Some people say common sense isn’t so common because not everyone has it. Well I would say the same for professionalism, unfortunately. Many who call themselves “Professionals” lack the ability to display ethical, professional behavior toward others. Whether due to a true skill deficit, or just ego, sometimes the very individuals who are in positions of leadership or authority can also be the most unprofessional.

Along with behavior theory, analytical skills, research design knowledge, etc., I strongly believe that an excellent BCBA or ABA therapist must possess Professionalism. Professionalism is simply setting a standard of behavior for yourself, and deciding that regardless of the situation or the client you will maintain that standard.

As an ABA professional, no matter how long you have been in this field your ethical behavior will set you apart from the pack. Professionalism shows people that you are in this field for the right reasons and have integrity. It doesn't matter how long you have been working in this field, it is important to have integrity and respect for the people around you. The way you treat people and interact with clients won’t be quickly forgotten. Trust me; parents have very good memories when it comes to bad experiences with rude, money-hungry, poor quality, or condescending ABA providers. 

The Golden Rule, “Do unto others as you would have them do unto you” is a great starting point for developing a habit of professional behavior. Families appreciate and deserve respectful treatment from their ABA provider.
 By making a professional impression upon your clients, you also help to raise the bar of what they expect in the future from other ABA professionals. So in a way, you have the opportunity to improve the behavior of people you may never meet.

Here are my own “Golden Rules” of professionalism in the field of ABA:

Kindness and manners are always appreciated – Manners go beyond just “please” and “thank you”. Remain mindful that as ABA therapists we often work inside of peoples homes: Clean up after yourself, greet everyone when you enter, and have a warm demeanor. If you need to schedule a meeting with the family you work for, don’t tell them when the appointment will be, ask when they are free. Return phone calls and emails promptly (within 24 hours is best) and notify clients if you will be late for a session. Even if you are only running a few minutes late, sometimes parents have rearranged their entire day to accommodate your therapy session.

Maintain boundaries with clients – Part of being a professional is understanding your role. You were hired to do a specific job, and that is to provide ABA therapy. No matter how nice or friendly your client may be, it’s inappropriate to become more of a friend and less of an ABA therapist. The risk of getting too close to a client is that you can lose your objectivity. The family could also come to depend on you more than they should.

Be tactful – Parents often tell me “It wasn’t what they said to me, it was how they said it”. Even bad news can be delivered in a way that minimizes hurt or angry feelings. Be aware of your tone of voice, facial expressions, and the words you choose. Are your words accusatory? Does your facial expression make you appear angry? Do you use lots of frustrated sighs when talking to a particularly difficult client? Be mindful of tact when communicating.

Don’t give false hope – Working with a family who has a special needs child is a very important job, and an emotional job. Parents will ask you all kinds of questions about the future, what could happen, what will happen, etc. It is highly unprofessional to answer emotional questions from a parent such as “Why did this happen” or “Will she ever talk”. Be careful of making recommendations based on your own opinion, as some parents may treat it as fact. If you mention in conversation that a certain supplement is great for hyperactivity, the parent might go purchase that supplement just because you “endorsed” it. No matter how long you have been in this field, I can guarantee that you lack the ability to see the future, or know everything there is to know about Autism. It is better to say “I don’t know” than to give a desperate parent false hope. 

Leave a situation the way you entered it (as a professional) – Leaving a company, position, or family can be emotional and difficult for both sides. Families or agencies often take resignations personal, no matter what your reason may be for leaving or how much notice you give them. It’s important not to burn bridges. This field and the Autism community can be smaller than you think.  Give adequate notice, offer to help train your replacement, and be honest about why you are leaving…..even if the employer doesn’t appreciate your honesty and chooses to be angry and resentful. You can make a choice to remain professional regardless of how you are treated.

Respect the expertise or knowledge level of non-ABA people – Avoid being condescending to non-ABA professionals who you must collaborate with, such as teachers, paraprofessionals, nannies, grandparents, etc. You should be able to explain what you do and what ABA is to anyone who asks, using simple language. I have met teaching staff who assumed that just because I was an ABA therapist I would be rude or dismissive. When you interact with people as an ABA professional you have an opportunity to not just represent yourself but the whole field. You have the power to change opinions and mindsets.

Confrontation” is not a bad word- Confrontation can get a bad rap. Just the thought of having to confront someone can make people feel anxiety or fear. Confrontations do not have to be hostile or explosive. In this field, being adept at confronting issues with a client is a must. Issues will happen, and as the professional you should be the first one to address it.  With tact and emotional self-control, you should be able to discuss and resolve any issue with a client. As one of my supervisors used to say "Be a grown up!".

Listen more than you talk- I believe that an indicator of arrogance is someone who talks much more than they listen. Have you ever been on  a job interview and not been able to get 2 words in because the interviewer won’t stop talking? People who cannot listen are people who do not value what others have to say. I remember many years ago I had a client say to me that she could tell I was new to the field, because I asked her so many questions and then actually listened to her responses. As professionals, we have so much valuable and important information to share with parents, but parents also have valuable information to share with us. Professionalism is knowing when to speak and when to just be quiet and listen.

"The one who loves their children is careful to discipline them"

 Proverbs 13:24

Instructional control is an ABA term that describes how to establish a paired, authoritative relationship. Instructional control is a concept that excellent ABA therapists or professionals are aware of, and understand how to establish. I don’t come across many parents who understand the need for instructional control or how to maintain it, so this post is targeted to parents.
 If you are fine with your 3 year old running the house, then this post isn’t for you. However, if you want to know how your 3 year old began running the house, and how to stop that, then read on. :-)

*NOTE: Some non-ABA treatments for Autism focus on child-led, child initiated therapy, and minimize or eliminate the step of the therapist establishing instructional control. For therapists or parents who support or engage in those treatment techniques, this post probably won’t be helpful for you.

“Instructional control” probably sounds like a cold, intimidating term that is only applicable to therapists or professionals. I would disagree with that. If more parents knew what instructional control was and how to get it, you would save yourself much stress and conflict in your home. As a parent, you teach your child everyday and you give demands to your child throughout each day. Proper instructional control is what motivates them to listen to you, to be compliant, and to do what you ask.

Many parents have asked me with a surprised or amazed face, “How did you get my child to do _____?” or parents will state to me that their child will listen to the therapist, but not to them. Why is that? Why will the child do something for me, but not for the parent? There are a few reasons for this, but a primary reason is lack of instructional control.

So what exactly is instructional control? How do you get it? How do you lose it? How do you know if it’s lacking in your home?

The best way I can explain instructional control is to say in a situation lacking instructional control, the child is the BOSS. They are in charge, and they call the shots.
 Kids don’t just wake up one day and start running the house. That is a misconception. Inappropriate behaviors were reinforced, consequences were not delivered, and over time the child learned that they are in charge.

Based on my experiences, these are the top errors I see parents make that cause them to lose (or never gain) instructional control:
  • Arguing/debating with children
  • Bargaining/compromising with children
  • Parents not on the same page
  • Giving attention to poor/inappropriate/undesirable behaviors
  • Allowing aggression to any form ( Yes, your toddler “playfully” slapping you as she cries is still aggression)
  • Avoiding giving demands to avoid problem behaviors
  • No structure or order in the home
  • Making endless and empty threats, always “promising” to punish but never actually doing it
  • Underestimating the child/rationalizing problem behaviors (“I know she just bit me, but she’s really tired”)
  • Problem with seeing the child unhappy/ Child must always like you

If you see one, or two, or several things on that list that you do regularly, don’t feel bad. I have been inside of enough homes to know that many parents don’t understand how the errors listed above undermine their authority and lead to a lack of instructional control.

When I first start working with a child (after successful Pairing) I'm going to begin establishing the relationship that the child and I will have.
I can’t properly teach a child who doesn’t listen to what I say or refuses to do things I tell them to do. Establishing instructional control isn’t difficult, but it does require a certain mind-set. Sometimes parents have difficulty being firm with their children, and aren’t comfortable being a disciplinarian. When I am working with a child I am the giver of reinforcers, I am “that fun lady who shows up and plays with me”, I am giving undivided attention to the child, and I am always modifying my curriculum to keep them successful. BUT, I am also swift to provide consequences, I create structure and order, and I follow through with everything I say.
 Despite what some may think, ABA isn’t about being mean, harsh, or cold to children. If I never showed compassion, love, or kindness to my clients they would never want to work with me (and understandably so).

About 80% of the things I do with a new client serve the purpose of establishing instructional control. Even simple actions can help me communicate to the child that they are not in control, they do not run the session, and their behaviors have consequences. Here are a few examples of things I intentionally do with new clients in order to establish instructional control right from the start:

  • Limit access to reinforcers- The child should not have free access to highly reinforcing items. If they do, what is their motivation to complete tasks or comply?The child should be clearly taught "I do ____, I get _____". Making reinforcers contingent upon target behaviors will help you gain instructional control.
  • Present a united front with the adults in the home- For me this means that I present myself as being on the same team as the parents. If Dad says the child must wear mittens to go outside, then I help enforce that. If I say that the child can’t watch TV while I am in the home for a session, the parents help enforce that. To parents I would say: Do all the adults in the home present themselves as a united team? Does Mom back up Dad, and Dad back up Mom?
  • Create a schedule/routine and stick to it- Decide how you want the day to flow, and fill the child's day with activities. Engage in the activities with the child, as much as you can. Happy kiddos who are kept busy and engaged don't tend to exhibit problem behaviors.
  • Provide a stark contrast between “Good Job!” and “Let’s Try That Again”- When my kiddos do what I need them to do, I immediately reinforce with an animated tone of voice and facial expression. When they do not do what I need them to do, my tone of voice changes, my facial expression changes, and I do not provide reinforcement. If your child was only responding to your face or tone of voice, would they know when they have done the right thing?
  • Always be prepared before giving any demand- I don’t give any demand to one of my kiddos that, if they fail to comply, I cant follow through with. If I am writing data and the child bolts out of the room, I wont continue to write as I yell out “Come back and sit down”. I will stop writing, get up, and go get the child. Stop and prepare yourself before giving any demand, no matter how small. Treat every demand you give like an opportunity to reinforce, or provide a consequence (because it is).
  • Create opportunities to address problem behaviors- If a parent tells me about a behavioral trigger, I'm not going to avoid it. I can't correct a behavior I never see. If a parent tells me that turning off the TV causes a tantrum, then I'm going to sit down with the child to watch TV and then abruptly turn the TV off. When the tantrum occurs, I now have an opportunity to teach the child a replacement behavior. Parents, don’t get in the habit of avoiding behavioral triggers to prevent problem behaviors. That isn’t prevention, its avoidance.
  • Offer more choices combined with follow through-  You’d be surprised how rare it is for a special needs child to be offered choices. All day long they have a variety of people telling them where to sit, to be quiet, to walk over there, etc. When dealing with defiant children I will often offer a choice between activities instead of giving a demand. For example, instead of saying “Clean up the toys” I will say “Do you want to clean up the dolls, or the puzzle?”. I came up with the choices, but offering them still makes the child feel a degree of control. An important, but often forgotten, component of choice making is what happens if the child doesn’t choose. Then you choose. You decide what the child will do, and use prompting to get them to complete the task.

*Quick Tip: A great and helpful resource to fully understand instructional control: 7 Steps to Instructional Control

Premack Principle: If behavior B is of higher probability than behavior A, then behavior A can be made more probable by making behavior B contingent upon it.  (Also known as “relativity theory of reinforcement”, based on the work of David Premack)

The Premack Principle is an ABA strategy that is more commonly referred to as “Grandma’s Rule”. The name comes from when Grandmothers (those experts of children’s behavior) say to their grandchildren “You need to eat all your vegetables if you want some chocolate cake”. The child sees the yummy cake, and gulps down the peas in order to access the cake. What Grandma is actually doing has a behavior analytic name, and that name is “Premack Principle”.

Some professionals will also refer to this technique as “First/Then”, “If/Then”, or “High Probability/Low Probability”. Anyone can implement the Premack Principle to gain compliance, or to increase the likelihood of a particular behavior occurring. The Premack Prinicple can be used when you want the child to do something, and they find the behavior to be undesirable. Such as eating their peas, cleaning their room, drinking their milk, putting on a coat before going outside to play, etc. To put it simply: Premack Principle makes it easier to do an unpleasant activity by putting a pleasant activity right after it. 

When using the Premack Principle, you want to explain what the reinforcement is first. So if behavior B is eating chocolate cake and behavior A is eating peas, you would say “If you want a piece of cake, you need to eat all your peas”. Notice the word "if". Another thing I love about the Premack Principle is that accessing the reward is contingent upon completing the task. So if the child still refuses to eat the peas, what happens? They dont get any cake. Its that simple. The child is given the power to earn, or lose the reinforcer.

 A question I get asked sometimes is “Why does it matter which one I say first?” The reason you want to state the high probability behavior first is to prime the child to focus on what they are getting, and not what they are giving/what they have to do. Keep the child’s focus on the reward. If you state what they must do first, all the child hears is the demand. By stating the reinforcing item or activity first, it is often much easier to get a child to comply. 
Some children can handle it if you state the demand first, and for other children you must state the reward first. Typically, when I have clients who have a history of noncompliance then I am careful to state the reward first.

Many parents or professionals get in the habit of giving demands, the child balks or resists, and then the parent or professional reminds the child what they will lose. This is a common error many people make. It usually escalates into a debate or argument that looks something like this:
Parent: “Shawn, go clean your room”

Shawn: “No/I don’t want to/ I’ll do it later”

Parent: “If you don’t clean your room right now then NO video games tonight”

What is the child focusing on right now? They are focusing on the undesirable activity (cleaning their room), and what they will lose (video games). After this exchange, the child typically becomes more and more noncompliant and possibly aggressive, as the parent becomes more and more upset and frustrated.

It’s important to understand the Premack Principle in order to avoid setting yourself up for failure when you present a demand. A quick tip is if you find the words “If” or “First” coming out of your mouth as you are giving a demand, stop and think:

 “Have I clearly presented the reinforcement available?” 

If you have not, then what is the child working for? What does the child earn for compliance?
Don’t focus on or state what the child will lose, no one likes doing things to avoid contacting something negative. We all like doing things to contact something positive. As much as possible, ensure success by being aware of how you present demands. Don’t create situations where it will be likely that the child will refuse to comply. Every demand that comes out of your mouth has the potential of being followed, or being ignored. As the adults, if we are more careful of how we present demands then we can help the child be successful and contact reinforcement much more readily.

Here are a few examples of the correct way to use the Premack Principle (Remember, if the child is very noncompliant its better to state the reward first):

  • “We can read a story if you take a bath first.”
  • “You can take a 10 minute break if you finish 5 math problems by yourself".
  • “First you take a nap, then we’re going to the park!”
  • “You can watch 2 DVD’s tonight if you eat all your lunch at school today.”
  • “Who wants ice cream? (child raises hand) Okay, hurry and wash the dishes so we can have ice cream!”

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