FAQ Part III!- Letters To The Editor

First there was FAQ Part 1

  Then came the sequel, FAQ Part 2

And now it’s a trilogy!

I decided to compile some of the questions I’ve received from readers of my blog, in the hopes that it could help other people going through similar situations. ABA is such an enigma in that it is simple and very complex at the same time. When I explain ABA to teachers or parents they often say something like “Oh that’s what ABA is?? But that’s so simple! I already tried that”.

 Yes, on the surface ABA can seem very easy because at its core it is simply Operant conditioning. It is the application of ABA that can be quite complex. It is knowing which technique to choose, how to implement it, when to modify it, and what to do when it isn’t working that trips many people up. 

Many people who read my blog send me comments or feedback about posts they liked --or didn’t like-- or things they’d like to see on the blog. I also get lots of questions from professionals and parents. From the types of questions I receive it’s clear that there are many, many people out there dealing with difficult behavioral problems in their homes or classrooms.

The purpose of this blog is to share ABA with people and provide a place for encouragement and resources. I didn’t expect this blog to be read by so many people, and I have learned a lot about what ABA and Autism look like in different countries just from hearing from my readers.

Q- “My son wont stop banging his head on the living room floor/My daughter screams if you turn the TV off/ How do I get my child to stop doing ______?”

A- I get a lot of questions of this variety, with the same theme of “What do I do about XYZ” behavior. Behavior reduction is not that simple, and it’s not that cut and dry. When trying to intervene on a problem behavior it’s important to complete the FBA process, create a behavior plan, and then implement the plan. A professional can’t know with confidence what to do about a specific behavior just from hearing a few details about it. Also it would be unethical of any ABA provider to give specific advice regarding a client they do not serve.

Q- “My son has Autism, and he is 8. The school wants to place him in a self contained classroom but I really want him to be in an inclusion classroom. Which one is better?”

A- The decision on whether to place a special needs child in a self contained classroom or a typical classroom will vary from child to child. Does every child with Autism automatically need to be in the “Autism classroom”? No. I highly recommend reading this post. 

Q- “Why do I need a BCBA/What does a BCBA do?”

A- A Board Certified Behavior Analyst, or BCBA, is a person who is qualified to manage, oversee, and supervise direct staff (ABA therapists). BCBA’s are trained in analyzing behavior, conducting behavioral assessments, behavioral theory, data collection, and much more. The ABA therapist is the person who works with the child directly, usually in a 1:1 format (a BCBA can work as a direct therapist, they just usually don’t). Typically there will be at least 1 person over the ABA therapist acting as a supervisor. The reason it is preferable that this person be a BCBA is because of the knowledge and expertise necessary to supervise an ABA program. Many professionals without BCBA certification are not equipped to modify, manage, and intervene on behavior. For example, the ABA therapist may be knowledgeable about parent training and teaching skills, but they may not have understanding of why to avoid punishment techniques, or how to conduct a FBA.

Q- “I was able to secure some funding for ABA, but there are no providers in my area”.

A- This isn’t an unusual problem. Depending on where you live, there may be ABA agencies falling out of the sky. Or there might be one agency with a 2 year long waiting list or ridiculously high rates. You have two options depending on the requirements of the funding source. You could find laypersons and get them trained, such as teachers, paraprofessionals, the babysitter, etc. With proper training and supervision any of these individuals could be used as an ABA therapist. However, some funding sources specify that they will only pay for ABA services performed by a BCBA. If that’s the case, you could hire a BCBA who does not live in your area. They could provide long distance consultation, in addition to traveling to your home for in-person trainings or visits. The BACB website has an international directory of Board Certified professionals.

Q- "I enjoy reading your blog 'iloveaba.com' because I find it resourceful and informative. I have been doing ABA for slightly over a year and I really love it. Although, there are times I am stressful and worried especially during team meetings. I am quite a shy person thus team meetings with other therapists, consultant, and the parents is a little too overwhelming for me. As each of the therapists have to do a short session with our boy, I find myself getting anxious and jittery whenever it's my turn. I tried to ignore their presence in the room but I still feel so anxious that I end up making mistakes and not being able to perform well. I sense that the boy knows my emotions because most of the time when it's my turn, he will have tantrums or refuse to comply.

Does this happens often to ABA therapists? Could you share how I could overcome this problem? Like you, I am passionate about ABA but I don't seem to know how to overcome this fear and shyness in front of so many people."

A- I can SO relate to what you describe! I have definitely been in that situation. My very first client in this field used to have these huge training meetings that combined the home staff and school staff and we would have to take turns working with the child...while also being videotaped. It was incredibly stressful and I used to hate those meetings :-)  Looking back on it, what changed the situation for me is when my confidence grew. I used to feel timid, uncomfortable, and panicked doing therapy in front of everyone because I was scared I would make a mistake, or do something wrong. But to learn in ABA, you have to make mistakes! That's how learning happens. I know how scary it is to perform therapy while people watch, but its a valuable learning tool and it will make you a better ABA therapist. The only thing that can build your confidence (besides time) is really striving to become better. Watch ABA training DVD's, read books, read research articles, ask questions of the consultant, and I also recommend taping your own therapy sessions. Kind of like how football coaches review tapes of great games, as an ABA therapist it can be very helpful to view tapes of your own sessions and critique your performance.  

As your confidence grows, the fear will go away. Also the child is very likely responding to your timidness and lack of confidence. 

Q-“I was told that my child is too high-functioning to use Applied Behavior Analysis (ABA) because she is verbal and relates to other people. Is it true that ABA is best used with children who are lower functioning?”

 A- I have heard this myth before that ABA is only for young kids or children who cannot speak yet. However, that simply isn’t true. I have worked with children all over the Spectrum, who varied in how impacted they were by their diagnosis. ABA can be successful for older kids as well as adults. It all depends on what the goals are. ABA therapy with a teen may focus on more cognitively advanced skills that the child has deficits in, such as dating, employment, joke telling, puberty issues, etc. Progress is possible when using ABA with an individual of any age. Some funding sources severely minimize or cut off funding for children over a certain age. This does not mean that ABA can’t help a teen or adult, it just may be difficult to find a funding source to pay for it.

Q- "I was just hired as a middle school teacher with 8 students who have autism.  I'm reaching out to you to ask advice as to how to approach my students on my first day.”

 A- The suggestions I have for you are the same ones I would give to a therapist going to work with a new client. You want to start off by building and establishing rapport, taking baseline data, and observing/analyzing behaviors. I know it’s a bit different for you because you have many students, not one child you are working with. I would suggest creating time blocks in the day where you are interacting with or observing/taking data on specific students. So maybe during Circle Time you observe and collect data on 2 students, and then during recess you interact with 2 different students. Just keep rotating through until you have the information you need on all students. This information will be invaluable to you once you start teaching, and it will help you to differentiate instruction among the students (which I believe should happen in every classroom).

Q- “I'm thinking about working for an autism organization as a line therapist this summer and am wondering if you have any advice for me. Do you like your job? How difficult or consuming is it to be a line therapist?”

A- I get many questions like this. Being an ABA therapist is definitely not a job for everyone. I love what I do, but I have seen therapists get hired and very quickly quit. It depends. Not all companies are created equally, so sometimes you can work for a company that is unprofessional, treats staff badly, and pays very little. So that could cause someone to leave the field because they think all companies are like that. How difficult the job is will depend on the training provided to you, and how much support the company gives you. Also the more you learn and as your experience grows, you will become more confident in your abilities which will also make you like the job more. Here is a helpful post for anyone interested in entering the field of ABA.

Q- “I have a heart for people, especially kids with Autism. I want to go to school but am having a hard time choosing a degree. I am creative and systematic, very much a puzzle solver and I get bored quick the same old routine everyday. Would behavioral analyst/specialist/consultant be a good career choice?”

A- If you want to become an Autism Consultant, which is a BCBA, then the BACB website lists the specific degrees required to obtain certification. In addition to a degree, you need specific coursework (which may or may not have been part of your degree program), you need to be supervised by a BCBA while you gain ABA experience, and you must pass a rigorous exam.
Oh, and if you decide to become a BCBA don’t worry about being bored. There is so much variability to the field! You can decide where you want to work, with what ages, and the daily duties change based on who your clients are. It’s definitely not a typical 9-5 job, which is what I love about it!