Showing posts with label Parent education. Show all posts
Showing posts with label Parent education. Show all posts

 



Something I do regularly as part of clinical consultation, is what I call Quality Assurance.

 

Basically, providing clinical guidance to a family or fellow professional who wants to know: “Is this normal? Is this what ABA should look like? What should I expect from services? Can I request that the provider start/stop doing (blank)?”.  Issues can range from the simple to the complex, such as answering questions like “Is this a good Behavior Plan?” to “How many hours a week of therapy does my child need? Does it have to be 40?”.

 

Doing this regularly, I hear LOTS of crazy stories. Lots of sad stories. And lots of “Wait…..What?!” stories. I love when I get to tell the client everything looks great, and the intervention being provided is sound, ethical, and evidence - based. But I don’t always get to say that ☹

 

Of course every scenario and situation is different, so its hard to summarize the main takeaways for ensuring you and your child are receiving high-quality therapy services.

 

But.

 

There are a few general points that I usually explain to people during these consults, that I would love to openly share. I hope its helpful for any who need it.

 

First things first--- if you are wondering or questioning if you are receiving high-quality services, or if intervention is “working”, then unfortunately I’d have to say….. probably not. 

People who are accessing great special education, Speech services, Occupational therapy, or ABA, generally don’t wonder if they are. The wondering and questioning is usually a sign that your “parent gut” is picking up on an issue. When you dig into it further, usually more issues or problems are revealed. So tip #1 is if you are currently skeptical or doubtful of the services being provided, DO NOT ignore that. Don’t minimize it and don’t brush it off. Investigate further.

 

Tip #2 is: Attitude matters. I talk to so many people who say “Well he/she is an expert in their field, so who cares if they’re kind of arrogant... condescending…rude…never returns phone calls…..mistreats me”. Nope. Full stop. It is not okay for a professional to treat you like trash, just because they are highly knowledgeable and in demand. Asking for qualifications + basic human decency is not too big of an ask.

 

Tip #3: As the parent or caregiver, you should expect to be involved in your child’s intervention process. Any school, therapist, or provider, who is treating you like an unwanted green bean dish at the buffet is not acting with your best interests in mind. It is not unusual to expect to have treatment goals explained to you, in detail, minus the jargon, until you understand. It is not unreasonable to expect your questions to be answered, and your feedback to be incorporated into treatment. This is your CHILD we are talking about. Of COURSE you should expect to be treated respectfully and like a team member.

 

Tip #4: You should know the ethical obligations of the service provider. If you are receiving ABA services, do you know what is considered unethical behavior for a BCBA? What about for a RBT? No? Then how will you know if the team is behaving unethically? I’ve spoken with families of children who exhibit highly violent or dangerous behaviors, and there isn’t even a Behavior Plan in place. That shouldn’t happen and is unethical treatment. If you don’t know what you should be getting, its kinda hard to ask for it.


Last tip: Look for progress. This is probably the #1 complaint people have when I speak with them, is their child has been participating in XYZ treatment for ABC amount of time and nothing is better Nothing has improved. Language is still a huge area of deficit, no new skills are being demonstrated, behavior at home is still awful and challenging, they still can’t go out to eat as a family, the child still isn’t toilet trained, etc. Now the specific amount of progress, I can’t tell you that part. It varies by individual. But you should expect to SEE the intervention working. If your child was tantrumming for 5 hours a day when services began, is it less now? If your child would only eat 4 foods when services began, is it more now? Has the intervention helped any of the areas that are highest priority to you as the parent? No? Then why continue??

 


Regardless of the specific intervention, treatment, or therapy, these basic tips should help answer many of those “parent gut” questions that start whispering to you that something is wrong, even if you can’t pinpoint specifically what is wrong.

Listen to that instinct, do more digging, ask more questions, and reach out for clinical help or guidance when you need to!


 


*Recommended Resources:


Ethical Guidelines for ABA Providers

Ethical Guidelines for Speech Pathologists

Ethical Guidelines for Occupational Therapists

IEP/Special Education Law Resource

Informed Consent in Therapy (when disabled adults or children are being treated, it is the parent who must give informed consent)

Parent Participation in Therapy

Code of Ethics for Educators 

Disputing an IEP 

Parent Involvement in the Therapeutic Process Improves Care 


Read more »

Tameika Meadows, BCBA, Blog Author

 





Recently, there were many publicized and non-publicized mass closings in the ABA industry. This means many people lost their jobs. It also means many clients abruptly lost access to needed services.


Since this happened, I've talked to parents from all over wanting to know how to recognize a private equity backed company or how to spot warning signs or clues of a low-quality provider. 

It won't always be possible to see shutdowns/company closures coming, and just because things start off going well doesn't mean they will continue that way. Just ask all the families who started off 2020 happily receiving ABA services, and then COVID hit, and then.....yeah.

While there is always some level of trust required, and some element of risk when initiating services with any provider, I also care very much about helping caregivers develop the skills to weed out low-quality providers and avoid the worst of the bunch. 


The biggest tip I can give is the title of this post: interview providers.

Please don't just Google providers in your area, and sign up for services with the company that answers the phone the quickest. This is far, far too important not to do your due diligence. Treat this with the same level of seriousness as researching a new car to buy, or choosing your child's pediatrician, or deciding which private school is best. Choices are great, but choices also come with a responsibility to carefully evaluate each choice. Despite what many people think, nope, low-quality ABA treatment is NOT better than no treatment at all.



TONS of resources below--- use them, share them, download and print them. Listen to your "parent gut", ask questions, and watch for discrepancies between what you are being told and what you actually receive. No provider should start off the client/company relationship lying to you, hiding information, dodging your calls, etc. Yet, I hear stories like that from families all the time (e.g. "Its been bad like this since the very beginning..."). Be a picky parent, and advocate for what you know your child needs. 

Many of the anti-ABA voices out there are products of low-quality, unethical, and terrible ABA services. The potential for harm and mistreatment is high in situations where clients are working with poorly trained, poorly supervised, poorly equipped, or horribly overworked RBTs, BCaBA's, or BCBAs. If it doesn't feel right, it probably isn't right. Conversely, if it seems too good to be true it likely is.



**Caregiver resources**


Hiring Solo Providers: Hiring Direct Staff, Hiring a BCBA, Parent-Led services

Choosing a Company: Center or Clinic, Choosing an ABA Provider, Questions to Ask a Potential Provider, Tips for Choosing a Provider, Sample Interview Questions , More Tips for Choosing

Evaluating the Quality of Treatment: Is it ABA?, Is it Good ABA?, High Quality Treatment, How to Recognize High Quality ABA, What is Good ABA, 30 Indicators of Quality ABA, Helping Parents Choose Treatment

What is Private Equity: PE and ABA, PE and Autism Care, The Impact of PE, List of PE backed providers

Ethical Responsibilities of RBTs, BCBAs, and BCaBAs (Practitioners have ethical guidelines, not companies/organizations. Consumers can file complaints about unethical organizations to their insurance provider, Better Business Bureau, applicable accreditation board, or are encouraged to consider legal action): BACB Ethics, ABA Ethics Hotline, Reporting Licensed Practitioners

Signs of a Low-Quality/Unethical Provider: Good v. Bad ABA, Signs of Low Quality Staff, Exploring Quality in ABA

Food for Thought about the current state of the industry: Low standards in the ABA Industry 

Free Handouts: Tips for Screening ABA Providers , What to Expect When Initiating ABA Services

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Tameika Meadows, BCBA, Blog Author


 Birthday parties. Let's talk about it.


Parties, gatherings, events, picnics, etc., where there will be lots of people, noise/music, activity, chatter/laughing, and hidden, unspoken rules for "appropriate" behavior.

The event may even be outdoors, which brings a whole host of safety concerns.

Or, the event could be near a body of water (pool party), which definitely adds even more safety concerns.


For parents with Autistic children, or another disability, do you just not go??? Is that the way to do this? How do you get a child through elementary school without ever attending a birthday party?? These days, kids have to invite the whole class. So in an average school year, your child may receive several birthday invitations, to loud, active, parties full of running, screaming kids, hopped up on sugar and soda.

Before we jump into what to do, let's back up a bit and describe the challenges: Why are birthday parties sometimes so not fun, and so very hard? 

Birthday parties/large gatherings are (often) loud, full of junk food/ice cream/candy/cake, full of people, tantalizing presents, music or entertainment, and the expectation to socialize ("You kids go play"). All of this can combine for quite the sensory nightmare.

Your Autistic child may find the event overstimulating, scary, uncomfortable, or painful (overstimulation that one cannot leave can be painful). Your child also may be unable to tell you any of that, which leaves demonstrating the discomfort through their behavior.

I have seen this up close many times, both "on the clock" and off the clock. I've been at kids birthday parties and seen that girl or boy seriously struggling and having an awful time, or attended birthday events with clients to provide support during the party. 

I think its critical to reset expectations and have a clear understanding of just how scary parties can be for Autistic children or adolescents (I'm not mentioning adults because, typically, adults with disabilities are not forced to attend events they seem not to enjoy, the way small children are).


The questions below should be carefully considered based on your child's age, temperament, sensory profile, and support needs, with strategies in place in case the party experience goes badly. Have a plan, then have a backup plan, and don't go it alone. Bring at least 1 other adult with you, or if you are hosting the event, assign helpers among family ands friends who know what to do and will quickly jump in if your child is having a hard time.


Things to Consider:

- Do you have to attend/throw the party? No really, think about that. What would happen if you just...didn't go? Or what would happen if your child didn't have a 4th birthday party? I'm pretty sure the earth would still keep spinning. Sometimes, the level of support that would be needed as well as the needed accommodations aren't feasible. In that case, is it better to force your child through something they are unlikely to enjoy, or to just skip it? I'm not saying forever, and this could even be a case by case decision. Small party at a neighbor's home? Sure. Huge community pool party with 6 clowns, a DJ, and group party games? Maybe not.


- Don't try to stay the whole time, instead play it by ear. For some children, they aren't excited about the cake (feeding issues are common with Autism). They don't care about the social games or group activities. They don't yet have the ability to wait, so they won't understand why they can't start ripping into set aside food or activities (and may not understand why they can't open someone else's gifts). What will YOUR child do at the party that they find fun, entertaining, and is safe? Think about that, before you take them to a 2 hour birthday party.

- Understand that vigilant supervision may be needed. This does mean dropping your child off may not be a safe option (as the party host will be super busy), and if you stay with your child, you may need to keep them in eyesight at all times. It isn't unusual for my clients to 100% "veer off from the group" during parties, only to be found sometime later upstairs in a closet, or trying to access YouTube on the family laptop, or casually digging through someone's refrigerator. These can be very embarrassing moments, that could easily be prevented by keeping a close eye on your child, especially if the party or event will be held outdoors.

- Speaking of embarrassing, there is nothing embarrassing about accommodations or supports. If you are taking your child to a party or event where they can't wear their noise canceling headphones, or freely STIM (family members, sadly, can be very judgmental about stimmy kids at birthday parties)  without being treated poorly, that may not be the kind of event you want to attend. Again, parties are overstimulating for many Autistics. So it makes sense that they will do MORE of what helps them calm or regulate in response to being at the party. In other words, if most of the kids are quietly playing Candyland, but your child is in a separate room happily squealing and jumping, while chewing on a straw, will this be a problem for other people at the party? If so, I don't think your child is the problem.

- Take preferred foods, toys, and leisure items with you. Please do not expect that your child who eats 3 foods at home, will magically attend a birthday party and chow down on Cheetos, cake, and pizza. If they won't eat it at home, they likely won't eat it at the party. Also, don't withhold stim items or comfort toys because the child is in public, and other people will see. Those favored items may help keep your child calm and comfortable, in a chaotic and loud setting. On that note, it can be helpful to bring items your child may grab, snatch, or steal, if they see it in public. For example, I worked with a boy once who loved to suck on pencils. If he was out somewhere and saw a pencil, he would try to grab it and put it in his mouth. So in that situation, I'd recommend bringing oral sensory items with you so the child doesn't need to hunt throughout someone else's home for something to satisfy that chewing desire. Think about things like this in advance, and plan accordingly.

- The biggest tip, and the one I see cause parents the most pain and distress, is this: Please don't expect your child to be a different person socially, just because you're at a birthday party. If your child is not very social at home, they likely won't be very social with 23 other kids present. In fact, they may exhibit new behaviors you usually don't see at home (such as pushing, swatting at, or running off to get away from the other kids). This can be very hard for parents to watch. So can bullying and stigma, such as if your child DOES want to join the play, and the other kids are being mean or cruel to your child. Remember that earlier tip about close supervision? It's very important to watch how your child interacts with the other children, so you can stop any bullying or rudeness in its tracks, and so you can monitor when your child's social battery is "full". Most of my clients fill up that social battery very fast.....maybe 15-25 minutes of social interaction, and they're done. And that is OKAY. Not all children want to "Go play" with their peers for hours and hours. Observe your child, redirect them to solo play or maybe a calming activity as needed, and when they seem to be all done with being around so many people, its time to head for the door so the event can end on a high note. Don't be ashamed or embarrassed to say "S/He's ready to go now. Thanks for inviting us, bye guys!". 



I hope the largest theme coming across in this post is that large events/birthday parties aren't necessarily about you, as the parent. They aren't about the party host, the games, the clown, catching up with friends, hanging out, etc. They are about helping your child be successful, in what is likely a highly overstimulating scenario.

It is important to provide your child with the support and tools they need to engage with the event, to endure the event (again, consider if it would be best not to go if they seem to just be "enduring" parties), or to excel at the event. Whether the bar is set at engagement, endurance, or excelling, will depend on your child. 
And don't lose hope and feel defeated if right now, you are at an endurance level. That doesn't mean things will always be that way! As your child grows and matures, and most importantly as they develop more skills and abilities, they may begin to enjoy parties. Maybe even, to have fun at parties.
Give it time, and be patient. Both with your child, and with yourself.





*Recommended Resources & Resources:




Ghanouni, P., & Quirke, S. (2022). Resilience and Coping Strategies in Adults with Autism Spectrum Disorder. Journal of autism and developmental disorders, 1–12. 






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Tameika Meadows, BCBA, Blog Author



Its common, its common, its common.



That is the first thing that needs to be said to any caregiver who ended up here while researching "picky eater" + Autism. You are not the only one experiencing this.

Autistic individuals (because this is not just an issue for children) exhibit higher rates of food refusal, and a more limited food repertoire, when compared to typically developing individuals (Bandini et al, 2010).

Examples? Sure.


Across my clients, I regularly see issues with:

Rigidity around meals (where to sit at the table, what plate to eat off, which spoon to use, must have the tablet in order to eat)

Food refusal challenging behavior (throwing plates, flinging cups to the floor, spitting food out, tantrums, pouring liquids out onto the floor)

Highly selective food intake (daily diet consists of less than 10 foods, likes chicken nuggets but only from a specific fast food place, will only take specific liquid from a specific sippy cup or bottle)


To define the term, a picky eater can be described as regularly refusing foods, or consistently only eating the same foods with little to no variation permitted.

Many parents of toddlers deal with a picky eating phase at some point or another, and often the child outgrows it.

So, what is the critical determining factor when it comes to Autism that tips the scale from someone who is just "picky" to a serious health problem/eating disorder and concern? Usually, it is a combination of variables that must be examined and weighed:

How old is the individual? If out of the toddler phase, how frequently is this issue happening (weekly? daily? or only at holiday meals?)

Does food refusal occur with challenging or aggressive behavior?

Is this impacting school/daycare, or the ability to go into community locations?

Will the individual skip several consecutive meals (refuse to eat across more than one day)?

Is this impacting the individual's weight, organs, toileting/digestion, skin, hair, or nutrition? Is your doctor concerned?


The key factor for seeking out intervention for this issue is when the food selectivity is causing harm to the individual. When any specific behavior impacts the health/body of the person exhibiting it, that is clinically referred to as a "self-injurious" behavior. Self-injurious behaviors should not be ignored, and often require intervention and treatment.

So what to do? 

 It may be helpful to reframe the way we view picky eaters. Sometimes families can view this behavior as their child willfully choosing to make meals a dreadful adventure. Choosing to be difficult and fling plates across the room in order to cause chaos. However, challenging behaviors often occur for complex or multifaceted reasons. Some Autistics use the term "sensory eater" and not "picky eater" to describe this issue, and explain it like this:  

"Picky eaters don’t like a variety of foods, much like the sensory eater. However, when picky eaters try new foods, it doesn’t cause a sensory overload....There is a sensitivity to textures, where children can only handle one texture, such as smooth, pureed foods. In this case, they might be able to eat yogurt, however, hand them a bag of chips or a slice of turkey and they immediately begin to gag" (www.researchautism.org).


If a specific food texture, smell, sight, or tactile experience is causing significant distress, if there are tooth or gum issues making eating painful or uncomfortable, if the individual has trouble swallowing, or if unknown allergies are present, making digestion painful or uncomfortable, doesn't it make sense for the individual to refuse a food (or eventually, any food that looks like THAT food) or exhibit excessive selectivity? Now, imagine the individual has no means to communicate how food makes them feel. Doesn't it make sense that they may cry, spit, hit or punch, or fling a plate onto the floor? 


When seeking out Feeding Intervention (which is a clinical specialty), it is important to first obtain medical rule out. This means first speaking with your doctor to discuss the issue, and see if the individual's health has been impacted. The doctor may also be able to make a referral to a qualified specialist.

Not every professional will be trained in feeding interventions, so this isn't as simple as just asking the current therapist to also target feeding. I see families do that a lot, without also asking about the therapist's qualifications to address this issue. 

It probably doesn't need to be said, but feeding challenges can have serious health complications and you don't want to gamble on unproven treatments, untrained professionals, or questionable practices. Not only could they harm your child, they could worsen/ingrain the problem even further.

SLPs, BCBAs, OTs, Healthcare professionals, and Multi-Disciplinary clinics or facilities, can all incorporate feeding intervention into therapy goals. The Children's Healthcare of Atlanta recommends the following step-by-step process for initiating feeding intervention/feeding therapy:

  • Medical Screening
  • Behavioral Evaluation
  • Nutrition Assessment
  • Oral-Motor Skills Assessment


 Remember, before seeking out therapy or treatment talk to your doctor first. Also, any feeding intervention that occurs on-site will need a caregiver training portion where the parents are taught how to implement the procedure at home/in the community.



*Further Reading:

Autism Feeding Issues

Kinnaird, E., Norton, C., Pimblett, C., Stewart, C., & Tchanturia, K. (2019). Eating as an autistic adult: An exploratory qualitative study. 

Bandini LG, Anderson SE, Curtin C, Cermak S, Evans EW, Scampini R, Maslin M, Must A. (2010). Food selectivity in children with autism spectrum disorders and typically developing children. 

Autism & Picky Eating

Problem Eating

Assessment & Treatment of Pediatric Feeding Disorders

Feeding Problems in Children with Autism

Eating Disorders Can be a Sign of NeuroDivergence


Read more »

Tameika Meadows, BCBA, Blog Author

 



Today's quote is from...me! From a recent podcast interview with Dr. Mary Barbera:

"Good ABA start with parents. So, for any parent or caregiver, if you are trying to determine a quality place for your child to receive ABA services, you really have to start by looking at what's the goal of intervention. I really feel like that's like the foundational first step, because if you are speaking with a company or a provider and they're talking about: 'We're going to fix this, we're going to correct blank, we're going to make your child more.../ We're going to remove stigma',  and other words like that, all of those words are getting at normalization. Which should not be the goal. The goal should not be to magically make it as if your child were born differently. The goal should be to give the client as many supports as needed to contact the things they to need to contact in life. For example, letting people know when you want food, using the bathroom,  attending school, etc., because in certain parts of the world children with disabilities don't attend school. So, we really have to look at what this means for the client and removing barriers to being able to do different things in their life. And then we address each barrier one by one. That should be the goal of ABA. 'We're going to help your child do _____/We're going to make it easier for your child to do ____". That should be the kind of language that is being said by a provider, or by a company.  It should be very, very concerning when you are contacting an ABA provider saying you need help and that provider is instead telling you, 'Here's what we're going to do', and they're not listening to you and they're not taking your input and they're just saying, 'Oh, yeah, yeah, we know what to do. We know autistic kids. Here's the standard protocol. Here's the strategy'. No, that is not how that should work. Absolutely not."



Good ABA services are a must for some people. Yes, people. Not just small children.

It can be a must for disabilities beyond Autism.

It can be a must inside of the classroom.

It can be a must in adult day programs and residential settings.

It can be a must when harmful, destructive, violent problem behaviors are serving as a barrier to least restrictive settings and placements.


ABA intervention at its core, is about teaching new skills and removing barriers that get in the way of learning and being successful in life. NOT a push for normalization.

Quality intervention that is generalized across caregivers and settings, can bring about amazing long-term success and developmental gains.


Take a listen HERE for more tips on distinguishing between good & bad ABA providers.






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Tameika Meadows, BCBA, Blog Author


 

"This is hard" is a statement I often hear from families both in the midst of intervention, and pre-intervention during the assessment phase.

Families without support and services find it hard helping their Autistic child navigate the world, and families in the midst of therapies and interventions find generalizing them to be hard.

It's hard to consistently generalize an intervention plan outside in the home, on the weekends, on Sunday at the grocery store, on vacation at Grandma's house, or at 6am on a Saturday when your child only slept 2 hours.


But its also hard to supervise/monitor your child 24-7, to break up sibling fights all day long because your child can't share, to find quality childcare options when your child is highly aggressive, or to figure out if your child is ill or sick when they can't tell you.

Both are hard.


It is rarely a discussion of hard vs easy, and much more common is a decision regarding which "hard" is acceptable. Yes, toilet training is hard work. On the flip side, changing an 8 year-olds diaper isn't exactly easy. Nor is it easy to afford to buy diapers for that many years.

Yes, teaching your child to use utensils instead of eating with their hands is hard. On the flip side, restricted diet and issues around mealtimes can be made worse if the child will only eat finger foods (typically, starches and carbs). That is also hard.

Yes, it is hard to consistently follow a Behavior Plan when in public with your child. On the flip side, being asked to leave locations, having friends ask that you not visit, or being scared someone will call the police on your child during a public outburst, is a hard reality to live out.

You have to decide which "hard" to accept.


I intentionally use the phrase "intervention plan" and not "ABA therapy", because maybe your child isn't receiving ABA services. Maybe you don't want that, or can't access it.

But are they receiving Speech services? OT? PT? In special education at school? Attending an Autism preschool program?

If so, these are all interventions designed to minimize developmental delays and target current deficits.


Whatever kind of intervention your child participates in, there are a few components that tend to be the same across different therapies:


1. Consistency. In order to be effective, the intervention must be applied consistently. Frequent staff turnover, frequently canceling appointments, or other issues like this can negatively impact results.

2. Training must carry over to the home setting/caregivers. There is no way to generalize the intervention if you have no idea what it is.

3. Caregiver Participation. In order for #2 to happen, the caregivers must be willing and available to participate in the intervention/treatment plan.

4. Focus on progress vs miracles. Progress can be slow, it can be up and down, and at times it can mean treading water. Sometimes an absence of regression IS progress. If you have sky high expectations of the intervention process, this can cause "provider hopping" where families move from one agency, provider, or intervention to the next looking for magic. That just is not how quality, ethical treatment works.

5. Individualized Intervention. It doesn't matter if your child receives 30 minutes of Speech each week, or 15 hours of ABA. Are the treatment goals and the teaching methodology suitable and appropriate for your child? "Cookie-cutter" intervention is when treatment is applied in a lazy, vague, and generic way across multiple clients. In order for intervention to be effective, it must meet your child where they are and incorporate their unique interests and motivation(s).


*More resources below:

Happy or Therapy?

The Easy Way vs The Hard Way

Evidence Based ASD Interventions 

Effective ASD Interventions 



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Tameika Meadows, BCBA, Blog Author


I already have a post with tips for evaluating the quality of your in-home ABA provider.


But what about those families who want clinic/center (these words are pretty interchangeable, so for this post I will just use "center-based ABA") based services? What questions should families ask during intake? What are some potential red flags? Should parents directly observe sessions or is that too distracting?


Keep reading, and hopefully I can help answer these types of questions.

As ABA therapy services continue to grow and expand (fueled largely by increased funding, which leads directly to increased providers/companies) center based treatment is becoming more prevalent.

When I was first certified as a BCBA, there were less than 5 center options in my local area. Today, I would estimate that number to be over 100. If you are reading this and you live in a fairly urban or metropolitan area, then you likely know of at least a handful of ABA centers in your area.


Parents contact me all the time with so many questions about center based treatment. When it comes to ABA therapy, the experience can be quite different from other therapies. 

Many families have experienced center based treatment via Speech Therapy, Physical Therapy, Counseling or other Mental Health services, or Occupational Therapy. But these are usually 30 to 50 minute appointments that occur once a week. ABA therapy is often highly intensive, and sessions can occur daily. There is also (usually) a focus on setting up a day that resembles a preschool experience, including large group instruction, recess, school readiness instruction, toilet training, lunch/meals eaten as a group, Art or Music, etc. It is a busy, very planned out, full day experience.

Centers differ as far as policy and procedure, so there will be variability from one company to the next regarding how parents are included in the intervention process. There will also be variability related to state laws, funder requirements, or if the center is part of a chain (usually owned by massive private equity firms) or a small center with an owner on-site. So just know that some of the suggestions below may be more or less applicable to your situation.


First, let's answer a few questions-


"Which is best, home or center based ABA?" - There is no concrete answer to this. It depends on your child, their needs, the priority of intervention, etc. Obviously, if peer/social interaction is a priority then center based services have the advantage of peers being on-site. However, many parents have concerns that their children will pick up new challenging or inappropriate behaviors if they spend their whole day with other disabled children. So as you can, there are pros and cons to center -based treatment, just like with home -based treatment.

"Why do we have to agree to block scheduling?" - A block schedule is when the center only offers a few options for scheduling. For example: 'Part time - 8am-12pm, Full time 8am-5pm'. This usually has to do with consistency in scheduling staff, and the major disruptions to other clients that can be caused by changing staff schedules. For the most part, centers do not have the same scheduling flexibility as in-home treatment. If your family needs a more flexible, adaptable schedule that can change from time to time, then you probably would not be a good fit for center based treatment.

"My spouse and I both work full-time and center based is easier because it has the same schedule as day care/preschool" - Yes, many parents prefer center based intervention due to the schedule (child is there all day). However, ABA is not respite. It is important to look beyond the ease of the schedule, and to determine if a center based setting is the best fit for your child and their needs. Also, 2 working parents can make parent involvement very difficult when it comes to center based intervention. Which brings me to the next commonly asked question........

"How does parent training/caregiver support happen at a center if both parents work full-time?" - This can be challenging. Usually, for center based intervention at least one parent will meet with the case BCBA on-site, each month, to go over client progress. If neither parent can do this on-site, this meeting could be held via Telehealth. If that still is not a feasible option, then it is likely center based intervention isn't a good fit. I would suggest home based services that occur in the evening hours or on the weekend, so parents can be actively involved with treatment. 


Now, let's talk about indicators of quality-

High-quality center based ABA providers will look like a high-quality home based provider for the most part. There should be credentialed individuals (e.g. RBT or BCaBA) working directly with your child and overseen by a BCBA, there should be an initial assessment conducted to create an individualized treatment plan, there should be ongoing monitoring of the intervention and data analysis, and there should be clear, transparent billing, supervision, and staff training policy and procedures. 

As a parent, you should know who is working with your child on a weekly basis (this may vary, due to staff vacation, illness, or changes, but you should know when it varies). You should know what goals are being targeted with your child, and how they are being taught (most parents never ask). You should know the Behavior Intervention Plan, or the strategies being used to reduce harmful or inappropriate behaviors. You have the right to watch/view these procedures and be trained on how to implement them at home. The center facility should be clean, appropriately staffed, have both passive and active play areas, have an appropriate person to bathroom ratio, doors and windows should be secured (monitored with alarms, locks, etc.) to keep clients safe, there should be ample toys and materials, etc. Not only should you be able to tour the center as a parent, but you should be able to see where your child receives 1:1 intervention and to examine the therapy space.


And of course, I cannot leave out potential red flags. Occurrence of any of the items below should raise your concerns, and lead to an action step (Speak with the facility Director or Manager, talk to your case BCBA, and if necessary, remove your child from the program)- 

  • The absence of any of the criteria described for a high-quality ABA center
  • Staff/Director or Manager are consistently angry, upset, or otherwise seem miserable. Do you want to work with people who are miserable every day? Then why would your child want to?
  • Poor communication/No communication, specifically when it comes to billing/invoices/charges, clinical supervision, conflict with the staff, or behavioral strategies used
  • Your child experiences significant regression after starting services at the center
  • Massively high staff turnover. I say "massively high" because ABA as a field is known for high staff turnover. But, if you have been at the center less than 30 days and can't keep track of who is on your child's team---> that is a problem.
  • Lack of outdoor space where clients can play and get fresh air (many centers today are located in business/office spaces that lack outdoor play areas)
  • Lack of toys, materials, or manipulatives for clients to play and explore
  • As a parent, you are pushed to sign on for an amount of treatment hours you are not comfortable with, and do not feel are necessary
  • As a parent, you are never allowed on-site. Yes, there is HIPAA, and client confidentiality, and all sorts of reasons why parents may not be able to just walk in any time, without exception. BUT, the center should have figured out a way to remediate this issue. For example, a discreet meeting area or conference room where BCBA or Director meetings occur, a waiting area where parents can request to meet with their child's RBT or team members, or discreet observation windows where parents can view their child during therapy unobtrusively
  • As a parent, you are pushed to terminate services with other providers to focus only on ABA. Or, you are pushed to terminate services with other providers and swap them out for services offered at the center
  • If you do not know what your child is working on (treatment goals), never received any data, reports, or graphs, or your child is working on things you specifically rejected or said you wanted removed from their treatment plan----> that is a big problem.



*Further Resources:







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Tameika Meadows, BCBA, Blog Author


I don't work with adult clients often, but I do regularly work on life skills/building independence, and pre-vocational training stuff with children and adolescents.


The thing about adulting is that trying to shove a bunch of information and life lessons into your grown child is a bit too late. Especially if we're talking about Autistic adult children who may or may not ever live independently, may or may not hold down steady jobs/have a career, and may or may not attend college or technical school.


Wayyyy before you think you need to start teaching this stuff, is when I recommend teaching this stuff. :-)


For any parent, its a hard thing to look at your 10 -year- old and start thinking about teaching them to do laundry, independently grocery shop, change a flat tire, or shop online. But, if you expect your child to do all these things one day as an adult, then yes, absolutely start teaching it early.

Your teen or adult child can start learning today, to do things like:


  1. Personal care/Hygiene/Grooming
  2. Shopping & Money Management
  3. Electronic Use & Internet Safety
  4. Vocational Training (*which should be a natural extension of interests, hobbies, or strengths)
  5. Driving or Navigating Public Transportation
  6. Time Telling/Time Organizational skills
  7. Employment Seeking (resumes, interviews, etc.)
  8. Self-Advocacy/Assertiveness ---- probably my #1 Adulting 101 skill to teach


For children with disabilities (not just Autism), it may take more time, more repetition, and more real-world practice for these skills to be taught. Which means starting sooner rather than later is the way to go. Think about your own adulting for a second-- when you first left home, did you know how to scramble eggs without burning them? Or manage a credit card responsibly? Or negotiate with a pushy salesman when buying a used car? If you answered "yes" to these questions, then you were far superior to most of us! 

The reality is that whether your child will ever be able to live separately from you or not, as a parent I'm sure you want to help them be as independent as possible, and be able to make decisions about their life/have a say in their own life. Teaching some common 'Adulting 101' type of skills can be the way to do this, and be sure to combine that instruction with actual real world practice. Despite what we may like to think, school will not teach our children everything they could possibly ever need to know by graduation day. Nope.


What do I mean by real world practice? Well, I've worked with high school age clients before who received vocational/life skills training at school, or through a special program that helped them get part-time jobs. The problem was, these skills didn't generalize outside of those settings. If Charles learned to cook chicken breasts at school with Ms. Larson, that did not automatically mean he could cook chicken breasts at home, with Mom and Dad. If Kacey helped out in a local daycare classroom every Tuesday afternoon, that didn't not mean she could successfully baby-sit her younger brother at home.

Like any other skill, life skills need explicit, intensive instruction, as well as multiple generalization opportunities in real world situations. Multiple generalization opportunities means that the instructor/supervisor needs to differ. The setting needs to differ. The materials/items used need to differ.

Don't just teach your child to wash/load the dishes at home. Let them practice at the neighbor's home, at Grandma's house, etc. The steps of the skill will vary a bit as it is generalized across opportunities, and that's a good thing! There are very few adulting tasks that are done the exact same way, every time. We also know that many Autistics lean towards rigidity and sameness of routine, which can be a good thing or can be highly detrimental to learning if it gets in the way of doing something differently. For example, if the sink, dishwashing liquid brand, or the equipment used (e.g. type of dishwasher) change, can your child still wash the dishes?


It is hard to look at your children when they are young and know with certainty what their future holds. That has nothing to do with Autism, I think any parent would agree with that. Since we don't know what the future will bring, it makes sense to start preparing our children for an uncertain future now.


You may be wondering, "How young is too young to focus on this?". It may surprise you to learn that I start teaching life skills (Adulting 101) with clients as young as 2 or 3. Yup, its true. 

A toddler can learn to clean up their toys. A toddler can learn to put their empty cereal bowl in the sink. A toddler can learn to pour their own juice. A toddler can learn to put dirty clothes in a washer, or pull clean clothes from a dryer. Why not?? If your children are young and you don't know where/how to start with this, just start with teeny-tiny baby steps:

  • Let your child help as you complete household chores.
  • Slow down before leaving the house, and let your child put their own shoes on, or put their own coat on, or grab their own bookbag.
  • Cooking is a life skill. As early as you can, introduce no-heat recipes such as making a sandwich or fruit salad.
  • When in public settings, help your child pay for their own meal, or hand the cashier money for purchases. Let your child place items on the conveyer belt at the grocery store, or teach them to shop by giving them a visual grocery list.
  • Allow older children to have some responsibility for younger children. Let your 6 -year-old help you care for the 1-year-old.

There are SO many resources out there for teaching life skills and increasing adaptive functioning. This doesn't need to be hard or overwhelming! 
Ask your child's therapists for help and ideas, or talk to their school and see if there are any specialized trainings, classes, or programs available for students on the Spectrum. Most school districts have far more programs and community connections than most parents know about.


You got this!



RESOURCES- 



Essential for Living  Assessment Tool





Organization for Autism Research: Transition to Adulthood

The Life Skills Lady

Transition to Adulthood Research Findings


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Tameika Meadows, BCBA, Blog Author

 




If you are unfamiliar with ABA services, you may first hear about it as a recommendation post-diagnosis. Or, from a school system recommending behavioral services. Or, you might seek out an ABA provider if persistent, challenging, or harmful behaviors are happening in your home, in the community, or at your child' school.


For most people, the process of starting up ABA services will involve multiple steps, an extensive timeline, and lots & lots of paperwork (seriously.... a mountain of paperwork). To briefly summarize, the child must be diagnosed, an ABA provider must be found/identified, an intake assessment must occur, insurance authorization has to happen, staff must be assigned to the case, and only then do services actually begin. I would say a best case scenario would be all of that occurring within 1-2 months. Unfortunately though, best case scenarios don't always happen.


Just like there are valid, honest reasons why ABA therapy isn't for everyone, there are valid reasons why starting services with the ABA agency/clinic up the street isn't the best idea. Sometimes it will make much more sense to work with a solo practitioner/BCBA.

If you aren't familiar with the title BCBA, a Board-Certified Behavior Analyst is someone trained in the science of Behavior Analysis, holding a Masters degree or higher, who has gone through roughly 1-2 years of highly regimented supervised experience and passed a rigorous exam. BCBAs can practice independently, so this means you do not need to go through a company or agency to work with one. Similar to physicians, BCBAs have specialties. All BCBAs will possess a standard skillset/range of knowledge on behavior, but the specialty will be a combination of an individuals post-certification experiences and training. For example, some BCBAs specialize in feeding disorders. Others have worked with early intervention populations exclusively, and others focus more on OBM (Organizational Behavior Management) rather than special needs populations. 


For most families, it seems like a simple equation: need ABA services ---> call up a local company ----> start services. But, there are some scenarios where this would actually be a bad idea:


  • Brief or Short Term Consultation - Most ABA companies are focused on servicing clients needing intensive, multi-year therapy for many hours each week. If you have a specific behavioral need or only need short term help, it actually would be faster, and simpler, to just work directly with a solo BCBA.  And on that note, lets talk about speed of services starting up....

  • Delay to Onset of Services - I regularly talk to families who are sitting on wait lists to access services. Or, their child completed an initial assessment with a company, but they haven't heard anything for 30, 60, days and counting. There could be many reasons why you experience a significant delay to start services, but the most common reasons would be staffing (no available staff), and funding issues (problems with getting services authorized or company is not in network with your insurance provider). If you need help now, I strongly suggest contacting a solo BCBA rather than a company/agency.

  • Wanting Highly Experienced Staff - As part of my role, I regularly conduct intake assessments with families new to ABA. Many times they will ask me if I will be the one working directly with their child, and I then explain that ABA treatment utilizes a tiered-service delivery model. In a tiered model, the supervisor/BCBA is usually the most degreed and experienced person on that case. The individual working directly with the client, is usually called an ABA Therapist, or Registered Behavior Technician (if they are credentialed). The education and experience of the direct staff can vary, and a high-quality company will have a rigorous training and onboarding process for direct staff before they can work with clients (a poor quality company will not). If you want Masters degree level clinicians working with your child, that can be hard to find at a company. 

  • Rural/International/Low Supply Area - I have worked privately with families as a Consultant for many years. The main reason why these families chose to hire me instead of going to a company/agency, is because in this was not an option for their area. Some of these families lived in very rural areas with no ABA providers for miles. Others lived outside of the US, where knowledge of ABA can be minimal or absent. For others, there were TONS of ABA companies in their area. The problem with that though, is that high demand can = insane wait lists. I'm talking sitting on a wait list for 1-3 years. In these situations, it makes far more sense to work with a solo BCBA via Telehealth/technology. I do not recommend sitting on a wait list for any significant length of time without also pursuing other options.

  • No Diagnosis/Non-ASD Diagnosis - In most states that have Autism mandates for insurance coverage, a diagnosis of Autism is required to receive ABA treatment. If your child is not diagnosed, you're stuck on a wait list just to get a diagnosis (which can happen), or your child has a non-Autism diagnosis, then you may not be able to receive services from an ABA company. Not all companies accept private pay clients, especially the very large ones. In this situation, it would make more sense work with a solo BCBA.

  • Funding Issues/Insurance Issues - Similar to the above point, there can be challenges with accessing ABA therapy through your insurance. For some, a high annual deductible must be met before insurance will kick in. Or, per session co-pays might be very high (keep in mind there will be multiple sessions per week). Sometimes the insurance may cover an amount of ABA that is very minimal, or does not allow for quality supervision of treatment. I have worked with families  where due to their specific insurance plan, I could only see them once a month. That is not enough for high-quality services. 

  • Language Barriers - If you live in an area where that predominate language is not your first language, you may experience a barrier to accessing treatment. For example, many families in Atlanta speak Chinese or Spanish as their first language. But not all ABA companies in Atlanta have Chinese or Spanish speaking staff, or translators available. So what does this mean? It means it can be challenging to initiate services, participate in assessment, and understand what is going on in therapy. If this is your situation, you may want to find a solo BCBA who speaks your first language for ease of understanding and communication. Another bonus is this BCBA would be able to provide translated documents and paperwork to you, in your dominant language.

  • Professional seeking Consultation - Lastly, what if you are not a parent seeking services for your child, but rather a related professional who wants to collaborate with a BCBA? Maybe you are a teacher, SLP, Psychologist, or PT, and you have a particular client/student with challenging behaviors and need some help. This is not a scenario that would be appropriate for calling up an ABA company. It would be far more feasible (and faster) to locate a BCBA and ask about individual consultation. Keep in mind that ethically, the caregivers of the specific client must consent to this consultation as well.



There will be exceptions to all of the points above, depending on the area where you reside, the funding sources available, the quality of local providers, and your specific behavioral needs. 
For example, it is often more difficult for parents of older children or adults to access services. Also, not all agencies accept all insurances. Or maybe your current ABA provider seems to have a revolving door of staff, and just when you acclimate to the team members: they change. These are all scenarios where you may want to consider private consultation.

Just keep in mind that if services in your area are lacking/low quality, full of impossible waitlists, or if you have funding challenges, you do have other options available to receive ABA intervention for your child.





*Resources:





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Tameika Meadows, BCBA, Blog Author

 *Recommended Reading: ABA Haters 


I feel very unqualified to write this post.


The ABA Reform movement (also referred to as Autistic Activists & Allies) is not new, but you may be unaware of it. Many ABA peeps are. 

There's a vocal community of Autistics and pro-neurodiversity/anti-ABA parents, individuals, and professionals who work diligently to spread the word about their viewpoint of ABA. Sometimes this is due to actual experience with ABA therapy, but not always. 


If you want to understand why an Autistic dislikes ABA therapy, obviously the best person to ask would be an #ActuallyAutistic.

However, there are a couple of reasons why I am writing this post anyway, despite feeling unqualified to do so:

1. Lots and lots of parents come to my blog as a source of information about ABA. I don't want my silence on this topic to make it seem like I think ABA therapy is perfect with no flaws. I do think this industry has flaws, I have worked for low-quality employers, and I think parents making treatment decisions for their child need to know how to navigate this issue.

2. Although there are some in the ABA Reform movement who are pushing more for "ABA Eradication" and less for "ABA Reform", I think ABA professionals should be a part of this conversation. We are the ones in the field, day in and day out, working with vulnerable populations who don't always have a voice (either figuratively or quite literally). We cannot just stand by and watch this ABA conversation happen, we need to join the conversation.


If you think ABA, as a treatment or as an industry, is perfection and needs no improvement, you may want to stop reading now. <------------------------------------------


If however, you see the field's issues with clinician burnout, inefficient staff training, low-quality employers, person-first treatment planning, questionable research, teaching Autistics to mask, or respecting client dignity, and want to be a part of the CHANGE for the better, then read on.


My 1st post on anti-ABA'ers, or "ABA Haters" was written several years ago. I keep it up because I think it's important to see the evolution of change. 

Most of us do not change our minds about something instantly. It is a process. We receive new information, analyze that information, reject it and return to old thinking, or accept it and enter into a different level of understanding. Of course, I'm also minimizing the reality of defensive mechanisms, circular logic, and cognitive dissonance, and how these concepts impact our ability to change our mind.

I used to think people were anti-ABA because they had never experienced quality ABA services, or maybe received ABA decades ago when there was less accountability of providers, more "old school" tactics used, etc. I thought if they could see for themselves what ABA can do, how it can help, and how we impact lives everyday, that anti-ABA'ers would "come around".

I have since changed my mind on that.

For those of you that don't know, receiving low-quality/unethical ABA treatment is not the only reason why someone may hate ABA. 

Other reasons could include: being against the idea of "treatment" for a neurological difference, seeing Autism as a cultural identity and not a problem to solve, being against the high intensity of ABA services, taking issue with the tiered service-delivery model ABA uses, being angered by ABA providers or companies using "cure" or "recovery" talk (yes, this still happens today), viewing the origins of ABA as unethical and inhumane, viewing the current state of ABA as unethical and inhumane, and a strong displeasure with the lack of Autistic voices/input in the top Autism advocacy organizations, Behavior Certification Board for Behavior Analysis, leadership/ownership of ABA agencies and companies, or leadership in ABA state associations.

These are valid points, and they deserved to be heard without the lens of professional defensiveness.


Again, there are some in the ABA Reform community who think the best way to fix ABA is to 

Shut. 

It. 

Down.


But there are others who do want to see ABA improved, implemented more compassionately, and become more receptive to Autistic feedback and experiences. More about support and accommodations, and less about trying to force someone to not look or act Autistic.


Below are a ton of great resources for more information about Autistic voices, differing views on ABA, and anti-Ableism advocacy. The best consumer is an informed consumer, and I think it's important to present the information and let people decide what is best for them.

It is so important to be aware of what the main population served by ABA providers (*It is true that not all ABA professionals work within the Autism community, but a gigantic chunk of us do*) has to say about ABA therapy, and the ways it can improve.


If you aren't willing to at least non-defensively listen, then what you're really saying is you aren't willing to change your mind. And how sad is that?



*Resources- 

Do Better Professional Movement 

The Great Big ABA Opposition List

Autistic Self-Advocacy Network 

BCBAs + Autistics Towards a Reformed ABA Facebook group

ABA Reform Facebook page

Beautiful Humans Podcast: The ABA Reform Movement Ep. 26 (Go take a listen, this is an amazing conversation!)

A Perspective on Today's ABA from Dr. Greg Hanley

5 Important Reasons Even "New ABA" is Problematic 

The Controversy Around ABA

Stimming Deserves Acceptance 

Nice Lady Therapists 

"I Am a Disillusioned BCBA" 

ABA Inside Track Podcast: Trauma Informed Care Ep 134 

Behavioral Observations Podcast: What is Trauma Informed ABA Ep 131

What's Wrong with the Autism 'Puzzle Piece' Symbol

"Why Autism Speaks Doesn't Speak for Me"

Avoiding Ableist Language: Suggestions for Autism Researchers 

"Why Autism ABA Goes Against Everything B.F. Skinner Believed In"

Eye Contact for Recipients Validation

"Autism Doesn't Have to be Viewed as a Disability"

"How To Ask an Autistic"

Outdated Autism Terms & Language

Autism Wars 

The Controversy over Autism's Most Common Therapy

For ABA Practitioners: How to Respond to ABA Hate






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Tameika Meadows, BCBA, Blog Author

 


*Recommended Resources:

Helping your ASD child cope with COVID

Strategies for supporting learning at home

Homeschooling special needs children

Mastering Homeschooling

Podcast Episode: "Take Off the Cape"


During this global pandemic, schools have been as impacted as everyone else when it comes to figuring out a New Normal. 

The most recent stats indicate that globally, there are 1.2 billion children learning outside of the classroom due to school closures (source: We Forum) . E-learning has increased dramatically, with parents and caregivers now finding themselves thrust into the role of "Home Education Assistant".  

I have multiple clients who are learning at home this year, and both the parents and the children are struggling to adjust to this unanticipated change. 


For the children, it may be hard to understand why they aren't at school, why the regular routine has been so disrupted, and why they have to sit and learn at a computer all of a sudden.

For the parents, this is an added stressor during an already challenging year, it is hard to navigate a school at home schedule while also working from home (or returning to work on-site), and for parents of ASD children there are added unique challenges to help the child benefit from online learning.


Very few of the clients I serve are able to sit and learn through a device/computer screen for an entire school day. That just isn't happening. So what we are doing instead is helping the caregivers in the home learn how best to support their child's school day with this new format. Especially since none of us really know for sure when schools will be "back to normal".


Below are some tips I share with my client families, I hope they are helpful for you and your children:


  • Tip #1 is THE MOST important tip: Talk to your treatment team. By "treatment team", I mean the ABA team/case BCBA, Speech Therapist, Teacher, Counselor, etc. The best person to ask about your child's learning is a professional who already knows and works with your child. Seriously, I have had so many meetings this year with client teachers, and the teachers were all so understanding, accommodating, and willing to work together, because this year is hard for all of us. You will have no idea how much the online school day can be modified until you ask.

  • A daily schedule will be your BFF. It will be nearly impossible to adjust to the demands of school at home without a consistent schedule in place. Create a schedule based on when your child needs to log-on/be active in class vs. when they can work on assignments off-screen/off-camera. Be sure to include breaks (Pleeeeeease don't expect your child to sit at a computer screen all day with 0 breaks. That won't end well), meal times, reinforcement time/play, and calming or sensory activities as needed. Just like the rest of us, your child is probably highly stressed from the challenges of 2020. Though they may be unable to communicate that, just depending on ability level.

  • Seek help if you are physically unable to supervise your child's online learning. I have some client families where both parents are working from home right now. It is tough, but they are able to adjust their day so at least one parent is always monitoring the child's learning. I have other client families where this is not at all possible. Every household is different. Consider having a neighbor, grandparent, older sibling, or family friend monitor your child during the school day. For some families, "monitoring" may be all that is needed. For other families, see the next tip.....

  • DO understand that for some children, sitting at a laptop and attending for more than a few seconds at a time will not be possible. It won't. You are not a bad parent if this is the case. You have not failed, and you should not beat yourself up. This simply means your child will need a high level of support to benefit from schooling at home. I have some clients in this scenario, and it does mean that an adult must sit with the child and help them participate in online school. But guess what? For these types of kids, a 6- hour school day is not the goal. A 4- hour school day isn't even the goal. We work on helping the child participate as much as possible, and then we take breaks. Then we try some more. Then we take breaks....get the picture? Which leads me to my last tip....

  • Let's get real. And I mean, really real. We are in the midst of a pandemic. Families are struggling mentally, emotionally, financially, etc. Your child with ASD may not understand what is going on, and why all of a sudden you are acting like a teacher. Stress levels, anxiety, and depression, are sky-high for many people. You have to assess your capacity as a parent to do school at home. It truly is not for everyone. And that's OK! Please re-read tip #1. Talk to the school. Talk to your child's teacher. Explain your situation, and discuss the barriers to teaching your child at home. See what strategies or modifications the school can make. You might be surprised how many options you have that you just don't know about. You are not Superman or Superwoman, and are under no requirement to be perfect. Do the best you can, in the surreal circumstances we all find ourselves in right now. Best of luck to you!


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Tameika Meadows, BCBA, Blog Author

 "You are not Superman, and you are not Superwoman. Take off the cape."

Tameika Meadows 


Today's QOTD is from an amazing podcast I had the privilege to join: "Shifting Perspectives", hosted by Yolande Robinson.


During the insanity that has been 2020, parents of Autistic children, teens, and adults, have had to repeatedly pivot and navigate new situations when it comes to lack of supports, no access to community providers, increased unemployment, schools or colleges shut down, homeschooling nightmares, increased anxiety, increased depression, and on and on. 

We have all been impacted by this pandemic and global turmoil, but for families raising special needs children there are unique issues and factors that come with the territory. 

What is needed now is encouragement, support, practical strategies, and a reminder that no one should be trying to "do it all" right now. That just isn't possible. Focus on what can be changed and improved, and learn to adapt to what cannot.


Podcast episode link:  Episode 19  "Take off the Cape"









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Tameika Meadows, BCBA, Blog Author

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