I've discussed on my blog how to find ABA therapists for your in-home therapy program, and recommended a resource for how to do this ("Behavioral Intervention for Young Children with Autism" by Catherine Maurice).

 This post is for parents who have already found a pool of potential therapists and are ready to begin interviewing. If your child receives ABA services at school or through an agency then you typically don't get much say in who will be assigned to your child's treatment team.
However, even if you are dealing with a school or agency you can still ask to meet the team and inquire about their background before they start working.

 It's important to treat the hiring process seriously. If you want competent and dedicated therapists then take the time to recruit carefully before hiring anyone. Avoid spending the interview laughing and chatting; the therapist isn't interviewing for a position as your buddy. Project the level of professionalism that you expect to receive.





I hope this information serves as a minimum standard of how to interview ABA providers.:

- Decide before you meet with any potential therapist the job expectations, schedule, minimum and maximum pay rate, and create a short summary of daily job responsibilities. You may be hiring someone with little ABA therapy experience. This person may assume that if their last client paid $20 per hour then so will you.  On the other hand, you may find yourself interviewing a therapist that has many years of experience. Just because someone has worked with many families doesn't mean they are competent. Make all of the information about the position clear -put it in writing- and discuss it with the potential therapist. Explain what you expect regarding job performance (such as stating you will video record sessions). Don't let the ABA therapist be surprised when they begin working for you. If you expect them to stay 30 minutes after each session to go over notes and data with you, tell them that upfront.

- Parents often have the misconception that an ABA therapist is an all-in-one job title.....it's not. Most ABA therapists are only qualified to implement programs and run a session with your child. They may not be qualified to write programs, do assessments, or train teachers. I talk to so many parents who hire an ABA therapist and quickly realize the person has a limited skill set. The person who manages or supervises an ABA program is the Consultant. The person that implements programs is the ABA therapist. 

- Schedule the interview for a time when your child will be home. Observe interaction between the potential therapist and your child. If you can't observe actual interaction, let the therapist view video clips of your child. Even experienced therapists may not be comfortable with ALL behaviors. It is important that any potential therapist be comfortable working with your child on their best and worst days. Be honest during the interview. If your child becomes aggressive at times, say that upfront. Its better to scare someone off during an interview than to have a therapist abruptly quit on you after a bad session (I've seen this happen).

- I believe the most important characteristics when hiring anyone are: Attitude, Willingness to learn, and Energy. Any therapist you hire will need some training, even if its just learning about your child's personality. If the potential therapist doesn't respond well to feedback and doesn't seem passionate about their work then that shows a minimal willingness to learn. Regarding attitude, as anyone who works with special needs children knows there are great days and horrible days. If a potential therapist is cranky, argumentative, or rude during the interview process, imagine how that person will act after a bad session with your child. A positive and upbeat attitude is essential for anyone who wants to teach children with Autism. Moving on to energy,  I'm not saying that the person should arrive at your home and be bouncing off the walls. What you are looking for is a lack of energy. Does the person seem tired, overly quiet, or very soft spoken? Anyone working with young children should be able to "turn on" an upbeat, animated persona and leave their troubles at the door. If you are interviewing someone and cant picture them smiling, clapping, making goofy faces, or shouting "Hooray", then that is not an ideal ABA therapist.

- Most families tend to hire high school or college students with minimal experience as ABA therapists. This is usually due to low cost. When working with students you may want to consider including an employment clause where the individual agrees to a minimum length of employment, such as one year. There's a few reasons families choose to do this- 1) As stressful as high staff turnover is on the parents, imagine how stressful and confusing it is for the child to constantly have to get used to new people, 2) Students tend be transitory, so by placing an employment length commitment on them you are sending a message about the seriousness of committing to the job, and 3)Think of all the time and money you will spend on training a new therapist. You don't want a situation where you spend thousands of dollars training a new therapist, and he/she quits on you after 2 months of employment.

- Ask questions! So many times I have observed interviews and the parents just summarized the position and listed the pay. At no point did those families find out any information about the person they were interviewing, that wasn't clearly listed on a resume. Beyond the basic information you need to get to know your potential staff. Here are a few questions to ask:  

• Motivation for doing this kind of work?
• What do you know about Autism? What do you know about ABA?
• Do you believe a child with Autism can recover fully? Why or why not?
•  What would you do if our child bites or hits you?
• Describe your strengths.
• Why should we hire you?
•   What is your personal philosophy about special education?
•   What was the last book you read about Autism?
•   How do you feel about being videotaped?
•   Have you changed a diaper? Have you changed a diaper on a child over the age of 5?
•   How do you feel about bodily fluids getting on you, such as spit, vomit, urine, blood, etc?
•   Willing to train new therapists in the future?
•   Willing to attend training sessions, conferences etc.?
•   What do you think the primary responsibilities of a therapist are?
•   What type of activities would you do with a child of X age? 
•  What do you do when a child totally frustrates you? 
•   How do you handle temper tantrums? How do you handle meltdowns?
•  What are your favorite children's books?
•  What kind of relationship do you want with our family?
•   What kind of boss do you work best with?
•   What  important traits do you think a therapist should have?
•    How would you describe your temperament?
•    Do you plan to pursue Board Certification one day? Why or why not?

You may have noticed I haven't listed specific requirements for experience, salary, or education. If you do a quick search online, you'll find tons of recommendations about education and experience requirements that ABA therapists should have. In my experience most families cannot find or afford a therapist who actually meets these standards. Sadly, the demand for experienced ABA professionals far exceeds the supply. You may need to recruit inexperienced individuals and spend time training them if you can't locate quality professionals in your area. 

In no way am I saying families should lower their expectations when hiring ABA staff. If you want an ABA therapist with 5 years experience and a degree, then stick to what you want. However, know that it might be very difficult to find such an individual who has availability and is affordable. 

That is why I stress to parents to look beyond a potential therapists' experience and education and find out who the person is, how passionate they are about learning, and if they truly enjoy working with children. Those factors, along with time and training, can turn an inexperienced babysitter or family friend into an amazing ABA provider.





*See below for a sample "Help Wanted" advertisement, to use when locating ABA therapists. Feel free to use it!:

Private family seeking fun and energetic behavior tutors!  No experience is needed. We are happy to train the right individual.

Position: We are seeking 1-3 behavior tutors to provide ABA therapy to our adorable 5 year old daughter, who has Autism. ABA stands for Applied Behavior Analysis, and is a behavioral treatment that has been successful for children with Autism. Your job will be to play with our daughter and to help her learn!

Availability: Afternoon (3:00 pm- 6:30 pm) and weekend availability is especially needed.

You Provide:

§        4 year degree in Psychology or Education is preferred

§        Must be willing to submit to a criminal background check, and/or fingerprinting

§        Ability to commit to a weekly schedule, and to show up for work on time

§        Reliable transportation is a must

§        Positive, can-do attitude!

We Provide:

§        A relaxed and caring work environment

§        Great starting salary ($11.50 per hr) with possibility for a raise after 6 mo. of employment

§        We will supply all necessary therapy materials and supplies

§        We work with a Consultant who will provide all training

§        An adorable and happy student for you to teach!

If interested, please send your resume along with a short introduction. Tell us about any related experience, what you know about Autism, and why you think you are a good candidate.

Read more »

Tameika Meadows, BCBA, Blog Author

*Great resource: Behavioral Intervention for Young Children with Autism: A manual for parents and professionals by Catherine Maurice, Gina Green, and Stephen Luce.


 This is a very important topic that's close to my heart. I love working with families who are new to ABA therapy or Autism. I got my start in this field working with families in rural or international areas who knew very little about behavior therapy, or the diagnosis of Autism. It was challenging, but I learned a lot. Today with advances in technology, research, and with SO many parent-friendly resources available, its much easier for parents of newly diagnosed children to know what to do and how to get connected to help or resources.

Even if you never knew anyone Autistic before your child was diagnosed, its likely that you have read a book or article, or seen someone on TV discussing Autism. Yet despite all of that parents have so many questions about treatment options. Just type the word "Autism" into a search engine and watch how much information you get back. This mass amount of information can be hugely intimidating for parents who are new to Autism.

This post is specifically for families who want to start an in-home ABA program for their child. If you are in that situation there are either no providers in your area, or for various reasons you cannot access the providers in your area (such as lack of funding, excessive waitlists, etc.).

In order to be brief I will focus in on 4 critical areas: After the Diagnosis, Why ABA, In-Home ABA, and Maintaining Balance.

• After the Diagnosis- Once parents receive confirmation that their child is Autistic, there are often a series of emotions that follow. Please understand: Autism should not be viewed as some horrific announcement. Yes, Autistic children may learn, progress, and interact differently than a typically developing child but "different" and "bad" are not synonymous. After receiving a diagnosis, the truth is you are now able to access treatment options. Many treatment options are only available if your child has a diagnosis. There are just so many decisions to make and no one can make these decisions for you. The clinician who gave you the diagnosis cannot give you a "Recipe For Success" for Autism. There is no standard treatment plan of what to do next. Many new parents ask me for one, but it doesn't exist. What you want to focus on is a therapeutic method that addresses your child's unique deficits and weaknesses. That may mean ABA therapy, and it may not. When working with special needs children the goal is to help them reach their personal level of "successful".  For some children that may mean they will always require significant care across their lifespan. For other children that may mean they will eventually hold a job, live alone, and report high levels of life satisfaction.

• Why ABA?- Once you have decided on pursuing treatment for your child now you have the decision of what therapeutic method to select. Just to name a few options: Occupational Therapy, Speech Therapy, Early Intervention Services, Physical Therapy, etc. The list of treatments for Autism is ever growing, and ever changing. Certain treatment methods are dropped and labeled as "fads", and other methods change and morph into something else. What is most important when deciding on a treatment method is to look at your child's needs. What skills do they need in order to have a better quality of life? Determine your child's needs and then select a therapeutic method that will meet those needs. It is important to select a therapeutic method that has empirical data to support it, and has been proven to work with specifically with Autism. It's nice if a therapy works great for children with speech disorder, but how do you know it will work for your Autistic child? Especially if the provider has no Autism experience? I see that a lot, where my clients will begin a new therapy or enrichment program but quickly be asked not to return because the instructors don't know how to teach them/can't handle the challenging behaviors.  The treatment method should also have a method of showing progress and gains, which many treatment options out there are lacking. Without proper data how do you know the treatment is working? If you are spending hundreds of dollars on a treatment, don't you want evidence that it is working?  It is important if you are spending time and money on a treatment method that you are confident in its track record. 

• In-Home ABA- If you have decided on ABA as a treatment, you have a few choices available. Your child's school can deliver ABA treatment to your child during the school day, you can contact a local company who will send therapists to your home, or you can run the in-home program yourself. Obviously, the last option is the most labor intensive on you, the parent. However not every school offers quality ABA services, and not every family lives near an ABA company (especially if you live in a rural, or international area). Often times even if you do, the agency has a long waiting list. Waiting lists in this field are very, very common because the demand is so high. If you are considering running your child's in-home therapy program, then great for you! I love to encourage parents to take charge and not to wait around for a spot on a waiting list to come available. That may take months or even years, and that's valuable time that you could spend teaching your child. To get started you will need to assess your child's abilities, hire therapists, hire a Consultant/ BCBA, and gather supplies and materials. As far as resources and supplies, you need to know what programs you will be teaching in order to know what materials you need. A great resource on writing ABA programs is:   "Behavioral Interventions for Young Children with Autism" by Catherine Maurice.  This book is amazing, and I haven't come across a more parent friendly resource. I am also a fan of: "The Verbal Behavior Approach" by Mary Barbera, that focuses on Verbal Behavior.  Basically, Verbal Behavior is a form of ABA that focuses on communication and language being taught/increased behaviorally.  

• Maintaining Balance- Once you have your in-home program off the ground, you may find that your household has become an ever changing flow of therapists, schedule changes, meetings, and chaos. It can be a strange experience to get used to having therapists in your home several hours a day. If you have other children they may resent the fact that no therapists come over to play with them.  Juggling therapies, hiring therapists, attending team meetings...it may all get to be just too much. Its important to remember to keep a balance and to stay organized. Running an ABA program is somewhat like owning a business. You need to stay on top of staff, keep up with progress, handle hiring and firing, make suggestions for performance improvement, etc. If you are organized it makes everything so much easier. Create a system that works for you and stick to it. As the in- home program is implemented and time begins to pass, it is essential to hire a BCBA (or equivalent). If you cannot afford to hire one to completely run the program, then you can ask the BCBA for their consultation rates. You can also ask if they have a sliding fee scale, or provide a discount if you sign up with other families in your area. I find that most families seek outside help when things start to go wrong or progress stalls. Or as I like to say, for "troubleshooting". I strongly recommend if you are having issues with your in- home program, to consult with a BCBA before you make any decisions. If you don't understand why you need a BCBA, I strongly recommend this amazing blog post, from Thinkingautismguide.com.

 Below is a list of resources for starting or running an in-home ABA program. I hope they are helpful.

BOOKS

Let Me Hear Your Voice – A Family’s Triumph over Autism, Catherine Maurice
Teaching Developmentally Disabled Children – The Me Book, O.Ivar Lovaas 
Behavioral Intervention for Young Children with Autism, Maurice, Green & Luce 
Teaching Children with Autism, Robert & Lynn Koegel 
Visual Strategies for Improving Communication, Linda Hodgdon
Treasure Chest of Behavior Strategies for Individuals with Autism, Beth Fouse



WEBSITES

These websites are a great resource for parent-therapists who do not have access to, or cannot afford to hire ABA professionals.

 http://www.maximumpotentialkids.com
 http://www.rethinkfirst.com
 http://www.autismabacurriculum.com

Read more »

Tameika Meadows, BCBA, Blog Author

 

Motivating Operations (M.O.) is an important ABA concept that refers to the internal processes or desires of an individual that change or improve the value of a certain stimulus.  This change can improve the effectiveness or value of a certain reinforcer (E.O., or Establishing Operations), or it can reduce or lower the value of a certain reinforcer (A.O., or Abolishing Operations).

Basically when someone refers to M.O., they are describing Motivation.

So why is this an important concept for anyone who works with children with Autism to know? 

Well, one way that children with Autism may differ from NT children is a lack of motivation. It is that lack of motivation, or atypical motivations, that can cause a child with Autism not to exhibit behaviors many typical children exhibit: point to objects excitedly (joint attention), make eye contact and smile, use communication effectively, display socially appropriate behaviors, etc. Children with Autism often additional extra motivation to perform tasks or activities that other children enjoy.

For example, birthday parties are considered fun and exciting and typically, children  do not need extra motivation to attend one. But for a child with Autism birthday parties might be stressful, loud, chaotic, and overstimulating. So in order to successfully take a child with Autism to a birthday party it may be necessary to provide additional motivation. If you have a good understanding of M.O., it can be a powerful tool to make any stimulus  more motivating to your child or client.

Motivation is key within all aspects of life. Teachers often create highly motivating environments for their students using visuals supports within their classrooms, presentation of exciting curriculum units, and presentation of material using multimedia, such as showing a movie. Some students are intrinsically motivated to learn, and some are not. When you understand M.O. then you know how to take a non preferred item or activity, and make it preferred....even if only temporarily. Please see the example below:

You are trying to teach a 4 year old child non-verbal child to request juice. So far you haven't had much success. You are aware that language training needs to take place all throughout the day, so you offer juice to the child in the morning, afternoon, and evening, and you even vary the type of juice to see if that grabs the child's interest. Unfortunately none of these strategies seem to be working.

Besides being an empirically supported behavioral tool, using M.O. correctly can save time and money. Instead of increasing time output by offering the child MORE juice, hoping that will get MORE language, or increasing money output by buying apple juice, orange juice, and pineapple juice, try manipulating the M.O. 

Firstly, stop offering the child juice for a few days. Only allow them to drink water, milk, etc. This will make the juice more powerful when you bring it back because the child hasn't had it in a while. After a few days have passed wait until the child has an increased desire for juice. This could be after the child has been outside playing in the sun or after the child has eaten pretzels or salty snacks. Then offer juice to the child and try to get a mand. That is how you successfully use M.O. to manipulate the power, or desirability of a stimulus. ABA at its core is about manipulating the environment to bring about desired changes in behavior, and M.O. is an excellent tool to have in your arsenal.

Here are a few more examples of M.O.-

1. "Fluid Loading" (providing free, unlimited, highly preferred fluids to drink) a child during potty training, to increase the likelihood they will have to urinate.
2. Removing Skittles as a reinforcer because you notice the child just plays with the candy and doesn't eat it. Then bringing the Skittles back the next month, to increase the likelihood the child will want the candy.
3. If you are trying to teach a child about automobiles, wait until they are playing with their Thomas the Tank Engine toy to have them learn the label "train".
4. If you are working during a session with a child who is refusing to sit down, go outside and have them jump, swing, run, hop, etc, and exert physical energy. Then take them back inside, to increase the likelihood that they will want to sit down.
5. Don't work on self help skills such as proper fork grip, and drinking from an open mouthed cup, at arbitrary times of the day. Work on these skills during mealtimes, so the child is more likely to want to want to use the skill so they can receive the reward (food).

Read more »

Tameika Meadows, BCBA, Blog Author