[Deleted User]

ABA consultants and treatment providers

I would recomend (my opinion)that parents only accept training and services from a board certified behaviour analyst.You can find out exactly what this is by going to http://www.bacb.com.

The Behavior Analyst Certification Board®, Inc. (BACB®) is a nonprofit 501(c)(3) corporation formed as a result of credentialing needs identified by behavior analysts, agencies within several state governments, and consumers of behavior analysis services.

The BACB’s main purpose is to develop, promote, and implement a voluntary national (and perhaps eventually international) certification program for behavior analyst practitioners. The BACB has established uniform content, standards, and criteria for the credentialing process. It seeks to ensure that the program meets 1) the legal standards established through state, federal and case law; 2) the standards for national certification programs as established by the National Organization for Competency Assurance and the National Commission for Certifying Agencies; and 3) the "best practice" and ethical standards of the behavior analysis profession.

The BACB program is based on the successful Behavior Analysis Certification Program operated by the State of Florida. The Florida Program has been in operation for nearly twenty years and helps to ensure the competency of practitioners through stringent requirements for completing appropriate professional experience and specific formal education; passing a professionally-developed written examination; and obtaining ongoing continuing education. Similar criteria have been used to credential behavior analysts in California, Texas, Pennsylvania, New York, and Oklahoma. The BACB program evolved out of efforts of the State of Florida to nationalize the certifications developed by the Florida program.

[Deleted User]

I am disturbed by many posts in the past few days. In particular on the subject of training and parent participation.

On training: I would suspect that govt. supplied training is tied to the direction that govt. wants to go with moving IEII funding to Community Living groups. This is an obvious move to divide and conquer which ultimately pits differing special needs groups individuals against each other to fighting for a piece of the Community Living budget. Our children will come out losers if this scenario happens as ABA would (if properly funded) take too big a bite out of the budget.
Furthermore does the govt. have qualified people to train? No. No more than they employ qualified ABA practitioners. If this was a morally valid attempt by govt. to meet our childrens medical needs they would be working with local post secondary institutions to attract some of the best academics in behaviour analysis to fill this void and establish a more pro ABA treatment approach by the psychology departments. To draw an analogy; would govt. hire a doctor to teach us parents to perform heart surgery on our children (suffering with heart disease) if there was a shortage of open heart surgeons in this province? No. See, its just another attempt at minimizing the validity of treatment and saving $s while pretending to do something.

Parent participation. If you are a therapist who thinks ABA goes out the window when you leave the home, have the guts to share this in a team meeting. I know that I , as a parent have to work 60+ hours plus a week to pay for ABA. I do however live and breathe ABA strategies in free time with my child though few people would recognize that at a glance. My spouse however is very involved with all aspects of the program, including discrete trials. She was trained and continues to receive training by our treatment provider. This is how it should be, we (parents) cannot become expert treatment providers by attending a govt. supplied course(s). Unfortunately some Community Living Groups are jumping at the chance to do just this because the govt. has directly tied their cooperation in this to maintenance of their budgets.

[Deleted User]

A year ago I began working on a team where the consultant would simply photocopy programs out of a book and then hand them to the parents. This person did not suggest targets to begin with, nor did they even once modify programs at all to suit the child's age or ability, which was impaired.

It was left up to the team to take these broad directions and try to narrow it into simple steps. Fortunately two of us on the team had enough experience that we were able to do this. I thought it strange that this person was paid a lot of money to come for a consultant visit and all she did was photocopy notes. I could have done that (I never would though…)

During these visits, we as a team, woudl ask questions about behavioural problems and program direction. This person said several times that the team were best able to decide on behavioural interventions and future programming issues. I would agree that the team, working one on one with the child should be consulted over functions of behaviour, areas of interest, targets etc however none of us felt qualified to make the decisions expected us. After all, what is the purpose of a consultant if not to direct the team? Why would parents pay $75 – 250 an hour if I could do it for $10?

Finally it reached a point where I no longer felt comfortable. We were not simply writing steps of teaching we were being asked to make decisions that were beyond our training level. None of us on that team had the educational background or years of experience and supervised training required to do those things. Fortunately for that family we did have enough training to realize how little we really knew.

Just one therapist's perspective
Anonymous out of respect to the family mentioned above, as well as the Consultant and fellow team members

[Deleted User]

To the anonymous posting re: therapists designing programs!!

YIKES!

that is my first reaction.

Anon, your instincts are correct, that sounds potentially dangerous.

I would never, NEVER, NEVER allow my therapists to design my childs programs. Particularly therapists who have 4 months of training.

Having worked with the same consultant for 2.5 years with both of my children, there are times when she gives us a program verbally during her consultation (we are not on a workshop model)and it might be very similar to a program she has given us before or it might be identical to a program that she gave us for our daughter, then and only then do we not require her written instructions on how to implement. But those instances are few and far between.

When that does happen we run through exactly what she wants verbally, have her show us and then write it down verbatim.

However the usual practice, even when I know what she is referring to is to have HER demo what she wants and then ask her to also send a written version as well.

Our Consultant has a high degree of expertise. She can think through all the possible situations that might arise. She knows the behavious that may come up as well as those we are already dealing with. She knows the implications involved. Our therapists may (MAY) have some ideas on these, they are familiar with the current behaviours but they don't necessarily know how the behaviours morph into new problems. Therapists usually do not have years of experience implementing and designing programs. It takes extensive periods of time to have enough experience to know how to program well, vs. write out a program from a book.

And with only four months of experience I would say your therapists, as great as they might be, do not have enough knowledge to be doing so.

It sounds as though your consultant focusses on training her/his team and that is a good thing. We want our therapists to grow and expand in ability but it should be part of a process.

I think your concern about weeks of faxing things back and forth is also valid.

The role of a therapist, in my OPINION is to implement, not invent.

ABA is an extremely powerful tool. Used incorrectly it is still powerful but the results are disasterous, used correctly and the results are astounding.

Michelle Himmelright

[Deleted User]

Hi there. I have a question about the consultant's role in the delivery of ABA therapy. I would very much like to hear back from both parents and consultants with respect to your experiences. The question arises as a result of a minor difference of opinion with government officials about the type of services we want to receive.

Having had the very rewarding experience of working with WEAP when our child first started ABA, our understanding of the role of the consultant was as follows: The consultant assesses the needs of the child and provides to the "team" (consisting of parents and line therapists and, if lucky, a lead therapist), specific programs for the child. The consultant provides those programs either in the form of very detailed workshop notes or, better yet, in the form of completed acquisition sheets. The workshop time is devoted primarily to assisting the team in the development of skills relating to the DELIVERY of the programs.

In contrast to this, I have been presented with a slightly different view of the role of the consultant. This role sees the consultant as someone who empowers the team to not only DELIVER the programs but to DEVELOP the program. The workshop consists of the consultant talking about certain programs, behaviours etc. The therapists are expected to take detailed notes themselves. From those notes they are expected to write up their own acquisition sheets. The consultant agrees to review the notes (by way of fax) before the therapists start writing the acquisitions sheets.

My concern with this, arising in part out of our recent experience, is that what tends to happen is that there is a two to three week period after the workshop where the notes and aquisitions sheets are faxed back and forth. It takes at least three weeks before our team is provided with a completed set of aquisition sheets that have been reviewed and approved by the consultant. In the meantime, the therapists are delivering what they THINK is the program. In the past month, this has resulted in some subtle but not insignificant mistakes in the program design such that the consultant had to modify a program that our son had been receiving for the previous four weeks, at the next workshop.

I don't know. Perhaps I am being too beurocratic and uptight about this. But with all of the greatest respect for our great team of line therapists, I don't think they should be developing programs with only four months of experience. While I understand the value of having them learn, I would think that learning would best come from seeing well developed programs being presented to the team as a done deal rather than having them experiment with our son as they try to develop the program.

Alternatively, perhaps there is a new school of thought on how best to deliver ABA programs with which I am unfamiliar.

As I said before, I would very much like to hear the opinions of both parents, consultants and therapists on this issue.

[Deleted User]

Just want to support that last Anonymous post.

It's vital that what we therapists do during 'therapy hours' is carried over into everyday life by the parents and other caregivers. It's how skills are truly learned and generalized.

To use a really practical example, let's say I'm working for you, with your little boy, and we decide to start teaching him how to tie a shoelace. Well, I and the others on the team teach him to tie a shoelace in about 16 sittings. That's awesome! We now have a target list that shows he can tie a shoelace. The thing is, if you as a parent continue to allow him to wear only velcro shoes or tie his shoes for him, he's not going to retain or generalize this new skill, and it is quite likely that he will eventually stop doing it even in therapy sessions, because once an item is mastered it does not get targetted every day anymore.

Training for parents is important. I think that's part of why consultants require at least one parent to be at all workshops, and why the parents are basically 'in charge'. (The consultant gives programs, but usually asks the parent if that's something they want their child to learn. We also consult parents on appropriate language.)

However, parental training does not and cannot replace the value of having a well-trained, qualified ABA consultant in charge of training therapists and developing programs. An appropriately trained and qualified consultant is going to have the background necessary to assess behaviours and design appropriate intervention, never mind actually developing appropriate curriculum for the child.

If the government is planning to train parents in an attempt to forego the costs of hiring actual consultants, I have to wonder if any of them were actually listening to Tristram Smith at the Autism 2002 conference. He was very clear on this point.

-Janna (*full* ABA Therapist on the North Shore)

[Deleted User]

There have been a lot of postings lately with parents stating that they want ABA, and that they DO NOT WANT TRAINING. I whole-heartedly hope that all families with children who have Autism get ABA, no matter what the age of the child is. Nonetheless, I find it quite disturbing that so many parents are refusing to take training. I used to work as an ABA therapist, and now work with parents of children who have Autism. Yes ABA works, but we all know that the child is going to progress the fastest if their skills are generalized into all environments. If there is one thing that I have seen over and over again, especially in homes where there is an ABA program, it is that the ABA stops as soon as the therapist leaves. Sure there are families out there that have the time to learn the ABA (which I have to say is the training that you are saying you don’t want) and follow through with it. There are also other families who do not have the time and energy to do this. In these families, I have seen great progress during the ABA sessions, and great loss of skill as soon as the therapists leave the home. My point is, that if parents do not receive training, the therapy ends after each session. If parents aren’t trained in how to work with their Autistic child, that child’s skills will regress after the trained therapists leave. On the other hand, if parents receive training, they are able to follow through with the lessons from the ABA program and the 40 hours per week becomes 24-7.

[Deleted User]

I have a son who needs lovaas and I too want MSP for his treatment.

Ditto

[Deleted User]

P.S.

I just posted to anon 1249pm

just wanted to clarify if you meant "resources" as in training rather then specifically monies, sorry I may have misread. I agree that we have some great Lovaas consultants, we don't have nearly enough. Thank you.

[Deleted User]

Re to the Anon at 1249pm

I understand what your saying that the government says that the government money is tight. But my thoughts are this (***opinion only for what it's worth***)

It would hold more weight if the children with diabetes, cancer, cerebal palsy, heart defects, rare diseases, and outward physical defects weren't covered by MSP. However, they are. Even children with ADD or ADHD have access to MSP services.

Lovaas doesn't have to be expensive for the goverment. If they pay specific Lovaas providers and allowed us to have so much covered we can pay the balance or into a flex spending. Patients with terminal cancer are covered by MSP with great expense. I know it's not fair to compare our children to other kids, but the fact this is a medical condition that should be covered by the medical community.

I know that the Government is tight with monies, and I am not trying to be a finger pointer. But my child deserves the medical treatment of my choice best recommended by my doctor. Autism can be helped by Lovaas and in the long run it's cheaper then instutionalizing them. Yes we can keep our children home all their lives if we wish, but it's nice to know with Lovaas we may not have too because they can be helped. My thoughts….. Sorry for rambling.

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