What's driving you?

You can call it motivation, drive, desire, "the big payoff", or any other name, but Motivating Operations, or M.O., basically refers to the invisible and frantic magical fairies hidden underneath your behavior and secretly impacting why you do what you do.

For ABA practitioners, why is this such an important concept to know about, understand, and then apply nearly every day? Take a look at this example:


Example A- ABA therapist arrives at child's home for therapy session, immediately walks in to child tantrumming for popcorn and not wearing any pants. Therapist silently redirects the child away from the kitchen to the therapy room and prompts the child to put their pants on. Therapist then prompts the still screaming child to sit at the therapy table, and begins teaching. Multiple fully prompted trials later, the child earns a break. The therapist offers a choice between Legos and playing with clay. The child chooses neither. The therapist then prompts a forced choice of going outside. Outside the child is whining, irritable, and repeatedly attempts to run back into the house. The therapist blocks and redirects all attempts to go indoors, and tries several times to get the child interested in playing basketball using full physical prompting.

If this example summarized just the first 20 minutes of the therapy session, how do you think the session would go overall? Pretty not great would be my guess.
Now, take a look at this example where the therapist constantly followed or contrived the child's motivation:

Example B- ABA therapist arrives at child's home for therapy session, immediately walks in to child tantrumming for popcorn and not wearing any pants. The therapist uses this opportunity to target manding, and asks the parent to give her the popcorn. The therapist then shows the child the popcorn, models the label ("PUH- POPCORN"), and withholds the popcorn. After the child successfully mands and receives some popcorn, the therapist puts more in a baggie and says "Come with me, and you can have more!" and walks to the therapy room. The child quickly follows. Once in the therapy room the therapist takes some moments to interact and pair with the child before beginning instruction. At the therapy table, the child works well to earn more popcorn. The therapist offers a choice between juice (the popcorn likely made the child thirsty), or Legos. The child chooses juice. The therapist explains "FIRST pants, THEN juice". The child complies with putting pants on, in order to get some juice. Once in the kitchen the therapist lines up 3 kinds of juice so the child can choose which one he wants. The therapist then pours a pretend cup of juice, and gives some to a baby doll everytime the child drinks. The child laughs, and then wants a turn giving the doll juice. 

Are you seeing the differences? No? No worries, I'll point them out:

• Successful therapists think on their feet - You will not always work with your clients in the most ideal circumstances. That's life. A big part of what I do is being able to quickly scan a situation, alter my game plan based on what I see, and then alter my game plan some more based on how the child responds. You can't get stuck in tunnel vision where all that matters are your session goals. What if materials are missing? What if its a parent training session and they aren't home yet? What if the grandparents are in town and want to watch the session? You have to roll with it!
• Successful therapists know when to let a kid have a bad day - So you get to the home and the child is half naked and screaming over popcorn. Are they not allowed to have a bad day?? When you're angry do you always want to wear pants? I didn't think so. Don't make the mistake of arriving to the session and thinking its your job to immediately get things under control. What does the child learn from you prompting them straight into work? Why not use the real life situation unfolding in front of you to teach communication, or to teach the parents how to handle the behavior themselves? We can allll-ways squeeze in more Parent Training. 
• Successful therapists ALWAYS think about "What does the client get out of this?"- I don't present any instruction or directive to my clients without first establishing in my mind why they should do it. Compliance for the sake of compliance is great, but just like the rest of us most of my kiddos need a reason to clap hands....or come upstairs...or walk with me. Are you just barking out orders to your clients, or are you making sure they are aware of what reinforcement waits right behind your demands?
• Successful therapists can take the written programs and embed them into any task - This is something I spend a lot of time helping my staff improve upon, because I think it is one of the most critical things they can learn. Teaching is not just what occurs when you are reading SD's off your data sheet. Teaching can happen anywhere, anytime. Part of thinking on your feet will require that you develop the skill of making anything therapeutic. This means being able to alter your original game plan but still keep your original goals in mind. It also means doing what the child wants to do, and ninja-sleuth style sneaking your targets into it. NOT blocking the child from what they want to do and prompting them to do your thing. 
• Successful therapists focus on relationship, more than trials: Which is more important at the end of the therapy session, that your data sheet is fully completed or that the child is calm, engaged, and excited about you returning? I can hear you saying, "Well, can I get both of those?". Mmmmm, not always no. Sometimes you may run less trials then you need to, or spend less time at the therapy table, or not even probe some of those new targets. But, you get some amazing eye contact while playing with bubbles, or the child reaches for your hand as you walk down the hallway, or you get to show the parent a better way to get the child to stay seated during lunch. Your job is far more than filling out a data sheet.

Getting this concept of motivation (I mean really getting it), and knowing how to follow/contrive motivation will help any ABA practitioner be more effective, have less aversive relationships with your clients, and lower stress or frustration when therapy sessions get chaotic. 

Whenever one of my staff calls me up after a session to tell me how horribly it went, after some digging and open-ended questions, what I usually hear are a series of missed opportunities to capture motivation and use it wisely. In other words, the client was definitely motivated to do some stuff....just not any of the stuff you wanted them to do. Instead of using that, the staff just implemented a lot of heavy handed prompting. 

Is the client desperately clinging to Mom? Have Mom join the session. A sibling is having a loud play date just down the hall from the therapy room? Let your client work for breaks to go join the play date. Dad is in the kitchen baking amazing- smelling- yet- totally- distracting cookies? Have the client join Dad and help cook, while also targeting fine motor (mixing), one step directions ("Get the spoon") and self-help skills (pouring a cup of milk). 

Don't fight against your clients M.O., use it!

*References/Recommended Reading:

Langthorne, P., & McGill, P. (2009). A Tutorial on the Concept of the Motivating Operation and its Importance to Application. Behavior Analysis in Practice, 2(2), 22–31.

"The White Book", chapter 16