Disclaimer: This post represents some of my experiences as a facilitator inside of schools. It is a somewhat continuation of my Classroom Observation post. This information is not meant to be a factual statement of what every school is like, or how every teacher views ABA. In no way is it my intention to bash schools, or educators. For the record, I love teachers! :-)

End of disclaimer.

School Shadow or Facilitator: A 1:1 aide who is in the classroom to help a particular child learn successfully, minimize problem behaviors, and have positive social interactions.
Self- Contained Classroom: A classroom setting composed of only children with disabilities. The classroom could be an Autism classroom, or it could have children with a variety of disabilities. The teacher is usually a special education teacher.
Inclusive Classroom: A classroom setting where children with disabilities are taught alongside typically developing students. The teacher is usually a general education teacher.
IEP: Individualized Education Plan. An IEP is used when a child is not able to benefit from the general curriculum. It contains specific and detailed modifications that are necessary for that child to learn.
IDEA: Individuals with Disabilities Education Act is a federal mandate that guarantees early intervention services to infants and toddlers with disabilities, and special education or related services to school age individuals (3-21).

Many of my career experiences as an ABA provider have been with families in isolated areas (rural or international), where ABA knowledge can be seriously outdated or nonexistent. My experiences with the school systems in these areas has been a mixed bag. There have been occasions where schools sought out my services, invited me in for help with particular students, and teachers graciously and happily welcomed me into their classrooms to provide behavioral recommendations. Teachers: when you welcome ABA therapists or BCBAs into your classroom and collaborate with them about strategies, it helps us SO much to do our job better. Thank you.

The flip side of these more positive experiences includes a variety of negative experiences with school administrators or teachers who didn’t want to learn about ABA, made negative or hurtful statements about my client, or were rude or even hostile towards me.

 Over the years I've had to conduct some difficult conversations with parents about their child’s school and/or teacher.  Often when I go into a classroom to observe my client or meet a teacher, it is the first time anyone representing that child has been allowed to do that.  It is very common that the family asks me to go into the classroom just to observe a problem behavior, and I report back to the family with a laundry list of problems with the classroom. Just a few weeks ago I was conducting a school observation, and the information I reported back to the parents was so disturbing to them that they switched their child's school.

As a professional it’s my job to share with my client what I see during a classroom observation, regardless of how painful, surprising, or stressful the family may find that information. Minimizing or withholding information obtained during a classroom observation to spare a family’s feelings is not a good idea, and I wouldn’t recommend it.

What can be the most difficult is sharing my professional recommendations with a family when I know they have no better options. Some families can’t afford to move to a better school district, they can’t afford private school, or the school their child attends is “the best” the county or district has to offer. Some parents don’t want to engage in the fight and battle it can be to push for excellent services from a school system.  Let me say that again: it may be necessary to demand, battle, and push for the services your child/client needs from the school system. That first “No” you hear should not be treated as final.
I used to have a college professor who would say all the time ”IDEA guarantees parents a free and appropriate education for their child, not the MOST appropriate education”. So yes, sometimes the school will flat out deny what you are asking for, or you request a Cadillac and they hand you a beat up Chevy. However, I have seen parents fight and fight, and get that Cadillac. So if you stop asking after hearing “No”, you could be undermining your own progress.

I feel this is such an important issue in the world of ABA therapy because unless you are a therapist working with toddlers or adults, you will have to interact with a school system in some way. Even if its only to "un-teach" (yes, I know thats not a word) the problem behaviors that the teacher is inadvertently reinforcing. You will have to give parents recommendations and strategies to help their child successfully learn in a classroom environment.  You will have to go observe inside a classroom and be prepared to report back to the family with your findings. You may be asked to conduct therapy inside the classroom, or to attend crowded IEP meetings.

The goal when working with a school age child should always be to help that child benefit as much as possible from the general curriculum being taught at their school. Most ABA therapists know this doesn’t always happen, but it should be the goal.

So let’s talk about some problems and solutions for the ABA therapists and parents out there who do not have the ideal school situation.

  • What is the best school setting for a child with Autism: self contained, inclusive, public, private?? – There is no clear cut answer to this question.  Just because your child has Autism does not mean they should automatically be shuttled into the “Autism classroom” The needs of your child/client will determine what the ideal school setting is. It is important to look at the services the school offers, the way your child learns best, and the training/Autism knowledge of the teachers.
  • Teacher has limited to no ABA knowledge – It may be necessary to request a different teacher or to ask that additional training be provided for the teacher. For example, I have observed self-contained classrooms where the teacher clearly didn’t know how to address aggressive behaviors. If you are working with children with disabilities all day long, you need to know what to do about behaviors. If the school administration will not provide additional training to the staff (including paraprofessionals) then you may need to hire a Consultant to go in and train the staff. Or, you could hire a school shadow to be in the classroom with your child.
  • School refuses to allow ABA team or BCBA inside the classroom – This is probably the #1 complaint I hear from my clients. The family has a great ABA team in the home, and the school absolutely refuses to allow any of those people into the classroom. Its unfortunate, and frustrating…. and it happens. Always try the sugar first: If the school says “no”, try explaining how helpful it would be to the teacher if the ABA team could provide recommendations and strategies in the moment. Speak to the highest person in command first. Don’t waste your time talking to a Special Education Director if the Principal makes all the decisions. The sad reality is, if the sugar doesn’t work its time for the spice: consider another school placement for your child, or pursue legal action.
  • School refuses to accept the child; claims they “are not equipped” to handle the child’s needs – This happens very often with my young clients, the under 4 kiddos. Private schools, preschools, and day cares will sometimes flat out refuse to accept children with Autism. As frustrating as this can be, do you really want your child in a classroom where they aren’t wanted?? (I had a 3 year old client once who was not allowed to attend preschool unless I went with him, and this was a child who didn’t even have problem behaviors. If I got sick, that child had to stay home. Ridiculous much?) Try to work with the school setting: explain what the home ABA goals are, use data to show the progress the child has made, see if the school will allow your child to attend part time on a trial basis, and lastly offer to have a 1:1 aide attend school with the child.
  • School claims to have their own “Autism expert” but this person is not a BCBA – Sometimes the “Autism/Behavior Expert” is a school counselor, a teacher, a Special Education Director, etc. This person may not have much Autism knowledge, and could have little to no behavior management knowledge. It may be necessary to hire your own BCBA to train staff, conduct FBA’s, and attend IEP meetings to represent the best interests of your child. If the school cannot or will not hire a BCBA, you may have to.
  • How do I know if my child needs a school shadow? Is that really necessary? – If your child needs individualized attention, modifications, or assistance in order to learn successfully then YES, they likely need a school shadow. If your child is not toilet trained, or has severe problem behaviors, they likely need a school shadow. An excellent school shadow could prevent your child from being kicked out of school due to serious problem behaviors. It is unreasonable and unrealistic to expect the teacher to provide the same kind of 1:1 attention and modifications as an ABA therapist does. If your child needs that much assistance, then a school shadow is the way to go.
  • The classroom has 2 paraprofessionals in it, so the school said a 1:1 aide isn’t necessary – I hear this one a lot. What many parents don’t realize is that paraprofessionals may or may not have specific Autism or behavior management training. The paraprofessional could be sorely under -qualified to handle a student with serious learning needs or problem behaviors. From my observations, sometimes paraprofessionals are unsure of what to do inside the classroom. You may need to explain to the school that your child needs an ABA trained person with direct experience with your child’s learning style, who also can intervene on problem behaviors. Just having para’s inside the classroom doesn’t mean they know what to do.
  • Does my high functioning child who performs at grade level need a 1:1 aide in the classroom? – Possibly. Some families think school facilitation is only for children severely affected by Autism. That is completely not true. I know of very high functioning students who have school shadows. Some of these students don’t even know they have a school shadow. This is what’s called a “Blind Shadow”. Only the teacher is aware why the shadow is there; the students think the person is just a classroom helper. Even high functioning children with Autism may need individualized assistance, such as with emotion regulation, or socialization. Many of my high functioning clients have school shadows because without that assistance they could go an entire school day without speaking to a single child. Again, it can be unrealistic to expect the teacher to not just teach your child, but to make sure your child is socializing and not being ignored by peers.
  • We have tried various strategies, we paid for the teacher to be trained, made several accommodations to the classroom, and my child/client is still struggling and his/her learning is suffering. What do we do?!?- Time for some tough love. Ready? Not every child with Autism will be able to learn or thrive in a general education setting. If your child has severe problem behaviors, sensory processing issues, or the school systems in your area lack adequate training for staff, you may experience the same school problems year after year. At some point, a decision must be made to look at alternative educational options such as homeschooling, private schools, charter schools, etc. I know that’s hard to hear, but you can completely modify the classroom,  hire a BCBA and school shadow, and your child may still fall far-r-r-r behind the rest of the class. Please do not sit back and watch that happen. Look objectively at the school setting that is available to you, and determine if they are equipped to teach your child. Not “children with Autism”...... YOUR child. If they are not, do not continue to send your child to that school.

*Quick Tip: So many families and teachers do not understand the role of a school shadow, and what this person should be doing inside the classroom.  This Guide to School Facilitation is helpful and practical; please share it with your child’s teachers and your ABA team.

Intraverbal- A verbal operant first defined by BF Skinner in his book “Verbal Behavior”. An intraverbal is a type of language that involves explaining, discussing, or describing an item or situation that is not present, or not currently happening. Examples include: Answering the question “How old are you”, filling in the missing words “At the zoo last month, we saw some _____, _______, and a ______”, or singing songs “Sing the alphabet song”.

Intraverbals can often be quite challenging and time consuming programs to teach during ABA therapy. Even for therapists or parents who don’t know the verbal operants and aren’t sure what an “intraverbal” is, they usually want their child/client to perform a variety of intraverbal skills.

Common questions/complaints I get when a child lacks an intraverbal repertoire include:

“She only uses language to ask for things, she isn’t conversational”
“He can greet his teacher by name every morning when I take him to school, but if I just randomly ask him: What’s your teachers name? he won’t say anything”
“He can sing the entire Barney song (“I love you”) while watching the videos, but if I ask him to sing it during bath time he just looks at me”
“She doesn’t participate when we play The Question Game during dinner. We all take turns answering questions like “Name a pink animal”, “Sing your favorite song”, and “What should we have for dessert”. I know she’s verbal, why does she refuse to answer these questions?”

Teaching a child to mand (request) is extremely important, particularly when beginning an ABA program, because manding is how the child can communicate wants and needs to the outside world.
Unfortunately, in some ABA programs a child can get stuck at only using language to mand or tact (label). This would look like a child who only communicates with others to request ("popcorn please") or to label ("red car"). The child might spend their entire day manding and tacting, and to the parents and therapists there is no problem! The child is talking and communicating…clearly the ABA was effective. Eventually someone notices that when asked direct questions, the child won’t respond. Or when placed with peers, the child wanders away or just stares blankly at them. At that point, either the staff and family begin to think the ABA “isn’t working”, or the child is blamed for being difficult or stubborn and just choosing not to talk.

An ABA program should teach all components of language, not just the ability to request or label. Most conversation consists of a variety of intraverbals, and if you want your child/client to move past talking and really begin communicating, then intraverbals are the way to teach that.

So how and when do you teach intraverbals?

-         Work on building a strong repertoire of mands and tacts before introducing intraverbals.
-          Strong receptive skills can also help a child learn intraverbals, because you can begin teaching by having the child receptively describe an item (Give me the one that is a utensil), and then you can remove the tangible item and present the demand as an intraverbal (Name a utensil). Similarly, you can also transfer as mand or tact to an intraverbal response by first teaching the target response as a mand or tact with the item present, and then removing the item and teaching the target response as an intraverbal. You can bring the tangible item back out as a prompt, but you would then need to fade that prompt in order for the target response to be a true intraverbal. I tell this to therapists all the time: If you are holding up a card or object, you are not teaching an intraverbal.
-          Be sure to minimize student error. I would suggest using Errorless Teaching, where the child is not allowed to practice making errors. The therapist is quick to provide full prompts, and then fade out those prompts systematically. Especially with intraverbal programs, it isn’t uncommon to see escape behaviors to get out of the demand. Intraverbals are hard. Rote responding, studying the room, or looking at the therapists face will not reveal the answer to an intraverbal question. Understand the difficulty of intraverbal questions before you begin teaching them, and be prepared that you may need to use new and varied reinforcers, and effective prompting to help the child contact success and stay motivated.
-          Here are a few Do Nots: Do not begin teaching intraverbals too early, or at too high of a difficulty level. Do not completely avoid teaching intraverbals ...they're the building blocks of conversation. Do not begin teaching intraverbals before echolalia is under control. Otherwise, the child will just repeat your question or statement, and become frustrated when that isn’t the right answer.
-          The simplest types of intraverbals are usually songs, or fill- ins. This would include things like: “Ready, set, (go)”, “1, 2, (3)”, “A cow says (moo)”, “I love (you)”. You may be saying to yourself: Oh, my child already exhibits some of these fill -ins or my child can sing songs. That must mean they’re ready for  intraverbal programs! Not necessarily. With Autism, it is common that skills can present in a splintered fashion (the child can count up to 100 objects, but can’t rote count to 5 ). So this is why careful assessment of the child as well as looking closely at their programs is necessary before teaching intraverbals. When in doubt, seek the help of a qualified BCBA.

*Quick Tip:

Here is a list of some advanced intraverbal goals. Depending on the needs of your child/client, some, all, or none of these programs could be added into your current ABA program. Start simply... build up to complex:
Meow says a ____/Ribbit says a _______ (Reverse fill-ins)
Tell me something that flies in the sky, it’s an animal, and it says “chirp” or “tweet” (Intraverbal Feature Function Class)
Socks and ________/Knife, spoon and ______ (Associations)
You use a towel to _______ (Functions)
Where do you bake cookies?/What can you kick? (WH questions)
Is a banana a vegetable? (Yes-No questions)
Name something that does NOT have a tail. (Negation)

*Disclaimer: This post will be most helpful for families who hire staff directly, and ABA therapists who are independent contractors.

I have mentioned briefly in previous posts about hiring ABA Therapists (Hiring ABA Therapists: The Interview, Hiring ABA Therapists: The Other Side of the Interview ) that it is important during the interview process to clearly outline the position, discuss rules/policies, and determine if the lovely person sitting in front of you will be a good fit for your child. Not every ABA therapist will be a good fit for every family. I have worked with all kinds of professionals, some were very sweet and motherly, and some were strict and no-nonsense. Some ABA therapists are great and energetic with preschool aged children, and some ABA therapists are horrible with young children. Matching a particular type of therapist with just any family isn’t the best idea. Ideally, you want the therapist to be a good fit with your family, have good rapport with your child, as well as be experienced and educated in ABA methodology (although this can always be taught).

It is important as a parent hiring staff, or as an ABA therapist working with a family, to view yourself as a professional. I started out in this field working for families directly, and I made many mistakes as far as professionalism, communicating with the family, asking for pay raises too quickly, getting too close to the family, etc. Working in someones home as an ABA therapist is not a typical 9-5 job, and for many families it’s their first experience being a “manager” over staff. Conflicts, problems, and miscommunications can arise on the side of the parents, or the ABA staff. I love to share information on my blog that can prevent other people from making the mistakes I made, especially ABA therapists who are new to this field.

In addition to understanding how to conduct the hiring interview (from the perspective of the parent and the ABA staff) I highly recommend creating an Employment Contract

The purpose of the employment contract is to clearly outline the expectations, guidelines, and requirements of the position. For parents, you should have all ABA staff sign a contract before working with your child. For ABA therapists, before beginning work with the family you should sit down and go over the contract together. 

Putting everything in writing and talking about each issue in the contract can help prevent or minimize awkward, embarrassing conflict in the future, such as:

Does the therapist offer babysitting services?
If the therapist stays late for 45 minutes after the session, is that overtime? 
If the therapist works on the 4th of July, is there vacation pay offered?
If a sibling of the client breaks one of the therapists toys, who pays for that?
What does the therapist do if he/she shows up for a session and the child is throwing up?
How much notice does the therapist need to give before quitting?
Can the parents sit in on the therapy session and observe?
Who buys reinforcers: the parents or the ABA therapist?
Does the therapist still get paid if the family abruptly cancels a session? What if the session is cancelled after the therapist has already arrived at the family’s house?
Can the parents leave the therapist alone with the child, or do they have to be home the entire session?
If the parents are divorced, is the therapist expected to conduct therapy at 2 separate homes?
How do pay raises work?
Is mileage reimbursement offered?
Will punishment techniques be used?
If there is no BCBA or Consultant, who is responsible for managing and overseeing the progress of therapy?

I work with many families who hire inexperienced individuals and then provide them with training. This can be expensive, as well as take weeks or months to accomplish. Imagine how frustrating it would be to spend hundreds of dollars and several months training a college student, only to have her quit suddenly after she was denied a raise. I see things like that happen all the time, which is why its so important to hammer out these employment details before beginning work, or before hiring an ABA therapist to work with your child.

For the parents, the employment contract will help you to make clear what your expectations are and the level of professionalism you expect. If the person is unwilling to sign the contract or wants to change everything in it, that’s a pretty good indicator of a poor candidate for the position. I recommend mentioning the contract during the initial interview, so all candidates will be forewarned that there are specific standards of excellence that must be met in order for them to be employed by your family.
For ABA therapists, having an employment contract demonstrates that you are a professional, and that you have guidelines and policies that you need to maintain in order to work with a family. Often the family will look to the ABA therapist to establish the level of professionalism, so if you show up to the interview with a contract to discuss, that sends a clear message: “I’m a professional, and I take my job seriously”.

Here is a sample contract from the perspective of the parent, and the ABA therapist:

*Note: These are just samples; you will likely need to modify the content to fit your particular needs and concerns. For both parents and ABA therapists, it’s important to emphasize that the contract is a requirement for employment and is not optional. For ABA therapists, I also suggest adding a Parent Involvement Policy to the contract, in order to communicate to the family from day 1 the level of involvement that you expect from them. I do not personally recommend working with a family who is unable/unwilling to actively participate in the ABA treatment.

“If a child doesn’t know how to read, we teach.”
                                          “If a child doesn’t know how to swim, we teach.”                                               
“If a child doesn’t know how to multiply, we teach.”

“If a child doesn’t know how to behave, we…..Punish."

John Herner, National Association of State Directors of Special Education President 1998-1999

I recently had the opportunity to conduct a teacher training. Staff training is my favorite part of my job, but particularly when I get to speak to teachers. I believe that all educators (not just special ed teachers) can benefit from an understanding of ABA and behavior management in order to effectively run their classrooms.

Every time I get to train or consult with educators, I get to spread the word about ABA. I get to emphasize that those annoying, frustrating, "nonsense" behaviors are functional for the child. Simply punishing behavior will not bring about true success. Problem behaviors are opportunities to teach, and impart wisdom to the child that they may use for the rest of their lives.

 Instead of looking at problem behaviors and thinking about what you want the child to STOP doing, try looking at problem behaviors and thinking about what skill you could teach to replace those disruptive and challenging behaviors happening in your classroom.
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