As a Board Certified Behaviour Analyst (BCBA), I specialize in Applied Behaviour Analysis (ABA). I love what I do, and I am constantly working towards developing a deeper understanding of it.
Over the years, I have heard different interpretations of what ABA is and what it looks like. Most commonly when someone describes what they think ABA is, it’s more of a clinical interpretation. A therapist, at a table with a child, doing some kind of tacting or manding activity, in a colourful room with lots of sensory toys. There is almost always an expectation of data sheets, token systems, and highly skilled individuals to deliver treatment. Well, this is true but does not reflect all the different methods of service delivery that can be offered using Applied Behavioural Analysis.
That all being said, do you know what I am most passionate about when it comes to ABA?
Parents.
I know, shocking, right? Most BCBA’s might be expected to say something like behaviour (obviously), research, data, schedules of reinforcement, blah, blah, blah, etc. Don’t get me wrong. I have a deep love for those things too; but I am truly about the parents, or caregivers in an individual’s life- as “parents” can come in many forms.
Parents are my bread and butter. They are my greatest tools and the best advocates for their children. I find myself frequently inspired by the parents I work with. Perhaps this is why I enjoy what I do so much.
Most parents are geniuses and, often without knowing it, have all the answers. Well, they have the answers I need anyway.
How do we turn behaviour on?
How can I stop the behaviour if I absolutely had to?
What are their children’s preferred things, activities, etc.?
What does that look, that sound, etc. mean?
The little idiosyncrasies that make up this individual in front of me, parents know. Parents can identify a complex need of their child based off a pitch or tone in an unrecognizable utterance the child makes; parents can anticipate a change in mood from a slight shift in a facial expression that is unnoticeable to an outsider. Parents truly are the experts. So, why aren’t more therapy approaches placing a heavier emphasis on delivering service in a mediator model, where parents are the implementers?
Well, there are a few reasons for this, to be quite frank. 😉
Intensive early intervention has a deep pool of evidence to support therapist delivered treatment, at a young age for those individuals on the Spectrum. Then, there is also sending your child, with or without a diagnosis, to see a therapist, counsellor, or psychologist for some good old talk therapy that has many, research supported benefits that I do not have space to list here.
For me though, it always comes back home. After those kids, teens, or adult children are done at therapy, they gotta go back home. Without teaching parents or caregivers how to respond to behaviour or promote skill development, it will be an uphill battle to achieve generalization or maintenance in that setting.
The other consideration is that all of this- this diagnosis, the challenges that come with the diagnosis, etc.- all of this, is forever.
Many of the families we work with, their children have a diagnosis that will be with them for the rest of their lives. The needs and interests of the child changes as they grow into a teenager and eventually into an adult. With that comes changes in medication, behaviour, abilities, etc. Having access to specialists in the field is helpful and important; however, with a growing need for services, many families end up on waitlists trying to access help to address all of the above concerns. Shifting treatment approaches to be more heavily focused on parent skill development in the therapeutic approach being delivered would potentially alleviate some of the waitlist strain.
Now, some readers may point out that parent coaching and courses are offered in many locations – and that is true- we offer it too. It is a fantastic way to introduce caregivers to behaviour analysis and principles. However, an individualized approach that is designed with parent input and to account for potential barriers in the home setting, will make the training more applicable, and in turn, increase the likelihood of generalization and maintenance.
One of my favorite pieces about approaching treatment in a mediator model is that it promotes comradery. It’s me and this family, down in the trenches; battling it out together to figure out what is going to work for them to reach the goals they have set out. I love this spirit and exchange of ideas. I love that we get our creative juices flowing, thinking outside the box, to design strategies that are practical and workable for that family. We move beyond clinical, to the nitty gritty of applied. As behaviour practitioners, when we utilize this approach, we are able to teach and model behaviour principles in a natural setting. We are able to test in the moment if something works and if it will be maintainable and realistic to implement. The learning becomes personal for the family; the gains are palpable, and the knowledge sticks.
Those parents, my mediators, are the key to everything. I have found more success in implementing and maintaining my recommendations when my mediator not only has a say in the design but understands the rationale and the behaviour principle behind the design- the “why” of what I am suggesting and how it is linked to the behaviour. With that knowledge, parents are better able to highlight barriers that will prevent them from being able to use the strategies daily, without placing judgement on themselves. Hidden or unidentified barriers can be the undoing of any good behaviour plan.
One of those frequent barriers I come across is forgetting we are not superheroes; we are human. We get sick, we get tired, and sometimes we just need a break. Too often I hear “I know. I should be more patient” from the parents I work with. Behaviour analysts can understand that when an individual is not engaging in a behaviour, there are a few factors at play (e.g., establishing operations affecting motivation, availability of reinforcement, learning history, etc.). When a parent flogs themselves for not engaging in “perfect” parenting behaviour, it is often with great joy that I get to dive into behaviour principles and point out how they are actually responding to environmental contingencies (i.e., barriers) that have been deterring them from being able to reach that “perfect” parenting moment. Translation: if you set your goals high where you have to be a “perfect” parent which means engaging in play activities, or doing homework, or following through
every
single
time….
You will fail.
Anyone would fail. It is an unrealistic expectation. Being a parent is hard. I bet, most of the time, you are already doing a really great job of it. Are they still alive? Yes? Check that box. High five!
When we understand behaviour analysis, we can better see how our own behaviour and the behaviour of those around us interacts with motivation, satiation, deprivation, reinforcement, and so on. Gathering knowledge on these concepts helps us set the stage to create more of those “perfect” moments between parent and child. We can identify when that moment won’t be available and when it will be. So, hang up your flogging tools, we won’t need them anymore. Let’s teach mediators how to set things up for success, recognize when to adjust expectations so that the needs of the family can be met moment to moment, all the while creating meaningful behaviour change.
With a mediator model of service, where the focus is on teaching parents in the ways of behaviour analysis and principles, behaviour analysts will be ultimately trying to put themselves out of business. I concede, it is not the best business model! 😉 However, there are few moments for me that compare to the look on a parent’s face when they engage in a strategy designed just for them and their child, and it goes exactly as we planned- together.
Gamache Behaviour Consulting delivers service in a mediator model. Our mission is to not only provide compassionate and practical behaviour strategies in the home, but to empower parents to be their own therapists; to understand and manage behaviour concerns so they can know what to do now, and many years from now.