Wednesday, October 5, 2016

"He's doing just fine!"


Photo source: www.mymetroparents.com, www.autism.lovetoknow.com

Here is a very, VERY, common experience that I have when meeting with the teachers of a client:

"Oh, he is doing just GREAT this year! We aren't having any problems"
"Nope, we aren't seeing ANY of that at school"
"What social skill deficits??"
"Sometimes I have to tell him to do something over and over, but other than that everything's fine!"

For ABA therapists/BCBA's who see clients at school, OR your client receives non-ABA therapies (such as OT or Speech) sometimes it can feel like we are speaking 2 different languages or talking about 2 completely different children. Have you ever experienced that? I have, and continue to experience it.

I think first of all it is helpful to put yourself in the shoes of the non-ABA professional. They may not share your perspective, methodology, or clinical training. Also, they may not have as much history of your client as you do. Just think about one of your clients and what they are like at home. Now think about that same client at school. If you were the teacher and never saw that child at home, what would you think about their capabilities? See what I mean?

So once you understand that the teacher could have a different experience of your client, next it is important to make sure everyone has similar levels of expectation. I find pretty often that if I am meeting with a client's school team and having one of those "Are we talking about the same kid" moments, its a good idea to back up and address Expectations.
From working closely with my clients and seeing them in a 1:1 therapy setting, I get to know how well they can perform. I know how many words they can say, how many colors they can name, and how quickly they can come out of a tantrum. The school team does not always have the opportunity to get to know your client this intimately, so you have to share what you know! I might be sitting in a meeting thinking that my client can do FAR more than work on tracing letters, but the teacher may be sitting in that same meeting thinking that tracing letters is a perfectly reasonable goal. So a great place to start bridging the gap between the ABA team and the school team is by outlining expectations. What is expected of the child? Are the goals developmentally appropriate? Are the goals challenging enough based on what the child can do in a 1:1 setting? Are non- academic milestones being addressed, like socializing with peers or waiting to access reinforcement?

Here are a few more tips that I have found helpful when working collaboratively with school staff:
  1. Provide a brief snapshot of information to the school team that summarizes what goals are being worked on during home therapy. I have found it can also be helpful to share video clips of therapy sessions, because some teachers I interact with have no idea what happens during an ABA therapy session. The may not know that my client is fully capable of sitting quietly, labeling animals, or manding for reinforcers.
  2. Consider sharing resources on basic ways to maximize teaching, such as how to deliver reinforcement or how to deliver a demand. Now, the last thing you want to do is alienate or offend the school team. A teacher with 25 years experience will not want to be told how to deliver a demand. So use polite, respectful language. For example, "Here is a brief handout that lists some strategies we have found to be very successful when working with Jared at home".
  3. Use specific examples and concrete, simple language (translation: NO jargon) to help the teachers pick up on skill deficits they may be overlooking. A problem I see often is the teacher will state that my client is doing so well that they don't need the ABA therapist in the classroom. I then have to, tactfully, point out that the very reason my client is doing so well is because the ABA therapist is in the classroom. Realize that the teacher may not pick up on everything the ABA therapist is doing to keep the client moving through their school day.
  4. Give the teacher immediate feedback (if possible). To give in the moment feedback you need to be in the classroom on a regular basis. If you aren't allowed in the classroom, you can still ask the teacher specific questions to draw out detailed information and then give them feedback based on that information. If you are able to be in the classroom, then definitely grab opportunities to prompt the teacher and quickly praise, OR to gently alert the teacher when to intervene. For example: "Ms Katie, you told Jared to clean up the blocks and instead he went over to the kitchen center. This would be a great time to use that gestural prompt I showed you". 
  5. Sometimes the teachers really are not having difficulty with your client inside the classroom, but its because demands are avoided and problem behavior is not corrected. Examples - Teachers avoid calling on your client, taking items away from your client, or redirecting perspective behaviors. In order to avoid vocal protest or a tantrum, demands become optional requests.
  6. Data is your friend. Some of the experiences I reflect on where the teachers were super adamant that my client was doing "just fine", required a bit more elbow grease than just some handouts and gentle prompting. In those situations I would observe in the classroom and collect data on a specific behavior, such as prompt instruction following. Its one thing to tell a teacher that they are regularly dropping demands. Its a much more powerful thing to show the teacher on a data sheet that during a 2 hour observation they dropped 15 demands. Again, remember your goal is not to alienate or offend. Once you hit the teacher with the data, follow up with help or support. For example, "When we work with Alice at home we have a specific procedure for gaining prompt compliance. Can I show it to you?"

Hopefully, your take away from this post is that when you have those "Are we talking about the same kid?" moments that you are not alone!
 It's important to remember that professionals from other fields have differing viewpoints about learning and behavior, and even if you think a behavior is very maladaptive they may not see it as a problem.
Its just realistic to expect that non-ABA professionals will not think the way you think, which means they won't share your perspective. The key is approaching people with a motivation of collaboration, not division, and to show the school staff that you are there to help.


Recommended:

Increasing teacher intervention implementation in general education settings through consultation and performance feedback. Noell, George H.; Witt, Joseph C.; Gilbertson, Donna N.; Ranier, Deborah D.; Freeland, Jennifer T. School Psychology Quarterly, Vol 12(1), 1997, 77-88



0 comments:

Post a Comment