Applied Behavior Analysis Therapy in Schools for School Administrators and School Staff Part II

Vanessa Tucker Author

04/11/2024 Added

28 Plays

Description

Searchable Transcript

Search:

[00:00:06.570]Good afternoon.
[00:00:07.560]Can you hear me?
[00:00:10.710]Yes.
[00:00:11.790]Great.
[00:00:12.660]Well, thank you for the warm welcome.
[00:00:14.610]Coming to you from Washington State,
[00:00:16.620]and it's good to see that some of you are back.
[00:00:19.530]I am very excited to continue this discussion,
[00:00:23.880]so hopefully you're here for the same reason as me
[00:00:27.660]in wanting to do better in collaborating with our partners,
[00:00:32.280]whether our partners, our school, or BCBAs
[00:00:36.570]that work with them.
[00:00:38.610]So without further ado,
[00:00:39.960]I'm going to go ahead and get started.
[00:00:41.610]If there are questions, Annette or Megan,
[00:00:45.120]that you feel I I need to answer,
[00:00:47.460]go ahead and just let me know,
[00:00:49.020]and I'll gladly take a pause and try to address that.
[00:00:53.550]So, what I wanna do today
[00:00:54.900]is a little bit different in scope.
[00:00:56.730]We talked quite a bit last time about,
[00:00:59.700]well, what is a behavior analyst,
[00:01:02.857]and how do they practice in a clinical setting,
[00:01:05.457]and what makes that different from
[00:01:07.230]practicing in a school setting?
[00:01:09.360]So if you were not in attendance at part one,
[00:01:13.020]I would encourage you to go back and view that
[00:01:15.600]because I think we need to start there
[00:01:17.340]with determining what is the scope.
[00:01:19.860]And I don't mean scope of competence.
[00:01:21.450]I mean the scope of practice in each setting.
[00:01:25.380]So if we are moving beyond that to,
[00:01:28.770]okay, now we recognize that
[00:01:31.440]there may potentially be different scopes
[00:01:33.630]of practice and policies in different settings.
[00:01:36.270]We need to move on to the what do we do about that?
[00:01:39.510]And what I'd like to do today
[00:01:41.670]is to give you a framework
[00:01:43.290]and then model it for you in a couple of different ways
[00:01:45.960]based on some real scenarios.
[00:01:48.150]And I'll just throw it out there that if you are a BCBA
[00:01:51.660]and you're attending today
[00:01:53.490]and you're wanting to know more about
[00:01:55.170]how do I partner with schools,
[00:01:56.820]some of the things they do
[00:01:57.960]are just not meshing with my understanding,
[00:02:00.120]and I need to make sure and do the right thing,
[00:02:03.480]then the two trainings in April are really for you.
[00:02:06.510]But I would encourage others to attend as well,
[00:02:08.820]just in case you're wondering
[00:02:10.080]what people are thinking and wanting.
[00:02:12.240]So we'll start here with is some general
[00:02:14.400]foundational touchpoint.
[00:02:16.710]One of the first ones that I will offer is that schools,
[00:02:20.640]meaning school districts and agencies, have to offer a FAPE,
[00:02:24.690]or a free and appropriate public education,
[00:02:28.290]to all students that are on
[00:02:29.850]an individualized education plan.
[00:02:32.130]I think we start here,
[00:02:34.320]especially when we're thinking about
[00:02:36.900]the expectations of people
[00:02:39.480]in every single setting we've discussed,
[00:02:41.760]whether that's the school setting
[00:02:43.440]or people on the outside in the clinical setting.
[00:02:46.620]And what that might include is ABA services
[00:02:50.880]in some way or another.
[00:02:53.100]One of the things that we touched on
[00:02:55.050]quite deeply in the first session is that
[00:02:58.350]ABA is often mischaracterized as being something separate,
[00:03:02.370]something completely different from
[00:03:05.100]what schools might already be doing.
[00:03:07.320]And so we spent some time talking about the fact that
[00:03:10.770]ABA is a set of scientific principles that
[00:03:14.070]when applied to socially significant behavior
[00:03:17.490]should result in meaningful behavior change.
[00:03:21.000]And then I would have you think about the following.
[00:03:25.200]We are already applying some of these principles
[00:03:30.090]to the things that we do in schools.
[00:03:32.400]So these services might already be
[00:03:34.560]embedded in the instruction that we provide.
[00:03:36.900]So if we think about direct instruction,
[00:03:39.870]of course the principles of systematic instruction
[00:03:44.190]and database interventions are baked in that,
[00:03:47.190]or behavior supports.
[00:03:48.540]When we do things like a token system,
[00:03:51.720]or we provide a group-based contingency,
[00:03:55.620]or we work really hard on having a ratio of
[00:03:58.920]five positives to one negative,
[00:04:01.770]those are all based on principles
[00:04:03.750]from applied behavior analysis.
[00:04:05.310]I think we need to get away from
[00:04:07.680]this idea that ABA is something so magical and different
[00:04:11.880]that we have to bring it in from the outside.
[00:04:13.830]I would say that that's really not true.
[00:04:16.530]So that is the first thing that I want you to take away.
[00:04:20.700]That is a good through line from the first training to now.
[00:04:24.870]And then as we move forward into thinking
[00:04:27.600]more about what might ABA look like in the school setting,
[00:04:32.250]it can be provided in various ways.
[00:04:34.440]So let's say for example,
[00:04:36.480]you have a small group of students
[00:04:38.880]that's demonstrating some challenging behavior.
[00:04:41.520]Maybe it's with getting on task
[00:04:43.740]or staying on task or being motivated to do the work.
[00:04:47.430]We might apply some principles such as
[00:04:51.210]let's reteach the routines and expectations.
[00:04:55.320]Let's provide higher levels of reinforcement,
[00:04:58.470]let's make the work more fun,
[00:05:00.540]let's make sure that we offer something tangible
[00:05:03.360]that the kids like afterwards.
[00:05:05.970]Those are ways that we're applying
[00:05:07.980]the basic principles upon which ABA is based.
[00:05:11.370]Now, it also could be something more along the lines of
[00:05:15.990]an individual student has more complex needs,
[00:05:19.440]and then we think about, well, for that student,
[00:05:23.400]what does their program look like?
[00:05:25.020]What does FAPE look like for them?
[00:05:26.850]It could be very different
[00:05:27.960]than what works for most other students.
[00:05:30.810]So what that might involve is us then
[00:05:33.900]looking at other agencies,
[00:05:35.970]and that could be anything from
[00:05:39.270]the students already getting services,
[00:05:41.460]and we are just partnering with them
[00:05:43.950]to having an agency provide some contracted work.
[00:05:47.610]And really it's very situationally dependent.
[00:05:52.800]So as with anything else,
[00:05:55.260]it's totally dependent on what data is showing.
[00:05:58.830]And that to me is a very important thing to keep in mind.
[00:06:03.600]If something is working,
[00:06:05.520]we don't need to add something else to it.
[00:06:07.800]But if we try things
[00:06:09.510]and we know that it isn't working,
[00:06:12.210]then we need to demonstrate we tried something else,
[00:06:15.210]and then whether or not that works again
[00:06:16.980]is a basic data answer,
[00:06:19.710]and that comes from progress monitoring.
[00:06:22.200]And also, the services that we provide to students
[00:06:26.130]should be informed through parent input.
[00:06:28.380]And one of the things we talked about last week
[00:06:31.470]was that oftentimes parents will come in
[00:06:34.770]with their outside providers
[00:06:37.170]simply because there is a lack of trust
[00:06:40.320]or a feeling of a lack of collaboration.
[00:06:43.800]So this is just setting it up for...
[00:06:46.020]This is what we talked about first.
[00:06:48.000]It's a very small part of that.
[00:06:50.160]How is that going to inform what we do now?
[00:06:53.400]So I wanna start by kind of mapping out
[00:06:57.660]more of a continuum of what this might look like.
[00:07:01.170]So let's think first about private ABA services,
[00:07:04.680]recognizing, first of all, I should say,
[00:07:07.680]whether a BCBA is working in a school
[00:07:11.460]or working in private clinical practice.
[00:07:14.580]They both have the same training
[00:07:17.130]in terms of we're all held to the same standards,
[00:07:20.070]we're all held to the same ethics.
[00:07:22.800]We may have a different scope of practice,
[00:07:26.010]meaning that in a school setting,
[00:07:28.410]the true meaning of a related service is access.
[00:07:32.370]In a clinical setting, it is different.
[00:07:35.850]There's more leeway and room for what is possible.
[00:07:39.750]So let's look at how this trajectory might go.
[00:07:42.630]First of all, it could be that a student,
[00:07:44.970]a client is receiving services outside of the school day.
[00:07:49.560]So that could be in the morning,
[00:07:51.330]could be in the afternoon after school,
[00:07:54.660]it could be in the evenings, it could be on weekends.
[00:07:57.210]Sometimes what that looks like is school services such as...
[00:08:02.250]We have spring break coming up in a few weeks
[00:08:04.410]in my daughter's district.
[00:08:05.850]And maybe during that time,
[00:08:07.590]some of those hours are utilized during that time.
[00:08:11.340]So that's one way that it could look.
[00:08:13.830]But another way and a way that I think is common
[00:08:17.220]and something that we grapple with in schools is,
[00:08:19.410]what if an outside provider
[00:08:22.200]wants to come into the classroom?
[00:08:24.780]And I get asked that all the time.
[00:08:26.640]What do we do in those situations?
[00:08:28.350]Is that okay to do?
[00:08:29.400]What's the purpose of that?
[00:08:31.800]Why would they want to do that?
[00:08:34.200]And what are the implications?
[00:08:36.210]So as you are moving along,
[00:08:38.760]if you are a school administrator,
[00:08:41.250]you are having these questions.
[00:08:42.780]And I'd like to talk a little bit about
[00:08:44.580]what the purpose is of these in just a second.
[00:08:47.910]It could be that services are provided in school,
[00:08:52.140]and this could be by an outside provider.
[00:08:55.080]So we do see situations in which
[00:08:57.690]the outside ABA provider has either been
[00:09:00.900]contracted by the district
[00:09:03.150]or the insurance company is paying for this person or team
[00:09:07.980]to work alongside that student and their team
[00:09:10.650]during the school day.
[00:09:13.140]Okay, so the services are in school in the third point.
[00:09:17.490]And the fourth point is that
[00:09:20.520]the services are provided in a clinic
[00:09:22.650]by the provider during the day.
[00:09:25.320]And my preference of course, always,
[00:09:29.160]and I believe I said this maybe a couple times
[00:09:32.010]during the first presentation,
[00:09:33.810]is the natural environment
[00:09:35.280]for school-aged children in school
[00:09:37.260]for a lot of reasons,
[00:09:39.060]not one of which that is...
[00:09:40.740]I think the most important would be inclusion
[00:09:43.590]and wanting students to be around their peers
[00:09:46.500]in a normalized setting as much as possible.
[00:09:48.900]Still, this is the what is possible in the scenario.
[00:09:53.700]Here is the thing I want you to be aware of.
[00:09:56.220]And I'm gonna use the, hopefully this will work.
[00:09:59.040]I don't know how that works in a webinar,
[00:10:00.510]but we'll try it.
[00:10:01.830]I wanna use the spotlight here.
[00:10:04.110]So I want you to note this nice red rectangle down here.
[00:10:09.390]All the services here are guided by a treatment plan.
[00:10:13.830]Now let me have a caveat to this.
[00:10:15.900]So the treatment plan is a plan that is developed
[00:10:19.710]in order to get insurance authorization.
[00:10:22.920]It's not an IEP.
[00:10:23.753]It's not the same thing as an IEP.
[00:10:26.010]It is designed to
[00:10:28.650]basically provide services
[00:10:31.800]because they are medically necessary.
[00:10:34.440]So if we're looking at services provided
[00:10:37.170]outside of the school day in home or clinic,
[00:10:39.810]that's based on the treatment plan.
[00:10:42.630]If the provider is wanting to come in and observe,
[00:10:46.230]they're still operating on the treatment plan.
[00:10:49.020]If services in school are provided by the outside provider,
[00:10:53.400]maybe not.
[00:10:54.990]And we're gonna talk about a scenario
[00:10:56.790]in which we have to decide.
[00:10:58.290]So while the alongside part is paid for by that insurance,
[00:11:05.670]in the school setting,
[00:11:06.810]we have to start thinking about
[00:11:08.610]what plan is guiding the work,
[00:11:10.560]and I'll get to that in a minute.
[00:11:12.180]But certainly this last one on the right hand side,
[00:11:15.510]if the student is inside the clinic all day,
[00:11:19.050]by far, the first plan to be considered
[00:11:23.610]would be the treatment plan, caveat being this.
[00:11:27.570]If, for example, the district said,
[00:11:30.037]"We're gonna contract with this clinic
[00:11:32.160]to provide services all day in the clinic,"
[00:11:35.160]and the district is going to provide for
[00:11:38.640]educational services in some way,
[00:11:41.340]then we would say it could be both.
[00:11:44.940]So in each of these, know that,
[00:11:47.940]when it comes to private outside ABA,
[00:11:50.640]that treatment plan is guiding the work.
[00:11:53.910]But inside school,
[00:11:55.200]we have a very different scenario going on.
[00:11:57.900]So I'll go ahead and close the annotation for now,
[00:12:01.500]but I might use that tool again.
[00:12:02.820]We'll see how that goes.
[00:12:04.380]So let's talk about what is possible in school,
[00:12:07.350]and I want to actually start with
[00:12:10.530]that green round rectangle down at the bottom.
[00:12:14.520]The IEP is the guide,
[00:12:16.350]and this is something that can get lost in translation
[00:12:20.910]when you're dealing with someone who is untrained,
[00:12:23.940]who doesn't understand the policies,
[00:12:27.180]the requirements of the school to provide FAPE.
[00:12:30.297]And it's not just for services,
[00:12:32.070]it's about placement and intensity.
[00:12:34.740]So I know I'm speaking to the choir here right now,
[00:12:37.680]but obviously the IEP guides the services.
[00:12:41.097]And so let's talk about this
[00:12:42.990]in terms of this continuum of what is possible.
[00:12:45.900]So once again, I'll get this little spotlight out
[00:12:49.980]and actually maybe I'll try an arrow instead.
[00:12:52.320]So how might this look?
[00:12:54.330]Look a lot of different ways.
[00:12:56.100]One of the ways it might look is on the left.
[00:12:58.200]There might be some behavior consultation
[00:13:00.630]by a school ABA staff.
[00:13:02.460]Now what does that mean?
[00:13:03.840]It could be that that person is BCABA,
[00:13:09.120]so an assistant behavior analyst,
[00:13:11.040]or it could be that they're a behavior technician,
[00:13:14.310]or it could be the BCBA themselves.
[00:13:16.680]So it can look a lot of different ways,
[00:13:18.870]depending on who is on the team.
[00:13:21.840]And that behavior consultation can be anything from
[00:13:25.710]helping to more effectively manage a group,
[00:13:28.770]to how to create a robust individualized system
[00:13:35.010]for dealing with aggression or elopement
[00:13:38.970]or other behaviors that we see.
[00:13:40.857]The behavior consultation is usually time-limited.
[00:13:45.870]So you can think of it almost like a tier two,
[00:13:49.110]maybe a tier three intervention,
[00:13:50.610]depending on whether or not you are
[00:13:54.900]characterizing your tier two interventions as short term,
[00:13:58.350]rapid and short term.
[00:14:00.180]So let's look then at the next one.
[00:14:02.130]Short term services by school ABA staff.
[00:14:05.130]And again, I'm purposely using ABA staff
[00:14:07.650]because in many school districts
[00:14:10.830]there will be a, quote unquote, "behavior team,"
[00:14:13.830]which could be small or large depending on where you are
[00:14:17.070]and how many people you have,
[00:14:18.690]or it could be provided by
[00:14:21.420]we call educational service districts in Washington state.
[00:14:25.230]You have something similar where it's a pooled agency
[00:14:28.920]that then supports districts.
[00:14:31.050]So the short term services could look like
[00:14:33.660]what I had just said in the first one,
[00:14:35.880]could be basic consultation,
[00:14:38.430]but it could also be something else.
[00:14:40.770]It could be that there's a functional behavior assessment
[00:14:45.120]and a behavior intervention plan,
[00:14:47.340]and then there's time to implement this plan,
[00:14:50.970]train everybody so that they know how to
[00:14:54.420]implement the interventions that are planned,
[00:14:57.450]respond with the correct reinforcement,
[00:15:00.180]take data and know what to do with it.
[00:15:03.060]And those services are usually designed to be faded.
[00:15:07.080]So could be that there's a structure in place
[00:15:10.530]for a six week time period in which the student is receiving
[00:15:14.100]services with a plan to fade.
[00:15:16.200]Whatever that looks like, it's going to be different,
[00:15:18.390]depending on every single person.
[00:15:20.760]Well, what happens when you've got someone
[00:15:24.150]who needs longer term services,
[00:15:26.430]whose FAPE is dependent
[00:15:28.830]on something that's more restrictive?
[00:15:31.020]Well then we might move to the next scenario,
[00:15:34.260]which could be something more long-term,
[00:15:37.320]and that might mean that BCBA
[00:15:40.530]has a student on their caseload
[00:15:42.990]and serves them a number of hours per week.
[00:15:46.470]Maybe they also deploy a behavior technician
[00:15:50.340]and they supervise them
[00:15:52.200]because we know that not all kids
[00:15:54.480]are going to magically be fine after a certain period.
[00:15:59.010]There are times where we have to consider
[00:16:01.710]that FAPE may something that is more restrictive,
[00:16:06.003]the dose is bigger, and the time period is longer.
[00:16:11.370]Okay, so we have all those pieces that we can consider.
[00:16:14.580]However, it is possible,
[00:16:16.857]and this gets to what I was saying before,
[00:16:19.500]that services in the school
[00:16:21.270]are done by contracted clinical staff
[00:16:24.930]for a wide variety of reasons.
[00:16:26.640]It could be that there's a capacity issue.
[00:16:29.310]So the idea here is we want to have a team,
[00:16:33.570]we think we need a team to support the student.
[00:16:36.720]We don't have those people,
[00:16:38.700]and so we need to then contract with them
[00:16:41.490]from a local agency clinic that
[00:16:45.420]may or may not be that local, by the way,
[00:16:47.040]depending on where it is that your district resides.
[00:16:50.580]But the idea here is that they are providing services
[00:16:55.230]that are outlined in IEP to provide FAPE.
[00:16:59.130]And then of course as we move along this continuum,
[00:17:02.310]we see that services during the day could be in what?
[00:17:06.090]In Washington State, we call it non-public agency.
[00:17:10.440]In other states, you might call it something else,
[00:17:12.480]but just to define that for you.
[00:17:15.450]From my perspective, it's an agency
[00:17:18.150]that is not a public school,
[00:17:20.550]but that receives public funds on contract
[00:17:24.390]to service students.
[00:17:26.070]So it could be you've got local agency here
[00:17:30.510]that is an agency that is not a school,
[00:17:34.710]but they are overseen by
[00:17:37.860]a school district who's their sponsor,
[00:17:40.050]and then students can, on contract, attend that.
[00:17:43.170]So those services could be there,
[00:17:44.910]and we have a number of them in Washington state.
[00:17:47.100]My understanding from talking to some of you out there,
[00:17:51.360]I said that's not as common
[00:17:52.497]and I don't know if that's regional or not,
[00:17:55.440]but it also could look like
[00:17:57.540]the student is served in the clinic
[00:18:00.150]completely away from the school or from a school
[00:18:03.990]and everything in between.
[00:18:05.910]Where it gets sticky
[00:18:08.100]and where we need to do some problem solving
[00:18:10.830]is these two right here,
[00:18:14.880]so the second from the right and the last one on the right,
[00:18:18.450]because we still have to provide a FAPE.
[00:18:21.180]And by we, I'm always talking about the district.
[00:18:24.660]And so if we're having contracted clinical staff coming in,
[00:18:29.460]we still have to provide whatever the FAPE is on the IEP.
[00:18:33.390]So for example, if a student has academic goals on their IEP
[00:18:37.590]and specially designed instruction,
[00:18:39.780]we have to make sure that,
[00:18:42.030]if clinical staff are being contracted,
[00:18:44.850]that student is still contacting
[00:18:46.890]and working with certificated academic staff
[00:18:51.030]or an SLP or OT for their related services.
[00:18:54.027]And the same is true, especially on the right.
[00:18:58.050]Where it gets even more fun is when
[00:19:01.860]clinic staff have a treatment plan
[00:19:04.230]because students also receiving insurance-based ABA,
[00:19:08.790]and there is no such thing as medical ABA.
[00:19:11.070]I established last time that ABA is ABA.
[00:19:14.280]It doesn't matter if it's in school or at home.
[00:19:17.550]It's still the same scientific principles.
[00:19:21.420]So we keep the idea here that
[00:19:24.477]the IEP is our roadmap for FAPE
[00:19:27.690]but there are times where other things come into play.
[00:19:31.350]So we have to have a process for figuring out
[00:19:34.740]what part are they going to play, if any,
[00:19:36.900]and to make sure that all stakeholders understand.
[00:19:40.410]So I will go ahead and stop for just a minute
[00:19:43.410]and see if there are any questions before I move on.
[00:19:54.570]Doesn't look like it,
[00:19:55.590]so I'm gonna go ahead and continue.
[00:19:59.190]So there's a conundrum that I need to call out.
[00:20:03.886]And for those of you in this virtual room that are BCBAs,
[00:20:08.130]and even for those of you that aren't,
[00:20:10.410]it's something that needs to be said.
[00:20:13.110]When we think about outside services for a child,
[00:20:16.290]we might think about a therapist of some kind.
[00:20:19.410]So let's say a cognitive behavioral therapist
[00:20:22.410]to work on issues around psychosocial issues in the family.
[00:20:27.300]It could be a therapist that works on
[00:20:30.840]your fine motor skills outside or speech.
[00:20:33.990]Those services are usually approved
[00:20:37.080]and scheduled at about one to two hours a week maximum,
[00:20:41.610]and that is what insurance approves.
[00:20:44.790]That's how they are delivered.
[00:20:47.460]There really is no other outside service
[00:20:50.520]that is considered medical or habilitative as ABA,
[00:20:55.470]that provides as much therapy time as ABA does.
[00:20:59.040]They're kind of a unicorn when it comes to
[00:21:02.250]thinking about how all this plays out.
[00:21:05.280]So a treatment plan for a typical student
[00:21:09.150]could be 30 to 40 hours a week,
[00:21:12.270]and there isn't another outside service
[00:21:14.640]that provides 30 to 40 hours a week.
[00:21:17.250]You would never find a therapist that would offer
[00:21:20.280]30 hours of therapy unless it was private pay.
[00:21:23.580]And even then, I don't think
[00:21:24.510]there's a therapist that would do that.
[00:21:26.490]So this is in part because of
[00:21:29.670]the legal push to have ABA covered by insurance,
[00:21:33.630]and to make that mandated in all states,
[00:21:36.060]but also, based on research, looking at the number of hours
[00:21:40.950]that somebody needed ABA services
[00:21:44.040]in order to benefit when they had a diagnosis of autism.
[00:21:48.000]So we have this unique situation where
[00:21:51.930]ABA plans can offer to a family
[00:21:55.320]much more than other therapies could ever or whatever do.
[00:22:00.390]And the conundrum continues
[00:22:02.100]because oftentimes what happens is the clinic will say,
[00:22:07.597]"We don't have time before school or after school
[00:22:11.130]to serve your child,
[00:22:12.090]but we do have time during the school day,"
[00:22:15.870]which then leads to families being given the choice of,
[00:22:20.010]well, you can take your child out of school
[00:22:23.610]for part of the day to come in and get these services.
[00:22:28.170]This conundrum looks something like what I put below,
[00:22:31.650]something to the effect of the ABA company said
[00:22:34.170]we are approved for 30 hours a week,
[00:22:36.180]but they only have time during the day right now.
[00:22:39.540]And this leads to some difficult outcomes for families.
[00:22:44.250]For example, a family then has to choose,
[00:22:47.250]do I put my child on a wait list for ABA
[00:22:51.060]and continue on with school?
[00:22:53.070]Do I pull them out for part of the day
[00:22:55.350]so that they can benefit from these services?
[00:22:58.560]Or do I attempt to have my ABA provider
[00:23:02.940]come in during the school day
[00:23:05.220]to provide services while the child's in school?
[00:23:09.120]Either way, this is a situation that is unlike any other
[00:23:14.610]that we've had to contend with as school districts
[00:23:19.560]with very few exceptions.
[00:23:21.570]So this is where we are at right now.
[00:23:24.870]And I wanna go on record saying I don't fault ABA agencies
[00:23:29.610]for being limited in terms of time and staffing,
[00:23:32.850]but I think where we need to go
[00:23:35.220]is with the understanding that
[00:23:37.800]school is the natural environment for kids,
[00:23:39.870]whatever that looks like,
[00:23:41.460]and we should really try to invest in helping families
[00:23:45.870]to understand that.
[00:23:47.670]So this conundrum is part of the reason
[00:23:50.940]why we are even having these discussions.
[00:23:54.030]The good conundrum is that we are, as BCBAs,
[00:24:01.290]increasingly more common in the school setting.
[00:24:04.320]And what I mean by that is
[00:24:06.240]we are being hired by school districts,
[00:24:10.260]or are being welcomed to work alongside districts,
[00:24:14.040]or even to be tapped for some consultation,
[00:24:17.070]none of which is a bad thing.
[00:24:18.990]So hopefully the audience sees
[00:24:20.910]kind of the picture I'm painting here is where we really are
[00:24:25.050]in terms of our kind of the state of the state
[00:24:28.950]that we are in.
[00:24:31.260]Okay, so how do we navigate this?
[00:24:35.400]What do we do when we're at this intersection of
[00:24:39.330]what BCBAs can do in a school for students
[00:24:43.890]and what schools need to be doing for students?
[00:24:48.150]Well, let's take a look.
[00:24:49.710]First of all, I'd like to talk to the school districts,
[00:24:52.200]and I'd like the BCBAs in the room to hear this as well.
[00:24:56.100]The district, inevitably, is responsible for giving a FAPE.
[00:25:01.470]They have to be the ones to do that, no matter what.
[00:25:05.040]So here are some questions
[00:25:07.740]that I would have district asks at the very beginning.
[00:25:11.310]So as a district you might ask this question.
[00:25:15.210]Will you hire a BCBA?
[00:25:17.520]Is it possible that you could do that
[00:25:20.310]as a means of meeting some of these behavioral needs?
[00:25:24.120]And I would advocate for that.
[00:25:25.950]I think that's a wonderful way
[00:25:27.510]to be able to add a level of behavior support
[00:25:32.670]to what you're already doing, to what you're offering.
[00:25:34.920]So that's a question.
[00:25:36.030]And if you did that, how would that look?
[00:25:38.910]So some things that you might wanna be thinking about
[00:25:41.970]if you're the district people in the room is,
[00:25:44.550]will the BCBA be the head of a behavior team?
[00:25:49.290]And will he, she, or they be deploying people out
[00:25:54.270]and then supervising them in doing tier three interventions,
[00:25:58.470]tier two interventions?
[00:25:59.580]So how would that look?
[00:26:01.860]And as I was saying, I am from Washington,
[00:26:05.820]and we're seeing an increase in BCBAs being hired
[00:26:09.990]to work for school districts
[00:26:11.520]and to have behavior technicians that work with them.
[00:26:14.700]So it's really something that
[00:26:16.350]is a matter of design and choice for your district,
[00:26:19.110]and it's a way of kind of heading off with,
[00:26:21.240]yeah, we recognize that that would be a wonderful support.
[00:26:24.990]So let's go on to see.
[00:26:26.550]What if you decided to partner with outside agencies?
[00:26:30.780]If you did that, what policies are needed?
[00:26:34.650]And I ask that because, oftentimes,
[00:26:38.040]what I'm seeing is the policy is a blanket nobody comes in.
[00:26:42.960]We're not partnering.
[00:26:44.370]We're not having observations.
[00:26:46.410]we're not doing anything.
[00:26:48.270]And when that happens, I think districts actually are taking
[00:26:51.990]a very shortsighted view of how they could potentially
[00:26:56.850]be sending a message that they don't want to
[00:26:59.820]engage with families and support them in their efforts
[00:27:02.760]to meet their child's needs.
[00:27:04.710]So to be thinking about that I think is a wise move.
[00:27:09.090]Now, if you did partner,
[00:27:11.130]if you decided to partner with
[00:27:13.410]all agencies that they're allowed to come in,
[00:27:16.680]what will that look like?
[00:27:17.850]And when would you say no?
[00:27:19.979]And of course as a district, it's okay to say no.
[00:27:22.890]If there's a situation where it is denying a FAPE
[00:27:26.820]or it is impeding staff to work
[00:27:29.580]or it is creating some other hardship,
[00:27:32.730]saying no is the obvious choice
[00:27:34.740]for a district administrative team.
[00:27:37.380]Now the next one, E, is very important.
[00:27:40.650]We have to think about complex kids
[00:27:43.290]and the continuum of services that they might need.
[00:27:46.350]So having some decision rules around,
[00:27:49.350]all right, when do we say it's time to contract out
[00:27:54.150]because we need this person to come in
[00:27:56.190]and support a program,
[00:27:57.660]or we need this person to come in
[00:28:00.600]and support this student, either short or long term.
[00:28:04.410]This is sort of a laundry list to be thinking about.
[00:28:06.810]And then, ultimately, each time we have a situation like E,
[00:28:12.600]we need to think about whether a reevaluation should occur
[00:28:16.320]because we're talking about adding on a service
[00:28:18.870]and really kind of trying to rectify
[00:28:21.630]what's the barrier and what's the need here.
[00:28:23.610]So reevaluating is a smart choice.
[00:28:26.820]Creating a new IEP that reflects that,
[00:28:29.400]also a very smart choice.
[00:28:31.560]Okay, so that's for the districts in the room there.
[00:28:35.040]Any questions from district personnel before I move on?
[00:28:44.400]Okay, if not, I will continue.
[00:28:46.613]This is good because we have a lot to cover.
[00:28:49.710]Not that you can't talk because you certainly can,
[00:28:52.140]but just some general advice that I would give you.
[00:28:55.920]This is something that I think
[00:28:59.266]our district friends need to know is that
[00:29:02.070]the ABA providers that you work with, it is...
[00:29:07.920]I think the assumption's out there
[00:29:09.240]that they understand school laws and policies,
[00:29:11.670]and that when they make a mistake, they did it on purpose.
[00:29:14.610]And so I will come forth as the Pollyanna to say,
[00:29:18.930]I wouldn't assume that.
[00:29:20.370]I would not assume that they understand
[00:29:22.350]school law and policies.
[00:29:23.700]And if there is a mistake,
[00:29:25.050]it's probably on us to provide training
[00:29:29.130]so that they understand
[00:29:30.450]this different culture that they're working in.
[00:29:33.150]There are some that do,
[00:29:34.740]but I would say that the larger majority do not.
[00:29:38.340]Now, the other assumption that I see is the second one
[00:29:41.430]that the parent asks for ABA involvement,
[00:29:43.890]meaning that there's the assumption
[00:29:45.780]that the district is failing to provide services.
[00:29:47.987]That's not always true.
[00:29:49.380]I think sometimes the parents are just looking for
[00:29:52.440]that nice cross collaboration that they would like to see
[00:29:55.710]between their provider and the school setting.
[00:29:59.220]So I think avoiding that assumption is healthy,
[00:30:02.550]although it's always good to
[00:30:03.870]keep in the back of your mind that,
[00:30:06.330]hey, if they're providing that,
[00:30:08.130]we should probably find out
[00:30:09.150]how we can collaborate with them.
[00:30:11.730]And I would say you should assume this,
[00:30:14.220]that you should offer and provide training.
[00:30:16.800]Now, it could be that when you...
[00:30:19.140]Let's say you bring on a new BCBA into your district,
[00:30:24.660]I would assign them to a mentor
[00:30:26.670]and make sure that they were trained on what school means.
[00:30:30.420]Because if they're coming from a clinic,
[00:30:32.580]they're probably not going to be as well versed
[00:30:35.310]in anything that I think we take for granted
[00:30:38.100]as special educators.
[00:30:39.540]So that would also include though your district staff
[00:30:43.110]who may have no idea how to collaborate
[00:30:46.110]with an outside person.
[00:30:47.310]In my first training, I shared the stories about,
[00:30:50.850]a couple of stories about me and my first attempts
[00:30:53.730]to work with BCBAs,
[00:30:55.347]and it wasn't my best work at all.
[00:30:58.650]And what I will say to that is
[00:31:00.510]I could have used some training and mentoring
[00:31:02.910]and now I make sure that people know,
[00:31:05.040]and you should provide that.
[00:31:06.750]I would assume that the family needs coaching
[00:31:10.860]in what ABA is, what it looks like in the school setting,
[00:31:15.690]and what outside providers can and can't do.
[00:31:18.570]And to some degree, that goes back to
[00:31:21.210]my recommendation around make sure that you have
[00:31:23.580]your policies and procedures in place.
[00:31:26.700]Families often don't know.
[00:31:28.350]They don't know that they can't just bring their person in
[00:31:31.620]or ask for them to come in during the school day.
[00:31:34.350]And I think it's only fair for us to have
[00:31:36.540]that discussion with them.
[00:31:38.310]And I would also say assume that part of your work
[00:31:41.040]is going to be establishing goals,
[00:31:43.260]establishing timelines, and establishing parameters.
[00:31:46.230]And so for the BCBAs in the room,
[00:31:48.300]we call these antecedent interventions.
[00:31:50.970]We wanna make sure that we set people up for success
[00:31:55.680]before we have problems.
[00:31:57.510]So that's the general advice that I would give
[00:32:00.240]to all of you that are working in schools.
[00:32:02.670]Now I want to model a problem solving process,
[00:32:07.290]and it looks a little something like this.
[00:32:09.780]So this is just the way that I have encouraged districts
[00:32:12.840]to think about how they're going to collaborate with
[00:32:16.650]and potentially message about ABA
[00:32:19.800]and utilize ABA in some way.
[00:32:22.710]So you can see this as a continuum,
[00:32:24.450]and I'm going to discuss each of these,
[00:32:25.950]but let me just really quickly go over this.
[00:32:27.990]So the idea here is that there's some ask, whatever it is,
[00:32:32.700]the ask could be anything,
[00:32:34.860]and we need to have a way to respond.
[00:32:37.740]And the way that you respond to that
[00:32:39.240]is to have an IEP meeting.
[00:32:41.130]Everything should be done in the context of an IEP meeting.
[00:32:44.910]I have heard stories of people saying,
[00:32:46.477]"I asked and I just got a no on email."
[00:32:49.320]That's really setting the district up for
[00:32:52.740]problems later that are avoidable
[00:32:55.200]by meeting with the team
[00:32:57.630]and having a procedure to discuss things.
[00:33:01.320]So what are we discussing?
[00:33:02.700]We're discussing what the ask is.
[00:33:04.800]We're discussing what are the potential barriers.
[00:33:07.830]Is there a way that this ask might be impeding FAPE?
[00:33:12.900]One thing that's not here but I think is assumed is
[00:33:15.570]how could we benefit from this?
[00:33:17.190]What could go well for the team and for the child?
[00:33:21.690]And to that end, we need to engage in some planning.
[00:33:24.060]So what might this look like?
[00:33:26.100]And set some parameters.
[00:33:27.660]Parameters can be anything from what
[00:33:29.910]someone can do or not do,
[00:33:32.070]how long, where, and goals.
[00:33:36.869]What do we see as a team coming from this?
[00:33:39.990]And I think the lack of setting goals
[00:33:42.360]is one of the areas where people get really, really stuck.
[00:33:45.960]And then we need to continue meeting
[00:33:47.820]and we need to continue talking to each other.
[00:33:50.340]So I think those are some of the things
[00:33:52.620]that I would advocate are appropriate in this situation.
[00:33:56.940]So here's this first scenario.
[00:33:58.230]So I'm gonna start out with an easy one.
[00:34:00.900]And I'm not really a screen reader,
[00:34:03.000]but I'm going to for this.
[00:34:04.080]So a family of a six-year-old with autism
[00:34:07.260]ask the district to allow their BCBA and their RBTs,
[00:34:10.220]so these are outside clinical people,
[00:34:12.360]to observe once per week to obtain data.
[00:34:15.330]Per the parent, this is for the purpose
[00:34:17.370]of assessing generalization and maintenance of skills
[00:34:20.460]taught in the home and in the clinic.
[00:34:23.130]So we have to think about how do we proceed with this.
[00:34:26.370]This is a very, very common scenario
[00:34:29.730]that gets asked of districts all the time
[00:34:32.190]by families that are accessing outside services.
[00:34:35.940]So what I wanna do, I'm actually going to leave
[00:34:39.360]my beautiful screen sharing for just a minute,
[00:34:42.030]and then go back in.
[00:34:43.740]I am going to
[00:34:47.040]model the use of this.
[00:34:48.900]So let's go ahead, and I see that there's a chat.
[00:34:52.110]Oh, hi Matt, good to see you.
[00:34:57.510]I'm gonna close the chat now and sorry for that,
[00:34:59.790]but there's a wonderful person in this class.
[00:35:02.190]So welcome.
[00:35:03.780]Okay, so we have this scenario.
[00:35:06.420]There's a six-year-old in the middle of all this
[00:35:09.180]with an outside agency and the school.
[00:35:11.940]The agency wants to come in and take data.
[00:35:15.090]How do you proceed?
[00:35:16.950]Well, let's go ahead and think about
[00:35:18.960]what we're talking about.
[00:35:19.920]What is the ask?
[00:35:21.270]So the thing that we have to grapple with is
[00:35:24.600]family wants BCBA to come in to observe
[00:35:31.260]the solution is meet in all situations as a team.
[00:35:37.620]So when we meet with the team,
[00:35:39.480]we're going to go back to what's the ask.
[00:35:43.320]What is that?
[00:35:44.490]And then the next thing that we're going to do,
[00:35:46.650]and I realize that I'm summarizing what could take an hour.
[00:35:50.250]But for time's sake, I'm just modeling for you.
[00:35:53.610]Potential barriers, what's the influence on FAPE?
[00:35:58.020]Well, a potential barrier that I see
[00:36:01.050]because I can't have interaction with you
[00:36:03.510]is confidentiality.
[00:36:05.730]That's one.
[00:36:06.930]The next one is,
[00:36:09.420]what if the BCBA and the RBT
[00:36:14.100]don't understand the school setting
[00:36:16.590]and then they go back to the family and say,
[00:36:20.227]"Oh no, something is wrong"?
[00:36:22.860]So another barrier might be information
[00:36:27.630]given to the family and many others.
[00:36:31.050]So then as you can see,
[00:36:33.960]the solution is just to go down the list itself
[00:36:38.130]and to work our way into planning.
[00:36:41.640]So let's say, okay, we're going to agree.
[00:36:44.070]We recognize that
[00:36:46.620]we can get over the barrier of confidentiality
[00:36:48.960]by discussing with the family and the BCBA and RBT
[00:36:53.340]who they can look at,
[00:36:55.020]that they can't take video or take photographs,
[00:36:58.860]and they can't ask questions,
[00:37:00.300]all the things that we're going to do.
[00:37:02.460]And then to make sure that we are engaging in the planning,
[00:37:06.360]what is the planning going to be?
[00:37:08.220]Could be anything from when it will start,
[00:37:12.720]frequency of this.
[00:37:14.910]We can go on and on.
[00:37:16.560]And then our parameters and goals.
[00:37:18.630]So parameters is information sharing,
[00:37:23.730]data collection for generalization.
[00:37:26.970]One thing I would wanna see as an administrator on this team
[00:37:30.390]is how is that information going to be used both ways.
[00:37:34.470]So I would like to see the treatment plan
[00:37:37.200]to know whether or not there's something
[00:37:38.730]that this IEP team needs or could use,
[00:37:42.180]and that's where we continue to meet.
[00:37:44.250]So we're going to do information sharing,
[00:37:46.740]data review, and planning.
[00:37:49.860]So that's the problem solving process in a nutshell,
[00:37:54.030]using a very, very easy case to start.
[00:37:58.110]So I'm going to go ahead and go from the current slide,
[00:38:01.980]and we'll get back into this.
[00:38:03.810]So this is just an example for you
[00:38:06.480]of what that might look like.
[00:38:08.100]Here's some things you might wanna think about
[00:38:09.780]in that scenario.
[00:38:11.310]In this particular situation,
[00:38:13.830]the team is not trying to provide services in school,
[00:38:16.890]but that's something we have to make sure
[00:38:19.050]at the get go that we ask.
[00:38:21.300]The second one is knowing what they are doing,
[00:38:24.540]that they're just trying to collect data for generalization.
[00:38:27.090]So when we teach skills that the holy grail
[00:38:31.530]is that these skills will be able to work in
[00:38:35.310]multiple settings with multiple people
[00:38:38.490]and even novel situations
[00:38:40.560]and over time what we call maintenance.
[00:38:43.290]So this is not an an unreasonable ask.
[00:38:46.440]It's just knowing what it is.
[00:38:48.180]So again, the parameters for this could be timing,
[00:38:52.140]so when.
[00:38:53.250]how long?
[00:38:54.480]Are we talking about an hour?
[00:38:55.710]Are we talking about six hours?
[00:38:58.110]There's this phenomena that happens with observers.
[00:39:03.330]So when you have someone come in,
[00:39:05.100]it could be the nicest person in the world,
[00:39:07.560]but it's stressful.
[00:39:08.820]So if we've got this person in there,
[00:39:10.890]even if they're just observing Johnny,
[00:39:13.620]you feel like you are on stage,
[00:39:15.750]and that is impact on the team.
[00:39:18.630]So thinking about duration is important.
[00:39:21.390]Confidentiality agreement,
[00:39:22.890]I would make sure that your district has that in place.
[00:39:26.610]And also that it is clearly discussed
[00:39:29.220]that there will be no interference
[00:39:31.110]with the student or other students.
[00:39:32.790]So if the BCBA or RBT is in the room,
[00:39:36.930]they shouldn't be prompting or redirecting that student.
[00:39:40.680]And if it's going to be problematic,
[00:39:42.450]we need to talk about what would that observation look like?
[00:39:45.000]Do they need to be in another room
[00:39:47.520]and watch through the window?
[00:39:49.620]I bet if I pulled everyone in here,
[00:39:51.690]we've all done that in some way or another
[00:39:53.730]in order not to have observer effects.
[00:39:56.520]And we should agree upon the number of visits.
[00:39:59.670]So all done within the context of the IEP meeting.
[00:40:03.840]And then of course we're going to send prior written notice
[00:40:06.480]to make sure that everyone is clear and we've documented it.
[00:40:11.160]Let's look at another case.
[00:40:12.450]So this scenario here.
[00:40:14.700]the district is serving a student
[00:40:17.370]who is engaging in high rates of self-injury and aggression
[00:40:22.080]toward others as well as property.
[00:40:24.810]While the staff in the school
[00:40:25.830]are trained in special education
[00:40:28.110]and general behavior supports,
[00:40:29.940]they're not trained in specific supports
[00:40:31.800]for such complex behaviors.
[00:40:33.420]There's no BCBA available to serve the student
[00:40:35.970]within the school staff or district.
[00:40:38.220]Situation's not getting any better.
[00:40:39.930]People are getting hurt.
[00:40:41.250]Sound familiar?
[00:40:42.210]This is a very familiar scenario,
[00:40:44.040]at least here where I live.
[00:40:46.590]The student's family works with an outside agency
[00:40:49.590]who provides services after school.
[00:40:51.780]Staff have suggested that perhaps
[00:40:53.910]it is time to seek their help
[00:40:55.440]to support the student so he can access his IEP services.
[00:40:58.800]So how do you proceed?
[00:41:01.620]So again, we would apply that same problem solving process.
[00:41:05.670]And so for the sake of time,
[00:41:08.070]I'm not going to to get in here and draw it out,
[00:41:12.060]but we would go in and we would do this throughout
[00:41:16.320]to make sure that we were addressing it both proactively
[00:41:20.340]and responding as we should.
[00:41:23.490]Again, the team, including the family,
[00:41:27.510]needs to go through this process
[00:41:29.340]because the ultimate thing
[00:41:30.600]they really need to come up with is,
[00:41:32.610]are they providing a FAPE right now?
[00:41:35.070]And whether that's yes or no,
[00:41:37.260]that is a consideration that should be noted.
[00:41:40.350]And depending on the outcome of that,
[00:41:42.240]including going through the IEP and determining
[00:41:45.270]the effects of the behavior on access,
[00:41:48.570]the team might want to consider a couple of things.
[00:41:50.760]First of all, could they contract
[00:41:53.130]with an outside APA provider
[00:41:55.590]to provide the behavioral services?
[00:41:57.870]So we're not talking about providing educational services
[00:42:01.290]because, to be honest, that's not something
[00:42:03.870]that most of us are trained in.
[00:42:05.760]So could it be that we find someone
[00:42:08.820]that could work alongside
[00:42:10.440]the educational staff in the school,
[00:42:13.050]or is it possible that we provide ABA
[00:42:17.760]and provide that person in an educational setting
[00:42:21.990]such as clinic or non-public agency?
[00:42:25.080]With the second one,
[00:42:26.820]we absolutely have to think about a reevaluation
[00:42:30.810]because that is a significant change of placement,
[00:42:33.570]in fact, so is adding in an ABA provider as well.
[00:42:37.290]So either way, your district would need to make sure
[00:42:40.770]that they were reevaluating to determine
[00:42:43.560]what is it that the student needs,
[00:42:45.150]and then looking at, can we provide that?
[00:42:47.880]And if we can, do we contract and what does that look like?
[00:42:51.420]Now I noticed that there was a question
[00:42:52.860]in the chat or maybe a comment,
[00:42:54.510]so I just wanted to quickly grab that and see.
[00:42:58.740]So since we as a school district
[00:43:01.110]have a board of education policy related to people,
[00:43:03.990]including professionals visiting schools,
[00:43:05.790]would not see this as something
[00:43:07.050]that an IEP team would consider,
[00:43:09.270]Why would an ABA clinic person be any different?
[00:43:14.160]That's a really good point.
[00:43:15.390]If you already have that policy in place,
[00:43:18.840]and I knew that as perhaps the principal of the building
[00:43:22.920]or the program administrator.
[00:43:25.950]Guess what we would have to decide
[00:43:27.900]is whether or not that met the policy.
[00:43:31.290]And if it doesn't, then I think we have to say no.
[00:43:35.734]This is a policy and it's a policy that we have to follow.
[00:43:39.510]And so it's not always possible.
[00:43:41.100]However, I will present the flip side to this is
[00:43:45.750]there are reasons why a person might come in
[00:43:49.320]to make sure that what they're doing
[00:43:51.780]is generalizing or vice versa.
[00:43:54.990]So, that's probably beyond the scope
[00:43:57.930]of this limited time that I have,
[00:44:00.000]and I appreciate the question.
[00:44:01.230]I'd be happy to talk to you more about this offline,
[00:44:04.800]in my emails at the end.
[00:44:06.540]I know that that is a situation
[00:44:08.460]that you're facing, many of you.
[00:44:11.130]So I will move on, but thank you for that question.
[00:44:13.890]Here's another scenario,
[00:44:15.420]so I'll try to read this as quickly as I can.
[00:44:18.630]A parent has been sending her child to a clinic all day,
[00:44:22.230]five days a week since the pandemic restrictions began,
[00:44:25.800]Insurance has continued to pay the fees
[00:44:27.870]for full day services.
[00:44:29.130]The BCBA on the case has slowly started to suggest
[00:44:32.520]that perhaps it is time for the student to return to school.
[00:44:36.390]The district has maintained contact with the family
[00:44:39.600]and has continued to offer IEP services,
[00:44:42.000]which the parent declines.
[00:44:43.890]The student has been developing
[00:44:45.300]stronger social skills and language,
[00:44:47.220]but has limited communication partners
[00:44:49.140]and no access to academic instruction from a teacher.
[00:44:52.560]The parent reluctantly agrees to give it a try
[00:44:54.990]and the school team brings the student in with the ABA team.
[00:44:59.580]In school services start, but they start on the wrong foot.
[00:45:03.720]So I'll just put it out there like this.
[00:45:05.820]The teacher places a student in a separate room
[00:45:08.280]with the RBT from the clinic.
[00:45:10.320]The RBT runs programs,
[00:45:12.780]and this is a term that
[00:45:15.210]pretty much everyone as BCBN here can recognize.
[00:45:18.360]They're running these instructional programs
[00:45:21.030]and the teacher is working with other students.
[00:45:23.370]So you can already see how this situation
[00:45:26.280]has not started off on the right foot at all.
[00:45:29.880]The teacher does not provide any attention
[00:45:32.280]or services to the student
[00:45:33.810]other than to occasionally reprimand him
[00:45:36.330]when he is aggressive.
[00:45:37.950]The RBT begins to report
[00:45:39.570]that the student isn't receiving any services
[00:45:41.880]and that the teacher's classroom is a mess.
[00:45:44.970]The RBT communicates constantly with the parent.
[00:45:48.000]The teacher never does.
[00:45:49.770]Situation comes to a head when the mother tells the district
[00:45:52.380]that the teacher isn't following the treatment plan,
[00:45:55.650]and that the RBT is the only source of information.
[00:46:00.420]So in this situation, which is real,
[00:46:03.180]what's do we do about that?
[00:46:05.730]How do we proceed?
[00:46:07.950]So because we are looking at the provision
[00:46:11.370]of FAPE in this situation,
[00:46:13.380]we should go through this problem solving process
[00:46:17.190]and talk about what the ask is.
[00:46:19.650]So there are multiple asks here.
[00:46:21.840]meet with the IEP team and talk about what are the barriers
[00:46:25.620]that are influencing this child's FAPE.
[00:46:27.927]And in my opinion, a lot of things should have been done
[00:46:30.660]that weren't done.
[00:46:32.040]This planning that you see here in this process model
[00:46:35.820]really wasn't done.
[00:46:37.200]The student was simply just put in the school.
[00:46:39.510]So I don't fault anyone in this situation
[00:46:42.360]other than we have to think and plan very carefully
[00:46:45.960]when we are saying yes to something
[00:46:49.170]and what is it that we're saying yes to.
[00:46:51.930]So some thoughts on this.
[00:46:54.030]Where did things go wrong in the first place?
[00:46:56.940]There were some important steps
[00:46:58.440]that were missed in this process.
[00:47:00.000]So in this situation, what actually did happen
[00:47:04.110]is we had to bring the team together
[00:47:05.910]when we saw what was going on.
[00:47:08.280]Side note, the ABA team, the clinical team
[00:47:13.140]needed and received immediate training.
[00:47:15.930]And that training was,
[00:47:17.910]we don't do treatment plans in a school setting.
[00:47:21.150]That's not what we're there for.
[00:47:22.590]We are supposed to be there
[00:47:24.450]to help the team to implement the IEP.
[00:47:27.090]They'd never seen the IEP.
[00:47:28.650]They didn't know what was in the IEP.
[00:47:30.510]So again, this is where the team didn't come together
[00:47:34.590]and was not prepared to work together.
[00:47:37.410]Also, having the RBT communicate with the mom,
[00:47:41.880]that needed to stop right away.
[00:47:43.800]And the mom and the teacher had to figure out a way
[00:47:46.800]to communicate with each other.
[00:47:48.600]So you can imagine if you were the administrator,
[00:47:51.780]you had a lot of work to do to repair.
[00:47:54.570]Also, the parent didn't understand
[00:47:56.820]that the treatment plan wasn't
[00:47:58.890]going to be implemented in the school setting.
[00:48:01.260]The IEP was going to be implemented in the school setting.
[00:48:04.500]So in this case, what needed to happen and did
[00:48:07.020]is the team needed to get together, clarify what the ask is,
[00:48:11.040]and come up with a plan, including goals.
[00:48:13.470]What is the goal for having these staff in that setting?
[00:48:17.880]What is the goal for the student
[00:48:19.290]in terms of being able to integrate
[00:48:21.300]into that classroom setting?
[00:48:23.370]And then come up also with communication norms
[00:48:26.130]so that the teacher was not clear
[00:48:28.590]that she needed to communicate with the mom,
[00:48:31.290]and the mom was highly reinforced
[00:48:33.840]by having constant communication with the RBT.
[00:48:37.197]And so this is where we need to get together and say
[00:48:40.740]how is mom going to be informed every single day
[00:48:43.710]about what her child is doing.
[00:48:45.120]Child's nonverbal, by the way.
[00:48:46.440]They're not able to talk about how the day went.
[00:48:49.140]So what will that look like?
[00:48:51.750]And then the assertion needs to get out there
[00:48:54.330]that the IEP drives the program.
[00:48:56.700]The treatment plan never drives the program.
[00:49:00.180]And so the consultant that worked with the clinical team
[00:49:03.570]really had to do some education around that.
[00:49:06.270]And that's okay, these things happen.
[00:49:08.490]It's just important to recognize that
[00:49:11.010]not every team is going to come in
[00:49:13.590]trying to be ready to understand your setting.
[00:49:17.160]And then there certainly does need to be a system
[00:49:19.650]for increasing instructional access.
[00:49:21.510]You can imagine how confused that teacher was.
[00:49:24.780]They had no idea how to embed these services
[00:49:29.070]and bring them alongside.
[00:49:30.780]So of course she said, "Well fine,
[00:49:32.400]I'll just work over there because they're here."
[00:49:34.647]But that really was not the intent of this.
[00:49:37.980]And then lastly, training, ongoing training.
[00:49:41.820]What does the BCBA team, the ABA team do?
[00:49:45.600]The parent needs to know all of that.
[00:49:47.400]They need to understand what's happening in school
[00:49:50.250]and the team as well needs to understand this.
[00:49:52.500]So a lot of things needed to happen here
[00:49:55.440]in order to make this go smoothly.
[00:49:58.200]So the bottom line in this,
[00:49:59.787]and it feels like this timeframe always goes very quickly,
[00:50:03.180]but I wanna leave a little bit of time for questions.
[00:50:06.300]So aspects to consider
[00:50:08.910]when we are having ABA providers come in,
[00:50:12.990]whether hired or not,
[00:50:15.300]is that we have to provide a FAPE.
[00:50:16.770]That's the bottom line first.
[00:50:18.810]And we should assume everyone needs training,
[00:50:21.720]and that's from the parent to the IEP team
[00:50:24.840]to the ABA providers themselves.
[00:50:27.720]Everyone will need training in what is ABA,
[00:50:30.750]what is the purpose.
[00:50:32.400]All of these pieces need to fit together
[00:50:35.340]and there need to be some non-negotiables
[00:50:38.280]in terms of offering FAPE that, for example,
[00:50:41.730]academics are provided by a teacher
[00:50:44.250]or a paraprofessional who who is monitored by the teacher.
[00:50:48.480]And materials need to be designed by the teacher.
[00:50:52.080]There needs to be a problem solving process
[00:50:54.360]in every situation.
[00:50:55.710]If it's not the one I modeled,
[00:50:57.450]develop one on your own in order to keep FAPE at the center
[00:51:01.860]and figure out what the ask is and what your plans will be.
[00:51:05.340]I know that for the superintendents in the room and others,
[00:51:09.480]there's usually a policy,
[00:51:10.980]and I advocate for a case by case basis,
[00:51:13.950]which is hard when you're trying to say,
[00:51:16.207]"Here's our structure, here's our routines."
[00:51:18.870]But there are times where this can be of great benefit
[00:51:21.930]to the family and the relationship.
[00:51:24.450]It's also important to know when to draw the line.
[00:51:27.180]So in this situation that I just discussed with you,
[00:51:30.570]the line had to be drawn around
[00:51:32.460]communication with the mother
[00:51:34.020]or mother expecting that the treatment plan
[00:51:36.870]would be followed.
[00:51:37.703]And we needed to redirect the team to the IEP itself.
[00:51:42.690]And then also just knowing that ongoing
[00:51:45.960]shaping and growing of skills of all team members
[00:51:49.200]will be necessary.
[00:51:50.430]It's not a one-time deal.
[00:51:52.380]So these are the things I think
[00:51:53.640]as I'm thinking about having ABA in school
[00:51:57.210]that are incredibly important.
[00:51:59.160]And again, I would advocate that
[00:52:01.380]the work that a good ABA team can do can be very significant
[00:52:06.120]when it is planned and implemented correctly.
[00:52:09.330]So this is my contact information,
[00:52:12.180]I just wanna make sure that attendees
[00:52:13.950]know that this is in here so that
[00:52:16.140]you're not all relying too much
[00:52:19.380]on Annette and Megan to provide that.
[00:52:22.170]So if you wanna get in touch with me,
[00:52:24.270]there's my information.
[00:52:25.530]I will stop sharing now
[00:52:28.320]and open it up for questions or comments.
[00:52:49.998]So Annette or Megan, do you have any questions
[00:52:52.950]or has anyone communicated with you,
[00:52:55.140]anything that they're wanting to discuss?
[00:52:58.920]I don't see any yet,
[00:53:00.780]so I'm hoping that if we just pause,
[00:53:02.940]there'll be a little more conversation in the chat box.
[00:53:07.320]So- Sure.
[00:53:09.180]Yeah, I loved those scenarios
[00:53:11.010]and just the problem solving process that you went through.
[00:53:16.710]It looks like Martina has a question.
[00:53:23.400]Okay, let's start with that.
[00:53:26.010]If a medical provider deems ABA services medically necessary
[00:53:30.360]and the state, Colorado, has a house bill in place
[00:53:33.060]that states ABA services must be provided
[00:53:35.850]in the school setting as it is medically necessary,
[00:53:39.120]when those hours cannot be completed outside of school,
[00:53:41.850]does the IEP or treatment plan drive the student need?
[00:53:45.990]Well, to me it seems like Colorado has put
[00:53:49.530]the school district in a conundrum.
[00:53:52.710]So I apologize that you're in this situation.
[00:53:57.660]When you have a situation like that,
[00:53:59.940]what I think you need to do
[00:54:01.920]is to first of all say when a student is in school,
[00:54:05.490]what is the access issue?
[00:54:07.290]So when we're talking about providing a FAPE,
[00:54:10.350]it is because something is a barrier to access,
[00:54:13.080]whether that's behavior, or academic needs,
[00:54:16.710]or fine motor, or whatever it is.
[00:54:19.260]So if there is,
[00:54:21.560]if if ABA services are contracted with an outside agency,
[00:54:26.760]then perhaps that treatment plan could be a part of it.
[00:54:29.940]What I can't figure out from your comment...
[00:54:33.570]Is it Martina?
[00:54:34.560]Is does this mean that the school setting
[00:54:38.790]is responsible for paying for these
[00:54:41.340]or that the insurance company is paying for this?
[00:54:45.600]Do you happen to know that?
[00:54:53.070]No, we are not, the insurance.
[00:54:54.600]Okay.
[00:54:55.433]So in that case, what I would suggest is that
[00:54:59.310]you look at the treatment plan, look at the IEP,
[00:55:03.360]and figure out what components of this plan,
[00:55:07.530]if provided alongside the educational services,
[00:55:13.260]are likely to encourage access and decrease barriers.
[00:55:18.240]I would never, ever think it's wise
[00:55:21.420]to have a treatment plan supersede
[00:55:24.300]the FAPE that's being offered in IEP.
[00:55:26.850]I just wouldn't.
[00:55:27.750]And so I'd have to look into that more,
[00:55:30.810]but that's my first answer.
[00:55:33.030]Deirdre, what I was referring to in training
[00:55:37.410]is through IRIS, the Vanderbilt IRIS modules,
[00:55:41.340]and I can provide more to you later on that.
[00:55:45.270]And yes, that was it.
[00:55:47.220]Okay, so thank you.
[00:55:48.840]That's a really good question
[00:55:50.010]and I was not aware that Colorado was there,
[00:55:53.250]and I'm in the Ninth Circuit as well.
[00:55:54.900]So I'll have to find out now how that may or may not apply
[00:55:57.990]in Washington State.
[00:55:59.460]Any other questions or comments?
[00:56:10.630]Okay, Carrie, in addition to educating...
[00:56:13.260]Woo, okay, let me go (laughs) up a little bit here.
[00:56:16.920]Let me see.
[00:56:21.210]In addition to educating families about how ABA
[00:56:23.730]is embedded in the school day,
[00:56:24.810]do you have any strategies
[00:56:25.800]for getting students back into school,
[00:56:27.450]decreasing time out of school day for clinical ABA?
[00:56:30.840]Oh gosh, that would be in and of itself
[00:56:33.060]a great webinar to have just on that.
[00:56:36.168]And I think one of the ways that we start to do that
[00:56:39.270]is to help families, first of all, to know
[00:56:42.210]that school is a natural environment for kids.
[00:56:44.550]And that's a message that also needs to be sent
[00:56:47.100]by the clinics.
[00:56:48.720]And I think that we have to start there.
[00:56:50.820]We have to come to agreement
[00:56:52.800]on what is the natural environment for skill learning
[00:56:57.660]and for skill generalization and maintenance.
[00:57:00.360]So that's one thing.
[00:57:01.890]I think getting together and setting goals
[00:57:04.860]around how much time we're going to start with.
[00:57:07.560]And then could we fade that time
[00:57:10.020]by at first having providers maybe come in the school
[00:57:13.830]to observe and then have crosstalk?
[00:57:16.800]Those are always.
[00:57:18.882]But again, Carrie, my contact info is at the end of this,
[00:57:22.200]and I would be so happy to talk to you more about
[00:57:24.510]some strategies around that.
[00:57:26.610]So please do reach me if you need to.
[00:57:30.060]Okay, so Gina, as a school IEP team member,
[00:57:33.450]but not a case manager,
[00:57:34.650]how do we recommend these planning sessions?
[00:57:36.720]What's been happening in our are
[00:57:37.953]a is the community-based ABA clinic is recommending
[00:57:40.360]30 to 40 hours of ABA
[00:57:42.480]and then just go to kindergarten, get an IEP.
[00:57:45.390]So what happens is we have these students
[00:57:46.740]who have never been in a school setting with full-time ABA
[00:57:50.160]showing up to kindergarten without any notice of needs.
[00:57:54.810]And notice of needs meaning that they're just showing up
[00:57:57.420]but no one has said that they have a disability
[00:57:59.910]or that they have these behaviors?
[00:58:04.260]Okay, so to me, that is training around Child Find
[00:58:08.850]and understanding the role of special education preschool.
[00:58:13.740]Gina, to me, that's a side conversation
[00:58:16.500]around helping the clinics to understand
[00:58:18.630]the role that we have
[00:58:20.010]in providing those part C services.
[00:58:22.140]So if you want contact, me and we can talk through
[00:58:25.620]a good answer for that.
[00:58:33.040]Okay, so I wanna say thank you again for coming,
[00:58:36.930]and there are two more sessions.
[00:58:38.790]I'll let Annette take over for that part.
[00:58:41.070]Was really wonderful to have you here.

The screen size you are trying to search captions on is too small!

You can always jump over to MediaHub and check it out there.

Comments

0 Comments

Applied Behavior Analysis Therapy in Schools for School Administrators and School Staff Part II

Description

Searchable Transcript

Comments icon comment

Related Channels

Comments