Activity schedules are amazing tools that can benefit a household in many different ways:

1. Ease transitions
2. Promote independence/Self-management/Leisure skills
3. Teach play skills (particularly independent play)
4. Prompt behavior without a therapist/adult being present
5. Decrease unsupervised "free time", which is often filled with problem behaviors
6. Teach following a schedule/teach routines
7. Signifies when reinforcement is available
8. Teach choice making

I love, love, love activity schedules. A common recommendation in my behavior plans is to "keep the child engaged". Most of my clients exhibit their worst problem behaviors outside of therapy sessions and school. Why is that? 

It's often because the home environment does not provide the same level of routine and structure as school and therapy sessions. For most of my clients, down time is not their friend. Down time is usually filled with behaviors that Mom or Dad do not want to see increase, like eating carpet lint, dumping out the dog's food bowl, or sitting on top of the refrigerator.

If you are working with an ABA team, ask them if this is something your child could benefit from. If you don't have the support of a team, then keep reading and I'll explain how you can make one yourself.

Firstly, parents often say to me "Is this really necessary? Will he/she always need to have a photo schedule to follow? Won't this be inappropriate when he/she is a teen or adult?". My response to that question is to inquire if the parent ever uses some type of planner (including digital ones) to organize or structure their days. Roughly 80% of the time they tell me they do. I then explain that a planner is a glorified activity schedule. Don't believe me? Okay:

Activity schedule with photos----->Written schedule with no photos----->To Do list----->Organizer/Planner/Scheduling app

Now that you know even adults use a version of an activity schedule, how do you know if your household could benefit from one? If any of these scenarios ring true for you, consider implementing activity schedules:

1. Afterschool/on the weekends/after therapy sessions the child's problem behavior skyrockets
2. Breaks from school/3 day holiday weekends are just the WORST, and your child seems to amp up their problem behaviors day by day
3. The child must be constantly supervised or they will break, climb, or destroy something in the home
4. The child has no leisure skills, and lacks the ability to just "go play" (these words mean nothing to them)
5. Telling the child "stay in here" also means nothing, and they tend to just wander all over the house
6. Mom or Dad cannot do laundry, take a phone call, respond to emails, have company over, or cook dinner unless someone else is home to keep the child entertained/busy
7. Toys sit around gathering dust, because your child only interacts with them for a few seconds before losing interest
8. Other children in the home rarely get their share of parent attention or time 
9. The child will only sit and attend to electronics (TV, iPod, tablet, etc.). Books, toys, puzzles....nope.

Are you starting to love the idea of an activity schedule yet? :-)


Now for the fun part: Making one! *Puh-lease do not buy an activity schedule online. For one, it will not be individualized to your child. For two, it's super easy to make

Decide which part of the day you want to introduce this visual support  (I suggest picking the part of the day that is currently the MOST difficult to keep your child entertained)

Decide what you want the child to do instead of wandering around, being glued to an electronic, or engaging in problem behavior  (Puzzle? Read? String beads? Sensory tub?)

Create a visual display of each step. The schedule can show one activity or multiple activities (On a piece of cardboard or thick paper, tape a photo of each separate activity in the order they should be completed)

Consider the use of a timer and reinforcement  (Timers help ease transitions, and reinforcement is behavior superglue)

Prepare the area (Have all materials organized and nearby, tape the schedule to the wall)

Teach your child to follow the schedule  (You will need to prompt and reinforce)

* More information:

Book: Activity Schedules for Children with Autism-Teaching Independent Behavior 

Research: Use of activity schedule to promote independent performance of individuals with Autism and other Intellectual Disabilities

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Tameika Meadows, BCBA, Blog Author

*Recommended Post: "HOW Much Therapy?/Intensity"


Consistency may be the #1 word I use most often when speaking with staff or with consumers/families. It would be quicker if I just made a sign that said "Be Consistent" and held it up in front of my face at work. Quicker, but also super odd.

Why is consistency so important when it comes to ABA?

Let's step away from Autism, therapy, and teaching for just a sec and talk about behavior change in general. If you've ever tried to change your own behavior, then you know that you get out what you put in. That New Years resolution you made back in January...how's that going? If it's not going so well, it may be because your initial commitment to changing your behavior has lessened or waned over the past few months.
For me personally, I am one of those weird people who actually enjoys exercise. Am I a gym rat? Good grief, no. I hate gyms. Do I run a mile every morning? Ummm, no. If you ever see me running, something is wrong and you should go get help. But I do have specific types of exercise that I enjoy, especially if its outdoors. I also regularly will neglect my exercise routine for various reasons. In other words, I am not consistent. Despite this, I get health benefits from my "sometimes" exercise. If I were more consistent, the results would be much more dramatic. However, I am pleased with exercising for enjoyment and for health, and not necessarily to be a size whatever.

And that in a nutshell is why your BCBA keeps blabbing on and on about Consistency: The behaviors in your child that you want to see dramatically change, will require dramatic consistency. 

I get it, I really do. You have other things going in your life besides implementing interventions. There's laundry to do, and jobs to maintain, and other children to raise. There's also just being tired. Being a parent is tiring.

But this is why a quality BCBA won't give you 50 hard things to do at once. This is why a quality BCBA will break down large behavior change processes into manageable chunks. This is why when parents say things to me like "I want him to be able to play independently", or "I want her to be able to tell me about her day at school", I explain how far away we are from that goal. I then explain the specific steps that lead up to that goal, and lastly what that would realistically look like:

-It looks like running a behavior protocol even when you have family staying over at your house.
-It looks like taking your child to a birthday party/family event only for as long as they can tolerate being there. 
-It looks like filling out data sheets as you simultaneously cook dinner and help your other children with their homework.
-It looks like embedding (translation: creating) opportunities in the day to play with your child, or to run language trials.
-It looks like following the behavior plan when you are tired, sick, or your spouse is out of town for 2 weeks and you have no help.


The beauty of consistency (and its saving grace) is that it will look different from one family to the next. I hope your BCBA told you that as well.
Consistency in my house means that we work hard all week to get a fun day Friday. Fridays are for relaxing, eating ice cream, and kickstarting the weekend.

In your house, consistency may mean hiring a part time nanny/asking your friend to come over every Tuesday because you need an extra pair of hands. Or it may mean only collecting data weekly because every day is impossible. Or it may mean you only observe 1 therapy session a week because you work from home and can't do more than that. Whatever sacrifices must be made in order for consistency to happen, it is SO important that this is communicated to the BCBA. We cannot help you overcome barriers that we do not know you have.

Anytime I go over a new behavior plan with a family or with the direct staff, there's always the part where I put the plan down and say "Okay, now is the time where you ask me all your REAL questions". See, there are the polite, typical, questions, and then there are the REAL questions that basically get at: "When I haven't slept/the child is sick/when this gets really hard/during the Extinction Burst/when we are in the community, how are we supposed to follow this??".


Consistency is very, very important. Especially if you are tackling significant areas of behavior change, such as teaching a child to communicate or extinguishing aggressive behavior. But consistency does not mean 100% perfect. No one is 100% perfect. It just means that as much as possible, even when it's hard to do so, you
stick.
to.
the.
plan.

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Tameika Meadows, BCBA, Blog Author

Related post: Hiring ABA Staff: You're Hired!


There are few things I hate about my job (thankfully for me), but right near the top of the list is when I encounter a parent who tells me about a really bad experience with ABA staff/an ABA company.
Some of the stories I hear are bad or unprofessional, and some are just shocking. And hugely disappointing.

I think that if more parents were aware of how to evaluate the quality of therapists/technicians, many of these situations could be avoided. Speaking of: wouldn't it be helpful if I made a checklist for parents to evaluate the quality of ABA staff? Yup, I already did that. Check out my free resources section ;-)


When a parent realizes the "professionals" working with their child leave much to be desired, I usually see 1 of 2 responses:

Response #1: "I don't want to rock the boat/make a fuss/complain, so I'll just deal with it and hope this gets better"
Response #2: "This person/company is horrible, so I will make no complaint and just move to a new company blindly trusting that they will be better"

The recurring word in each response is "Better". I talk to many parents who have unmet desires that their ABA team will get "better". If quality, ethical, and professional treatment is not just expected but demanded, then parents wouldn't need to silently hope for "better". "Better" basically means that whatever is happening right now is not great, but maybe....somehow....all on it's own...the situation will improve. I don't usually see that happen, and I wouldn't advise a parent to follow that kind of cross- your- fingers- and -wish- for- better approach.

Instead, I would urge parents to be aware of what ethical treatment should look like (here, read this) and to remain an informed consumer. I would also urge parents to please speak up if you are dissatisfied with your ABA team. The provider cannot correct an issue they are unaware of, nor can any staff disciplinary measures be enacted if the company is unaware of problems.

What I usually see whether the parent gives response #1 or response #2, is they say nothing about their issues with the staff. Instead, they just hope it improves or they simply move on to a new company.
Looking at it from the staff's perspective, how does that help them improve their skillset?
Looking at it from the company's perspective, how does that help them weed out the weak links from their employee pool?
And most importantly, looking at this issue from the child/client's perspective: how much valuable learning time is wasted hoping staff improves or bouncing from one company to the next?

No matter which perspective you use to look at this issue, it's imperative to maintain clear and open lines of communication between the parent and the ABA team. No one can meet unspoken expectations.


Clear and open communication is not complaining, it isn't rude, and the provider should not take offense. Speaking for myself,  I would much rather a parent tell me plainly they don't like something I am doing, than just silently dislike me. The beauty of ABA treatment is we can always hit "reset" and modify what we are doing. 

Parents: do not feel like you can't openly communicate with the team because they may retaliate, become passive-aggressive toward you, or even openly hostile toward you. If this is a valid concern for you, then you are not dealing with professionals.

When is clear and open communication of grievances necessary? Well, that will depend on your expectations as a parent. While I can't answer that for you, I CAN name several common parent grievances that should always be addressed with the staff directly, and if necessary with the company management/owner:

• Staff seems under-qualified for their position, visibly lacks confidence, or openly tells you they are "new" - Would you fly on a plane if the pilot walked out and told all the passengers that this is her first time flying a plane and she's a bit nervous? No right? No is the right answer to this question. But I talk to parents all the time who can visibly see that the staff is nervous, scared of their child's behaviors, or even asking the parent for tips! **YES, I have seen scenarios where the staff asks the parent what they should do**  If you are experiencing this issue with your ABA team, address it immediately with the BCBA or agency.
• Staff either rejects parent input or politely listens to the input and then does the opposite - This is the technology age, where parents can do a quick internet search and find out massive amounts of information about ABA. Parents suggest specific strategies, programs, or goals to me all the time, that they read about or saw online. It is my job to incorporate their input when I can, and explain the reasons against it when I cannot. What is NOT my job is to flat out refuse. Or to nod and smile and then completely disregard what the parent said. Address this issue immediately.
• Showing up for work seems optional - Probably the #1 reason I see ABA staff get fired off  a case is because they just don't show up for work. They are habitually late or habitually cancel, often with short or no notice at all. Not only is this completely unprofessional behavior, it is detrimental to treatment. If you have a headache and the bottle of aspirin says to take 2 pills, and you take 1/8 of 1 pill, don't expect to feel better. In the same manner, if your ABA treatment plan states that your child needs 20 hours of therapy each week, then they need 20 hours of therapy each week. Address this issue immediately.
• Issues with billing/payment/co-pays - Many parents tell me that they were shocked to receive a bill from the ABA provider because they thought insurance covered everything. Or they didn't understand how the BCBA could bill for services if she was not at the home. Or the staff was asking them to sign timesheets for hours that weren't actually worked. The HR/Billing department of the company should have thoroughly and clearly explained the intricacies of billing and payment to you before services ever began. If you have a parent co-pay you should know that in advance, and if the staff are billing in codes only (e.g. code 97151) then you should know what kind of service that code stands for. Receiving an invoice for thousands of dollars should not come as a nasty surprise. Address this issue immediately.
• It's more Babysitting than actual Therapy - I know, I wish I didn't have to state this either. It seems fairly obvious. But I hear it often enough from multiple parents that I know it's happening. ABA therapy sessions can look probably 100 different ways just depending on what skills are being targeted. Will every session be at a small table with flashcards? No, that's a big myth. Can sessions that appear to be just play actually target multiple goals? Yes, they sure can. However there is a large difference between playful yet intentional interaction, and the therapist sitting with your child and watching cartoons. Or texting on their cell phone as your child plays alone in a corner. Or working with your child for a few minutes and then taking a 20 minute smoke break. And no, I am not making these examples up. Unfortunately, I have seen this and worse. The ABA staff should be able to explain to you their goals for the session, which programs they will teach, and which parts of the session you can participate in. Yes, you should be able to participate in at least some parts of the session. If it is not clear to you as a parent when "therapy" is happening, and when the staff is just hanging out with your child: Address this issue immediately.

If clear and open communication does not result in concrete improvements or resolution, or if it directly results in staff retaliation, anger, or hostility, then it's time to move on. 

As a parent you have every right to expect to deal with mature professionals who will put your child first before their preferences or ego.

The ABA provider is there to help you and your child, so if that help comes attached with unethical behavior, poor attitudes, and habitual tardiness, well that's not really any help at all is it?


**Recommended Reading: Signs of a Bad ABA Therapist

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Tameika Meadows, BCBA, Blog Author