Ahhhhhh, IEP Meetings. :-)



They can be quite an experience. In the years I have been working as a Behavior Specialist, I have seen firsthand how emotional the implications of IEP Meetings can be to families. I have spoken with parents right after an IEP meeting who ran the emotional gamut from frustrated and angry, to scared and concerned, to depressed and tearful. I have met and worked cooperatively with some amazing educators who inspire and encourage me, and I have also encountered and dealt with educators who are very anti-ABA, incredibly resistant, or even combative.
 Families often deal with a new teacher, or set of teachers, every academic year. This can be a tiring and exhausting process. Just when you adjust to and get close to your child's teacher, the school year ends and its time for a new teacher, new classroom, and new personality.  I'm sure most people would agree that a great, well trained, and passionate teacher can be the best thing to happen to a child with Autism. Some families absolutely LOVE their child's teacher, and other families despise the teacher.


The Home-School Connection basically means keeping lines of communication open between the parents, home therapists, school, teachers, and other related therapists. The more everyone knows the child's goals, strengths, and weaknesses, the better for all involved. The home therapist needs to know how the child does at school, and the teacher needs to know what the child is working on at home. Research shows that when a family communicates regularly with the school and teachers about the home ABA program, and when that school includes the family in all aspects of the child's educational planning, the child does better with skill acquisition, skill generalization, and maintenance of learned skills (“The Home/School Collaborative Model.”  Children & Schools, Volume 30, Number 3, July 2008).

For all therapists, it is important to help the family you work for understand how to communicate with the school, and be sure to incorporate school skills and goals into your ABA sessions as much as you can to help the child generalize.
For all parents, it is important to view your child's teacher (or teachers) as an important member of your child's therapeutic team. I see so many families who have estranged or tense relationships with their child's school and/or teacher. It is unfortunate when that happens, but if you are a parent in that situation hopefully this information will be helpful to you.

 Below are some general tips for therapists or for parents, to keep the Home-School Connection strong, which will ultimately benefit what we all care the most about: the children.


  1. Think Positive, Speak Positive- If you can re-frame the way you think about your child's school and their teacher, it will impact the way you speak to educators and administrators at the school. Try and focus on what you do like about the school, the good things you see in the classroom, positive qualities in the teacher, etc. When you speak to people at the school, begin any conversation in a pleasant tone and manner. Have a smile on your face when you speak to the teacher, always greet any extra staff in the classroom (such as paraprofessionals), and be sure to verbally recognize any small steps the teacher makes towards progress or improvement. Many parents and teachers get stuck in negative/ defensive communication patterns. The teacher sees the parent walk into their room and becomes instantly stressed and on guard. The parent sees that the teacher sent a note home, and automatically feels fear and annoyance. Break that negative pattern. The current method of communication and problem solving is not effective, that is why arguments keep occurring. If something isn't effective, why keep doing it? Change your approach, change your thinking, and change your actions.
  2. Keep Lines of Communication Open- How does your child's teacher keep ongoing communication with you, and how do you communicate with them? Weekly conferences? Monthly meetings? Daily notes that are sent home? Or do you only hear about your child's progress (or lack of progress) via report cards, and planning/ IEP meetings a few times a year? That is simply not enough communication. These children can change so quickly in terms of motivation, attention, and focus from week to week that their school performance may have incredible variability. You need to consult with your child's teacher and decide together what your method of communication will be. Most families I work with use a notebook or binder in which the teacher writes brief daily notes about the child's behavior, attention, and school performance. This is a quick and simple way for the parents and home therapists to know how the child is doing at school. If the teacher declines your suggestion to incorporate daily notes, don't give up. Be persistent. Make other suggestions, offer to brainstorm with him/her, and stress the importance of this issue. Teachers have many duties, and larger and larger classrooms, and sometimes they don't have the time to write daily notes. Maybe weekly notes would be better. Or maybe a quick email sent after lunchtime. Help the teacher create a system of communication, and include the home therapists in the exchange of information as well. 
  3. Reinforcement Isn't Just for your Child!- The basic principles of behavior management work on ANYONE. That means they will work on your child, your husband or wife, your boss, and even your child's teacher. Let the teacher know they are doing a good job. Comment on new items or objects placed in the classroom. If you know the teacher just returned from a vacation, inquire about their trip. When the teacher takes the time to speak to you before or after school, thank them for doing so. Everyone likes to hear feedback that they are performing their job well. Be mindful of how many times you contact the teacher with a compliant, or a negative statement, and how many times you complimented, or gave positive feedback to the teacher. Start any school conference or meeting by thanking the staff present for their hard work and dedication (even if you have yet to see any hard work!). Praise and compliments are free, so give them away.
  4. Be Aware that You are an Advocate- Maybe you are a parent who doesn't have a Behavior Analyst working with your child. Maybe the school doesn't have someone on staff who is adequately trained in Autism, or knowledgeable in ABA. What do you do in these situations?? You become your child's advocate first, and parent second. Offer to come into the classroom and show the teacher techniques or strategies. Give concrete examples of behavior techniques to them, and explain why they work. Approach the school and the teachers as the expert on your child (which you are). Educate, and make the teacher aware of ABA. Do not assume your child's teacher is adequately trained to incorporate ABA principles into the classroom. They may need your help to do so in an effective way. I have helped a few parents put together documents, video clips, or short reports before IEP Meetings. A sample report could include: a short video clip of your child working at the table during an ABA session, a list of items they find reinforcing, a current list of active programs, a list of mastered programs, and detailed areas of strengths and weaknesses.

Parent participation in ABA Therapy is vital to a child’s success.  

If the parents are not involved in their child’s therapy the likelihood of success is much lower. When parents are involved in the development and implementation of interventions the intervention procedures are more likely to be generalized across contexts and people, and the child is likely to learn and use skills more quickly.

 ABA professionals often possess knowledge that parents do not have. This could be knowledge of behavior theory, learning strategies, or motivation and attention. It is part of my job to educate parents about every aspect of their child's programming as well as how to address behaviors, and how to make ABA a way of life in their home. This is my favorite part of my job.  I love parents who ask questions and provide me with new perspectives on problem solving.

Unfortunately, some professionals feel they don't have to provide parent education as part of their job. Maybe they are uncomfortable giving advice, or think parent education is only for the BCBA. However, everyone who works with the child has a responsibility to share information with the parents.The family and the ABA professionals are a team and the more we all work together the better it is for the child.

Sometimes as an ABA Therapist you will encounter families who are oppositional, resistant, or of the opinion that it is your job to "fix" their child. ABA Therapy cant happen in a vacuum if you want to see real results. ABA must have parent involvement and caregiver carryover to bring about lasting and significant change. As ABA professionals we cannot be on call 24 hours a day, and we cannot move into homes to deal with situations as they arise. When the ABA professionals are not in the home, the family needs to continue working on critical skills in order for treatment to be most effective.

To the direct therapists:  use every opportunity you have to show the family how to run an ABA session. Parent education should be such an integral part of your job as an ABA Therapist, that if you called in sick the child's mother or father could run the session in your place.  For the most part parents genuinely WANT to learn strategies and techniques, and if someone would take the time to explain it to them they would be very grateful.

For the parents: you should feel encouraged by the ABA Therapists to ask questions about your child's therapy. The therapist(s) should never make you feel embarrassed or stupid for asking questions, and should explain programs to such a degree that you could teach the program yourself if necessary. I encourage you to view yourself as an important member of your child's therapeutic team.

 The speech therapist may have specialized knowledge about language and articulation, the occupational therapist may have specialized knowledge about coordination and movement, and the ABA therapist may have specialized knowledge about behavior. However, the parent is the expert when it comes to the child. As a professional I rely on the parents to give me feedback about progress, to alert me of any changes in behavior, and to provide me with valuable information about their child's learning style. The magnitude of what I can accomplish as a professional is limited if the parents are not on board.

Parents are the most natural advocates for their children because they know the child best and because increased parental participation is correlated with increased child success. Additionally, parents are most effective at advocating for their child because they are emotionally invested in their child’s welfare and they are the most constant people in the child’s life. When parents are involved and advocate for the rights and meaningful education of their child amazing things can happen.



How do you know if the ABA Therapist working with your child is terrible, good, or great at their job?

There are many specific characteristics to look for. I have worked with many families who often fall into two categories when dealing with in-home therapists:



  1. The family has a great and dedicated therapist, but isn't aware of it because they are expecting perfection. They go through therapist after therapist and find flaws in all of them.
  2. The family has a mediocre, or even bad therapist, but they don't replace the therapist because: they don't know how bad the therapist is or they are afraid they wont find anyone else.
It is important as a parent to know what signs to look for to judge the quality of the in home therapist. Therapists, this is important information to know so you can strive to match these characteristics. An effective and quality in home ABA program needs many things: a qualified and experienced supervisor overseeing and running the program, materials and supplies, consistency and a regular schedule, and a GREAT therapist or team of therapists. The therapists are the glue of any ABA program, as they are the ones doing the day-by-day teaching.

 After reading this list you might realize you have a GREAT therapist working for you. Appreciate and provide feedback to that therapist that they are doing a wonderful job. Its okay to reinforce each other just like we reinforce our kiddos! 


Traits/Characteristics of a Great ABA Therapist:
  • He/she is passionate about their work, enjoys talking about ABA strategies and principles with you, and sharing techniques with you.
  • He/she seems to genuinely like, not just tolerate, being around children. You see or hear the therapist laughing and having fun with your child before or after sessions. They don't just finish the session, clean up, and head home.
  • He/she talks about career goals within ABA or a related field. It isn't just a "job" to them; it is a career path they are interested in.
  • He/she becomes emotionally invested in your child's progress. If you have been struggling for months with toilet training, and you call the therapist excited one night that your child just peed in the potty the therapist will be excited with you.
  • He/she asks for feedback and supervision. If no supervisor is available they seek out books, movies, or research articles about ABA, Autism, behavior, etc, so they can increase their knowledge. 
  • He/she is a team player, and open to communication with the child's teacher or related therapists.
  • He/she responds appropriately to suggestions for improvement and constructive criticism. They do not respond by being defensive, making excuses, or becoming upset. They want to learn how to perform their job well.
  • He/she has an open mind regarding different approaches, strategies, interventions, or methods of behavior management. If you tell the therapist you are considering a supplemental therapy, they will hear you out and ask questions about it, even if they cant ethically support or endorse it.
  • He/she is a consistent individual. They show up on time, work the full session (doesn't consistently leave early), call when they say they will call, attend required staff meetings, etc. It is apparent that they take their job seriously, and are a professional.
  • This last one is very important: He/she is making progress, and improving. Sometimes families see areas of weakness in an ABA Therapist, and expect the person to fix those areas overnight. As long as the therapist is trying to improve and working on their weak areas, that shows you the therapist is a dedicated individual who takes their job seriously.

A great ABA Therapist is a gem to any family, and has the potential to bring about huge changes in your child's learning. Start looking for signs of greatness when seeking ABA therapists to hire, and if you realize you already have a great therapist working with your child make sure you show them your appreciation.


Part of what makes ABA Therapy so cool and fun is that it isn't a typical job. Its definitely not a standard 9-5 and is a very unique and exciting job to have.

But it is a real job, and ABA Therapy has responsibilities and duties that are serious. I have seen new therapists start working with a family and then very quickly those therapists are no longer around. If you show a family that you are an ethical professional who takes your job seriously then you will likely be with that family a long time. If you don't, you will likely be replaced.

Based on what I have seen, here are some tips on what NOT to do as a new ABA therapist. This information will also be helpful for parents who want to know when its time to fire a current therapist.

Signs of a bad ABA Therapist: 
  •  Consistently cancels therapy sessions, arrives late to sessions, or pulls a "no show"- This one is pretty straightforward. You were hired as an ABA Therapist and you and the family/agency set up a schedule together.  Be on time, arrive for work when you are supposed to, and if something comes up call the family and let them know. Simply not showing up or being consistently late sends a message that you are not reliable and that you don't take your job seriously. Especially if you are working with a family with multiple therapists or multiple children, they probably have a very busy schedule. If you miss a therapy session that throws their whole day off.
  • Talks to friends or family about their clients, giving details and private information- As an ABA Therapist what you do for a living is far more exciting than most jobs. It may be tempting to complain to your friends, spouse, or family members about the children you work with. However, you never know what words you say might get back to the family or someone who knows the family. Confidentiality is important as a therapist because it shows the family you can be trusted and that you are an ethical professional.  Even something as simple as speaking to the child's teacher about behavior issues at home can be a confidentiality breach unless the family has told you this is allowed.
  • Gets too close to the family, crosses boundaries- For someone new to the field, you probably aren't used to a job  that takes you into someones home. It can be very easy to make friends with the family and parents of the child you are working with, to laugh and talk, and start sharing details of your private life. It is important to remember you are a professional and you are not there to make friends. Don't share any information about your life that will make it difficult or uncomfortable for you to do your job. Do NOT friend clients on social media, this is extremely unprofessional. Sometimes a family will see you more as a friend and less as a therapist unless you keep clear professional boundaries.
  • Has a distant or poor relationship with the family of their client- On the flip side of getting too close to a family is being too distant from a family. Sometimes therapists will forget to do simple things like greeting the family when they arrive to the home, or asking the parents how they are doing. You shouldn't just arrive at the home and go straight to work with the child. You are still a guest in someones home and you should take a few minutes to greet everyone with a smile and a few words.
  • Vague about salary expectations- Sometimes as a new therapist you will be working for a family who is also new to ABA. They may have never hired an employee before, especially one who will be coming into their home. Salary conflicts are common and a way to prevent this is to be clear and upfront about what you expect to make before you are hired. Ask about salary raises, supplies/materials reimbursement, sick pay, holidays, etc. These are all questions you should get answered before you start work. If you stay late after a session, is that overtime? If you get ill and miss a session, are you expected to make that session up? If the family cancels a session at the last minute, do you still get paid for the session? Does the family offer mileage reimbursement at all? These questions are best asked in advance, rather than when these situations occur. No family wants to feel as if they are being held hostage by an ABA therapist who keeps demanding more money!
  • Overly negative or critical- Yes, we all have bad days. There will be days where you didn't get much sleep the night before and you arrive for a therapy session and the child is coughing all over you. You are allowed to have a bad day or be in a bad mood, however you should leave all of that "at the door" when you arrive for a session. You are there to work, no matter what your emotional state is. Telling a parent "Wow, your daughter is so annoying today", or "I just broke up with my boyfriend, and I'm not in the mood for your son's tantrums" are inappropriate and negative comments. They are also unprofessional. You want to share with the family how the session went without being overly critical or emotional. Instead of "Your son just kept hitting me!" you can say "He had 7 instances of aggression today. Are you seeing that much aggression too?" The second example is more respectful, and also is seeking clarification about the behavior. No parent wants to hear overly negative comments about their child.
  • Messy or disorganized - It is common courtesy to clean up the therapy room when the session is over and put things back the way you found them before you leave. Sometimes you will arrive to a home where the therapy room is messy, disorganized, toys are all over the place, etc. It is okay to ask the family if you can create order in the therapy room using boxes, shelves, labels, etc. If you give the child a snack before the session, clean up the snack when the child is done eating. Take neat and easy to read session notes, and clean up any toys the child was playing with before you leave. The parents shouldn't have to clean up after you once you are done with a therapy session, and you shouldn't leave toys or materials strewn all over their home.
  • Therapist brings children to work- Believe it or not, this isn't an unusual problem. It is one thing to bring your baby or child to a therapy session if the family has told you this is okay. It's a completely different issue if, without consent from the family, you show up at their house with your baby or children. You are basically requiring that they babysit your child. You cant run a session and watch your own child at the same time. If you worked as a cashier, lawyer, or bank teller, would you just show up to work with your child? Sometimes therapists think that because we work in someones home and children are already there, that it is okay to bring their child to work with them. When you arrive for a therapy session you are beginning a work shift. If the family has not given consent for you to bring your children and you cant find a babysitter, then you need to cancel the session for that day.



Photo source: www.littleleaves.org


If you are not currently working as an ABA Therapist or the parent of a child who receives ABA Therapy you might be wondering :

"What is ABA??"


Applied Behavior Analysis (ABA) is the science of changing socially significant behavior. 
ABA has its origins in the early 1900’s with the scientific work of B.F. Skinner. In its early days, ABA research was about studying how individuals and animals respond under certain conditions (Operant Conditioning), and had nothing to do with Autism or special needs. It was simply a science of understanding how behaviors are formed, established, and how they can be changed.

 It was not until the groundbreaking study by Ivar Lovaas (published in 1987) with a group of Autistic children that what we now think of as "ABA Therapy" began to take shape. 
At that time in history, Autism was considered to be an unchangeable condition and parents were advised to institutionalize their child as soon as possible to receive lifelong care. 
Lovaas’ study included 59 children ages 3 and under, and compared the impact of high quality intensive ABA Therapy, high quality less intensive ABA Therapy, and typical special education services but no ABA Therapy. The results of the study were amazing: almost half of the children who received the high quality intensive ABA Therapy became indistinguishable from same age peers (symptoms greatly improved), and in follow up studies this group of children maintained these gains well into adolescence.  
       
     Replication studies since 1987 have repeated Lovass’ results over, and over….and over again. Also, advancements in technology and further scientific discoveries have fine-tuned ABA into a highly sophisticated tool for effective and long- lasting behavior change.



     In the mid -1990’s, a book written by a parent of a child with Autism (“Let Me Hear Your Voice”, by Catherine Maurice) pushed this substantial body of scientific knowledge out into the world, and quickly this “new ABA therapy” began to be sought out by parents of special needs children all over the world.

     Explosion in public demand led to new funding sources, new populations to serve, and the profession of Behavior Analysis (the BACB) was born in order to properly train and equip individuals to be practitioners of the science of ABA.

     
       Applied Behavior Analysis (ABA) has become widely accepted as one of THE most effective treatments for behavior change, although many people still think ABA treatment is only for individuals with Autism. ABA is much broader than that, and should not be reduced down to only being effective with one specific population.
      You have likely heard ABA & ABA Therapy used interchangeably, but from reading this post you now know that ABA is a scientific study of behavior. Now let's talk about ABA Therapy.







 ABA Therapy is an umbrella term that covers many styles of teaching/treatment, such as Verbal Behavior (VB), Natural Environment Teaching (NET),  and Discrete Trial Training (DTT). ABA professionals mainly work in the areas of behavior reduction or skill acquisition.

There's 2 important things to know about ABA Therapy:

  •  The research of B.F. Skinner - ABA therapy is based in the research and life work of B.F. Skinner, the Father of Operant Conditioning. Operant Conditioning states that behaviors that contact reinforcement are strengthened, and behaviors that contact punishment are weakened. ABA is the process of manipulating the environment (what the individual finds reinforcing or punishing) in order to increase or decrease behaviors.
  • The research of Ivar Lovaas -  Dr Lovaas' study in 1987 that helped to show the world that children with significant social, cognitive, and/or communicative impairments can learn, and can greatly improve utilizing behavioral treatment.  The key is that the ABA treatment must be early and intensive for maximum benefit (although improvement is always possible).

 ABA Therapy incorporates behavioral techniques such as reinforcement, prompting, consistent consequences, and extinction. Strengths are generalized and expanded upon, and deficits are replaced with skills in order to help the individual be more successful in their environment. Behavior reduction and skill acquisition are closely connected when it comes to ABA Therapy; typically being simultaneously targeted.

 ABA Therapy has decades of rigorous research to support its efficacy, and people all over the world use intensive ABA principles in order to teach new behaviors to children, adolescents, and adults.

Being a behavioral therapeutic method, ABA Therapy focuses on what is observable and measurable. Precise and frequent data collection drives the course of treatment.
 ABA Therapy can take place in the home setting, school setting, community setting(s), or at a center/clinic. ABA Therapy is usually provided by ABA therapists, and the therapists should be supervised by a Consultant (usually a Board Certified Behavior Analyst).

ABA Therapy focuses on understanding behavior by its function, combined with examining the environment in order to develop a comprehensive strategy for behavior reduction.


Examples of ABA Therapy goals include:

Increase attending behaviors
Improve fine motor skills
Extinguish self-injurious behaviors (SIB's)
Reduce tantrumming behavior
Increase play behaviors with siblings
Generalize skills across environments
Successful homework completion
Increasing compliance to adult directives
Provide parent education in the area of behavior management 
Intensive, comprehensive treatment (often appropriate for early intervention learners presenting with broad skill deficits and intensive problem behavior)
Brief, focused treatment (often appropriate for advanced learners presenting with a few areas of skill deficit, or moderate problem behavior)



If you would like more information about ABA or ABA Therapy, please see any of the links below:

http://autism.about.com/od/alllaboutaba/a/abaoverview.htm
http://www.lovaas.com/about.php
http://www.abainternational.org/ba.asp
http://www.autism.com/index_b.asp
http://www.asatonline.org/treatment/treatments/applied.htm
http://www.autismspeaks.org/what-autism/treatment/applied-behavior-analysis-aba
 http://www.christinaburkaba.com/History.htm



**Quick Tip: Below are two amazing resources I highly recommend to anyone wanting to learn more about the application of ABA-

 The Cooper book  (often called the "White Book")  is a more technical guide that I recommend for professionals.
Applied Behavior Analysis by Cooper, Heron, & Heward

The Catherine Maurice book is a very parent-friendly resource to learn about ABA Therapy from the point of view of a parent.
Let Me Hear Your Voice by Catherine Maurice
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