Thursday, November 3, 2016

Input = Output



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If there was one blanket statement I could say to any family starting ABA therapy services that would sum up in a nutshell what to expect moving forward it would be: Input Equals Output. Or, put simply “You get out what you put in”.

Two examples that illustrate this concept nicely are crash/fad diets, and cramming.

Fad diets are usually cheap, promise quick results, and have very simple instructions like “Eat 2 apples every day at noon for 3 weeks and drink 3 glasses of water”. Once you follow the easy directions for a short period of time, BAM, you are supposed to drop some serious weight.
Cramming can take many different forms, but usually is a fast and last minute way to prepare for a test or exam. Late as in, quickly reading over your notecards as the exam is being handed out. Funny thing about cramming though, while you may be able to hold on to the content long enough to take the exam, a few days or weeks later that information is gone.

In various ways over the years, I have seen families approach ABA therapy like it’s a fad diet, or like they are cramming for a final. Quite predictably, the results have been disastrous.

ABA therapy is an individualized and high effort intervention methodology that requires highly trained individuals to oversee and/or implement in order for it to be effective and long lasting. So re-reading that sentence, if you approach ABA therapy with a fad diet mentality is it likely to be effective? No. How about long lasting? No.  This could look like: lack of progress, initial progress and then progress stalls out, slow or minimal progress, or variable progress/inconsistent gains. I was talking with a parent recently who told me her son had been receiving ABA therapy for months with no gains/changes. That struck me as extremely odd, but also very illogical. Would you stick with a diet plan for several months if you hadn’t lost a single pound? No, right? Then why would you continue with a therapeutic intervention that had no observable benefits?

If you are a parent who has been on the ABA train for a while now, you can probably look back at when things started and be amazed at how little you really knew about ABA therapy. The crazy thing about this intervention is you CAN see or bring about amazing progress while simultaneously understanding little about the process. Entry level direct staff can be taught to implement very sophisticated programs and behavior plans that they may not understand very well. So to a point, of course I don’t expect families to be ABA experts as soon as I meet them.
…BUT :-)

Sooner rather than later, as the parent you do need to increase your knowledge base of the therapeutic program you are now participating in. See how I did not say “your child is participating in”? Unless you are new around here (which if you are, Hi) then by now you should know that ABA therapy is not a spectator sport. It’s not watching your child disappear behind a door with a bubbly therapist for 2 hours, and then walking the therapist to the door and going on with the rest of your day. It’s not having a vague idea of what your child is working on, or glancing at the behavior plan once or twice.

If your child is receiving ABA treatment, regardless of the setting (classroom, in home, clinic based) then what you have done is volunteered for a training program. I bet you didn’t even know that! Yes, it’s quite true. You have volunteered to participate in a rigorous and comprehensive training program where both you and your child will learn new skills, learn new ways to understand behavior, and learn new ways to interact with each other. Think of the ABA professionals as your coaches, and you and your child are teammates in this training program.

So as a brand new volunteer participant (your uniform is in the mail) in this rigorous training program, what can you expect moving forward? Super glad you asked:

  • It won’t be easy- Hey, nothing worth having is easy right? Just remind yourself of that when it gets rough. Throw “easy” out the window, and embrace “challenging”. ABA therapy does not have to be hard, but it will likely be very challenging. More for you than for me. Why? Well, I don’t have the same emotional attachment to your child as you do. I also don’t have the same learning history with your child as you do. This means your child will give me less pushback, and it also means I am less bothered by their crying or tantrums. I know that on the other side of those problem behaviors are opportunities to learn to communicate, to learn to self-manage, and to exceed expectations. So I can push through initial difficulty in order to have future success. Can you?
  • No shortcuts- Think about those 2 examples again, of fad diets and cramming. Did you keep the weight off from that fad diet you tried? What about the cramming, can you still name all the US state capitals? No? Yeah, unfortunately shortcuts don’t tend to offer much longevity. I have yet to meet a family who says to me “Tameika, I want my child to learn to communicate, have less tantrums, and use the toilet…….for 6 months”.  The techniques and strategies the ABA team tells you to implement were selected because they are effective. Not necessarily because they are fast.
  • Expect your questions to generate more questions- If I may speak for all the BCBA's out there for a moment, we really are not trying to be difficult when we respond to your question with more questions. It’s just that we need a TON of information about the behavior in order to give you an action plan. For any given behavior, there could be 500 variables maintaining it, especially if it’s a behavior I have not actually seen the child exhibit. So its very typical that a parent will ask what seems like a very simple question, such as “How do I get him to stop (insert behavior here)”. It’s also very typical that the BCBA will respond with something like “Well what does he usually do before that? What about after? What time of day does this usually happen? How do you respond? Uh huh, and then what does he do?”, etc.
  • Expect your questions to generate more work – I know, now it IS starting to sound like we are just intentionally being difficult. Let me explain: when you approach the ABA team and ask for help/ask for their advice, what you are actually asking is “Coach, please show me how I can fix this problem”. Any question I get from a client is likely to lead to a new skill acquisition program, additional parent training, or a revision to the current behavior plan. The theme here is that I cannot just answer your question, I have to show you how to improve the situation.


**Recommend Reading-
Now that you know how much work therapy is, need to know how long that work is required? See How Much Therapy?


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