Raise your hand if you came out of grad school thinking ABA has all the answers. Have you ever scoffed at an occupational therapist’s report, with all of its mentalistic language and “poor measurement?” What about working with speech pathologists? How often have you tried to convince families to drop these therapies and fill in the space with ABA? Because after all, anything OTs and speech paths can do, ABA can do better.
If this is you, I cordially invite you to pull your head out of your ass.
Because no, ABA cannot do it better.
There’s a reason they have advanced degrees.
Don’t you hate it when people with no credentials are allowed to do your job? Those “behavior specialists” with no training who are somehow allowed to create behavior plans, it’s annoying isn’t it? Perhaps, a little insulting? Of course it is! The companies creating those types of positions are completely undermining the level of education and training it takes to do our jobs. One does not suddenly have all of the skills to address challenging behavior just because they’ve stayed at that company long enough without quitting.
But then why do we assume we can do occupational and speech therapies better? Unless you have those credentials, you have no more insight into what their training and education is than those creating “Behavior Specialists” do of ours. We’re doing the exact same thing because we don’t like how they measure stuff. And for the record, pushing your ideas and goals onto the speech path or OT and trying to get them to measure and run things the way you have your programs set up is not collaboration.
How to play nicely with others
ABA really likes to address the rigidity in autism, and we have a lot of tools for that, so let’s pull some of those out for ourselves. A good first step in learning flexibility is to accept others’ ideas. This means listening to their ideas respectfully and without trying to force our ideas onto them. Maybe we can even take turns and allow the SLP/OT to show us their goal. We can participate in that method while using nice words and staying calm. Then, when their turn is over, we can show them what we do with our goals, and hopefully they will also listen with nice words while staying calm. We can even have someone write this up as a social story for us to help us remember.
… and if this is pissing you off to read, imagine how your learners feel in your social skills groups.
Condescending roasts aside, BCBAs do not have a good reputation among these fields, and that is not unfair. We like to claim this just comes from listening to what others say on the internet, but if you take the time to talk to other professionals, most have had personal experiences to back up their opinions. It’s not just nasty rumors on the internet, it’s an actual learning history, and that is on us.
If you break it down, we are all going to have the same goals: To see the autistic learner we are serving succeed. Often, you’ll find we are even talking about the exact same things, we’re just using different languages. We allow parents and other caregivers to speak “mentalistically” without getting snotty about it and discounting everything they say. Why can’t we give this same respect to other professionals? Part of our jobs as behavior analysts is to be bilingual– able to describe the exact same things in layman/“mentalistic” terms as well as behavioral science jargon. No one is impressed by it and it makes you look like the only asshole in the room.
Practice flexibility with your language and clarify if you need to.
Maybe we can’t measure that, but they can.
We really like to get hung up on our measurement, but as I’ve pointed out before, private events are valid, even if we can’t measure them. The tendency to discount private events as unimportant is literally bad ABA, because it takes the radical out of radical behaviorism. Again, we can translate across fields with really very little effort. All it takes is listening with an open mind and an aim to really collaborate.
Is a speech therapist going to wait until the learner is able to label 100 common objects, including at least 3 examples of several of those objects within 3 seconds before they consider “labeling” mastered? No, but also, who cares? You know what they can measure? Anatomical differences that affect a learner’s ability to produce certain sounds (i.e. why your echoics program isn’t making any progress).
An OT is going to make statements about different private events, including sensory needs and how they can affect your learner’s ability to learn. This always makes BCBAs feel icky, but here’s the thing: Automatically reinforced behavior can be a result of medical needs or other types of discomfort we can’t measure. OTs have the education though to look at stereotypy, motor movements, and even attending skills to be able to determine the specific private events or neurological differences that might be motivating those behaviors.
I don’t care what you say, no behavior analyst was given this training. Sometimes the best we can do is make wild guesses at what’s motivating an automatically-reinforced behavior. If you really care about your learner’s wellbeing, is it not worth it to try something that will cause no harm, but might alleviate some discomfort, and increase their ability to learn from your programs? Hell, maybe the learner just enjoys it. That’s a good enough reason to do it.
There are still flaws
Like in any field, there are going to be quacks. I’ve worked with a wide variety of other professionals, and I’d be lying if I said there weren’t more than a few who definitely seemed incompetent. I’ve also met BCBAs and BCBA-Ds who were equally incompetent though, so let’s just deal with that and drop the ego.
Yes, some OTs may make suggestions that risk reinforcing challenging behavior, but that doesn’t mean we can throw the baby out with the bathwater. Part of our expertise is being able to break down skills into tiny, teachable chunks that set the learner up for success. We can also make big goals far less intimidating for both the learner and their team. Use those skills to figure out how to incorporate the OT’s goals into yours. Maybe the use of a certain sensory exercise may reinforce challenging behaviors, but could it possibly also prevent them just by being aware of timing?
Sure, the speech therapist may not take data the same way you would, how can they if they are only seeing the learner for 30 minutes a week? We probably see that learner a lot more often than that though. Break down the skill your learner’s SLP is aiming for, put it into the programs in a way that makes sense to both of you, and track it yourself. Here’s being flexible again: How many different ways can you measure that behavior or skill?
Put it all together
So many of us get stuck in this DTT, specific target format. They must label a ball correctly at least 80% of opportunities over 3 consecutive sessions before they can move on to labeling a chair.
Gross. Boring. Unrealistic.
Why not practice labeling different things, based on their interests? Turn it into a game or watch for spontaneous labeling during play. If there’s anything SLPs have over BCBAs, it’s their ability to present teaching moments in a truly child-led, play-based format. If you learn nothing else from your learner’s speech therapist, learn that. Have your RBTs track if they are labeling correctly during play, then come in once a week and probe to see how many things they can label. You might be pleasantly surprised, but more importantly, your learner and their therapist will probably have a lot more fun.
There is no one-size fits all for anyone, but especially people growing up with disabilities in a world not built for them. In the ancient world and up through the early 20th century, education was wider. Doctors didn’t train exclusively in medicine, they trained in herbalism, Latin, Greek, writing, religion, etc. Our modern world has become hyper-specialized, and it’s at the expense of everyone. The only way to truly serve other humans now is with a team approach. We need expertise from across every relevant field. If your learner has mental health issues, you should be working with psychologists and psychiatrists. If your learner has feeding issues, you should be working with a speech therapist and/or a skilled dietician. If your learner has autism, or other neurological differences that affect the brain structure, you should be working with an OT, and possibly a neurologist depending on the needs.
Working with, not against. Your learner deserves to be a part of a team.