my first supervisor who planted the seed in my mind that maybe I should consider Behavior Therapy as a career, not just a part- time job. I remember her fondly.

Once I became a supervisor myself, I wanted to be the opposite of the terrible ones I have worked with, and be comparable to the great ones. Part of being a great supervisor is of course, ABA knowledge and practical experience in the field, but it also means having the ability to put yourself in others shoes, over and over again.
I can’t treat all my supervisees the same, and they wouldn’t want me to. Actually if I did, inevitably someone would be upset. What feels like a comfortable degree of support for one supervisee, feels like being micromanaged to another supervisee.

For all of you out there in the position of leading/supervising a team of ABA staff, here are some helpful tips on how to best accomplish this and keep everyone relatively happy. Yes, I say “relatively” happy because in case you haven’t heard: “You can please some of the people all of the time, you can please all of the people some of the time, but you can’t please ALL of the people ALL of the time”. So don’t aim to be a perfect supervisor, since thats impossible. Strive for continual improvement.

Tips for Being an Amazing Supervisor

  • Rearrange your alphabet, “U” comes before “I” – It is the needs of the supervisee that should come first, not your own needs. That could mean spending nonbillable time training your direct staff, explaining the same concept 55 times if thats what the supervisee needs to understand it,  being open to the supervisee interjecting their own ideas and opinions into how you write programs or create data sheets, or rearranging your entire schedule to give the most time to the supervisees who are struggling the most. Being a supervisor means you are viewed as “The One Who Solveth All Problems”. And yes, problems will pop up that require your superpowers on your lunch break (just kidding! BCBAs don’t get lunch breaks), on holidays, and on weekends.
  • Forget about constructive criticism - Constructive criticism is defined as the process of offering valid and well-reasoned opinions about the work of others, usually involving both positive and negative comments, in a friendly manner rather than an oppositional one. The key word in that definition was “opinion”. Stay far, far away from the trap of offering your opinion to supervisees. I have been there, and you dont want to go there. Giving your opinions will cause people to react with defensiveness, and quite understandably, because they will feel attacked.  Instead, give corrective feedback. Keep it objective, and free of bias or personal opinion. Your supervisee doesn’t need to know that you thought her last report was horrible, and looked like she slapped it together  in 20 minutes. Instead, give specific criteria that needs to be improved. I suggest a rubric, it keeps everything objective and free of bias.
  • Use your behavioral principles- I mean, really….what kind of BCBA supervisor would you be if you didn’t use your superpowers for good? When was the last time you reinforced your supervisee, based on their M.O. at that moment (remember, it changes)? When was the last time you used errorless instruction to prevent the supervisee from making a mistake? How regularly do you use Behavioral Momentum with your staff? Here’s a biggie: do you take the time to pair and build rapport with new staff? Or do you just walk in and start giving demands? Hmmmmm, something to think about.
  • Avoid the “Warm Body: Warm Body” formula- The warm body formula is how I refer to lazy business owners and supervisors who match staff to clients based on company need only. No consideration is given to the strengths, areas of deficit, and career interest of the staff. Have you ever seen a staff who lives to work in early intervention get placed on a severe behavior case with an adolescent?  It’s not a pretty sight. Staff need to feel competent at their job, and when they are constantly feeling uncertain, inept, and stressed, that’s when people tend to quit. Listen to your staff, and regularly talk with them to determine their client preference, their long term career goals, and what they feel their strengths are. Staff interest should be a deciding factor when creating caseloads. Also, when it is clear a staff person and a particular client are not a good fit, don’t make the supervisee feel like if they just try harder it will all work out. Sometimes a bad fit is just a bad fit.
  • Keep your actions & behavior consistent- Do you promptly respond to your supervisee’s emails? Do you take the time to answer their questions, even when you have a 12 page report to finish? If you tell them you will bring them a Verbal Behavior resource next session, do you actually do it? If your behavior is not consistent, don’t expect their behavior to be. Being a supervisor also means being a mentor. Your supervisees don’t just listen to what you say, they watch your actions. If I always showed up to supervision sessions late and left early, or spent supervision sessions being standoffish and nonhelpful, I am sending a message with my behavior that being a supervisor means you do whatever you want and get paid for it. That’s a horrible message to send. If you are constantly complaining about having to work with unprofessional staff, make sure your own behavior is professional.
  • View your aggravating/annoying/irritating supervisees as learning experiences- So here is the best tip ever for current or soon to be supervisors: the things you don’t like about yourself, you will positively DETEST in a supervisee. Do you have a bit of a temper? Wait until a supervisee yells at you or gives you attitude. Do you have difficulty meeting deadlines? Wait until you get a supervisee who never submits his work on time….ever. Are you a bit socially awkward and find it hard to interact with consumers? Wait until you get an anti-social supervisee and have to help her develop her social skills!  As a supervisor you will work with all kinds of personalities and dispositions, and you will have some supervisees who just real-l-l-l-ly irritate you. The question is, what are you going to do about it?? Complain and gripe, and try to push the person off on a different BCBA? Or, you could put on your ABA hat and shape up an increase in the persons more desirable behaviors, while replacing their less desirable behaviors. For example, if you have the Eager Beaver type of supervisee who steps on your toes and loves to talk over you at parent meetings, put them in charge of something. Assign them to a task, so you now have the opportunity to work on their tact, and also to give them something to have control over.