*Recommended Post: Normalization

Iowa man sits at a messy table while holding paint covered pencil and brush


If you are implementing ABA treatment (regardless of the diagnosis, or lack of diagnosis, your client has) with the #1 goal of making the individual "normal", then you are doing it wrong.


"From cradle to grave, the pressure is on: Be normal." 
Gordon MacKenzie


'Teaching Loosely' is a concept I intentionally aim for when designing treatment, and it can include things like varying stimuli as much as possible (and using common items found in the home rather than purchased materials), having loose criteria for what is an "acceptable response" to any SD, moving away from formal SD's as soon as possible, and embedding multiple skills into one target. For example, instead of writing up distinct and specific targets to work on during a Play Imitation program, the goal may be to embed novel motor behaviors into play for the child to imitate (shake the doll, feed the doll, burp the doll, tickle the doll, etc.).

Why is this so important? Because creativity is where unique, God- given personality and character cause you to stand out from others.
Yes, as my clients are all somewhere on the ASD continuum they do have things in common: a strong desire for sameness, sensory issues, feeding issues or sensitivities, motor/coordination difficulties, etc. But they are also as different from one another as a zebra is from an elephant. Saying all my clients are the same would make about as much sense as me saying "I saw an animal the other day, it was either a zebra or an elephant. Whatever.....they're both animals". That's a crazy statement considering how much those 2 animals differ.
In the same way, it's crazy to plan treatment in such a way that ALL your clients learn "Familiar People ID" in the same way, or learn to tact colors in the same way, or spend the same amount of time on DTT drills.

Creativity is often given a bad rap, especially among us ABA peeps, because it takes us off-script. Before I'm seen as bashing the ABA peeps, this happens in classrooms as well. Think of the kid who has to hum as he does his work, or the kid who dances/wiggles while standing in line, or the kid who draws pictures of robots on his homework assignments. The script would say "this kid is inattentive...this kid is non compliant....this kid is disruptive". Instead of looking it at that way, what if the kid is creative? Or unique? Or has a vivid imagination?

I don't mean to make it sound easy as pie to consider the unique personality of the client when designing ABA treatment. It's not. It takes more time, assessment takes longer, program writing takes longer, and more constant revisions to programs are necessary. Something I like to do often is look at specific programs that aren't going well, and ask myself "How important is this??". Like any BCBA, I use specific assessments and curriculums to design treatment and consider typical developmental goals. But I also look at the specific client, their learning environment, and their overall learner profile. Is using a flat knife to spread really important for this child? What about neat handwriting? Or learning to ask a friend to play? For some of my clients, these are pretty important skills for them to learn. And for other clients, not so much. It depends.

I also don't mean to make it sound like everyone will just love a treatment plan that embraces creativity. Expect some push back. From who? Well, from the program implementers as well as the parents/stakeholders:

It's easier to assume what the child should learn, rather than teach what they are interested in learning.
It's easier to assume lack of competence in the child when a program isn't progressing, rather than think of ways to make the skill more functional.
It's easier to adjust the child to the learning environment/classroom, than it is to modify the learning environment/classroom to the child.
It's easier to demand the child change to meet your expectations, than to change your expectations to meet the child.
It's easier to use purchased materials or flashcards than it is to create teaching materials for the purpose of generalization, or just based on learner interest (e.g. Shrek themed emotion cards).
It's easier to teach the way you have always taught than to constantly change your teaching based on how the learner is responding.


That last point is my favorite.

If the session is flatlining quickly (learner is trying to escape, learner has shut down and isn't responding, learner is screaming and crying), don't just plod through a 3- hour session like that. Stop and assess: what's going on here? ---> Are you approaching the learner with powerful reinforcement? Have you made it clear the behaviors that reinforcement is contingent upon? Are your materials boring? Are you maintaining your energy and an animated affect? Is the learner getting to make frequent choices? When did the learner last have a break/creative time? (I like calling it creative time rather than just a break, because that makes it clear to staff that the learner decides what happens on breaks. Not the staff)

None of us typically enjoy working with non-creative people....they can take the fun out of projects or assignments, and suck the energy out of meetings. If that's the case, why do some of us work so hard to kill the creativity in our clients?
Kids are some of the most creative people I know, so I'd rather spend my time helping them hold onto that as they grow up, rather than killing it.





Photo source: www.newcap.org

A novel, based on the life of an 18th century peasant girl who marries into nobility...


I am totally kidding.


My newest book, "Everything You Ever Wanted to Know about ABA" is now available for purchase on www.Amazon.com.
I'm just going to say it: It's my best book so far.
(If you are unfamiliar with my previous books, just go to Amazon and type 'Tameika Meadows' into the search bar).


I stand by that huge claim. If you buy the book and hate it, let me know and I'll give you a cookie or something.

This is my BEST book yet because I combined all the ABA horror stories I hear from families, all the questions parents ask me when I first meet them, all of my kind-but-honest responses to those scared parents, cold hard data, but also warm, soft hope.
The book also includes 2 *bonus* Parent Checklists with over 50 suggested questions to ask potential ABA providers. I talk to so many parents with newly diagnosed children and tell them "You should be asking more questions", and they respond with "But I don't know what to ask!". Well.. now you will.


My hope is that any parent who finds themselves nervously facing their computer screen trying to process and digest everything about ABA to make a decision for their child, can instead just get this book and have all their innermost questions and fears addressed in clear, simple language.
If you have visited my blog for longer than 10 seconds then you should know by now that clear and simple language is how I roll.


Specifically, this book will honestly and plainly tackle the following common parent questions or concerns:

  • If ABA is so great, why does it get SO much hate? (I did not mean to rhyme right there)
  • How do I know if I'm getting quality ABA treatment?
  • How much should I be paying the ABA provider?/Why is this so expensive?
  • What will ABA therapy cost my marriage, or my family?
  • Do all children with Autism NEED ABA therapy?
  • Who can provide ABA therapy? What training do they need?
  • What setting for ABA therapy (home, school, center) is the BEST?
  • How much therapy is enough therapy?
  • I have NO idea how to read these assessment results from the BCBA. Help.
  • Can older kids or adults benefit from ABA therapy?
  • Isn't the goal of ABA therapy to force Autistics to be "Normal"?
  • What is the role of the parent in ABA treatment and why is parent training so crucial?
  • What the heck is a FBA (Functional Behavior Assessment)?
  • How quickly will my child progress/improve with ABA therapy?
  • Why doesn't my BCBA provide direct therapy to my child?
  • What is the difference between Non-verbal and Non-vocal?
  • Is ABA therapy the right choice for my child, and for my family? 
  • What will my child be like after years of ABA therapy? What should I expect?
  • Why are ABA providers so judgmental about sensory diets/sensory integration?
  • Why can it be so difficult to obtain ABA treatment for older kids/teens?
  • Why can't ABA sessions be 30-45 minutes long, like so many other therapies?
  • Can ABA ever truly "not work"?
  • Why does ABA force compliance?
  • Does ABA today still use aversives and punishers?
  • What questions should I ask this new ABA provider we just started with?
  • How can I determine if an ABA provider is practicing ethically or not?



And many, many more!

Order your copy today, all the cool kids are doing it: Click here to go to Amazon.


So much to say on this topic, far more than anyone would actually want to read.

Does ABA therapy require/demand/force individuals into a narrow and specific box titled "NORMAL"?
No. 
(Well, it shouldn't anyway)



I mean this in the best way, but many of the children I work with just are not going to fit into that "normal" box, no matter how much someone tries to push or squeeze them into it... it ain't happening.

And that's a cause for celebration!

The very thing I love about working with such a diverse group of kids, is that they are all different, yet all interesting. I work with some super fascinating small people, who constantly show me how dumb I am. And I thank them for it, because how can you grow if you already think you know everything? You can't.

As a provider, of course I know the research on the effectiveness of ABA therapy. I also know the many success stories I have seen with my own eyes, of children I directly worked with. But success story does not equal "...and then the child was totally normal!".

A couple of reasons why my job is not to drive families in my car to a fantasy location called "normal":

1) Each client/family I work with usually has their own idea of what "normal" means. If you have been in this field more than 10 minutes, you know this to be true. This client over here may live in a home where no one really cares what time they go to bed, as long as they stay in their room and are quiet. But that client over there, may live in a home where all the parents want most in the world is for that child to get their 7.5 hours of sleep every night.
2) Even when a family can explain to me what "normal" means for them, it quickly changes! Again, if you have been in this field more than 10 minutes you know this is true. Sometimes parents tell me they want desperately for their child to talk, but what they really mean is they want their child to communicate. Or, a parent may tell me they want desperately for their child to go to "normal" school with their big sister, but next thing you know that parent has decided to homeschool. Expectations change, as perspective changes.


So if ABA therapy is not about hitting a child over the head with your magical "normal" baseball bat, then how exactly is it decided what the goals of treatment will be? I'm so glad you asked.

If you are working with a quality ABA provider, the goal selection process will look something like this:

"I need to evaluate/assess your child to collect baseline data" – This just means data is collected at the onset of services to create a starting point. Over time, that starting point data will be reviewed again and again to make sure the child is progressing. If therapy has been happening week after week after week, but the child has not progressed past that starting point, then something is seriously wrong. This is why it’s important to collect that initial data, so over time you can compare the child’s current learning to their previous learning.

"What are your goals for therapy? Tell me the reasons why you initiated services." – The people who asked the ABA team to show up clearly had reasons for doing so, and we need to know what those reasons are. We cannot fully help if we don’t know what issues are happening. Treatment planning should always be a team effort, with the family/client working together with the BCBA to create goals.

"Let's discuss what your child's needs and wants are" - For many practitioners, the individuals we support cannot request our services, and they cannot communicate what THEY want out of therapy. But, it is still very much our job to not just design an intervention for them, but with them. You may be wondering how the heck would be possible for a non-verbal client? Preference assessments, skill probes, treating escape as a removal of assent, and embedding client interests and special hobbies into the treatment plan, would all be my suggestions. 

"What are the highest priority areas of concern in the home? At school? In the community?" – What this question is really getting at is “where do you want to start?”. It isn’t unusual that families want to work on…oh, 85 behaviors or so when you first meet them. Unless I can get a good idea of the priority level of those 85 things, the treatment plan will be a chaotic mess. Prioritizing treatment helps focus in on the areas of deficit that are impacting the client the most.

"Describe your household: rules, routine, disciplinary procedures commonly used, etc." – This question gets at Culture. Households form a sort of culture, or a way things are done. Stepping into a household/family dynamic and imposing completely opposing culture onto it, is not a great idea. It will likely lead to aggressive resistance. What is more helpful, is to teach the family strategies and techniques that line up with the way their household functions.

"Can you finish this sentence: In 5 years, I want my child to be able to....." – This question is really getting at long-term goals. Professionals need to know long-term goals, because every long-term goal is really made up of hundreds of baby steps. Gradually introducing those baby steps leaves less work to do down the road and increases the likelihood of successful skill acquisition.

"Your child scored low on (insert skill domain here). Do you care about that??" – One of my fave questions to ask. I have learned to ask this, because I used to do quite a bit of assuming. Things like “Of course, you guys want him to write his name, right?” or “Of course, you guys want her to stop eating with her hands, right?”. Maybe not. If I see an area of concern, I will bring it up. If the parent isn’t as concerned as I am or wants to stick a pin in that issue until a later time, then it’s really important that I know that.


My normal is not your normal, and vice versa. What's considered "normal" in your household might not fly in my household, and what's "normal" in your marriage could be unbearable for another couple. That's why normal is such a useless word to throw around, because it has too many meanings to actually mean anything significant. 

One of my pet peeves is when a parent says to me during an intake, "I just want him/her to be normal!". Ummm, and that means what?? 
Seriously, I need details over here. I do not have an intervention for "normal" behavior, nor do I know how to program for that.

Does ABA therapy seek to change individuals? Yes! Behavior change is the entire point of this therapy, either increasing appropriate, life benefiting, behaviors or decreasing inappropriate, harmful, behaviors. But Autism erasure should never be the goal of intervention.



“The two most important days in your life are the day you are born and the day you find out why.” 
Mark Twain






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