Sunday, July 26, 2015

Ready for the Interview?


Photo source: www.burnsmcdmedia.com, www.abetterinterview.com


*Recommended Posts:



I often receive emails from people about to interview for their first ABA position and feeling simultaneously excited and terrified, wanting to know what should they expect from the process. Many of these people are new grads, fresh out of an ABA certification program or degree program and ready to dive into ABA as a career. Hopefully if you are in a similar position, this information is helpful to you. This post is all about preparing for your first ABA job interview.

First of all it’s important to understand that an interview is not just about selling yourself. It should be a mutually beneficial meeting. In other words, you should be interviewing them too! From the first point of contact with the agency/center/ company, to hearing those words “We’d like to offer you the position”, you should be watching, listening, and paying attention to see if this is a place you want to work for:

Do you really want to pour your talent, time, and energy into the company?? Is it a fit for your interests, personality, and values? How do staff interact with each other? With the boss? Do people seem friendly and down to earth, or super busy and stressed out? How formal do social interactions seem? Are things messy and chaotic at the office/center, or organized and neat? If clients are present, how does staff interact with them? Is the interview a back and forth conversation or does the interviewer just shoot rapid-fire questions at you? Are you kept waiting even though you arrived on time or early? Is the interview date and time changed multiple times, with no advance warning?

Nowadays thanks to technology and especially if you apply for positions outside of your state or country, the interview process may occur over the phone, via Skype, and/or in person. You may be involved in a group interview (now that’s a fun process……this is sarcasm), or the more traditional 1:1 interview. You may be interviewed in stages, starting with non -clinical staff and working up to the company owner. You may be interviewed by multiple people at once, who all have questions for you. The interview can be casual or very formal, and can occur at the office, or in a public setting (like at a restaurant). While the norm may be sitting and answering questions, some companies may want you to role play or demonstrate skills, get down on the floor and interact with some actual clients (in your lovely business suit…..that’s fun. Again: this is sarcasm), or even review sample data or documents and then discuss.

Many people ask me what they should take to an ABA interview, or how they should prepare. See below for how to prepare, but as far as what to take with you I suggest:
·         Resume, cover letter, and references (only list people who can provide a STRONG recommendation), and some companies may request a salary history
·         Work samples are always impressive (remove any identifying information). If you don’t have any, bring relevant school assignments or projects
·         Bring energy, personality, and lots of questions! Don’t be that person who comes across as introverted, shy, or boring. That won’t impress the interviewer.

So now that you know what to expect and what to bring, how can you prepare for the interview process? By having an idea of what questions will be asked of you, and preparing in advance your own questions to ask. As someone who has conducted interviews of direct staff, I can tell you it doesn’t look good if the person doesn’t have any questions for me. Or, if they can’t answer/get flustered by my questions of them.
Below is my own list of some standard questions to expect, and some great questions to ask. I hope these tips help land you your dream job!


*Questions to expect


What made you want to apply for this position/why do you want to work here?
So tell us about yourself.
What is your availability? Can you work weekends?


Are you currently in school? If so what is your school schedule?
How many years of ABA experience do you have?
General disclaimer statement, such as “In this job, you may work with aggressive or challenging clients who kick, hit, scratch, bite, etc. Are you comfortable with this?”
Have you worked with aggressive clients before?
Do you have an age preference (older clients? Younger clients?)
How do you handle working with resistant or uninvolved parents or teachers?
What was your most recent salary rate/What are your salary demands?
Are you more of a leader or a follower? Why?

What type of work setting/environment do you thrive in?
What do you enjoy most about working with (insert the type of client the company serves)?
Describe your expertise with skill acquisition/behavior reduction/parent training, etc.
What is your experience with data collection?
Specific behavioral questions/terms, such as “Can you explain the difference between positive and negative reinforcement?”
What are your best assets/strengths? Name your weaknesses.

What are your career goals in this field?
A “story telling” question, such as “Tell me about a time where you had difficulty helping a client? How did you overcome it?”
If not certified: “Do you plan to pursue certification? Why or why not?
If you are certified: “Why did you choose to pursue certification?”
What do you know about our company? Have you viewed our company website?
So what questions do you have for me?



*Questions to ask:


What critical character traits or values do you look for when hiring staff?
Can you tell me about the types of clients I will likely work with (ages, diagnoses, behaviors, etc.)? What is the minimum caseload? What is the maximum caseload?
Who is responsible for purchasing/providing the materials or reinforcers I will use with clients?
Does the company have an illness policy/ session cancellation policy/ parent involvement policy? If not, then how are these issues handled?

Is there an employee dress code?
How are issues of conflict between direct staff and supervisors handled?
Is physical management training provided, and how often is it re-given? Does it include de-escalation strategies? If it is not provided, can I be reimbursed for pursuing my own training?
What is the pay rate for this position? How do pay raises work/when would I become eligible for possible pay raises or incentives/bonuses?
What typical commute can I expect each day? (15 miles, 25 miles, etc.) Is mileage reimbursement offered? Can I expect to be matched with clients that are reasonably close to my home?
What is the full benefits package (insurance, supplies/materials, tuition assistance, opportunities to attend conferences, etc.)? Do I need to work a minimum amount of hours each week to maintain these benefits?

Is there a written job description  I can review? 
What is the data collection and storage method? Binders, electronic, etc.
How are new hires trained (length of training, who conducts the training, topics covered, etc.)? Please describe the initial training as well as ongoing training I can expect to receive. Will I be paid during initial training?
How many candidates are you considering for this position?

Are employees required to sign a no compete or a minimum length of employment contract?
How will my unique skills and interests be used to match me to ideal clients?
How are difficult or problem families handled? What is the process for requesting to come off a case?
Will my direct supervisor be a BCBA?
What paperwork/documentation is necessary for submitting timesheets/billing? Is this paperwork due weekly or bi-weekly?







Friday, July 17, 2015

Behavior Management 101



 Photo source: www.sfari.org

*Recommended Reading: 
My FBA post
A Work in Progress by Ron Leaf & John McEachin (this book is a great resource)



The world of ABA therapy basically has two main areas of focus: Skill Acquisition, and Behavior Reduction. In a nutshell, skill acquisition is about increasing or adding appropriate skills such as attending, task completion, or following instructions.
Behavior reduction is about decreasing or extinguishing behaviors that interfere with learning or functioning, such as tantrumming, aggression, or elopement (wandering/running away).

Firstly, when beginning ABA therapy I have observed that people often want to just focus on skill acquisition. Parents request that their child learn to use utensils, get toilet trained, or learn to play appropriately with toys. Problem behaviors often are thought of as “we’ll work on that later”, or “there’s nothing that can be done about that”. Allow me to debunk these inaccurate beliefs. It is critical in order to effectively teach skills, that disruptive behaviors are dealt with. It is also critical in order to enter less restrictive learning environments that disruptive behaviors are addressed.
I was just telling a consultation client about a week ago, that her son’s behavioral issues will put him in a more restrictive support category than his cognitive level would suggest. In other words, his behaviors would place him in special education when intellectually, he is capable of grade level work. That is how detrimental problem behaviors can be. People often think it is the skill deficits that will lead a child with special needs to be placed in more restrictive settings. I would disagree. What I usually see is that as long as a child with special needs is calm, quiet, and compliant, it’s possible for them to be allowed in almost any setting. It is when the child makes odd noises, is aggressive, runs out of the room, or tantrums, that people quickly want to shuttle them into a more restrictive setting. It’s the behaviors that are likely to limit the child’s options, not their diagnosis/disability.

It isn’t uncommon, whether with parents or professionals, that people get plain ol’ freaked out about problem behaviors. When working with new staff, I often (amusingly) notice that when problem behaviors starts the staff will unconsciously start breathing faster, back away from the client, or their eyes will get very wide. This makes sense to me, because as a brand new ABA therapist problem behaviors used to freak me out too. I had no idea what to do if my clients became escalated or angry, so I would do whatever I could to prevent that from happening. Such as, avoid asking demands because I didn’t want my client to be “unhappy”. Giving my client a break from the table when behaviors started, so he/she would “calm down”. Skipping over/not teaching the programs my client seemed to hate, because I didn’t want to deal with his/her tantrums. If you don’t already know, these are HORRIBLE strategies that will lead to an increase in problem behavior. Yet, I see my staff and families do these strategies all the time. 

What is so great about ABA therapy, is there are more options to manage behavior than I can even type out in this blog post. You never have to feel hopeless or helpless about managing problem behavior. Isn’t that great news??
So now that you know it is not in your or the child’s best interest to avoid or postpone dealing with problem behavior, and that you have TONS of options to do so, let’s look at some of those options.

But first, read the disclaimer :-) :
“It is not possible within this post to provide specific behavior reduction strategies that will be effective for every individual, or for every behavioral problem. ABA therapy is not a cookie cutter approach, nor is it one size fits all. These helpful tips do not replace the need for a Functional Analysis of disruptive behaviors, conducted by an individual credentialed to perform such tasks”


BEHAVIOR MANAGEMENT TIPS

-          During intake/assessment, beyond just determining what skills to teach it is imperative to look at what behaviors to target for decrease. If the client has never received intervention services before, there are likely multiple disruptive behaviors that need to be addressed. It’s best to select the 2-4 highest priority behaviors, because it will be hard on the staff, the family, and the client, to try and tackle everything at once. Quick tip: select the behaviors that interfere with teaching, or are harmful to self or others FIRST.
-          A Functional Analysis and/or Assessment of the target behaviors must be completed, in order to understand WHY the client is engaging in the behaviors. Do not skip this step. It is really, really important.
-          Once the function of the target behavior(s) has been determined, a Behavior Intervention Plan must be created. The plan should include both preventative and reactive strategies for reducing the target behavior(s), as well as replacement behaviors/skills. For example, if my client pushes peers on the playground when they get too close to him, this tells me my client needs instruction in both social interaction as well as a method to communicate to replace aggression.
-          When the Behavior Plan is complete, ALL relevant caregivers must be trained on it. This includes parents, the nanny/babysitter, the ABA team, the teacher, etc. Whoever you do not train on the Behavior Plan, you are basically saying “You’re on your own….good luck!”
-          Data collection is essential. How will you know if the Behavior Plan is effective if you are not collecting data on the target behavior(s)? Regardless of how super- duper smart you may be, all of us have created Behavior Plans that just weren’t as effective in reducing the target behavior(s) as we thought they would be. It happens.
-          Be sure to set realistic behavior reduction goals. If the client is tantrumming 5-10 times per day when services begin, it would be ridiculous to set a goal of completely extinguishing tantrumming within 4 weeks. Be realistic. It took time for the client to learn the behavior, it will take time for them to “un-learn” the behavior.


Lastly, it is important to understand (and pursue additional training or expertise in) the art of de-escalation. If you are an ABA professional and work with aggressive/severe behavior clients, your employer should provide some type of physical management training to you.

De-escalation is a process through which you learn to identify when the client is becoming agitated, and you then begin to change your behavior to bring them back down to their optimal behavioral state. Instead of waiting for full explosion to occur, any step toward fully escalated would prompt a quick reaction. I have seen this method work quickly and effectively to defuse a potentially violent/dangerous situation. Sadly, this technique is the exact opposite of what most parents and professionals naturally do. When a child begins to yell or curse, it seems common sense to go TOWARDS the child or to speak LOUDER to the child, but in a proper de-escalation model those actions are both no-no’s. I also love de-escalation techniques because eventually the client can learn to independently calm themselves down, which should always be the optimal goal. 

Here is a very basic outline of a de-escalation strategy (these strategies need to be individualized to the learner):

Step 1- Learner is exhibiting known antecedents to problem behavior (yelling, arguing, pacing, etc.).
Step 2- Remove attention (stop talking, back away, remove dangerous items, avoid unnecessary touch), and wait for learner to calm. Once learner is calm, probe them with questions to get them to label the problem/issue (“What do you need?” or “How can I help you?”). Provide specific praise if they respond to you, and if possible, provide what they requested. If not possible, explain when they can access what they requested. If learner calms, redirect to original demand. OR…..
Step 3- Learner continues to escalate.
Step 4- Remove attention (stop talking, back away, remove dangerous items, avoid unnecessary touch), and wait for learner to calm. Once learner is calm, direct them to engage in a distraction task, such as a simple motor imitation task or 2 step instruction. Provide specific praise if they comply. If learner calms, redirect to original demand. OR…..
Step 5- Learner is completely escalated.
Step 6- Remove attention (stop talking, back away, remove dangerous items, avoid unnecessary touch), and wait for learner to calm. Once learner is calm, direct them to engage in a calming task or activity (squeeze a plush toy, sit on a bean bag chair). Provide specific praise if they comply. Only attempt vocal communication (“How can I help you?”) if it will not agitate the learner. If learner calms, redirect to original demand. If not, repeat step 6 as necessary.