ABA in Schools: It's a Different World Part 2

Vanessa Tucker Author

05/03/2024 Added

12 Plays

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[00:00:00.240]It's so good to see all of you again.
[00:00:02.280]And I'm going to share my screen.
[00:00:04.740]For those of you that come later,
[00:00:07.470]welcome.
[00:00:08.640]For those of you that are here now,
[00:00:10.440]it's good to be with you on a Wednesday.
[00:00:14.250]So I'm going to start from the very beginning here.
[00:00:17.670]And hopefully those of you that are watching this
[00:00:21.510]have watched part one first,
[00:00:23.100]that's going to be critical
[00:00:24.360]in order to really understand the foundation
[00:00:26.490]of this content.
[00:00:27.330]So if you, by any chance, did not watch part one,
[00:00:31.740]I would advise you to go back and do that
[00:00:34.260]so that you will be able to get a handle
[00:00:37.470]on some of the vocabulary terms
[00:00:39.660]that I will probably throw out pretty inconspicuously
[00:00:44.610]as we move along here.
[00:00:46.200]So again, my name is Vanessa.
[00:00:47.850]Just a little bit about me in the next slide.
[00:00:50.400]You've got some contact info.
[00:00:52.380]I wear a variety of hats.
[00:00:55.230]I work in higher ed,
[00:00:57.180]I also work for a clinic.
[00:00:58.920]I'm out in schools a lot.
[00:01:03.111]I dabble with working with adults
[00:01:05.280]and working with children,
[00:01:07.350]but mostly I like to work on the system issues that happen
[00:01:11.430]and the implementation issues
[00:01:12.690]that happen when BCBAs are in schools.
[00:01:15.180]So that's truly my interest in why I am here with you today.
[00:01:20.250]So if that's also you,
[00:01:21.750]then I'm in good company.
[00:01:24.720]So I also put a few emails should you want to get in touch.
[00:01:28.320]I love hearing from you,
[00:01:29.400]so please do touch base with me.
[00:01:33.390]Let me start out by saying that in part one,
[00:01:37.650]I really unpacked what school is all about
[00:01:41.520]and the foundational legal issues that are at work.
[00:01:45.870]So one of the things that you heard in that say
[00:01:48.510]is following IDEA,
[00:01:51.120]which is the federal law
[00:01:53.400]that protects the civil rights of students with disabilities
[00:01:57.300]who qualify for an IEP.
[00:01:59.970]And when we as BCBAs enter into that system,
[00:02:06.360]we have to remember that that system is bound
[00:02:09.000]by that federal law
[00:02:10.200]and they're also bound by their state laws and policies.
[00:02:14.160]So when we enter into a school,
[00:02:18.840]not only do we need to remember and understand
[00:02:22.530]that those things really are the focus
[00:02:25.620]and the driver behind everything that happens,
[00:02:28.740]but that also it creates maybe a situation
[00:02:32.730]where we are learners about a different culture,
[00:02:37.770]a different kind of an area of practice.
[00:02:41.730]And one of the things that I always try to remember,
[00:02:45.930]along with knowing that I'm entering an environment
[00:02:49.020]for which there are so many things
[00:02:50.880]that have to be considered,
[00:02:52.590]is that school is of tremendous value to all children.
[00:02:58.290]So including the students that we work with,
[00:03:00.840]that school is the natural environment for kids.
[00:03:04.920]And that is sort of my mantra
[00:03:06.990]whenever I walk into any building,
[00:03:09.750]no matter where I am or work with any family,
[00:03:12.990]is that school is a natural environment and an important one
[00:03:18.570]for all kids that are school age.
[00:03:20.940]Why is that?
[00:03:22.740]Well, this is the place
[00:03:23.910]where they learn those pro-social behaviors and skills.
[00:03:28.080]So that's number one.
[00:03:30.060]But if we move beyond that,
[00:03:32.010]we could think about school is the place
[00:03:33.960]where their non-disabled peers also access an education,
[00:03:39.630]where there are academic offerings available
[00:03:44.100]and people who have expertise
[00:03:46.590]that are also a part of that system.
[00:03:49.380]What I also want people to remember
[00:03:52.050]when they go into a school setting
[00:03:54.780]is that access is a key word.
[00:03:57.300]You're gonna hear me talk about that quite a bit today.
[00:04:00.300]And this is something I think
[00:04:03.360]has almost been a surprise to me
[00:04:06.600]that this is not valued more highly
[00:04:09.030]amongst people that I work with.
[00:04:11.490]That when we talk about what schooling might be,
[00:04:16.500]this is the right of every school age child,
[00:04:19.860]to access school just like every other child does.
[00:04:24.240]And what I want everyone to remember moving forward
[00:04:28.620]is that we also have a place in the school setting,
[00:04:33.300]so we don't have to just live in a clinic
[00:04:36.150]or working in a home setting,
[00:04:38.820]but we should have a prominent place at the table,
[00:04:44.100]at the IEP planning table,
[00:04:46.560]or otherwise,
[00:04:48.150]because,
[00:04:48.983]and this is irrefutable fact,
[00:04:51.600]that behavior is a marginalizing factor
[00:04:54.870]when a student engages in a behavior
[00:04:57.480]such as biting, for example.
[00:05:00.630]That is a barrier to being an inclusive setting,
[00:05:03.420]or maybe screaming or running.
[00:05:06.300]We can go on and on with what that might mean
[00:05:08.940]and how that might show up.
[00:05:11.040]The bottom line
[00:05:12.090]is that we have something important to offer.
[00:05:15.360]It's just now thinking through,
[00:05:18.840]what are the potential reasons why things might fall apart
[00:05:22.950]and how do we get them back on track?
[00:05:25.590]So that's really the focus for today.
[00:05:28.170]So I want us to come from a place
[00:05:30.750]going from valuing schools,
[00:05:32.790]a natural environment for our students to,
[00:05:35.970]what can we bring to the school setting as ABA providers?
[00:05:41.040]Well, first of all, let's think of the word access.
[00:05:43.950]So first of all, our students have better access
[00:05:47.100]to behavioral interventions.
[00:05:48.750]We do bring a skill set that I think is critical
[00:05:53.460]to the conversation.
[00:05:55.380]We also can be a big part
[00:05:57.900]of helping students to access their SDI.
[00:06:01.710]And again, if you haven't watched the first part,
[00:06:05.430]SDI is Specially Designed Instruction,
[00:06:08.490]and that is the package of service
[00:06:12.240]that is provided and discussed within the IEP.
[00:06:18.570]So that is something that is attached to an area
[00:06:21.240]in which a student qualifies.
[00:06:23.370]And if, for example, a student engages in,
[00:06:28.350]let's say, self-injurious behavior and aggression,
[00:06:33.210]that student may have a barrier
[00:06:35.490]to accessing their reading instruction
[00:06:38.610]or even their speech instruction.
[00:06:41.880]But we, as behavior providers, can help
[00:06:45.570]to put interventions into place that are function-based
[00:06:49.140]so that students can better access their SDI,
[00:06:52.470]their services.
[00:06:54.180]Also, we have the ability to,
[00:06:58.080]whether it's in a classroom or a small group
[00:07:01.680]or individually,
[00:07:03.390]increase that access to general ed
[00:07:06.360]and the inclusive environment of school.
[00:07:09.060]We live in an age where inclusion is the goal for students.
[00:07:14.130]Now, obviously it varies depending on what the needs are.
[00:07:18.390]So no one is,
[00:07:19.680]or very few people are saying,
[00:07:21.510]everybody should be in general ed all the time.
[00:07:24.030]That really does not meet the criteria
[00:07:27.240]for what is called a least restrictive environment.
[00:07:30.210]However, we expect that students will,
[00:07:34.170]that our teams will create a situation
[00:07:36.270]where they are included to the greatest extent possible.
[00:07:39.390]Now, we also have the ability to train people
[00:07:42.870]that are otherwise untrained.
[00:07:45.030]And that is something
[00:07:46.560]that I think we can lend a great strength to,
[00:07:50.220]just as I think about people who preceded me in my career.
[00:07:54.810]So when I first started teaching,
[00:07:57.120]I didn't know what an SLP was
[00:07:59.640]and I certainly didn't know what speech was
[00:08:02.070]or what did an occupational therapist do,
[00:08:04.680]I had no idea.
[00:08:06.630]But through working together,
[00:08:08.610]they were able to not only help me to understand
[00:08:11.250]what it is they do,
[00:08:12.870]but they were able to delegate some of those skills to me,
[00:08:15.540]which was a fantastic learning experience,
[00:08:18.000]and I didn't know what they did.
[00:08:20.070]So we have the ability to bring our skill set
[00:08:23.550]to educational staff,
[00:08:25.290]whether that is a teacher, paraprofessional,
[00:08:29.820]playground supervisor,
[00:08:31.740]other staff providers,
[00:08:33.270]it could be anyone.
[00:08:34.890]The other superpower that I think we bring to the table
[00:08:38.400]is the use of data.
[00:08:39.510]And I'm not saying that other professions don't use data
[00:08:42.030]because that would be unfair generalization.
[00:08:46.710]But we prize our data,
[00:08:49.170]we love our graphs,
[00:08:50.700]and that is something
[00:08:51.810]that I think people need more practice with
[00:08:55.050]and they need it in context,
[00:08:56.790]so not just looking at it in a journal article
[00:09:00.120]or maybe in their textbook,
[00:09:01.440]but actually see in real time,
[00:09:04.080]what does it look like to count frequency data
[00:09:07.020]and plot that on a graph?
[00:09:08.340]Or what does it look like to do momentary time sampling?
[00:09:11.130]And how could that help us
[00:09:12.540]to understand what's happening with behavior?
[00:09:16.800]The other things that I think we have the potential to bring
[00:09:20.550]would be a decrease in those very unsafe or target behaviors
[00:09:25.230]in a situation that is natural,
[00:09:27.000]again, school.
[00:09:28.500]So we think about the natural situation
[00:09:30.390]as something that is not contrived.
[00:09:32.010]In other words, we can practice all we want at home,
[00:09:35.940]but school is where other kids their own age are,
[00:09:38.910]more demands, more contingencies.
[00:09:41.490]So we want to make sure
[00:09:43.260]that we're really putting forth our efforts
[00:09:45.120]in that natural situation.
[00:09:47.280]And I think the thing that is most important
[00:09:50.790]about how we can contribute is to reactive management.
[00:09:55.260]So one of the big, big talking points in education is,
[00:09:59.970]how do we reduce things like restraint?
[00:10:02.790]How do we reduce isolation?
[00:10:05.220]How do we avoid suspension and expulsion?
[00:10:09.210]How do we avoid people putting hands on kids?
[00:10:13.320]And this is something
[00:10:14.310]that I believe we can have a great deal of investment in
[00:10:18.750]in terms of the school landscape,
[00:10:20.490]because obviously much of what we do
[00:10:23.280]involves preventing challenging behavior from occurring
[00:10:27.000]via function-based antecedent interventions.
[00:10:30.090]So with that in mind, I just wanted to start with,
[00:10:33.150]what are our selling points?
[00:10:34.800]What do we bring to the educational table?
[00:10:37.710]And again,
[00:10:38.543]acknowledging there are so many other professionals
[00:10:41.970]that also bring their basket full of their skill set too.
[00:10:46.050]But today we're talking about what could we bring
[00:10:48.480]to that school setting.
[00:10:50.280]Okay, so with all the things that we bring,
[00:10:53.910]what could possibly go wrong?
[00:10:55.920]Why wouldn't we be able to just jump in
[00:10:57.810]and do our good work?
[00:10:59.280]Well, there's a few things that tend to happen.
[00:11:02.820]So I've done a little bit of work professionally
[00:11:05.790]around the themes that seem to keep bubbling up
[00:11:09.600]as we attempt to bring our services in,
[00:11:12.570]and they're everything that you see here on the left.
[00:11:15.690]So for example, the idea of who owns the program
[00:11:20.670]or who is in charge tends to come up a lot
[00:11:24.300]when we're trying to work together,
[00:11:26.250]along with some defensiveness.
[00:11:27.720]And I can remember early on
[00:11:30.090]when I was consulting in classrooms,
[00:11:32.850]teachers would get defensive
[00:11:34.530]and it was because I was coming in
[00:11:36.330]and not really understanding that that was their space,
[00:11:39.570]and I needed to respect that.
[00:11:41.010]I just went straight in
[00:11:42.780]kind of for the throat of what was going on
[00:11:45.420]without really thinking,
[00:11:46.890]gosh, I need to develop a relationship.
[00:11:48.810]And that's my next point,
[00:11:49.890]is that if we fail to pair ourselves with these teachers
[00:11:55.380]and others that we're working with,
[00:11:57.060]we're probably going to fail to make much progress.
[00:12:00.150]There are perceptions,
[00:12:01.650]and I'm gonna focus a lot on those today,
[00:12:04.050]of what we do,
[00:12:05.310]but also to be fair,
[00:12:08.220]there are perceptions that we bring that may work against us
[00:12:12.690]in being able to collaborate effectively.
[00:12:14.520]So more to come on, how do we address those?
[00:12:17.790]How do we get past those?
[00:12:19.470]And then buy in.
[00:12:20.970]Now, this is to me,
[00:12:22.830]if we can figure out how to get people to buy in
[00:12:25.530]into interventions and actually do them,
[00:12:28.080]we're going to eventually work ourselves out of the job,
[00:12:31.050]which would be great, in my opinion,
[00:12:33.300]if we could have a world where we have less of the things
[00:12:36.630]that I mentioned on the last slide.
[00:12:38.820]Functional match.
[00:12:40.290]One of the things that I know can be really, really hard
[00:12:44.370]is understanding how much we as behavior analysts
[00:12:50.430]think about function.
[00:12:51.750]I mean, everything we think about is antecedents,
[00:12:54.690]consequences, and function.
[00:12:56.640]So helping people to understand
[00:12:59.970]what we are doing becomes something
[00:13:02.670]that needs to just be a part of our service.
[00:13:05.190]That training piece so that people know
[00:13:08.010]when we're talking about function,
[00:13:09.870]why is that so critical to the conversation?
[00:13:13.140]And then parent expectations can really work against us.
[00:13:18.150]And again, to me,
[00:13:19.320]I'll talk about this in a scenario,
[00:13:21.750]this is an area where we should direct
[00:13:24.720]some of our caregiver training
[00:13:27.030]toward helping parents to understand the purpose of school,
[00:13:30.360]the purpose of our services,
[00:13:31.950]and the limits of what we can do.
[00:13:34.710]And then lastly, IEP requirements.
[00:13:36.900]So when we start coming into schools,
[00:13:39.840]there can be some scenarios
[00:13:41.490]where with the best of intentions,
[00:13:44.130]we end up creating a situation
[00:13:47.400]where time to fulfill that IEP is impacted.
[00:13:51.570]And again, these are in no certain order,
[00:13:54.060]they're all equally apparent to me
[00:13:57.720]as I work through these cases,
[00:13:59.370]and hopefully you'll see that too.
[00:14:01.410]So let's go ahead and go to my beautifully colored slide
[00:14:05.610]that I did myself
[00:14:06.720]'cause I could figure out no other way to do this.
[00:14:08.670]So what I try to explain to people as I'm watching school
[00:14:14.880]and clinical ABA providers work together
[00:14:17.753]is that there seems to be this cliff
[00:14:21.030]with a valley in the middle.
[00:14:22.560]And so we see here on the left-hand side,
[00:14:25.200]let me get my little annotation marker,
[00:14:27.570]we see over here, this is school
[00:14:29.550]and school's side is worried about access,
[00:14:32.970]helping their student access school.
[00:14:36.810]And by that I mean the physical space,
[00:14:40.140]the instructional space,
[00:14:41.880]the social space,
[00:14:43.860]the leisure space,
[00:14:45.420]the adaptive space,
[00:14:47.010]all within the context most likely of an IEP.
[00:14:49.980]Sometimes your students may not have an IEP,
[00:14:52.440]but most of them will.
[00:14:53.490]But nonetheless, their thought process is access,
[00:14:58.980]along with many other things,
[00:15:00.690]but that's a big one.
[00:15:02.820]Then we have us, the clinical people.
[00:15:05.640]And what are we concerned about?
[00:15:07.620]Well, we're concerned about behavior,
[00:15:10.170]that's really what it comes down to.
[00:15:12.990]And so from school
[00:15:15.090]having kind of this global set of priorities to us
[00:15:20.880]where our priorities are very narrow,
[00:15:23.730]we can kind of get into this space
[00:15:25.920]of we're really not communicating
[00:15:29.430]and we need to bridge that somehow.
[00:15:32.400]So the cases that I'm bringing forward,
[00:15:34.260]all of which are current and real,
[00:15:37.800]will outline, how do we think about priorities?
[00:15:41.970]How do we think about perceptions of others?
[00:15:46.253]And I pause it that with every scenario,
[00:15:49.410]if we can think about it this way,
[00:15:51.690]we're going to make more progress.
[00:15:53.640]So please feel free, by the way,
[00:15:55.380]to use this slide and this model.
[00:15:57.360]Just make sure that you cite me for this
[00:16:00.600]because this is actually going into something written,
[00:16:03.210]but for now you're welcome to use it if you would like.
[00:16:08.010]Okay, so again, we have these two sides.
[00:16:11.430]How do we come up with ways to make this work
[00:16:15.690]so that we can do what's best for kids
[00:16:18.630]without falling down that valley somewhere in the middle?
[00:16:23.280]All right.
[00:16:24.900]So here's our first scenario.
[00:16:26.520]And while I'm not a big PowerPoint reader,
[00:16:28.380]as I've said before, I do think it's important to read this.
[00:16:32.280]So let me just move this transcript out of the way.
[00:16:35.820]A seasoned BCBA, it's probably you, is on a Zoom call
[00:16:40.260]with a school team regarding one of their clients.
[00:16:42.630]The school team is going over the IEP and BIP.
[00:16:45.840]The team focuses on all areas of qualification.
[00:16:49.590]And so just I'm gonna stop for a minute
[00:16:51.570]and say that an IEP is an individualized education plan
[00:16:56.040]and it is based on an evaluation.
[00:16:58.920]That evaluation dictates
[00:17:01.530]that the things the student qualifies in,
[00:17:04.620]such as academics or speech or whatever,
[00:17:09.000]only those things go in the IEP,
[00:17:11.520]nothing more, nothing less.
[00:17:14.010]So the team is going over all areas of qualification.
[00:17:18.420]This client engages in self-injurious behavior
[00:17:21.960]and physical aggression toward others in school and home.
[00:17:26.280]During the meeting,
[00:17:27.270]the BCBA messages her supervisor,
[00:17:30.330]why is the team focusing on everything in the world
[00:17:33.120]when only the SIB and the physical aggression matter?
[00:17:36.480]What is wrong with those people?
[00:17:38.610]During a debrief,
[00:17:39.840]the BCBA reiterates her belief
[00:17:42.390]that schools focus on everything,
[00:17:44.640]and in this case the only thing she wants to address
[00:17:47.100]is the behavior.
[00:17:48.480]It is her belief
[00:17:49.740]that a clinical team needs to come in there,
[00:17:51.900]meaning come into the school,
[00:17:53.640]work solely on the behavior first.
[00:17:55.890]She also commented on a lack of data and graphing.
[00:18:00.090]The BCBA is not a teacher
[00:18:01.980]and has many years of excellent clinical experience
[00:18:04.740]with complex behaviors.
[00:18:06.810]So this is a situation that happened yesterday,
[00:18:11.220]so this is quite new.
[00:18:13.350]And I bring this up
[00:18:14.820]because inherently you can see if I go back
[00:18:19.680]this divide here,
[00:18:21.180]if we're looking at my beautiful slide,
[00:18:24.120]the clinician's view is I have got to work on that behavior.
[00:18:28.680]That's the most important thing.
[00:18:30.600]And the school, on the other hand,
[00:18:32.580]has to focus on all parts of the IEP
[00:18:36.240]and how the behavior impedes access.
[00:18:39.570]So they've got many other competing priorities
[00:18:43.260]as compared to the clinician.
[00:18:46.410]So with that, let's think through
[00:18:49.170]what is potentially going to close the gap.
[00:18:52.860]And one of the first things that I would suggest,
[00:18:55.920]and this is what we did in this situation, is,
[00:18:59.670]on what points can we agree?
[00:19:02.250]Well, we can all agree
[00:19:03.810]that everyone is concerned about challenging behavior.
[00:19:06.600]Every single person in the room, whatever room,
[00:19:11.130]wants to help the student to be able to access school
[00:19:16.050]and to do so in a way that doesn't include headbanging
[00:19:20.520]or biting.
[00:19:21.930]So everyone's concerned about that.
[00:19:24.030]Everyone is concerned about the impact on health and safety.
[00:19:27.720]And so those are points of agreement
[00:19:29.850]that both parties share.
[00:19:31.470]And everyone is agreeing that, yes, we need to intervene,
[00:19:36.180]but in the school's perception,
[00:19:39.210]that is part of it,
[00:19:40.350]but then we also have the other things in the IEP
[00:19:43.800]that we must attend to
[00:19:46.050]versus the behavior analysts can get very narrow
[00:19:50.100]in their focus.
[00:19:51.900]And everyone has the desire to put forth
[00:19:56.130]a very good, strong support plan.
[00:19:58.680]There's no doubt about that,
[00:20:00.150]those are things that everyone shares in common.
[00:20:03.450]And I think if we can start there,
[00:20:05.760]we're going to have a lot less posturing, I guess,
[00:20:11.190]for lack of a better word
[00:20:12.450]or a sense of defensiveness.
[00:20:14.790]So with that in mind,
[00:20:16.290]let's move forward.
[00:20:17.520]Part of what I think we need to do
[00:20:20.850]is help others to see the priorities
[00:20:24.570]across those two sides of the cliff.
[00:20:27.600]So let's practice that with this case.
[00:20:31.980]Here's what I would say is a priority for me
[00:20:35.610]as somebody that is loosely involved
[00:20:39.570]with a case like this,
[00:20:40.800]would be, all right,
[00:20:41.633]what is it that if we did cross-training
[00:20:46.170]would help to move this forward?
[00:20:48.540]And I'm actually gonna start on the right with the BCBA.
[00:20:52.380]So I'm going to take my beautiful little pointer,
[00:20:55.440]and say that the BCBA is not wrong
[00:21:00.120]and the school is not wrong at all,
[00:21:02.730]and that is, I think, where we need to start there.
[00:21:04.830]There's no harm, no foul.
[00:21:06.240]But one of the things that became very apparent
[00:21:09.330]is that this BCBA needs to understand
[00:21:12.720]the requirements of an IEP,
[00:21:14.970]the confines of the IEP, right,
[00:21:17.160]the things that we have to do
[00:21:18.960]based upon this legal document,
[00:21:21.300]and also what schools focus on in an FBA,
[00:21:26.283]in a behavior intervention plan,
[00:21:27.990]because they may look different
[00:21:30.450]than what a clinical treatment plan would look like.
[00:21:36.690]Access is something
[00:21:38.460]that I think a lot of people struggle with,
[00:21:40.010]so let's talk about that for just a minute.
[00:21:41.880]When we're talking about the term access,
[00:21:44.850]we are talking about a student's ability
[00:21:49.680]to access general education and special education.
[00:21:53.910]So if I say that I want the physical therapist
[00:21:57.900]to work with the student,
[00:22:00.060]of all the things that physical therapist can do,
[00:22:03.690]the only thing you're going to do
[00:22:05.250]is the narrow part that helps that student to access school,
[00:22:08.670]whether it's using the gross motor muscles to sit to attend
[00:22:13.140]or being able to walk up and down stairs
[00:22:16.680]or access a drinking fountain or sit on a toilet,
[00:22:19.500]not everything else that a physical therapist can do.
[00:22:23.070]And this is part of the struggle, right,
[00:22:25.380]is we think, well, there's all these things we want to do,
[00:22:29.130]but we have to remember that access is the goal.
[00:22:32.100]And unlike a clinical situation
[00:22:34.380]where pretty much as the BCBA you are in charge,
[00:22:37.740]and that is your case,
[00:22:39.420]this is a team approach to working with these students.
[00:22:43.410]And sometimes the team has three people
[00:22:45.870]and sometimes it has 12 people,
[00:22:48.030]it just depends on the needs of the student.
[00:22:51.240]One of the things that I think is hardest
[00:22:53.220]is that schools have to think long term,
[00:22:57.570]they have to think, all right, this kindergarten student,
[00:23:01.050]what are we gonna do to get them to a place
[00:23:03.510]that when they're 16,
[00:23:05.460]they're going to be able to access their transition plan?
[00:23:08.640]And what will that look like?
[00:23:10.470]And how can we help parents prepare for that?
[00:23:13.350]So instead of thinking of the right now,
[00:23:15.840]there is going to be some long-term thinking
[00:23:18.690]that BCBAs will see.
[00:23:20.760]And lastly, that FAPE is a priority,
[00:23:23.520]and let me explain what that means.
[00:23:25.410]So when we're talking about FAPE,
[00:23:28.080]we're talking about free and appropriate public education.
[00:23:31.620]In the school setting,
[00:23:33.180]that is the prize,
[00:23:34.650]that's what we want.
[00:23:35.490]We want to produce an IEP that when implemented
[00:23:39.660]allows that student to have an appropriate education
[00:23:43.410]that is at no cost to the family,
[00:23:45.780]that is rigorously developed
[00:23:48.270]in light of their circumstances.
[00:23:50.010]So FAPE is all the things,
[00:23:52.560]it's not just the one thing.
[00:23:54.720]So I definitely want BCBAs to know that, yes,
[00:23:59.040]it looks like there's all these things
[00:24:00.960]and shouldn't we just focus on the behavior.
[00:24:03.690]It's a both/and conversation.
[00:24:06.150]It's all those things
[00:24:07.500]and what the BCBA can bring with their skill set.
[00:24:12.060]Now, what can the school use training in?
[00:24:14.730]What do they need to do a better job with?
[00:24:17.160]Data collection tends to be something
[00:24:19.710]that I'm sure all of us see
[00:24:22.410]is an area that needs improvement.
[00:24:26.100]And I'm not talking about the large-end data
[00:24:28.500]where we have teams come in
[00:24:30.540]and everyone gets tested and reading for one minute.
[00:24:33.570]That's not what I'm referring to here,
[00:24:35.220]I'm referring to methods
[00:24:37.380]of collecting different kinds of data on intense behavior.
[00:24:42.510]So, how do we measure and report data on headbanging
[00:24:49.680]or biting of hand
[00:24:51.450]or those kind of things,
[00:24:52.890]or the duration of something and how long it lasts?
[00:24:55.680]So when schools work with people like us,
[00:25:00.030]one of the things that I think we see,
[00:25:02.550]all of us collectively could probably attest this
[00:25:04.650]in this room,
[00:25:05.910]is that data collection is an area of struggle,
[00:25:09.330]and frankly, it matters
[00:25:11.010]because we need to understand exactly
[00:25:14.040]what the student is doing so we have a good baseline.
[00:25:17.100]Now, the other thing that goes hand in hand with that
[00:25:20.220]is understanding how to analyze that data and graph it.
[00:25:24.300]So one of the superpowers that we bring as BCBAs
[00:25:27.510]is that ability to look at the data,
[00:25:32.370]put it in a way that is visible and understandable,
[00:25:35.280]and then help teams make competent and quick decisions.
[00:25:39.300]Another is operationalizing behavior.
[00:25:41.577]And so one of the things
[00:25:42.930]that I see the schools need help with
[00:25:45.540]is getting to a point where their FBAs
[00:25:48.297]and their behavior plans are really focusing
[00:25:50.700]on kind of a behavior that, for lack of a better term,
[00:25:54.660]passes the dead man's test, right,
[00:25:56.460]that we can see, that we can count,
[00:25:58.950]that we can measure in some way.
[00:26:01.530]And the last thing I'll say,
[00:26:03.540]and this isn't the last thing I'll say the whole time,
[00:26:05.520]but in terms of this case,
[00:26:07.590]how to use these superpowers that we have
[00:26:10.590]in collaboration with other disciplines.
[00:26:13.380]And by the way, the first person I ever had teach me
[00:26:17.010]about data collection was a speech therapist
[00:26:18.960]in a school setting before I went to graduate school.
[00:26:21.330]So I don't ever wanna come across as,
[00:26:23.910]oh, we are the only ones that take data
[00:26:26.250]because that's absolutely inaccurate.
[00:26:28.590]But for today we're talking about what we do.
[00:26:31.620]And with that in mind, let me give you your first code word.
[00:26:34.410]Your first code word is total, okay?
[00:26:37.530]So that's your first code word, total.
[00:26:40.560]All right, so moving right along here.
[00:26:47.880]Here's the next scenario.
[00:26:50.490]Okay, your colleague asks to get together
[00:26:52.470]for coffee with you
[00:26:53.610]over a problem he's having with one of his cases.
[00:26:56.220]He is a BCBA at your clinic and wants to do a co-consult.
[00:27:00.600]He describes the situation by saying
[00:27:02.340]that he's starting to do a school case
[00:27:04.050]with an eight-year-old who is nonverbal.
[00:27:06.330]He started using PECS,
[00:27:07.530]which is the Picture Exchange Communication System,
[00:27:11.100]with her
[00:27:12.000]and has trained the family and the RBT.
[00:27:14.220]He states that he's gotten into it
[00:27:16.200]with the speech therapist at the school
[00:27:17.910]and he is not sure how to get her to do things right.
[00:27:21.570]She insists, he says, on doing it in a way that is wrong,
[00:27:25.800]and he wants to make sure that FCT,
[00:27:28.170]or Functional Communication Training,
[00:27:29.790]is implemented effectively
[00:27:31.170]as a means of replacing aggression.
[00:27:33.780]He said that the speech therapist complained
[00:27:35.580]to the principal and the clinical director
[00:27:37.980]about his insistence on the PECS protocol.
[00:27:40.800]He wants to know what you think about this
[00:27:42.540]and what you would do,
[00:27:43.470]because you have some school experience.
[00:27:46.500]So we're gonna sit with this for a minute.
[00:27:48.210]We probably have all had a situation
[00:27:51.390]where we've had a difference in how things should be done,
[00:27:55.230]just a different, I guess, background of experience
[00:27:59.940]that we bring to the table.
[00:28:02.100]This situation has all kinds of complexities
[00:28:05.400]that we need to think about.
[00:28:07.680]For one,
[00:28:09.240]and I'll move on to the next thing,
[00:28:11.640]in addition to thinking about what we have in common,
[00:28:13.680]we need to think about who the expert is.
[00:28:15.480]In a school setting,
[00:28:17.010]the expert in communication is the speech pathologist.
[00:28:21.330]And we BCBAs have had the tendency over the years
[00:28:25.680]of almost trying to say,
[00:28:28.320]no, no, we are the communication experts.
[00:28:30.900]And I think we need to acknowledge the part we've played
[00:28:34.260]in some of the, I guess, disagreement
[00:28:37.860]between the two fields of who has ownership, right?
[00:28:41.100]Who's in charge?
[00:28:42.570]And how do we do that?
[00:28:44.040]Well, I think first of all, again,
[00:28:45.510]acknowledging and giving space to the expertise
[00:28:49.020]that SLPs bring is, what do we all have in common?
[00:28:52.530]And so for this first one,
[00:28:54.450]we all want to prioritize the interventions.
[00:28:56.790]We don't have time to do every single thing in the world.
[00:29:00.390]If someone is nonverbal,
[00:29:02.340]we have a lot of work to do
[00:29:03.540]so that person can communicate effectively.
[00:29:06.690]They're already communicating,
[00:29:07.830]but probably with behavior.
[00:29:10.680]And I think everyone could also agree
[00:29:12.960]that we should focus on functional communication.
[00:29:15.600]So SLPs do use that term and do understand what it means,
[00:29:21.060]but they might use different terminology,
[00:29:23.010]they're not gonna run around saying,
[00:29:24.870]manding and tacting and things like that,
[00:29:27.270]they're going to talk about expressive
[00:29:29.310]and receptive communication and pragmatic language skills.
[00:29:33.120]And the other thing I think
[00:29:34.080]that we all bring to the table here is what we contribute.
[00:29:37.350]So our background as BCBAs means
[00:29:40.920]that we have had considerable training in verbal behavior
[00:29:44.670]and in thinking about behavior as communication
[00:29:49.020]that is functional in some way,
[00:29:51.270]it's meeting some kind of function-based need.
[00:29:54.150]And remember that the SLP, the speech language pathologist,
[00:29:57.270]has a master's degree, if not higher,
[00:30:00.600]in speech and language disorders.
[00:30:02.670]So we come into someone else's territory,
[00:30:05.790]we have to respect that there are people
[00:30:07.860]that also have expertise.
[00:30:09.930]And I find, by the way,
[00:30:12.169]I'll talk for a minute about this,
[00:30:13.440]but often parents perceive that people that work in schools
[00:30:17.490]are less competent or well-trained
[00:30:19.590]than those on the outside.
[00:30:21.030]So one way you could really combat that myth
[00:30:24.330]is to let them know that everyone goes
[00:30:26.520]to the same education programs,
[00:30:28.800]everyone gets the same training,
[00:30:31.110]but on the outside people are allowed
[00:30:33.690]to have a broader scope of practice
[00:30:36.990]than what SLPs might be able to do in a school setting,
[00:30:40.080]which is a lot more narrow and around access.
[00:30:42.720]So just sort of something to think about there.
[00:30:45.900]So let's start by looking at this case at perceptions.
[00:30:49.320]So if we're thinking about those two sides of the cliff,
[00:30:52.620]what is each person perceiving?
[00:30:55.080]So we'll start with our friend, the BCBA.
[00:30:57.930]What is he perceiving?
[00:30:59.250]Well, first of all, for him it's very laser-focused,
[00:31:02.160]that communication is the goal,
[00:31:05.040]and FCT, functional communication training, is the focus.
[00:31:09.510]And I would say also that he's pretty married to the idea
[00:31:13.170]that PECS is the way to go.
[00:31:15.180]It might be,
[00:31:16.380]but it might be that the way that he's doing it
[00:31:19.230]is not something that the SLP would want
[00:31:21.840]or maybe she wants other things in addition to that.
[00:31:24.720]At any rate,
[00:31:25.890]this BCBA perceives that he has the expertise,
[00:31:29.880]that he has the ownership of that expertise,
[00:31:32.700]and what that tells me as an outside observer
[00:31:37.140]is that he doesn't understand that SLP's role or training.
[00:31:42.810]And this is a huge area
[00:31:46.410]that we don't wanna fall in,
[00:31:47.700]total land mine if we can avoid it.
[00:31:50.790]It would be like me,
[00:31:51.930]I went to my physical therapist today,
[00:31:53.580]it'd be like me going in and saying,
[00:31:55.560]yeah, I already know everything that you do
[00:31:57.870]because I received some training in my degree,
[00:32:01.260]so I'm gonna tell you which exercises to print out for me
[00:32:05.100]and then we'll call it good.
[00:32:06.510]I would never do that
[00:32:07.620]because I know that that person has expertise
[00:32:10.170]that I don't have.
[00:32:11.580]So what we need to remember
[00:32:14.310]when we step in the door of the schoolhouse
[00:32:16.260]is that we do bring expertise,
[00:32:18.330]but there are other people in there
[00:32:19.710]who also have considerable expertise
[00:32:22.740]and they have different priorities and perceptions.
[00:32:25.830]The last thing that I would say is that this BCBA
[00:32:29.610]is so dedicated that they're really prioritizing
[00:32:34.440]that client-to-therapist relationship
[00:32:36.930]and putting it above working as a team for the client.
[00:32:41.580]And so that's where this person is really sitting.
[00:32:44.970]So let's go over and look at, what is the SLP,
[00:32:49.500]and in a larger sense, the school thinking
[00:32:53.040]and perceiving in the situation?
[00:32:55.740]First of all, the school's priority
[00:32:58.770]is that the IEP goals must be delivered.
[00:33:02.520]By the way, sometimes there is something
[00:33:04.530]called a related service,
[00:33:06.060]and that is when a person like an SLP
[00:33:09.390]or an OT or PT provides a service,
[00:33:12.240]may or may not have goals in the IEP,
[00:33:14.490]but it's still is service they're delivering.
[00:33:17.220]And that is the first thing,
[00:33:19.230]the IEP has to be implemented
[00:33:21.600]in order for that student to access a FAPE.
[00:33:24.360]If we come in
[00:33:25.800]and we are advocating for something different,
[00:33:28.770]we are actually getting in the way
[00:33:31.470]of that IEP being delivered as it is devised.
[00:33:35.640]Now, that doesn't mean that we can't get together
[00:33:38.310]and talk about, could we add this?
[00:33:40.980]Could we expand the goal?
[00:33:42.780]Could we change the goal?
[00:33:44.670]Could we have another mode of communication?
[00:33:47.310]But we can't just say, no, don't do it this way,
[00:33:49.560]I know what's best, do it that way,
[00:33:51.030]because then we're impeding the IEP.
[00:33:53.940]And then the other thing that the school knows
[00:33:56.160]and the perception they're operating from
[00:33:58.170]is this person has expertise in communication disorders.
[00:34:01.860]And they do, that's irrefutable
[00:34:03.900]that that is something that that person brings.
[00:34:07.680]One of the things that I think we can do a better job of,
[00:34:11.370]all of us, so all providers,
[00:34:14.100]is role release,
[00:34:15.360]and in role release, basically what you say is,
[00:34:18.300]yes, I have this expertise,
[00:34:20.250]but other people can also be trained
[00:34:23.790]on this delegatable skill.
[00:34:25.260]So perfect example is what I said on the last scenario
[00:34:28.500]around data collection.
[00:34:30.600]I can train people on how to do a functional analysis
[00:34:34.590]or how to take a, b, c data more effectively.
[00:34:38.010]That's delegation.
[00:34:39.330]Am I saying just go do it and I'll never see it again?
[00:34:42.540]No, I obviously have oversight into that, of course.
[00:34:45.930]We have to position those people
[00:34:47.970]as also having the ability to delegate
[00:34:51.600]and engage in role release.
[00:34:53.580]The SLP in the school setting hopefully is of the mindset
[00:34:57.690]that we have to work together as a group.
[00:35:00.720]We're not working,
[00:35:02.100]not operating in silos anymore.
[00:35:04.830]But the other thing that you need to be aware of,
[00:35:07.230]and again, I do fault our field for this perception,
[00:35:12.090]is that the SLP may not know the expertise that we bring
[00:35:17.370]in terms of communication.
[00:35:18.630]I would not say, by the way, that we are experts
[00:35:21.330]unless we're also an SLP.
[00:35:23.010]So if you're an SLP and a BCBA,
[00:35:26.100]you are a unicorn
[00:35:27.390]and you have tremendous skill in complementary areas
[00:35:32.940]toward working with students.
[00:35:34.530]But until that SLP knows what you can do,
[00:35:39.000]it's probably a good opportunity
[00:35:40.590]to provide proof of concept.
[00:35:42.570]So implement the IEP,
[00:35:44.670]but then also talk about, can we try PECS?
[00:35:48.000]How can we make this so that everyone agrees?
[00:35:50.610]And why would you want to use those?
[00:35:52.320]Maybe the SLP is very pro using a speech-generating device
[00:35:57.450]or maybe they are wanting more of a multimodal approach,
[00:36:01.890]rather than just focusing on one mode.
[00:36:04.650]So be open to the idea
[00:36:06.930]that their perceptions may not be the same as your own,
[00:36:10.380]and vice versa.
[00:36:12.450]Okay, I know I'm going really fast,
[00:36:14.100]so if you have questions, just put 'em in the Q&A
[00:36:16.410]and we'll get to them as we go.
[00:36:19.020]So some of the things that I would advocate for
[00:36:21.600]in terms of a team like this
[00:36:25.110]would be to provide some training and actions.
[00:36:28.080]So again, I'll start with the BCBA.
[00:36:30.990]When it comes to a BCBA
[00:36:32.880]like this person working in the school,
[00:36:34.830]whether they are a contracted provider
[00:36:38.310]and they're coming in to support in that case
[00:36:41.760]or they're just coming in as somebody who's an employee,
[00:36:46.680]this person needs to obtain training
[00:36:48.900]to understand what school means.
[00:36:50.970]How does schools operate?
[00:36:52.980]How does special education operate within general education?
[00:36:58.170]What is the IEP process?
[00:37:00.690]All of those things the BCBA needs to know.
[00:37:03.420]So if you happen to be an administrator
[00:37:05.790]watching this training,
[00:37:07.110]this is sort of one of those to-do list items.
[00:37:09.810]But even if you are a BCBA,
[00:37:11.400]it's also a to-do list item,
[00:37:13.350]is to obtain that training
[00:37:15.570]so that you understand the environment
[00:37:18.270]that you are practicing in.
[00:37:20.160]And part of that is learning about others you work with.
[00:37:23.460]So, what does an occupational therapist do?
[00:37:26.700]What does a physical therapist do?
[00:37:28.290]What about orientation and mobility?
[00:37:30.960]What do they do?
[00:37:32.640]What is the hierarchy of a principal to a teacher
[00:37:37.470]to a paraprofessional?
[00:37:39.300]So that is something that every BCBA
[00:37:42.540]that's in a school setting should know.
[00:37:46.120]The BCBA should also share information
[00:37:51.210]to the other team members
[00:37:53.070]about what functional communication training is.
[00:37:56.370]Because what I have seen,
[00:37:58.920]and I know we all do this,
[00:38:00.810]we come in with our treasured vocabulary
[00:38:03.750]of all the words that we say,
[00:38:06.150]and people might look at us and not understand.
[00:38:08.730]We're not the only profession that does this,
[00:38:10.560]because if you listen to a physical therapist talk
[00:38:12.720]during an IEP meeting,
[00:38:13.800]can be really, really intense and full of jargon.
[00:38:17.370]So my suggestion to you is that you share information
[00:38:20.550]about what it is you're proposing
[00:38:22.260]in a way that is contextualized.
[00:38:25.650]So if a student screams in order to escape an activity,
[00:38:31.410]a functional communication type of intervention
[00:38:35.010]might be to teach them to sign break
[00:38:37.560]or to put a break card down and to leave and take a break,
[00:38:40.830]so a safer escape strategy.
[00:38:44.820]Please do not engage in scope creep, right?
[00:38:48.030]So keep within the limits of behavior.
[00:38:50.580]What I just shared with you was a way for a student
[00:38:54.690]to leave a situation
[00:38:56.250]without engaging in a challenging behavior.
[00:38:59.250]Okay, so escaping something that is aversive
[00:39:01.800]by screaming or putting down a break card.
[00:39:04.920]A break card is an FCT strategy,
[00:39:07.350]it's still a behavior.
[00:39:09.090]So I'm not trying to get into all the language dynamics
[00:39:13.230]or things like that,
[00:39:14.130]I'm just trying to focus on a communicative behavior.
[00:39:19.110]And we have to remember,
[00:39:20.400]and this is something where it just comes with time,
[00:39:23.700]to collaborate with others in everything we do
[00:39:26.790]versus being the solo leader of the case.
[00:39:30.180]And the last thing,
[00:39:31.013]and this has been a beautiful addition to our field
[00:39:34.590]probably just in the last year or two,
[00:39:37.350]is to practice humility,
[00:39:38.940]coming in with the idea
[00:39:40.230]that we're a part of something wonderful,
[00:39:42.960]but we are not in charge of the whole thing
[00:39:45.420]and we are not the only game in town,
[00:39:47.370]so being in a place of humility and openness to learn.
[00:39:51.930]Now, the school team,
[00:39:53.580]what do they need to do?
[00:39:57.363]They have some other things
[00:39:59.713]that I would like to see them do as well.
[00:40:02.520]And that first thing would be to make sure
[00:40:05.430]that roles are clarified in advance,
[00:40:07.830]that everybody knows what it is they are doing.
[00:40:11.670]So if you are on a school team and you're a BCBA,
[00:40:15.150]you need that,
[00:40:16.110]you need to understand what your role is,
[00:40:18.600]and to me, that really is incumbent upon the school
[00:40:21.780]to provide that for you.
[00:40:23.940]Also, let's say that in this previous scenario
[00:40:27.030]we had someone come in
[00:40:28.170]and they're gonna provide some services,
[00:40:30.630]having a memorandum of understanding,
[00:40:33.120]or what's called an MOU, is very important as well.
[00:40:36.030]So the MOUs that we do for my clinic,
[00:40:39.330]we have designed to where we just call it out
[00:40:41.790]that if we're in a school,
[00:40:43.080]we are not a replacement for FAPE,
[00:40:45.450]we are not providing an IEP service, except for behavior,
[00:40:49.260]if that is what they're contracting for,
[00:40:51.690]and we very carefully describe what we're doing,
[00:40:55.140]how we fade,
[00:40:56.580]what we teach and what we don't do.
[00:40:59.430]I think that that just cuts through a lot of the mystery
[00:41:02.400]when you have those things and you make them available.
[00:41:05.490]But also schools should provide training for BCBAs
[00:41:09.660]to understand things like IEP online or other systems
[00:41:15.403]and all the vocabulary,
[00:41:19.200]all the jargon that comes with special ed and general ed.
[00:41:22.770]And then really working on goal setting.
[00:41:24.450]What is it that we want the team to do together
[00:41:27.270]in a certain amount of time,
[00:41:28.710]not just in our silos, but together.
[00:41:30.780]If we have an eight-year-old student who's nonverbal
[00:41:33.360]who has behavior,
[00:41:34.620]we're all going to be working
[00:41:36.030]on whatever the access point is,
[00:41:39.330]whether it's being in gen ed for an hour,
[00:41:42.870]working on something
[00:41:43.980]or playing with peers for 30 minutes without leaving,
[00:41:46.920]whatever it is,
[00:41:47.940]we have shared responsibility,
[00:41:49.620]the idea that everyone has something to add.
[00:41:54.210]And then I think the other thing
[00:41:55.920]is the term supervision gets very murky in school settings,
[00:42:00.870]doesn't it?
[00:42:01.703]So in our world, a clinical ABA,
[00:42:04.020]you're a supervisor and you have someone underneath you,
[00:42:07.200]you're supervising for X number of hours
[00:42:09.810]or whatever percentage per week,
[00:42:11.100]and that's that.
[00:42:11.933]In the school setting,
[00:42:13.950]supervision is like that to a point,
[00:42:17.430]so supervision might mean
[00:42:19.470]that I, as a teacher, am delegating things
[00:42:23.400]to a paraprofessional.
[00:42:25.080]I am designing those things, I train them,
[00:42:28.350]they implement them,
[00:42:29.490]I give feedback.
[00:42:30.930]That's very similar to what you're doing with supervision,
[00:42:33.870]but in the school setting,
[00:42:36.390]it is not the same stringent number of hours
[00:42:39.960]as, say, when you're working on a case
[00:42:41.550]and you've got an RBT.
[00:42:43.320]Now, that in mind,
[00:42:44.760]if you are the RBT supervisor,
[00:42:47.490]you need to make sure, BCBAs in the room,
[00:42:50.670]that the district understands
[00:42:52.050]that we have to maintain a certain percentage
[00:42:54.780]in order for that person to keep their RBT
[00:42:57.750]and to be in line with the BACB.
[00:43:00.720]So there's lots of work to do around that.
[00:43:03.180]So cross-training that goes both ways.
[00:43:06.660]Let's look at another case.
[00:43:09.630]This is more of dealing with a barrier,
[00:43:12.990]and this barrier is something that I'm seeing everywhere.
[00:43:19.890]So as I look across the landscape
[00:43:22.140]of what's happening out in our districts,
[00:43:24.840]and I'm from Washington State,
[00:43:26.940]there have been some that have said ABA just can't come,
[00:43:31.140]they're just not gonna come anymore.
[00:43:33.450]And I don't know if those in this particular webinar
[00:43:36.630]have seen or heard this,
[00:43:38.580]but here's some of the questions that I have thought about
[00:43:42.750]as I have heard this blanket statement,
[00:43:45.690]and it's, where did this come from?
[00:43:48.990]And some of the things that,
[00:43:50.850]let me just see what's on the next slide, yes.
[00:43:52.470]So, where might this have come from?
[00:43:55.230]Was there something that just flipped the switch?
[00:43:58.710]And I have watched
[00:44:00.030]as different districts have done different things.
[00:44:02.580]And I know that in Montana, for example,
[00:44:05.670]this definitely, it can't apply,
[00:44:07.800]but there are others where,
[00:44:10.110]or maybe it's Colorado,
[00:44:11.490]it's Colorado.
[00:44:12.600]So anyway, there are certain states
[00:44:14.550]where this might not be an issue,
[00:44:16.740]but in many states a district will just say,
[00:44:20.040]blanket statement,
[00:44:21.780]we're not having ABA providers come in,
[00:44:24.150]especially if they're outside clinical people.
[00:44:28.080]So I'm always curious, where did it start?
[00:44:30.900]Was there a catalyst?
[00:44:32.190]And then, how do you fix this?
[00:44:35.730]What do you do to get beyond that
[00:44:38.340]so that you're able to be in that place
[00:44:42.540]with other people and work effectively
[00:44:44.940]for the long-term benefit of the student?
[00:44:47.610]So this is a huge barrier that I am seeing.
[00:44:50.760]So here's a couple of things
[00:44:52.440]that I would say are definitely on my radar,
[00:44:57.750]and that would be past negative experiences.
[00:45:01.380]So that could be anything
[00:45:02.820]from the school district bringing somebody in
[00:45:07.800]and not doing all of those good onboarding type
[00:45:12.090]of training behaviors that we talked about,
[00:45:14.940]and then I overviewed.
[00:45:16.650]So then you've got a BCBA who comes in
[00:45:18.960]and they're just doing their job,
[00:45:20.670]they're just doing exactly
[00:45:21.900]what it is they've been trained to do,
[00:45:24.060]but it's not meeting the needs of the IEP team.
[00:45:27.810]So in that case, in my opinion,
[00:45:29.970]it's totally on the school,
[00:45:31.290]it's not on the BCBA
[00:45:33.120]who didn't understand the expectations
[00:45:36.720]of how to practice in that culture.
[00:45:39.450]It could also be, though, that BCBA came in
[00:45:45.570]and had negative things to say, such as,
[00:45:50.130]you don't understand what you're doing
[00:45:52.170]with sensory, for example.
[00:45:54.360]Let's pick that one since that seems to be controversial
[00:45:58.890]and yet used all the time.
[00:46:01.200]So if the BCBA comes in and says,
[00:46:04.920]you're not doing this right,
[00:46:06.810]there's no sensory going on here,
[00:46:09.780]that can lead to a pretty negative experience
[00:46:13.890]for the occupational therapist
[00:46:15.600]who has a lot of background education in sensory.
[00:46:21.480]So I think the first thing I like to do
[00:46:23.670]is try to figure out what happened.
[00:46:25.800]And if I was the clinical director,
[00:46:27.480]then I'd wanna go back to, where did this start?
[00:46:30.780]So those of you that are entering a situation
[00:46:35.160]need to try to figure out if you can, what happened,
[00:46:40.143]what led to this.
[00:46:41.517]And so you might be in a position of leadership
[00:46:43.530]where that's a question you need to ask,
[00:46:45.180]and I think it's okay to ask it.
[00:46:47.820]What led you, district, to this choice?
[00:46:50.160]And was there a specific instance?
[00:46:53.400]Just learning more about that cannot hurt.
[00:46:56.250]But the next thing I think that might be going on
[00:46:59.070]is an assumption about FAPE,
[00:47:00.900]so let me talk about what this means.
[00:47:03.180]So there are certain districts who say,
[00:47:06.150]maybe they don't have,
[00:47:08.130]let me back up for a second
[00:47:09.270]and say that in Washington State,
[00:47:11.580]a BCBA can be a related service provider in a school.
[00:47:15.720]So it's not uncommon now to have a BCBA hired by a district
[00:47:20.190]working for the district.
[00:47:22.050]And so if we put that aside for a minute,
[00:47:24.870]let's think of a situation where a parent says,
[00:47:28.260]I want my ABA clinic people to come in
[00:47:32.610]and provide services during the school day.
[00:47:36.060]And the district says, well, wait a minute,
[00:47:39.350]we need to provide this student with what's called a FAPE.
[00:47:43.080]So their IEP indicates these services for these many minutes
[00:47:48.180]by these people in these settings
[00:47:51.450]and includes these accommodations and modifications.
[00:47:55.140]So a district may say,
[00:47:57.450]well, if we let so-and-so's behavior team come in,
[00:48:01.920]then we may be admitting that that is what FAPE is
[00:48:05.460]and then we've got to pay for it.
[00:48:07.410]So that has happened
[00:48:09.570]and that has been an underlying reason
[00:48:12.420]for why some districts have chosen to put the full stop
[00:48:15.930]on having ABA providers come in.
[00:48:18.360]And then my experience has been that,
[00:48:20.970]and maybe it is with yours as well,
[00:48:22.200]I'd love to hear from you,
[00:48:23.280]so find my email and contact me.
[00:48:25.530]The districts will say, well, we'd rather hire our own
[00:48:28.860]and have them in district than bring in outside people.
[00:48:33.330]That sounds great,
[00:48:35.160]but unless there's training and onboarding and guidance,
[00:48:39.390]it isn't going to work as well
[00:48:41.700]as if we are proactive in doing all of those things.
[00:48:46.050]And then I think the third one
[00:48:48.240]is a true misunderstanding of what ABA is.
[00:48:54.851]And this to me is one of those elephants in the room
[00:48:58.410]that we are seeing and we're butting up against.
[00:49:02.130]So the idea that somehow ABA is so different and so separate
[00:49:10.200]is highly concerning to me
[00:49:12.000]in light of when I think about what a school does.
[00:49:15.840]So let's say you've got average third grade classroom
[00:49:19.770]and the teacher has set up a group-based token system,
[00:49:24.390]and contingent upon three focused target behaviors,
[00:49:30.240]the group will earn enough scoops in a bowl
[00:49:33.060]to get an ice cream party on Friday
[00:49:35.220]or enough popcorn balls to get a popcorn party on Friday,
[00:49:40.440]that is ABA.
[00:49:42.180]Or when we use direct instruction reading
[00:49:45.870]and we break things down, skills down,
[00:49:48.480]and systematically teach them
[00:49:51.300]with high levels of opportunities to respond
[00:49:54.120]and reinforcement,
[00:49:55.560]that is also ABA.
[00:49:57.510]So the idea that somehow our work is so mysterious,
[00:50:02.130]so separate,
[00:50:03.270]has really, to me, shown a misunderstanding of what ABA is.
[00:50:08.730]And then on the flip side,
[00:50:10.500]I would say that there are people who have made it that way.
[00:50:13.170]So for example, if you are BCBA
[00:50:16.410]and you come into a school to do programs
[00:50:19.950]and you pull the kid to run programs,
[00:50:23.370]I can understand where that misunderstanding comes from
[00:50:26.250]because part of the work we need to do
[00:50:28.650]is to show how ABA is a science,
[00:50:32.310]it's a set of principles about how we learn
[00:50:35.160]and how to shape that.
[00:50:37.110]And so if we just pull a kid aside
[00:50:39.480]and work on their program book,
[00:50:41.310]we're really not showing how those skills
[00:50:44.070]generalize to the gen ed setting
[00:50:46.470]or to the special ed setting
[00:50:48.210]and how they're contextualized to that setting.
[00:50:50.940]So the misunderstanding,
[00:50:52.020]I'm not pointing a finger at any one person,
[00:50:55.410]but this is something that is creating the opportunity
[00:51:00.060]for a district to say full stop,
[00:51:01.620]no, no ABA,
[00:51:03.330]without really understanding
[00:51:04.590]what it is they're saying no or yes to.
[00:51:07.530]So, how do we fix that?
[00:51:10.470]So this is gonna be my last set of points.
[00:51:13.470]We need to create a mindset as providers
[00:51:19.260]that we are collaborative and that we are additive.
[00:51:24.540]So we're not supplanting what's happening in schools,
[00:51:28.320]I think that's the thing we need to get away from right now.
[00:51:31.290]But the idea is that we work with school,
[00:51:34.140]we are additive to the school setting,
[00:51:36.900]we are supportive of the school setting.
[00:51:39.510]And that as a community as a whole,
[00:51:42.180]and I mean this needs to filter
[00:51:43.800]all the way into our ethics code,
[00:51:46.110]this needs to filter into our graduate programs,
[00:51:49.770]is this idea that we are humble,
[00:51:53.310]that we don't know it all,
[00:51:55.140]and that we are willing to learn about this environment
[00:51:58.590]that's often very foreign.
[00:51:59.910]I mean, all of us went to school,
[00:52:01.170]so it shouldn't be that foreign,
[00:52:02.580]but for some reason once we get into a clinic,
[00:52:05.250]we forget and we get so enamored
[00:52:08.490]by all the control that we have over this
[00:52:10.830]that it's hard for us to understand
[00:52:12.450]what's happening in school.
[00:52:13.560]So being willing to do that, I think, will move us
[00:52:16.440]a long way.
[00:52:18.000]Now, let's talk about parents for a minute.
[00:52:21.000]I see all the time, and you probably do too,
[00:52:23.790]the parents highly value what we do
[00:52:26.886]to the point where sometimes a parent will say,
[00:52:29.280]well, let me just put Johnny in ABA from 9:00 to 2:00
[00:52:34.320]and then they can go for the last hour to school.
[00:52:36.720]And I think we need to, as a community, say,
[00:52:40.770]school is the natural environment for children
[00:52:43.470]and we can support that
[00:52:45.840]by either serving the child outside the school day
[00:52:50.580]or working with the school
[00:52:53.850]to ensure that that child can access general and special ed.
[00:52:58.260]So I'm always trying to push parents back
[00:53:01.860]towards seeing school in that light
[00:53:04.410]because fundamentally that's what inclusion is all about,
[00:53:07.440]that everyone is able to access the school setting.
[00:53:10.920]So what I want you to be thinking about
[00:53:14.400]as you leave this webinar is what you can do as a BCBA
[00:53:20.160]in order to further that conversation.
[00:53:22.740]So the last code word,
[00:53:24.990]'cause I'm sure you're thinking about that, is eclipse.
[00:53:28.740]So for context,
[00:53:31.170]I just got back from trying to see the total eclipse,
[00:53:34.710]which I didn't because of clouds,
[00:53:36.720]but that was the word that occurred to me.
[00:53:38.910]So word one was total and word two is eclipse.
[00:53:43.380]So I'll open it now for questions or comments.
[00:53:45.840]We have a few minutes left in the webinar.
[00:53:48.990]What can you do
[00:53:50.520]or what has this made you think about in this hour?
[00:53:59.280]I don't believe you can talk,
[00:54:00.480]but I think you can write in the chat box.
[00:54:14.940]Annette, are people able to write in the box?
[00:54:22.440]Yes.
[00:54:23.273]Tisha.
[00:54:24.360]Should or can outside BCBAs take time
[00:54:27.360]to build rapport with the teaching staff,
[00:54:28.980]and what is the best way to do that?
[00:54:30.300]Yes.
[00:54:31.133]So hi, Tisha.
[00:54:33.420]Rapport is huge.
[00:54:34.530]Pairing with teachers is huge.
[00:54:36.300]So what we do is we come in and we sit and we watch
[00:54:41.760]and we learn about the environment,
[00:54:44.670]we learn about the good things that are happening
[00:54:46.950]and we highlight them.
[00:54:48.690]And then Flora just made an excellent point.
[00:54:50.700]We show our worth, what we can bring.
[00:54:53.280]We show them how to collect data and analyze it,
[00:54:56.670]but we do it alongside them
[00:54:59.160]so that they see that what we have
[00:55:01.140]is something that's scalable.
[00:55:02.580]So you teach someone how to use an a, b, c chart
[00:55:06.480]and then they generalize that,
[00:55:08.100]we've done our jobs, right?
[00:55:09.600]And so we should take that time, absolutely.
[00:55:14.220]And to me, the first thing I do is I go and I sit
[00:55:17.850]and I watch and I try to look for all the good things
[00:55:22.110]and learn about how this little ecosystem works.
[00:55:25.800]Maria says, "Clinic BCBAs only get one first impression
[00:55:29.100]when they come to schools with parents.
[00:55:31.020]How you present in that initial meeting
[00:55:32.610]gives schools an impression of how you're going to work
[00:55:34.890]with the team when you're building."
[00:55:35.880]Absolutely, I totally agree with that statement.
[00:55:40.200]Yeah, so I think if we come in with the idea
[00:55:43.410]of I'm in a position to learn about how I can help
[00:55:47.790]and add to this in some way,
[00:55:50.400]but also maybe I'm gonna learn some things too,
[00:55:53.760]I think that's how we start to build relationships.
[00:55:56.850]I think it's okay to say, back to Tisha's point,
[00:55:59.970]I'm not a teacher,
[00:56:01.050]I am a teacher,
[00:56:01.883]but in this situation let's say I'm not a teacher,
[00:56:04.800]I have things to learn from you as well.
[00:56:06.750]I hope that we can learn together.
[00:56:09.420]Jessica said, "I love the school as a natural environment.
[00:56:12.360]Comment, going to use this with a family
[00:56:14.430]to encourage them to send kiddo to kindergarten next year."
[00:56:17.010]Thank you.
[00:56:18.360]Write me and tell me how that goes, please,
[00:56:20.790]I would really like to hear about that.
[00:56:23.100]And I appreciate you getting that message out.
[00:56:25.740]Thank you.
[00:56:26.573]Other thoughts or comments?
[00:56:28.890]There's a Q&A here.
[00:56:30.150]Annette, do you wanna read it or do you want me to?
[00:56:34.320]I can read it here.
[00:56:36.030]How does a school-based BCBA determine
[00:56:39.930]how many minutes of ABA a student needs
[00:56:42.960]in the school setting?
[00:56:45.600]Ah, Savannah, what a great question.
[00:56:48.270]So I think every discipline has this question,
[00:56:51.300]how many minutes, right?
[00:56:52.830]And there's, as far as I know,
[00:56:57.180]the research doesn't say,
[00:56:58.410]well, if you do 30 a day or whatever.
[00:57:01.080]I think what you do is you try to figure out
[00:57:04.500]by doing an environmental inventory where the issues are
[00:57:09.270]and then figure out how much time is it going to take
[00:57:12.180]to analyze and then teach and reinforce those skills,
[00:57:17.100]and then see what the data says.
[00:57:18.600]To me, the data will tell the story, right?
[00:57:20.820]So if we say, let's say we do 45 minutes a day
[00:57:26.970]working with the kid in this situation
[00:57:29.340]and they make progress,
[00:57:30.360]great, then we're on the right track,
[00:57:32.100]but if they're not,
[00:57:33.210]then we might need to increase the time,
[00:57:36.420]or if they're in a small group,
[00:57:38.280]go one to one.
[00:57:39.810]And this is no different, by the way,
[00:57:41.850]than the same discussion around minutes that we have
[00:57:45.600]with reading, written language, math in a resource room,
[00:57:48.690]so it's exactly the same problem.
[00:57:50.610]So I'm glad you asked that
[00:57:51.570]because I'm not sure I know the best answer,
[00:57:53.760]other than look for about what the impact is,
[00:57:57.840]try to match that,
[00:57:59.460]and if it's working,
[00:58:00.390]great, you're on the right track,
[00:58:01.680]if it's not, then you need to adjust.
[00:58:04.260]And also keep in mind that minutes matter.
[00:58:07.530]So the more minutes that are spent on something,
[00:58:10.050]the less minutes that child has
[00:58:11.910]to be in the general education setting
[00:58:14.700]or to work on other things,
[00:58:17.100]so we wanna be careful about overserving as well.
[00:58:24.810]So thank you, that was a great question.
[00:58:26.940]Anything else that's coming to mind?
[00:58:29.180]Nicole.
[00:58:31.620]Nicole, I did unmute you.
[00:58:33.360]I saw your hand was raised.
[00:58:35.970]Did you wanna be able to talk
[00:58:37.410]or did you wanna type your question?
[00:58:42.780]If you wanna unmute your microphone,
[00:58:45.030]you're able to do that now.
[00:58:50.100]And if you don't, you can type it, Nicole.
[00:58:55.260]So let me answer Julia's question while we're waiting.
[00:58:58.080]If there are learner behavior gaps that are interfering
[00:59:00.390]with a child being successful in school,
[00:59:02.550]would that be an appropriate reason
[00:59:03.930]to pull the kiddo out for ABA to build some of those skills?
[00:59:08.670]If by pulling out you mean going to a clinic,
[00:59:11.430]I don't think so.
[00:59:13.080]And I would be very careful about just what Jessica wrote,
[00:59:18.090]about changing LRE.
[00:59:19.740]So this is the same discussion we have
[00:59:22.380]when we talk about, should an SLP work with a kid
[00:59:25.020]in a private therapy room versus in a classroom?
[00:59:29.340]If we are having behavior, in my opinion,
[00:59:33.480]the best thing to do is to provide skill instruction
[00:59:37.530]and then situate it in context
[00:59:39.420]of where it's really, really needed,
[00:59:41.460]rather than saying, well, we're gonna pull out
[00:59:43.620]and then we will try.
[00:59:45.600]A good way to think about this
[00:59:47.430]is let's take kids that have emotional behavior disorders.
[00:59:50.310]Sometimes people will say,
[00:59:51.600]well, they have to earn the right to be in general ed.
[00:59:54.870]If we waited for these kids
[00:59:57.420]to earn the right through their behavior
[00:59:59.940]in a behavior classroom to go into gen ed,
[01:00:02.580]some of them would never ever get to general ed.
[01:00:06.030]So I think there's a point,
[01:00:07.230]a tipping point where we need to say,
[01:00:09.300]we're gonna work on those skills alongside
[01:00:11.820]in the environment in which we expect them to access them.
[01:00:15.330]Marquina, I have no idea about the certificate,
[01:00:17.640]but Annette does.
[01:00:20.430]Yes, thank you for,
[01:00:22.020]I was just listening, Marquina,
[01:00:23.640]so I'm so glad you said that
[01:00:24.887]'cause I was just slacking off.
[01:00:29.250]The link that I just posted, I should have named it,
[01:00:31.800]that is the general certificate
[01:00:35.130]if you do not need BCBA CEUs.
[01:00:38.434]So just give me one moment to grab the next form.
[01:00:42.270]And this is the link to use.
[01:00:46.740]You have to fill out a short Google survey
[01:00:49.800]and add your words in there to get your BCBA certificate.
[01:00:58.500]So let's see, there's a general certificate
[01:01:01.650]that you just download and add your name to that,
[01:01:04.650]and then there's the BCBA survey that you have to complete
[01:01:08.550]and add your provider number, et cetera,
[01:01:12.480]to get to access your certificate.
[01:01:15.870]Okay, as promised, I'm going to share the links
[01:01:19.920]for our tri-state collaborative
[01:01:24.210]where you can,
[01:01:25.800]if you guys were as excited about this content as I was
[01:01:31.950]and you wanna share with a colleague or re-listen,
[01:01:35.670]you can, you know what?
[01:01:36.990]I wonder how well,
[01:01:38.010]yeah, I think you can differentiate there.
[01:01:40.410]The first link is to the Colorado website,
[01:01:44.010]the CDE State Professional Development site,
[01:01:47.880]that is where they archive their webinars,
[01:01:50.670]the second link is to the TASN website,
[01:01:54.780]and the third link is to the UNL Nebraska ASD Network site.
[01:02:00.420]So just a quick reminder,
[01:02:03.120]we hosted the last four webinars,
[01:02:05.940]so we actually will have them up and ready.
[01:02:09.030]Three of our three previous webinars
[01:02:11.340]have already been posted
[01:02:13.170]because we've had access to those.
[01:02:15.270]Our partners in Kansas and Colorado
[01:02:18.120]will be getting that information,
[01:02:20.250]all the files from us shortly,
[01:02:21.810]and we'll have those up as well.
[01:02:24.300]So you can check them out there.
[01:02:25.890]I would love, everyone,
[01:02:27.630]thank you for staying on
[01:02:29.130]and hearing all this great information.
[01:02:32.280]And let's just thank Dr. Tucker
[01:02:34.050]for sharing her expertise with us.
[01:02:37.020]Thank you so much for having me,
[01:02:38.460]it was wonderful to be able to share.
[01:02:40.770]And again, contact me if you need anything.

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ABA in Schools: It's a Different World Part 2

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