ABA from an SLP Perspective

Meggin Funk, M.S. Ed., BCBA and Ashley Meyer, M.Ed., BCBA Author

04/06/2020 Added

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2020 ASD Conference Breakout Session

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[00:00:00.170]Hi, my name is Meggin Funk.
[00:00:01.840]I'm a speech language pathologist
[00:00:03.800]and a board certified behavior analyst.
[00:00:05.770]And I currently work for the Nebraska ASD network
[00:00:08.770]as the western region coordinator.
[00:00:10.970]I've made the PowerPoint available to you
[00:00:13.150]at the following bitly link.
[00:00:15.180]Please let me know your role on the team.
[00:00:18.730]Today we'll look at identifying the historical tension
[00:00:21.780]between SLPs and BCBAs.
[00:00:24.640]We'll demonstrate the similarities
[00:00:26.360]between the two professions.
[00:00:28.320]Recognize the importance of teaming.
[00:00:30.250]And then explore the strengths of the two professions
[00:00:32.820]to support maximum student outcomes.
[00:00:35.500]As we look at the history of speech language pathology
[00:00:38.550]and applied behavior analysis, in this article
[00:00:41.730]by Koenig and Gerenser, we can see
[00:00:44.300]that in the 1950s, 60s and 70s
[00:00:47.870]that there were various literature and articles
[00:00:51.180]that sourced how SLPs actually used behavioral techniques.
[00:00:56.180]They used stimulus presentation, reinforcement,
[00:00:59.520]response shaping and modeling.
[00:01:01.560]They typically use these different techniques
[00:01:04.560]in the areas of articulation, fluency, language and voice.
[00:01:09.760]Then in 1957, after 23 years of work,
[00:01:13.840]B.F Skinner published "Verbal Behavior".
[00:01:16.930]And then in '59 Chomsky, a linguist from MIT,
[00:01:22.030]wrote a very critical review of Skinner's "Verbal Behavior",
[00:01:25.630]stating that it was really void of any value
[00:01:28.810]and went even further to criticize behaviorism,
[00:01:32.410]thus creating major tension between the two professions.
[00:01:36.320]Now, Skinner opted to never respond to Chomsky's criticism,
[00:01:41.380]he simply felt that Chomsky did not understand
[00:01:45.870]what he was talking about,
[00:01:47.270]because Chomsky was focused on structure,
[00:01:51.660]whereas Skinner was focused on the function.
[00:01:54.970]Skinner was actually fine
[00:01:56.340]with the formal classification of language.
[00:01:58.810]He just felt that there is a failure to account
[00:02:01.810]for the causes or what we would call function today.
[00:02:05.310]But there just wasn't a lot of research
[00:02:07.660]behind verbal behavior, so neither field probably gave it
[00:02:11.900]the respect that it was due.
[00:02:14.450]So between the 70s and 80s,
[00:02:16.550]the SLPs became very heavily influenced
[00:02:19.460]by Chomsky's theoretical linguistics
[00:02:22.030]and cognitive psychology or psycholinguistics,
[00:02:26.050]we would call it.
[00:02:27.250]And his generative grammar and semantics
[00:02:31.500]that encouraged a more natural non-intrusive,
[00:02:35.090]facilitation role versus
[00:02:37.550]that more intrusive stimulus manipulation role,
[00:02:40.600]which we would consider more verbal behavior now.
[00:02:43.470]The focus was on structure versus function.
[00:02:46.680]Now in the 80s and 90s, the SLPs began to see limitations
[00:02:51.250]of that generative language model.
[00:02:53.280]So they began to make a move back towards
[00:02:56.110]that pragmatic approach to communication looking
[00:02:58.580]at that functional component.
[00:03:00.580]But there was still no collaboration
[00:03:02.780]between the two professions.
[00:03:04.770]In the 1990s, we started to see that increase
[00:03:08.500]in the ASD rates.
[00:03:10.240]There just started to be more public awareness
[00:03:13.150]and publications of the various successful interventions
[00:03:17.710]as we sought out answers to help our students.
[00:03:21.610]So we started to see more and more success stories of ABA.
[00:03:25.550]Today, we are seeing more collaboration than ever
[00:03:28.760]between speech language pathologists
[00:03:30.970]and board certified behavior analysts to really try
[00:03:34.560]to improve on student outcomes.
[00:03:37.840]As far as points of tension, we are definitely going to see
[00:03:41.250]those theoretical issues just because
[00:03:43.590]they are different types of psychology.
[00:03:45.500]We have cognitive psychology versus behavioral psychology.
[00:03:49.490]But I think the overall there's just a lack of understanding
[00:03:52.250]between the two.
[00:03:54.120]We could see that there could be some difficulty
[00:03:56.550]on who takes lead within that language programming
[00:03:59.830]under that scope of practice.
[00:04:02.410]And then there can be differing priorities
[00:04:04.930]between negative behavior and communication
[00:04:07.310]or language versus communication skills.
[00:04:09.900]And then going back to those theoretical perspectives
[00:04:13.300]in that naturalness of the strategies implemented.
[00:04:16.920]There are different ways to take data,
[00:04:18.900]so varying data systems.
[00:04:21.090]But overall, I would say we're brand new to this basically,
[00:04:24.700]this collaboration, so there may have just been
[00:04:28.270]an overall lack of interprofessional collaboration
[00:04:32.100]between team members.
[00:04:33.980]Let's take a look at our professional qualifications.
[00:04:37.540]When we look at SLPs and be BCBAs,
[00:04:40.370]their educational backgrounds you can see
[00:04:42.500]that an SLP, is required to have a minimum
[00:04:45.000]of a Master's degree and it has to be
[00:04:47.940]in communication disorders.
[00:04:50.370]But a BCBA will have a minimum of a Master's degree
[00:04:54.760]in either applied behavior analysis,
[00:04:57.140]psychology or education.
[00:04:59.530]Bachelor's candidates in communication disorders are SLP-As
[00:05:04.140]but they are not certified with provisional licensures
[00:05:07.350]under supervising SLPs.
[00:05:09.800]Whereas a Bachelor's candidate or an individual
[00:05:13.870]having a Master's degree in a field outside of ABA,
[00:05:17.070]psychology or education, are BCaBAs with certification
[00:05:22.130]and practice under the certified BCBA.
[00:05:25.040]For an SLP to gain their certificate of clinical competence
[00:05:28.680]from America Speech, Language and Hearing Association,
[00:05:32.060]they must graduate from an accredited program,
[00:05:35.030]complete a clinical fellowship year of at least 1260 hours
[00:05:39.680]of hands-on training, under an individual with their C's.
[00:05:44.100]And then they must pass a praxis exam.
[00:05:47.570]This is a three year cycle of maintenance
[00:05:51.020]to maintain our C's.
[00:05:53.720]To become board certified as a behavior analyst,
[00:05:56.560]you must complete coursework requirements
[00:05:59.030]for the current tasks list.
[00:06:00.500]I was under task list four
[00:06:02.250]and now they have a fifth edition.
[00:06:04.520]You must be supervised, I took online training,
[00:06:07.900]so I was under the independent field work.
[00:06:10.530]So I was required to complete 1500 hours of field work
[00:06:15.610]with my supervisor,
[00:06:17.300]and then I had to pass our national exam.
[00:06:21.300]And I'm required to have continuing education
[00:06:24.940]and that's on a two year certification cycle.
[00:06:27.800]The SLP-A is able to provide intervention
[00:06:30.970]under the supervision of an SLP's plan of care.
[00:06:33.900]They do not assess, evaluate,
[00:06:36.700]participate in meetings or teachings.
[00:06:40.160]The BCaBA however, can assess, create intervention plans
[00:06:44.900]and participate in meetings
[00:06:46.400]under the supervision of the BCBA.
[00:06:49.480]For supervision and licensure,
[00:06:51.610]licensure is required in all 50 states now for SLPs.
[00:06:57.560]ASHA did set national standards since about '26,
[00:07:01.530]and has been certifying professional since 1952.
[00:07:05.450]And an SLP is only able
[00:07:07.380]to supervise two non-certified persons at any one time.
[00:07:13.010]The BCBA must take additional coursework
[00:07:16.310]to become a supervisor, an additional eight hour course.
[00:07:20.330]And then they have to have licensure in some states,
[00:07:24.530]at this time we are not required to be licensed
[00:07:27.720]in the state of Nebraska.
[00:07:29.060]When we consider the coursework
[00:07:31.320]in communication disorders versus applied behavior analysis,
[00:07:36.910]it was really easy for me to see that if I were just an SLP,
[00:07:42.650]I just didn't have all the skills that I needed to deal
[00:07:46.240]with problematic behaviors or behaviors in general,
[00:07:49.890]and vice versa.
[00:07:51.320]If I was just a Board Certified behavior analyst,
[00:07:54.430]I did not have all of the skills to deal
[00:07:57.610]with specific language and communication concerns.
[00:08:01.340]There's truly so much that can be learned from one another
[00:08:04.910]as we collaborate respectfully.
[00:08:07.220]We are both professionally qualified.
[00:08:09.700]So we need to make sure
[00:08:11.010]that we understand our scope of practice.
[00:08:13.380]Let's consider communication versus behavior.
[00:08:16.340]Communication is a process by which information is exchanged
[00:08:20.190]between individuals through a common system of symbols,
[00:08:23.430]signs or behavior.
[00:08:25.270]By this very definition, we would expect individuals
[00:08:28.480]with autism to have difficulty with communication,
[00:08:31.680]because it requires two individuals or more,
[00:08:35.080]which tends to be more difficult for them,
[00:08:37.710]as well as a common system.
[00:08:39.890]And we'll start to learn more about
[00:08:41.620]that as we dig into pragmatics.
[00:08:44.860]The definition of behavior is the activity
[00:08:46.930]of living organisms.
[00:08:48.500]Human behavior is everything that we do.
[00:08:51.480]As we look at the evaluation process
[00:08:53.420]for speech language pathologist,
[00:08:55.560]the evaluations can include expressive language,
[00:08:58.510]receptive language, pragmatic language,
[00:09:01.750]artic and phonology, voice and fluency.
[00:09:06.140]Then we take the language components,
[00:09:09.300]and they go into three different categories.
[00:09:12.160]We look at the content, and that's the semantics.
[00:09:15.670]That's the meaning behind our language.
[00:09:18.370]We look at the form and that's the phonetics,
[00:09:21.360]how we say the exact sounds.
[00:09:24.500]The syntax, the rules, the grammar behind what we're saying.
[00:09:29.420]Morphology is how we break down a word into the root,
[00:09:33.210]or if we affix a sound to the beginning or end of it,
[00:09:36.780]such as the s, er or ing endings of a word.
[00:09:41.410]So if we take the route car,
[00:09:43.410]it's very different than if we have the s at the end,
[00:09:46.970]car versus cars, they mean different things.
[00:09:50.420]And then pragmatic language,
[00:09:52.980]under the use of our language refers
[00:09:55.910]to that social language skill
[00:09:58.050]that we use in our daily interactions with one another.
[00:10:01.140]This includes what we say, how we say it,
[00:10:04.210]and that nonverbal communication components
[00:10:06.930]such as eye contact, facial expressions and body language.
[00:10:11.530]It's how we use those appropriate interactions
[00:10:15.530]in a given situation.
[00:10:17.370]The evaluation results help us to see the strengths
[00:10:20.620]of the speech and communication of a student.
[00:10:23.330]But it also helps us to find the skills deficits
[00:10:26.540]that need to be taught.
[00:10:28.020]When we look at evaluation from a behavior analyst,
[00:10:32.250]we look at what's called a functional behavior assessment.
[00:10:36.090]There is the indirect portion of the assessment
[00:10:39.030]and that's where we do interviews, checklists,
[00:10:41.510]reading skills, such as the fast,
[00:10:44.130]the functional analysis rating scale,
[00:10:46.560]or the QABF, which is questions about behavioral functions.
[00:10:51.400]And we can also do questionnaires.
[00:10:53.660]All of this is just leading us to information
[00:10:56.650]that may help us to identify conditions or events
[00:10:59.980]in the environment that correlate with a problem behavior.
[00:11:03.200]The team may need to take some scatterplot data at this time
[00:11:07.120]to help determine when the best time
[00:11:10.100]to do an observation would be.
[00:11:12.050]And that moves us into that second step
[00:11:14.480]of the descriptive assessment,
[00:11:16.500]where direct observations of the problem behavior
[00:11:19.240]within the natural environment need to occur.
[00:11:22.070]This helps us to confirm or disconfirm information gathered
[00:11:26.060]during the indirect assessment.
[00:11:28.060]During the observation, the information is broken into
[00:11:31.210]that ABC data.
[00:11:33.110]After data is taken on multiple occasions,
[00:11:35.500]we can begin to see a pattern
[00:11:37.770]and we can start to hypothesize a function.
[00:11:40.910]The four main functions we can remember
[00:11:43.210]by the acronym EATS, E-A-T-S.
[00:11:46.990]So a student can escape/avoid,
[00:11:49.620]they can try to gain attention,
[00:11:51.670]they can try to gain access to tangibles or sensory.
[00:11:55.980]So E-A-T-S, so escape/avoid, attention,
[00:12:00.290]access to tangibles or sensory.
[00:12:02.960]Then if we were in a clinical setting, we would possibly try
[00:12:06.200]to test that hypothesis using an FA.
[00:12:10.000]But in an educational setting, we tend to just try
[00:12:13.410]to move into developing that intervention strategies.
[00:12:17.030]And that's where we come up
[00:12:18.930]with our behavior intervention plans.
[00:12:21.310]So the evaluation results
[00:12:23.010]for behavior analyst help them find the students strengths,
[00:12:26.090]but also the skills deficits that need to be taught.
[00:12:29.340]This is where I had a huge aha moment as a behavior analyst
[00:12:33.520]who was also a speech language pathologist.
[00:12:36.280]One of the number one recommendations
[00:12:38.530]for intervention strategies
[00:12:40.440]is functional communication training.
[00:12:42.870]And I knew how to help with communication.
[00:12:46.220]So let's take a look at making the connection.
[00:12:49.060]Let me know in the chat box if you've ever been trained
[00:12:51.760]in verbal behavior.
[00:12:54.020]When we consider Skinner's "Verbal Behavior" again,
[00:12:56.900]remember we're focused on the function of the behavior.
[00:13:00.240]So he began with the mand.
[00:13:02.790]A mand is a form of verbal behavior
[00:13:04.780]that's controlled by motivation.
[00:13:06.950]And it directly benefits the speaker
[00:13:09.670]with a very specific reinforcement.
[00:13:12.490]This typically tends to be the first operant acquired
[00:13:16.300]by a child.
[00:13:17.520]So the basic principle is want it, say it, get it.
[00:13:21.190]You want a cookie, you say cookie, you get the cookie.
[00:13:25.490]The next verbal operant is a tact.
[00:13:28.450]A tact's a verbal operant which is controlled
[00:13:30.960]by a non-verbal stimulus,
[00:13:33.580]such as an object, event or a property of an object.
[00:13:37.950]And it's maintained by nonspecific social reinforcement,
[00:13:41.460]such as praise.
[00:13:42.720]So if we look at tact, we use our senses
[00:13:46.330]to interact with the environment.
[00:13:48.310]So we can tact things that we can see with our eyes.
[00:13:51.630]So I might tact my computer or my phone
[00:13:54.870]or the piece of paper that's sitting in front of me.
[00:13:57.300]We can tact things we hear, earlier I hear lawn mower
[00:14:01.360]or a car drive by or a dog barking.
[00:14:04.530]We can tact things we can smell,
[00:14:06.770]we might be able to smell the fresh cut grass
[00:14:09.600]or the rain on a spring day
[00:14:12.420]or fresh cookies baking in an oven.
[00:14:15.300]We can tact things that we can taste.
[00:14:18.860]We might have a fresh piece of mint gum in our mouth
[00:14:21.690]or taste that sour lemon.
[00:14:23.970]Then we can tact things that we can feel.
[00:14:26.800]I can feel my computer, feels smooth.
[00:14:29.550]Or maybe I've picked up a rock and it feels hard, rough.
[00:14:33.930]So we can tact things using our senses.
[00:14:38.070]The next verbal operant is an echoic.
[00:14:40.590]And an echoic occurs when a verbal response
[00:14:43.160]has point-to-point correspondence
[00:14:45.360]to its preceding verbal stimulus.
[00:14:47.800]And then it's maintained by nonspecific social praise.
[00:14:51.540]So I might say, "Say cat", and you say, "Cat",
[00:14:56.060]and I say, "Great job saying cat."
[00:14:58.740]That's an echoic.
[00:15:00.890]Then we're at the intraverbal.
[00:15:02.901]The intraverbal is a form of verbal behavior
[00:15:05.120]where the speaker responds to another's verbal behavior.
[00:15:08.850]So it's more like a conversation and it's maintained again,
[00:15:12.400]by that nonspecific social reinforcement.
[00:15:15.740]Intraverbal behavior is the most complex verbal behavior
[00:15:19.010]to teach because it requires both the receptive
[00:15:22.600]and expressive components of communication.
[00:15:26.760]So, it might be that I asked you a question,
[00:15:30.457]"What's your name?"
[00:15:31.750]And you've heard the question and you can respond,
[00:15:34.847]"My name is Meggin."
[00:15:36.760]Or I might ask you to complete a phrase or a song.
[00:15:40.330]So I could say, "Twinkle, twinkle",
[00:15:42.320]and then you could finish, "Little star."
[00:15:44.870]The next verbal operant is textual.
[00:15:47.940]The textual operant has point-to-point correspondence,
[00:15:50.990]but not formal similarity between the stimulus
[00:15:54.280]and the response product.
[00:15:56.320]So textual might be that you see the word cat,
[00:16:00.580]C-A-T written on a piece of paper,
[00:16:03.330]and then you say, "Cat".
[00:16:05.600]So you see it and then you say it.
[00:16:07.940]And then transcription is a type of verbal behavior
[00:16:11.710]in which a spoken verbal stimulus controls are written,
[00:16:15.710]typed or finger spelled response.
[00:16:18.150]So you might hear me say, "Spell dog"
[00:16:21.890]and so you use your pencil and you write
[00:16:25.030]on a piece of paper, D-O-G.
[00:16:27.860]In speech language pathology,
[00:16:29.530]we have five processes of communication.
[00:16:32.740]So we have thinking, that goes on at the brain level,
[00:16:36.250]and then it's broken down
[00:16:38.030]into either receptive or expressive.
[00:16:40.790]In the receptive components, we have the reading visual
[00:16:44.140]that we use our eyes to take in information.
[00:16:47.380]We have the listening and auditory
[00:16:49.730]where we use our ears to take in information.
[00:16:52.970]And then in the expressive component, we have the speaking
[00:16:56.910]and vocal where we use our mouth for output.
[00:16:59.650]And we have written where we can write
[00:17:02.100]to express ourselves as well.
[00:17:04.350]So let's look at the terms that SLPs use versus the terms
[00:17:08.240]that behavior analysts use.
[00:17:10.400]I'm gonna jump down to communication and verbal behavior.
[00:17:15.190]When Skinner was coming up with his terms,
[00:17:17.380]he really wanted to make sure
[00:17:19.510]that they were not misunderstood.
[00:17:22.190]So he chose verbal behavior as the process of using all
[00:17:27.490]of the verbal operants together for communication.
[00:17:31.750]Verbal behavior, verbal does not mean vocal,
[00:17:35.770]it just means everything that is used for communication.
[00:17:40.640]So verbal behavior means the same thing as communication.
[00:17:45.270]Receptive language that SLPs use
[00:17:48.260]is what he called listener behavior.
[00:17:51.260]That's the way we take in our information,
[00:17:53.400]through our eyes and ears.
[00:17:55.250]If we're taking in the information through our eyes,
[00:17:57.860]that's visual discrimination
[00:17:59.430]and if we're taking it in through our ears,
[00:18:01.730]that's a listener responding.
[00:18:03.670]Then we have expressive language.
[00:18:05.840]Expressive language is also known in ABA terms
[00:18:09.520]as speaker behavior.
[00:18:11.160]And that breaks down into the mand, tact, echoic
[00:18:14.400]and intraverbal that we discussed earlier.
[00:18:18.430]Vocal behavior then is our articulation
[00:18:21.900]and speech production.
[00:18:23.440]And function of behaviors is that pragmatic components
[00:18:26.880]or social skills.
[00:18:28.240]The mand simply means request.
[00:18:30.890]The tact is label.
[00:18:32.490]Echoic is that imitation of sound,
[00:18:36.050]and motor imitation, is imitation of motor movements.
[00:18:40.010]When we talk about intraverbals as behavior analysts,
[00:18:43.980]were really talking about cloze phrases,
[00:18:46.470]WH-questions in conversation.
[00:18:49.230]And then SLPs would say, "Let's model for the student"
[00:18:53.410]but the behavior analysts would say, "Let's prompt."
[00:18:57.130]And then we have the nonverbal which means non-vocal
[00:19:03.050]in behavior analysis.
[00:19:04.980]So if we look back at the five processes of communication,
[00:19:08.630]and we overlay those verbal operants,
[00:19:11.460]you can really see that we are talking about the same thing.
[00:19:15.640]So thinking would be, was gonna consider
[00:19:18.820]those private events going on inside of our bodies.
[00:19:24.126]And then it breaks into the receptive,
[00:19:26.600]which we would consider that listener responding
[00:19:29.200]and visual discrimination.
[00:19:31.150]We could break it down even further the reading
[00:19:33.420]and vocal is more that textual and visual discrimination.
[00:19:37.650]And listening auditory is the listener responding.
[00:19:41.670]The intraverbal I put right in the middle of the receptive
[00:19:44.510]and expressive because it requires both.
[00:19:47.110]The expressive then is that mand, tact, and echoic.
[00:19:51.010]So the spoken and vocal portion is the mand, tact and echoic
[00:19:55.750]and then the written would be the actual transcription.
[00:19:59.660]So you can see that we are talking the same language
[00:20:03.890]just using different terms.
[00:20:06.270]Let's talk about generalization.
[00:20:08.400]So I've heard it said that ABA just creates little robots.
[00:20:12.480]And I suppose if you just focused on the card sort system
[00:20:17.640]of verbal behavior, it could look like that.
[00:20:20.880]But what we are trying to do is for those students
[00:20:24.540]that are unable to communicate, we're trying to just set
[00:20:28.490]that foundation for them so that they value communication
[00:20:32.830]and they can start to build those initial skills.
[00:20:36.470]And we continue to make these verbal operations
[00:20:39.570]more complex, but then we're also going to take
[00:20:42.910]those newly learned skills
[00:20:44.950]and start to move them into the natural environment
[00:20:48.420]for that generalization of the skills.
[00:20:51.130]This is why it's so important
[00:20:53.010]that we make our goals functional
[00:20:55.510]and individualized for our students.
[00:20:58.220]We are working to make sure our students
[00:21:00.740]are well rounded communicators.
[00:21:03.660]If you look at this communication loop,
[00:21:05.970]our student may have a strength in reading
[00:21:08.840]or visual discrimination
[00:21:10.730]but if they have a deficit in those listening
[00:21:13.690]and auditory skills, they could be seen as a student
[00:21:17.300]who doesn't listen, though sometimes our students
[00:21:20.750]that are seen as having behavior difficulties,
[00:21:24.210]actually have a skills deficit in listener responding.
[00:21:28.290]So it's not the intention of ABA to create little robots,
[00:21:32.080]in fact, just the opposite is true.
[00:21:33.990]They always push for generalization.
[00:21:37.214]So there are three types of generalization
[00:21:39.430]that ABA discusses.
[00:21:41.250]They look at response maintenance
[00:21:42.950]and the way the learner continues to perform those behaviors
[00:21:45.930]after the intervention is removed.
[00:21:47.920]And speech therapy tries to do that as well.
[00:21:51.140]In fact, I had an administrator one time say,
[00:21:53.797]"Couldn't we just stop at sentence level for articulation?
[00:21:57.327]"Why do you have to take it all the way up to conversation
[00:21:59.817]"and multiple settings?"
[00:22:02.350]And I said, "That would be like trying
[00:22:04.907]"to tell a football team to just stop playing the game
[00:22:08.347]"in the third quarter."
[00:22:09.850]So that takes us to number two, the setting
[00:22:12.110]and situation generalization.
[00:22:14.450]So I always made sure that when I wrote my goals,
[00:22:17.660]I wrote it so that the learner would go across settings
[00:22:20.900]and situations.
[00:22:23.000]Same holds true for behavior analysis,
[00:22:25.380]we want them to be able to have these appropriate behaviors
[00:22:29.120]across all people in settings as well.
[00:22:31.710]And finally, we have response generalization.
[00:22:34.390]And that's where the learner emits untrained responses
[00:22:37.200]that are functionally equivalent to the trained response.
[00:22:40.000]So if we've been working on say, hey, or hello,
[00:22:43.100]and they respond, "Hi", then that is meeting that goal.
[00:22:49.210]Excellent professionals in both fields push
[00:22:51.960]for generalization of those functional skills
[00:22:55.300]that are best for our student outcomes.
[00:22:57.750]Learning my ABCs.
[00:23:00.010]As I studied behavior analysis, I really started
[00:23:03.200]to understand that it's all about the ABCs.
[00:23:07.267]And so there is such thing as setting events,
[00:23:10.900]like the student didn't take their meds
[00:23:12.860]or comes out of a domestic violence situation,
[00:23:16.620]things like that.
[00:23:17.453]All right, we understand that,
[00:23:18.900]but that antecedent behavior consequence
[00:23:22.640]is really what happens
[00:23:24.210]within just a couple of seconds of time.
[00:23:26.680]So the antecedent is what happens just one to two seconds
[00:23:30.090]before the behavior, then the behavior occurs,
[00:23:33.450]and then the consequence
[00:23:34.950]is what happens one to two seconds following the behavior.
[00:23:39.040]So when we look at the antecedent,
[00:23:40.920]we look at three different components.
[00:23:43.700]We look at the prompts, the motivation,
[00:23:46.900]and discriminative stimulus.
[00:23:48.830]As I understood that I was in control
[00:23:51.380]of those antecedent conditions,
[00:23:53.840]it helped me so much with my students.
[00:23:56.690]So for motivation and using that satiation and deprivation,
[00:24:01.780]I knew that if it was close to lunchtime
[00:24:04.040]and my students were hungry,
[00:24:05.380]that was a perfect time to try to get them to mand
[00:24:08.050]for various food items or maybe a drink.
[00:24:13.200]But after lunch when they were satiated,
[00:24:16.100]then that would be a better time for me to get them
[00:24:19.290]to mand for maybe tangibles, or access to sensory things.
[00:24:24.210]With discriminative stimulus, I tended to start
[00:24:27.150]with material items first.
[00:24:29.030]The students favorite toys, favorite foods,
[00:24:31.610]favorite, whatever they really, really loved,
[00:24:35.410]favorite movies, favorite activities.
[00:24:38.090]And then I paired myself with those really good things.
[00:24:41.430]And slowly I worked in my instructions.
[00:24:44.330]So pretty quick, I didn't have to have
[00:24:46.170]the materials sitting out to signal the availability
[00:24:49.010]of good things happening,
[00:24:50.590]but also I could just give an instruction
[00:24:54.060]and that would signal to my students
[00:24:55.960]the availability of reinforcement.
[00:24:57.990]And finally the prompt is what I used to support my student
[00:25:02.430]to just make sure that they got the answer correct.
[00:25:05.430]When we consider behavior,
[00:25:07.050]we're actually looking at the student's behavior.
[00:25:09.630]And so that is whatever is observable and measurable.
[00:25:14.240]That was so important for me to understand
[00:25:16.010]that we had to take away our emotions
[00:25:18.250]and just state the facts.
[00:25:20.060]What's observable, what's measurable.
[00:25:22.630]And then we move to consequences.
[00:25:24.530]Again, it's just one to two seconds following the behavior.
[00:25:29.090]And just like we are in control of the antecedent,
[00:25:32.460]we're also in control of the consequence.
[00:25:35.420]So it's the student's behavior, but as an adult,
[00:25:38.940]as the therapist or teacher,
[00:25:41.660]I'm in control of the antecedent and the consequence.
[00:25:45.870]There are three types of consequences.
[00:25:48.370]There's reinforcement, punishment, and extinction.
[00:25:52.540]When we consider reinforcement,
[00:25:54.270]we consider positive reinforcement
[00:25:56.490]and negative reinforcement.
[00:25:58.270]And positive and negative don't mean good and bad,
[00:26:01.780]they just mean adding something in or taking something away.
[00:26:06.290]So when we have positive reinforcement,
[00:26:08.530]we add something that will increase the future likelihood
[00:26:12.620]of a behavior occurring again.
[00:26:15.010]So if a student does their math worksheet,
[00:26:19.390]then we can give them praise or a high five
[00:26:22.240]and say, "Awesome job doing your math homework."
[00:26:24.860]We added in that praise and then hopefully
[00:26:28.650]that reinforcement will increase the likelihood of
[00:26:31.460]that behavior occurring again.
[00:26:33.570]We also have negative reinforcement,
[00:26:35.740]and that's where we can take something away.
[00:26:38.250]So a student who doesn't typically love to do math
[00:26:41.490]is sitting working on their math,
[00:26:43.410]they've gotten a couple of problems done,
[00:26:45.650]we can go over and say, "Great job working on your math.
[00:26:48.837]"You don't have to do your last two problems today
[00:26:51.717]"because you've done such a good job working
[00:26:53.747]"on the first part."
[00:26:54.950]So in this case, we've made their world a better place
[00:26:58.000]by removing something.
[00:27:00.340]This is called negative reinforcement.
[00:27:02.920]It's increasing the future likelihood
[00:27:05.300]of a behavior occurring again, by removing something.
[00:27:09.190]Punishment is a consequence,
[00:27:11.060]that decreases the future likelihood
[00:27:13.470]of the behavior occurring again.
[00:27:15.460]So positive punishment is where something is added in.
[00:27:19.120]So if a baby touches a stove, it causes pain to their hand,
[00:27:23.910]it adds something that worsens their world.
[00:27:28.070]So they are hopefully not going to touch the stove again.
[00:27:32.590]So touching the stove added something
[00:27:35.400]that made their world worse,
[00:27:37.520]so it will hopefully decrease the likelihood
[00:27:40.180]of that behavior occurring again.
[00:27:42.440]Negative punishment is what I would consider tough love,
[00:27:46.250]where something is removed in the hopes
[00:27:50.070]that it will decrease the future likelihood
[00:27:52.450]or the behavior occurring again.
[00:27:54.020]So if a student got to drive their parents car to go out
[00:27:58.020]and came home late, the parents might say,
[00:28:00.657]"Give me the keys, you've lost privileges of driving the car
[00:28:03.867]"because you came home late."
[00:28:05.730]That is when something is taken away from them,
[00:28:08.350]they've lost the privilege of getting to drive the car,
[00:28:11.670]in the hopes that it will decrease the future likelihood
[00:28:14.970]of them coming home late again.
[00:28:17.130]And then finally, we have extinction.
[00:28:19.790]An extinction is removal of reinforcement from something
[00:28:24.830]that was previously reinforced.
[00:28:26.770]An extinction doesn't have to be bad.
[00:28:29.621]SLPs use extinction
[00:28:31.960]when they're shaping up a student's behavior.
[00:28:34.560]So initially, the student was able to say, "Org"
[00:28:39.890]but now they can say, "Dog".
[00:28:42.430]So we no longer accept org, we own we will only accept dog.
[00:28:47.280]So we put org on extinction and we only accept dog.
[00:28:51.070]So extinction doesn't have to be bad.
[00:28:53.570]It's just not reinforcing a behavior
[00:28:56.520]that was previously reinforced.
[00:28:59.240]So as I looked at the ABC pattern
[00:29:01.250]and how that moved me into hypothesized function,
[00:29:05.920]then I could start to look and ask myself,
[00:29:09.727]"If the student is trying to escape or avoid,
[00:29:13.157]"what can I do to help the situation?
[00:29:16.387]"Is the material too hard or too easy?
[00:29:20.817]"Have I built up a really strong relationship,
[00:29:23.847]"so that student wants to be around me?
[00:29:26.367]"Am I an SD to that student?
[00:29:28.777]"Am I using motivating items for that student?
[00:29:32.847]"Could I prompt the student to make it easier for them?"
[00:29:36.890]And then if the behavior is maintaining,
[00:29:40.010]that means I'm reinforcing it in some way.
[00:29:42.810]So is there a way that I could stop reinforcing
[00:29:46.150]that escape or avoid behavior?
[00:29:48.870]And I could walk through that same pattern
[00:29:51.040]for attention, tangibles and sensory as well.
[00:29:55.150]So I have heard that reinforcement is just bribery,
[00:29:58.720]but that comes from an individual,
[00:30:01.420]I would say that does not understand that ABC pattern.
[00:30:04.830]So if we look at reinforcement,
[00:30:06.910]reinforcement has to follow a behavior.
[00:30:09.540]Whereas bribery comes before a behavior.
[00:30:12.990]It's truly all about the timing.
[00:30:15.870]So behavioral interventions,
[00:30:17.500]when used accurately by both professionals,
[00:30:20.520]is wonderfully effective
[00:30:22.180]in the long term change of behavior.
[00:30:24.980]Let's look at the models of collaboration.
[00:30:27.550]We have multidisciplinary, and that's when a team consists
[00:30:31.000]of professionals working independently.
[00:30:33.470]And I'd say that a lot of the time,
[00:30:35.940]that's probably what I experienced,
[00:30:38.430]was that we would come together for an MDT or an IEP meeting
[00:30:42.350]and we would talk and discuss and come up with our goals.
[00:30:45.370]But then there wasn't a lot of collaboration outside
[00:30:48.100]of that meeting.
[00:30:49.310]So the resource teacher would have her a little niche
[00:30:52.160]of time, the SLP, I would have two times a week
[00:30:56.370]for 20 minutes working on my own goals,
[00:30:59.500]the PT would have a small portion of time a week
[00:31:03.000]or every other week working on hers or his goals,
[00:31:06.143]and the OT might come in for 15 or 20 minutes,
[00:31:09.880]one time a week or every other week working on their goals.
[00:31:13.530]Then there's interdisciplinary
[00:31:15.300]where a team works towards a common goal,
[00:31:18.490]but each professional continues to work
[00:31:20.950]within their own area of expertise.
[00:31:23.200]And then there's transdisciplinary.
[00:31:25.570]And in that model, the teams work together
[00:31:29.000]across disciplines to accomplish goals.
[00:31:31.810]And this is what my experience was
[00:31:34.550]when we finally fully got verbal behavior implemented
[00:31:38.930]with our students.
[00:31:40.750]So in this model, we came together as a team.
[00:31:43.990]We did all of the testing, and then we sat down
[00:31:47.480]and we wrote all of these functional individualized goals
[00:31:52.100]for the student.
[00:31:53.420]And then we took those goals, those target skills,
[00:31:57.390]and we worked across disciplines.
[00:32:00.950]So our students began getting speech goals,
[00:32:05.160]academic goals, OT goals, PT goals,
[00:32:09.510]and they were working on them multiple times per day
[00:32:12.780]instead of just a couple of times per month.
[00:32:16.810]So as we began working together more and more,
[00:32:19.750]and we were setting aside time to meet each week,
[00:32:22.870]communication became more and more consistent.
[00:32:26.520]And we often started to celebrate all of the successes
[00:32:30.070]as we were looking at data,
[00:32:31.730]instead of coming together one time a year
[00:32:34.450]and looking at all the deficits.
[00:32:36.540]Our goals were more and more functional.
[00:32:39.030]And as we started to look at
[00:32:42.360]how we could benefit the student in the classroom
[00:32:44.960]in their specials, then those teachers understood
[00:32:48.260]that we were working to try to help them
[00:32:50.050]in their classes too,
[00:32:51.250]so they would even give suggestions.
[00:32:53.770]So there was just so much more team engagement
[00:32:56.490]across the board.
[00:32:57.980]Decisions were always data driven, because we knew exactly
[00:33:01.500]what we were looking at as far as data,
[00:33:03.610]we were on the same page, everybody became empowered.
[00:33:07.800]The Pairers knew exactly what was expected of them,
[00:33:11.080]all the different team members knew what to say,
[00:33:13.560]how we were reinforcing the different behavior.
[00:33:16.870]And when that started to occur in there was confidence
[00:33:20.960]that was built, then there was so much more openness
[00:33:24.040]to inclusion for the student,
[00:33:26.090]allowing for more access to their peers,
[00:33:28.940]building up those friendships, not only amongst the students
[00:33:33.070]but amongst the professionals and the adults as well.
[00:33:37.830]And so then that led to ultimate generalization
[00:33:41.530]across all these different people,
[00:33:43.600]all the different settings for the student,
[00:33:45.820]and then we just started to have better student outcomes.
[00:33:51.000]In conclusion, I just want to share
[00:33:54.050]that there can be resolution of tension
[00:33:57.480]and we can truly build on the strength
[00:34:00.590]of the SLP and the BCBA.
[00:34:03.230]We do need to stay child focused.
[00:34:06.030]When we stay child focused,
[00:34:07.680]it helps us to get out of our own way to stop being prideful
[00:34:12.090]in who we are as professionals, and just know
[00:34:15.340]that we have strengths to bring to the team,
[00:34:18.060]for the child, for the student.
[00:34:20.620]We need to use open, honest
[00:34:22.620]and respectful communication knowing
[00:34:25.250]that when we start to suspend this certainty,
[00:34:29.180]that we can truly listen to understand
[00:34:31.760]and learn from one another.
[00:34:34.060]We can allow space for differences, knowing
[00:34:37.200]that we have different educational backgrounds
[00:34:40.290]and different strengths to add to the team
[00:34:43.020]and be willing to be open and share with the team,
[00:34:46.600]all the different evaluations, the observations
[00:34:49.770]and interventions.
[00:34:51.510]And finally, when possible, work together to discuss
[00:34:56.470]in real time, when we are able
[00:34:58.880]to be with other professionals and work in real time,
[00:35:02.930]it just opens up a whole world of possibility,
[00:35:06.500]because we have that conversation going on.
[00:35:10.120]It's been such a pleasure getting
[00:35:11.680]to discuss SLPs versus BCBAs
[00:35:16.380]and how we can overcome these historical tensions
[00:35:19.470]and truly look at the strengths of the professional
[00:35:22.350]so that we can have a better teaming
[00:35:25.950]and ultimately see the similarities
[00:35:28.220]and how we are all striving for better student outcomes.
[00:35:32.440]Please feel free to contact me, mfunk@esu13.org
[00:35:37.140]with any questions or concerns, bye.

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ABA from an SLP Perspective

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