In this episode of Stress-Free IEPTM, Frances Shefter speaks with Evelyn Fromowitz, BCBA, Director at The Learning Tree ABA. Tune in to the episode as Evelyn provides an overview of the benefits of ABA therapy, how The Learning Tree ABA works on goals and programs in the child’s natural environment, and what parents can look for when selecting ABA therapy for their children. Evelyn explains how ABA therapy focuses on more than just changing behaviors. ABA therapy focuses on social skills, functional skills, daily living skills, communication skills, and more, while also working on decreasing maladaptive stereotypical behaviors.
Evelyn also discusses how The Learning Tree ABA offers parent meetings, that used to be called parent trainings. In the meetings, the therapist speaks with parents about what their child is learning and how it is working with the home when the therapist is not there. They also discuss whether any new experiences are expected, like traveling or events. The following week’s lessons can focus on what is not working and preparing for the new experiences. The whole family is also included when appropriate.
Frances Shefter is an Education Attorney and Advocate who is committed to helping her clients have a Stress-Free IEP experience. In each podcast, Frances interviews inspiring people to share information, educate you, empower you and help you get the knowledge you need.
FRANCES ( 00:00:37): Hello, everyone. ABA Therapy. I know some of you have heard about it but might not know what it is. So today’s guest, Evelyn Fromowitz is the Director of the Learning Tree ABA and she’s gonna talk to us about what ABA therapy is and why it’s beneficial. Evelyn, welcome to the show. Please introduce yourself. Tell the listeners a little about you.
EVELYN ( 00:01:01): Sure. Thank you, Frances, for having me. I’m super excited to be here today, especially to share some information for families that are in need of this information. As a lot of families don’t know what’s available for them and the resources that they do have at their fingertips and I’m happy to share the information that I have. Again, my name is Evelyn Fromowitz, I’ve been in the field of ABA for over 20 years. So this is definitely a passion of mine working with all kinds of children. And definitely I have a lot of years of experience working with children and individuals with autism across the board. From all the way from two years old, all the way up through teenage years and was really excited just about a decade ago, there was a law passed that, that provided families with this resource through their health insurance and requires the state health insurance to cover ABA services for children with a diagnosis of autism, which was super exciting because until then, these resources were not available and were not covered for families and the cost for ABA services could be exorbitant. Just because it’s not like any other therapies that they might be receiving once or twice a week and we could talk a little bit more about what ABA therapy is. But it requires a lot of consistent therapy pretty much daily. And that would be a huge cost to families and most families would not be able to afford it. So it was very exciting to hear this news that ABA services were deemed medically necessary. And we are very excited to be able to provide this level of service for families that are in need to help their children progress and develop, even with the diagnosis of autism.
FRANCES ( 00:02:51): That is so wonderful. I didn’t realize that there was a new law and that it’s covered because as we all know, medical expenses for neuro typical people are as expensive and then for neuro diverse, it’s just they pile on. So it’s great to know. Let’s go in like I know ABA therapy, let’s go in a little bit and define what ABA therapy actually is.
EVELYN ( 00:03:13): Sure. So ABA therapy stands for Applied Behavior Analysis and what we do, it goes back, it’s nothing new. Although people think that it’s new just because of this mandate that got passed just about a decade ago, but it’s been back. It’s been around since the days of B F Skinner, working on behaviors as we would any other working on different behaviors with children. And there’s a science and, and the data to back us up that we wanna make sure that the children are progressing in the direction that we want them to progress. So we have different programs that we’re working on, different goals, different targets running from social skills, functional skills, daily living skills, communication skills, which obviously we want to increase in order to help the child develop and gain those skills. And at the same time, we’re working on decreasing those maladaptive stereotypical behaviors that we see very often in the children that we work with, with autism and help decrease those, those behaviors in order so that they could function in society, as best as they can.
FRANCES ( 00:04:24): So it doesn’t just focus on the behavior, which I’m sure a lot of people think it does. And I, you know, I heard you say communication and all the other stuff which makes, which triggers to me. I know when a lot of times there’s children, especially with autism, the behavior issues are usually because they can’t communicate and get their thoughts across and tell somebody what they want and mean. So how does ABA play into that?
EVELYN ( 00:04:47): Now, that’s a great question. So we break the, the beauty of the ABA is that we break down the skills into tiny bits and tiny steps, which we sometimes call task analysis, which is different than a lot of other therapies where we break down the skill into small pieces and it’s a hierarchy of skills. So for example, and this is on a very basic level, when we’re working with a young child that, you know, just got the diagnosis doesn’t have that many. Communication is very different than vocal skills. So a lot of our children can communicate just not vocally with, you know, just with spoken words, but they might use a device, they might be pointing, and we want to really improve those skills to help them communicate the best way that they can. So if I, we over here at the Learning Tree, most of our services are provided in the comfort of the child’s home so that we could work on the goals and the programs in their natural environment. So if I come to a home and I’m working with the child and it’s beautiful that he’s able to identify different colors. But if he can’t go into his kitchen and ask for a cup of milk or a snack, then we want to improve those skills. Those are the skills that we want to target first in order to help him be able to function in his home and out in the community. So we would definitely start working if he doesn’t have any communication skills or it’s very limited. We want just to be able to point. Very often we’ll come in and we’ll ask the parent, what’s the best way that you, what’s the general way that your child communicates? And they’ll say very often, oh, he’ll scream, he’ll pull at me, he’ll pull my arm to what he wants. And then we know right there like let’s start working on at least the pointing skills. So we could say, hey, what do you want? And then be able to help him learn how to point to things that he wants, desired items, desired activities. We work a lot with making sure that the motivation is high so that when we come in, we know we’re doing a good job. When our clients are happy to see us, they’re, they’re excited. They pull that door open, they pull you right in. That’s when we know the child is ready to learn, they’re excited, they’re motivated. And that’s when learning really does take place at its maximum. So we want to gain the, that’s another question that we ask our families first is what motivates your child, what excites them, what do they enjoy? And working on those things, those activities, those items, whatever it may be. And obviously, we know especially with children with autism, every child is so different from the next. So what might be very exciting for one child might be very aversive to the next? So really building up that, that rapport with the client rapport with the family to get that information so that when we come in, we know, oh, he doesn’t like being touched at all, but he really likes Dora the Explorer. So let’s use a lot of that during our session. So those are some of the things that we might include, that we do include all the time during our session to make sure that the motivation is high so that learning can take place.
FRANCES ( 00:07:36): That is awesome. I’d love that. You said that because you focus on the individual child. I’ve heard, I know, I’m sure you’ve heard a lot of people are down on ABA therapy because they’re saying it’s forcing children to do things they’re not comfortable with and so forth. But from what I’m hearing, that’s not the case.
EVELYN ( 00:07:52): I’m so glad you brought that up Frances because it definitely is a misconception and being that I’m not new to the field and I’ve been in the field for 20 years, I do have an advantage of understanding at least where the families are coming from with that fear, with that misconception. Just going back 20 years ago when I was trained in ABA, it did look very different than it does today. So it was a lot of work at the table, needed me with the child for two hours. We were kind of trained into, force them to do different activities just because they had to learn how to be part of society, which definitely has moved that, that kind of way of teaching those techniques. We move more to natural environment teaching where we try to capture, we try to contrive situations within the the child’s general environment where learning can take place. We’re just maximizing those opportunities. And again, I learn, I learned very well with real life examples. If we come to a house and mom’s like, oh, you know what, I’m just gonna put away this baking activity. We were baking but oh your ABA therapist is here, we got to stop that and I’m like, no, no, no, no, no. Let’s talk about all the different skills that we could learn while we’re baking. There’s language to be learned, we can learn sequencing, we can learn about you know, labeling, requesting for items. How about following instructions, interacting with somebody else, taking turns. There’s unlimited amounts of learning opportunities that you can be doing with everyday situations in your home that we don’t need to bring in our flashcards and start working on, you know, different skills that I would have been doing 20 years ago, such as color identification, which yes, it’s important, but it’s not as important as some of those very functional skills that we want to incorporate during our sessions in a natural environment. We’re a natural environment teaching, right?
FRANCES ( 00:9:54): Which is great. Like I, I’m thinking back to my teaching days, which is a little more than 20 years ago. But I won’t say how long. But you know, the skill and drill that we used to do, you know, like and so, ok, you can skill and drill, they can do it right there in the classroom, but go across the street to the grocery store and then what?
EVELYN ( 00:10:14): That’s the real test, right?
FRANCES ( 00:10:17): So you’re teaching in the environment in the natural setting of where the skill needs to be.
EVELYN ( 00:10:25): Yes. And just for the families listening to this, we also want everyone to know it’s called natural environment teaching. So if they’re looking into different ABA programs and they’re really, you know, concerned, I don’t want that kind of discrete trial where everything is kind of robotic. They, that’s one of the questions that they could ask. The director straight out is, do you use a lot of natural environment teaching methods? Are your staff trained in natural environment teaching? So that you want to make sure that that’s the method, if that’s the family’s preferred way for their child to learn, that their staff are trained in that, and will be using that method in order to teach those skills. It skips over all that kind of, you know, the skill and drill that you just called it, it goes straight into generalization of the skill. So we just go straight into the natural environment, teach it in the natural environment so that we could skip that, that skill of having to learn first at the table in order to bring it home. So that’s the beauty of the home based program where we can go into the home, teach the skill and hopefully generalize it and maintain it within their home environment.
FRANCES ( 00:11:29): And it probably motivates the child more. Absolutely. You know, like with baking, like they know they’re baking cookies, they’re gonna get cookies at the end, they want to learn and participate.
EVELYN ( 00:11:39): Absolutely. And, and it’s interesting that you’re saying that they’re motivated. And again, Frances, like what we were saying before, for every child that’s so different. So for some children, baking is really exciting because they love cookies. Some children might not. And as BCBA myself, you can never take anything for granted. I mean, I love cookies, but that doesn’t mean that my client does. So you always, always assessing is this activity motivating for this child? And today right now because what might be working today actually might not be motivating for our child tomorrow. He might be on medication. He might have like really, his appetite might be down and baking for him today might not be so exciting. And always just reassessing is, is the activity that I’m doing or we call it a reinforcer. So is the reinforcer at the end really actually reinforcing for that child, this child right here right now and constantly reassessing that because it changes over time, it changes from child to child. And we just want to make sure that the motivation piece is always there in order. So like we said that the child can learn.
FRANCES ( 00:12:48): So it’s not like you evaluate a child at the beginning and like, ok, this is the treatment plan. This is the only thing we do and we need to go towards this goal. It’s just a living fluid, you know, adjust as necessary, fly by the seat of your pants.
EVELYN ( 00:13:01): Well, yes, but we definitely do have that, that report, report that we write at the beginning, it’s an initial assessment. That’s how we start our services. And insurances do require it at the very beginning to go in there for a BCBA, someone who’s a Board Certified Behavior Analyst come to the home, interview the parents ask them what, and it’s different than the assessment that they got in order to get that diagnosis. It’s really based on their skill level. So, hey, let, let’s go through some of these skills. Is your child able to do this? Did he master this skill yet? And if not, ok, let’s start here. Let’s start at this level and then build our way up if we’re working on social skills. Is your child able to do that or not yet? Ok, so let’s start at the very bottom. We do baseline. So some of it is built into that initial assessment just so we get a baseline of where our client is today so that we know which direction we’re headed and we’re not, it is fluid when we provide the services, but we wanna make sure that we are making progress. And then if we’re not, we take a step back and look at our data and be like, hey, you know what, we’ve been here in the home for two months and we haven’t seen too much progress in this area. What can we be doing differently? We definitely don’t want to be coming into the home every day. We know that time at this stage in life is of essence, we don’t want to be, you know, in a home, providing this level of service and at this intensity and not see that progress. So we’re constantly taking a look back at our data to make sure that the, you know, the behaviors are going in the direction that we’re intending for them to go. And then if yes, then we continue on and if not, we take a step back and say, hey, what can we be doing differently? It can be something simple as maybe it’s not motivating enough, maybe we might need to change our staff member there, maybe it’s just not a good match. There are so many variables that make the success successful. So we want to always be taking a step back. I know in our program in the Learning Tree where we, we have our BCBA’s taking a look at the data weekly to make sure that they are analyzing the data, making sure that it’s going in that direction. We also check in with the families on a regular basis to make sure that they’re seeing the progress on their end because it’s wonderful to see a client making a lot of progress during our session. But if it’s not being carried over into the home and the parents aren’t seeing those changes, we also need to kind of figure out why that’s happening and why we’re seeing that or, and really figure out what we can be doing differently to help generalize our skills.
FRANCES ( 00:15:32): That is amazing that you guys evaluate it weekly because it’s just, I mean, because you don’t, if you wait until, I don’t know, schools wait until the nine week mark. You know, it’s those whole nine weeks I don’t wanna say wasted. But if there’s been no progress now, ok, we need to turn. Not saying the schools need to do it weekly. Trust me from my teaching days. I try not to put more on the teachers but it’s, it’s like an added bonus that you guys evaluated uh sorry weekly. And I mean, ABA therapy is like supplemental to schools and IEPs. Correct?
EVELYN ( 00:16:05): That’s an interesting question for in, in general, the answer would be yes. There are a lot of schools that do implement ABA methodology in their school, which is great because the child is already used to having those programs being run. In a perfect world, it would be, you know, incorporated into the school so that we could be working on the same programs both in school and at home. And again, that would increase and improve our generalization of the skills and maintenance of the skills so that they, the child gets those skills at home, those programs being run at school and at home on a consistent basis. I’ll give you another example that might be able to clarify what I’m saying. If we’re sending a child that’s on a very intense toileting program at home and then we send them to school and the school kind of puts the child in a diaper and say, you know what, we don’t do toileting in school. You can imagine the effect that that would have on the success of our toileting program that we’re doing for three hours after he gets home versus, hey, if the school is on board and we can meet with them and they could incorporate the same program that we’re doing at home at school, chances are that client will make a lot more progress a lot faster than they would if we’re only doing it at home, but not at school.
FRANCES ( 00:17:20): Right? And so you work with the schools, right?
EVELYN ( 00:17:23): Very often in the ideal situation. Yes. And it depends on the school. And that’s one of our questions that we do ask our families during our intake process is, hey, will your school let us come in? We will be happy to come to any IEP meetings that you have or any team meetings again because we want everybody who’s on this child’s team to incorporate as many programs as they can. And we could work with them, we teach them, we train them, we share our treatment plans with them. So that they could ask questions and in an ideal situation which a lot of our families do have and our learners do have, we are able to incorporate and collaborate our care with other professionals as well. And that’s usually when our learners make the most, the fastest progress and the most progress.
FRANCES ( 00:18:07): Yeah, because it’s, it’s reinforcing and reinforcing in different environments. It makes sense because the repetition is what matters. But repetition, sitting at a desk constantly isn’t necessarily what we need.
EVELYN ( 00:18:20): Exactly. And when you’re talking about individuals with autism, we know that they have a hard time with generalization. So well, he might learn at home, he might have a harder time carrying over into school, whether it’s across different people, different settings, different materials, he might not be able to carry over those skills as easily as a neurotypical child. So we want to make sure that he gets that right away from all the different people in his lives and his whole village that’s working together with him. If everyone’s using the same method, the learning will take place much faster.
FRANCES ( 00:18:56): That’s great. And I heard you say two things: every day and three hours. How often is the therapy really happening? And for how long?
EVELYN ( 00:19:07): Pretty intense, right? That is a great question. And a lot of times we have families call to, to enroll their child or to register their child in our program and they’re not even so sure of themselves, of what this is gonna look like. Hey, my child has speech therapy therapy once a week, occupational therapy once a week for a half hour. So let’s get ABA therapy for a half hour. Some parents come in with that, just a misconception. And we do meet with each family at least virtually or on the, you know, or have a phone meeting with each family, to help them understand what ABA is about. So that they’re not just jumping in on a doctor’s recommendation. Let’s take ABA therapy without understanding what it’s about. And yes, Frances, like you’re saying, the intensity of the program, it’s pretty intense, the more consistent the services are being rendered, the faster the progress will take place. And again, back to that toilet training example that I brought, imagine if we’re only working with a child for a half hour in toilet training, I mean, how effective can we possibly be? Right. So, what’s considered medically necessary is determined or suggested by our BCB that goes in to do that initial assessment that we spoke about. She’ll go in there and she’ll do an assessment, a thorough assessment on the on the learner to find out what the skills are, what we need to work on and give a general suggestion of what would be considered medically necessary in that situation. To make it more, you know, hands on for those of you who, who are listening today and for you, Frances, most of our clients are getting anywhere between 10 to 40 hours a week. So, it’s a lot, depending on the age. Yes, depending on the age of the child and depending on their availability during the day. So, if a child’s going to school where they don’t allow outside providers to come in, they’re only available after 4:30. Right. And they go to sleep at seven. So even though what would be considered medically beneficial for them might not be possible given their busy schedule, but we try to do whatever we can in order to provide that level of service even after school. And again, to carry over those skills when we do our coordination of care.
FRANCES ( 00:21:16): Yeah, I’ve had clients say that their child’s in ABA for 2 to 3 hours. Monday through Friday after school, like basically home from school till bedtime. But, and I’m assuming it’s the same with you. I remember, but the ABA therapist works on bath time, works on feeding. So you’re still going through your normal routines. But then the ABA therapist is helping to work in the skills needed.
EVELYN ( 00:21:42): Absolutely. And incorporating, it takes like trained staff, all of our staff are either Registered Behavior Technicians or Board Certified Behavior Analysts. It takes those trained professionals to be able to capture and contrive those situations in their home environment so that we can work on communication, language. All those skills can be worked on from the minute that the child comes home all the way until the end following instructions, be able to complete a task, focus, focus and attention. So all those skills can be incorporated and it doesn’t have to look like therapy. So it doesn’t have to look like, oh, well, you’re not allowing your child to be a child because like again, we said, we incorporate whatever he’s doing anyway, in his routine, we’re going to stick in our goals of language and communication in there so that he’s able to learn while doing everything that he would normally be doing as a child. We’re not taking away their childhood and taking away those opportunities. We’re not gonna be like, oh, don’t play with your siblings outside on the trampoline because you’re in the middle of ABA session that would kind of take away what we’re out there to get. So we want to work on those. If he’s going outside and the neighborhood children are outside playing a ball game, we’re gonna be really focusing on social skills and social interactions out there. And when he comes back in and mom says, well, it’s bath time, then we’re gonna learn independent skills, learning how to wash himself, learning how to follow a task, learning to become more independent, et cetera.
FRANCES ( 00:23:06): That’s so great. That was going to be my next question is like, well, when do they get to be a kid?
EVELYN ( 00:23:11): You know what was coming? Because that one always comes. That’s usually a parent’s number one or number two, concern when they call us is wait, are we gonna allow my child to still be a child? And the answer is absolutely yes. And if you’re ever in a situation, the nice, the beauty of an ABA therapist coming in at home is that parents and family get to see it. So if at any point, you feel like, hey, this is a little bit too intense, my child’s crying through it. He’s not happy. These activities are not fun for him. It feels like almost like he’s not being a child, then you could always just monitor that and reevaluate that when your therapists are there because chances are if you’re monitoring it and your child’s happy and you see the way it’s being incorporated, families are calling us to increase services, not decrease them. Because they see that it’s working, the child is making progress within the natural environment. So definitely, I understand the family’s, you know, fear at the beginning. But they usually get as soon as we do our first check in with them and say how services are going. They’re like, oh, it’s amazing, you know, he’s really learning. He loves when the therapists come and he’s actually learning how to communicate better and interact with his siblings better. So definitely we are able to see the success of the program in that direction.
FRANCES ( 00:24:24): Because it, it brings the peace and harmony to the home because it’s, it’s, it’s challenging for everybody, you know, when you have a neurodiverse child that, you know, that needs a lot of attention, oftentimes, siblings or spouses kind of suffer and don’t get the attention because all attention needs to be on that child. And what came to mind is that when you’re doing it in the home, I’m assuming like the family is there and can learn some of the techniques so that they can practice them on the weekends, right?
EVELYN ( 00:24:56): Absolutely. You bring up another great point that we didn’t even speak about yet. Part of what we provide at the Learning Tree ABA is, is weekly parent meetings. We used to call them parent trainings, but then I decided that’s not a good word for it because the parents actually know their child better than we do. So why are we calling it parent training? I like to call a parent meeting where we meet with the family and we’re able to go over the child’s progress concerns and from week to week it changes. You know, the summer’s coming up and we want to prepare for that. And our winter program is gonna look very different than our summer goals and programs and different ways and activities that we can incorporate it. So we want the families involved. We want to say, hey, how’s it working for you? I know during session our learner is performing at this level. Is he doing that with you too? Oh, no. And why not? Let’s see what we could be doing differently. We’ll incorporate the family during our session, whether it’s a sibling, a younger sibling, an older sibling, parents, neighborhood children, whoever it is in order to enhance the learning that can be taking place, we want to incorporate everyone. So again, even if it’s a neighborhood child, just learning how to interact with that child might be very beneficial. Instead, you know, you say, oh he has a hard time with this. Can you help him, you know, figure out how to do that? And teaching everybody in that child’s village on how to help him make that progress can be extremely valuable as well.
FRANCES ( 00:26:24): I love hearing this because it’s truly what the child needs, you know. I didn’t even think of like, do you go out in the community? And apparently you do you know at least outside playing with the kids, it’s let the kid, what I’m hearing is to let the child live the child’s life and you come in to help with the skills while the child is living the child’s life.
EVELYN ( 00:26:47): That’s a perfect way to say it. And I love hearing from our families when we do our check ins like, you know what? It was amazing. We went to Target the other day with our behavior technician and we worked on, you know, following a list of things that he needs for school and we put it in the cart and he was able to interact with the other people on line. He was able to wait on line patiently. He actually had to go to the bathroom in the middle and was able to use the public bathroom, which is something that he was never able to do. I mean, there’s nothing more rewarding as either a director or BCBA or a behavior technician hearing those words when you’re really changing the lives of these children in their natural environment where the parents were like a few months ago, we would never been able to dare step into a big store like that without having a complete meltdown. We would have had an accident there. He would have been melting down. He would have been so embarrassing. We would have had to carry him out. It would have been a disaster and hearing that he was able to gain those skills. Go with his behavior technician, able to follow, you know, sometimes we prepare him, we do a social story to help prepare him what to expect in the store. Have a plan in place that we could do this trip successfully, maybe for a very short period of time, buy one thing and then leave and then the next time, buy two things and then leave and being able to build up on those skills on a, in a hierarchy, very systematic approach to be able to go soon with the family for 20 minutes to the store and be able to perform just as successfully. So that would be like the story of the day that would make us feel like everybody just like shake your pompoms or that was a huge success for everybody.
FRANCES ( 00:28:26): This is why we do what we do.
EVELYN ( 00:28:28): Exactly.
FRANCES ( 00:28:30): So that’s great to hear also that you go out to the community and wherever the family needs, and going on. So like I know you were saying that it’s all individualized on the child’s needs. Are there specific programs that might be included in a child session?
EVELYN ( 00:28:47): Oh, absolutely. So that’s part of the treatment plan that we spoke about at the beginning, we do an initial assessment, part of that initial assessment, what’s included in that is a list of different skills. Most of them are within the domains of communication, social functional skills that we want to incorporate on, on a very individualized level. And we put, we include it in that treatment plan. And again, like we make sure that each time we’re there, we’re not just playing with the child, we’re actually working on those skills and those skills, behavior technician actually takes data on every time that he or she is there. Mom can also incorporate those programs after we leave. And no two treatment plans that we have here at the Learning Tree look exactly the same. That’s because none of our learners are exactly where the other one is at.
FRANCES ( 00:29:40): I love that you say that because it was I I saw so I’m trying to remember where it was on social media the other day. But something describing autism about like how it’s a category trying to stuff all these kids in when in actuality, it’s like, they’re like snowflakes. No two are identical.
EVELYN ( 00:29:56): Exactly. It’s amazing to see. And I don’t think I could ever, sometimes people ask me as a BCBA, can it ever get boring? Can it ever get tedious? And I’m like, are you kidding? Like every single time I come to a client’s home, it’s so cool to hear how every child is so different, what they like, some of their stereotypical behaviors, it just sometimes it’s really cool. Like every, every child is just so different what, what their magnets towards, and being able to even use those stereotypical behaviors in order to not only decrease, like we want to decrease them, but we also want to work in a way that hey, if he likes fans and he has this obsession for fans, we can use that also as a motivating tool of like, hey, let’s do this and then we can look at the fan together. Those are some of the things that we could incorporate some of those like those splinter skills or those very specific interests, we could include them in our, in our program to help motivate our child, to learn and to even build up that rapport with the child.
FRANCES ( 00:30:55): That just triggered a memory from when I was teaching. I had a child on the spectrum, that when I started, he used to sit in the classroom like this and I started bringing him to the office and we discovered he loved watching the light from the, the copier going back and forth. He would just like kind of stand there and watch it. So it became, that became his reward. We would go, but he had to say hi to the, you know, to the secretaries. And once he said hi, they’d go copy something for him.
EVELYN ( 00:31:25): You see Frances, you were, you were providingABA therapy even without knowing it. So look at you.
FRANCES ( 00:31:33): I would say it was even before it was technically ABA therapy, but it made sense, you know, like it just, you know, everybody was like, how did you get him to do that? You know, like because you look at the child, see what the child likes and, and make it work.
EVELYN ( 00:31:51): And if you’re teaching the child how to count, let’s say, instead of counting, you know, little manipulative things in the classroom, go over to the copy machine and count how many times that light passes. Chances are he’s gonna learn how to count a whole lot faster and doing something that he really likes versus something that he doesn’t. So those are very important examples that not only for children on the spectrum and not only ABA, you know, just that’s how learning takes place.
FRANCES ( 00:32:18): In the natural environment. I remember there was an episode I think it was CNN that a friend and I were on and well in the audience on, but it was, they were talking about like, recess and taking away recess and she was an educator also and both of us were like, what do you mean? That’s where all the skills get applied, you know, like learning to count, learning to recognize letters of learning to, you know, whatever. If you don’t actually put it into place.
EVELYN ( 00:32:50): Exactly. Unfortunately, that’s pretty common. You know, that way of thinking of, well, if he misbehaves and we’re just gonna have to take him away from his friends versus wait one minute. Like that’s what he has to learn most. Let’s let’s be proactive, let’s set this up for success so that when he is out in the playground, he can be successful, learn those skills so that we see a decrease in them because chances are, if I turn to the school and I’ll say, well, listen, you’ve been taking him out of recess every time he misbehaves. But can I ask you, did those, did those targeted behaviors go in the direction that you’re like? Is it working, is what you’re doing even effective? And if it’s not, then why are we continuing? Let’s take a different route. So that would be some of the things that we would suggest to a school like, hey, this is what you’ve been doing, but has it been helping? And really having the data to back us up really helps us and gives us the fuel to tell the school. Hey, listen, we have the data to back us up. It hasn’t been working. The behaviors are exactly where they were three months ago. Can we try something else and be proactive?
FRANCES ( 00:33:49): Right. And that’s, I, you know, the former teacher administrator in me is like, because it was so set up the child needs to be punished. You know, the child needs to be suspended. It’s, it’s, they broke this rule. And like to me, suspension was like the worst thing ever because how is that going to improve behaviors? Kids want to stay home, you know, a lot of times. So they’re gonna misbehave even worse to get sent home for more days. Exactly. Yeah. Come in. Why are they misbehaving and let’s, let’s address that.
EVELYN ( 00:34:23): Ao you bring up another very good point. That’s something that we always work on as a BCBA, is really, we call it the function of the behavior. So, like you’re saying, Frances is why is the child doing what he’s doing? So, for all we know, sending him home from school is actually inadvertently reinforcing the behavior. And we want to always take a look as wait. And that’s usually the first question I asked, like, why do you think he’s doing what he’s doing? Is he doing it for attention? Is he doing it to escape a demand? Is he doing it because he wants a tangible? Like, what is, why is he doing it? Or maybe he just doesn’t have the skills to do what he needs to do. And that’s something that we need to teach. But being able to determine that function of behavior is key for helping us determine how we can respond next time in order to see those changes of behaviors that we’re looking for. So that’s a very important thing that we do also is try to determine that like, why is he doing what he’s doing?
FRANCES ( 00:35:21): Which is the, the functional behavior assessment that the schools do and then the behavior intervention plan, which unfortunately were usually not that great because most of them are not BCBA’s, you know, it’s a teacher doing them and they’re not trained.
EVELYN ( 00:35:35): Right. And that’s something that we do do is really work with a teacher at their level. And I always, you know, I have a team of BCBA’s wonderful BCB’s and registered behavior technicians working with me. And that’s something that I tell them is also like we got to meet our families where they’re at, we got to meet the staff members in the school where they’re at. So if they’re not ready for a 50 page behavior plan, they don’t give that to them, they’re not ready to implement it. It could be, they don’t have enough manpower to be able to implement a one on one. But what can they do that can be successful as well, might not be ideal but can be successful. And we will train the school whatever we feel like they can implement, given whatever they have available for them. Because I always say for the most part, we’re all on the same page. We all want to see our learners go in that direction. We all want those skills to be built up. We just have different training. So let’s meet together, let’s collaborate. Let’s be open with each other. See what can work. Because at the end of the day, we all want the same thing.
FRANCES ( 00:36:34): It’s so great that you recognize that because like as a teacher, if somebody came in like, oh here’s a 50 page report, you need to implement all that. Most teachers are gonna throw it in the circular filing cabinet, you know, like that’s the end of that. Whereas, but if you go in with a, hey, we discovered this technique at home is working really well. Do you want, you know, let’s see. Do you want to see if we can make it work in the classroom and how we can adopt it? I think almost every single teacher is gonna be wide open to that suggestion.
EVELYN ( 00:37:00): And Frances, I’m not even sure if you realize what you just said, telling the teacher that this has been successful in the home is actually the motivating piece that they need to hear. Just like our learners need to have that motivating piece teachers do, they don’t want you to just throw a report at them. I mean, I’ve taught in classrooms too. Nobody wants extra work. We all know that. So telling them, hey, this has worked for your client if you, I want, I want those behaviors to go down just as much, if not more than you do. So let’s work together. This has worked for us at home. Do you want to see if it could work in school, too? Great? Do you think that this is possible for you to implement in the classroom? No, why not? Ok. Not a problem. It’s too distracting maybe for the other students. I get it. Let’s do something that isn’t a little bit less distracting whatever it is that the teacher is honest about that might get in the way and working together with them, keeping that motivating piece for them as well because everybody needs that little carrot dangling in front of them. Like, why am I working so hard? Well, it’s because he has made progress like that at home. So if we just put in that much effort, it might actually go far in the classroom.
FRANCES ( 00:38:03): Yeah, that’s true. We all need the carrot. This has been so great. I feel like I could talk to you all day, but I know we have time limitations and so how can people reach out to you? Like if people are like, huh, this might be right for me and my child. What do people do? How should they reach you?
EVELYN ( 00:38:22): So they can always reach out to me directly. I’m at the learningtreeABA.com. We have our website https://www.thelearningtreeaba.com. I also have email, my email address is Evelyn @ thelearningtreeABA.com, but I would say start off with the website, you’ll have that information. There’s lots of great programs out there. And that’s something that if the families are, I think we brought up so many different points of different things that the families can ask whatever provider they go to. There’s so many different questions that they could ask beforehand to make sure that their model, their techniques match up with what the families are looking for. So at least I hope that even if that’s the only thing that families might have gained today is what to ask, before they just jump into something that they don’t know so much about, at least we give them those valuable tools. But if they want to reach out to Learning Tree or have more questions for me, they can definitely follow up. I would say start off with our website https://www.thelearningtreeaba.com. And I’d be happy to answer any questions they might have.
FRANCES ( 00:39:23): And all the links are going to be in the notes. This is great. Like it, it to me, I’m like, wow, you just gave everybody the list of stuff, whether you’re the right fit or not to any ABA therapist of what you should be looking for to make sure it’s the right fit because not everybody is gonna fit together the right way, the same way, right? So, thank you so much, Evelyn. This has been absolutely wonderful. I really appreciate you taking the time to come and be on my show and provide our listeners with just more information of what’s out there and what can be done.
EVELYN ( 00:39:54): Thank you for having me.
VOICEOVER ( 00:39:56): You’ve been listening to Stress-Free IEPTM. With your host Frances Shefter. Remember you do not need to do it all alone. You can reach Frances through ShefterLaw.com where prior episodes are also posted. Thank you for your positive reviews, comments and sharing the show with others through YouTube, LinkedIn, Apple Podcast, Spotify, Google Podcasts, Stitcher and more.
Stress Free IEP™ with Frances Shefter and Evelyn Fromowitz
In this episode of Stress-Free IEPTM, Frances Shefter speaks with Evelyn Fromowitz, BCBA, Director at The Learning Tree ABA. Tune in to the episode as Evelyn provides an overview of the benefits of ABA therapy, how The Learning Tree ABA works on goals and programs in the child’s natural environment, and what parents can look for when selecting ABA therapy for their children. Evelyn explains how ABA therapy focuses on more than just changing behaviors. ABA therapy focuses on social skills, functional skills, daily living skills, communication skills, and more, while also working on decreasing maladaptive stereotypical behaviors.
Evelyn also discusses how The Learning Tree ABA offers parent meetings, that used to be called parent trainings. In the meetings, the therapist speaks with parents about what their child is learning and how it is working with the home when the therapist is not there. They also discuss whether any new experiences are expected, like traveling or events. The following week’s lessons can focus on what is not working and preparing for the new experiences. The whole family is also included when appropriate.
Stress-Free IEPTM:
Frances Shefter is an Education Attorney and Advocate who is committed to helping her clients have a Stress-Free IEP experience. In each podcast, Frances interviews inspiring people to share information, educate you, empower you and help you get the knowledge you need.
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Read the full transcript:
FRANCES ( 00:00:37): Hello, everyone. ABA Therapy. I know some of you have heard about it but might not know what it is. So today’s guest, Evelyn Fromowitz is the Director of the Learning Tree ABA and she’s gonna talk to us about what ABA therapy is and why it’s beneficial. Evelyn, welcome to the show. Please introduce yourself. Tell the listeners a little about you.
EVELYN ( 00:01:01): Sure. Thank you, Frances, for having me. I’m super excited to be here today, especially to share some information for families that are in need of this information. As a lot of families don’t know what’s available for them and the resources that they do have at their fingertips and I’m happy to share the information that I have. Again, my name is Evelyn Fromowitz, I’ve been in the field of ABA for over 20 years. So this is definitely a passion of mine working with all kinds of children. And definitely I have a lot of years of experience working with children and individuals with autism across the board. From all the way from two years old, all the way up through teenage years and was really excited just about a decade ago, there was a law passed that, that provided families with this resource through their health insurance and requires the state health insurance to cover ABA services for children with a diagnosis of autism, which was super exciting because until then, these resources were not available and were not covered for families and the cost for ABA services could be exorbitant. Just because it’s not like any other therapies that they might be receiving once or twice a week and we could talk a little bit more about what ABA therapy is. But it requires a lot of consistent therapy pretty much daily. And that would be a huge cost to families and most families would not be able to afford it. So it was very exciting to hear this news that ABA services were deemed medically necessary. And we are very excited to be able to provide this level of service for families that are in need to help their children progress and develop, even with the diagnosis of autism.
FRANCES ( 00:02:51): That is so wonderful. I didn’t realize that there was a new law and that it’s covered because as we all know, medical expenses for neuro typical people are as expensive and then for neuro diverse, it’s just they pile on. So it’s great to know. Let’s go in like I know ABA therapy, let’s go in a little bit and define what ABA therapy actually is.
EVELYN ( 00:03:13): Sure. So ABA therapy stands for Applied Behavior Analysis and what we do, it goes back, it’s nothing new. Although people think that it’s new just because of this mandate that got passed just about a decade ago, but it’s been back. It’s been around since the days of B F Skinner, working on behaviors as we would any other working on different behaviors with children. And there’s a science and, and the data to back us up that we wanna make sure that the children are progressing in the direction that we want them to progress. So we have different programs that we’re working on, different goals, different targets running from social skills, functional skills, daily living skills, communication skills, which obviously we want to increase in order to help the child develop and gain those skills. And at the same time, we’re working on decreasing those maladaptive stereotypical behaviors that we see very often in the children that we work with, with autism and help decrease those, those behaviors in order so that they could function in society, as best as they can.
FRANCES ( 00:04:24): So it doesn’t just focus on the behavior, which I’m sure a lot of people think it does. And I, you know, I heard you say communication and all the other stuff which makes, which triggers to me. I know when a lot of times there’s children, especially with autism, the behavior issues are usually because they can’t communicate and get their thoughts across and tell somebody what they want and mean. So how does ABA play into that?
EVELYN ( 00:04:47): Now, that’s a great question. So we break the, the beauty of the ABA is that we break down the skills into tiny bits and tiny steps, which we sometimes call task analysis, which is different than a lot of other therapies where we break down the skill into small pieces and it’s a hierarchy of skills. So for example, and this is on a very basic level, when we’re working with a young child that, you know, just got the diagnosis doesn’t have that many. Communication is very different than vocal skills. So a lot of our children can communicate just not vocally with, you know, just with spoken words, but they might use a device, they might be pointing, and we want to really improve those skills to help them communicate the best way that they can. So if I, we over here at the Learning Tree, most of our services are provided in the comfort of the child’s home so that we could work on the goals and the programs in their natural environment. So if I come to a home and I’m working with the child and it’s beautiful that he’s able to identify different colors. But if he can’t go into his kitchen and ask for a cup of milk or a snack, then we want to improve those skills. Those are the skills that we want to target first in order to help him be able to function in his home and out in the community. So we would definitely start working if he doesn’t have any communication skills or it’s very limited. We want just to be able to point. Very often we’ll come in and we’ll ask the parent, what’s the best way that you, what’s the general way that your child communicates? And they’ll say very often, oh, he’ll scream, he’ll pull at me, he’ll pull my arm to what he wants. And then we know right there like let’s start working on at least the pointing skills. So we could say, hey, what do you want? And then be able to help him learn how to point to things that he wants, desired items, desired activities. We work a lot with making sure that the motivation is high so that when we come in, we know we’re doing a good job. When our clients are happy to see us, they’re, they’re excited. They pull that door open, they pull you right in. That’s when we know the child is ready to learn, they’re excited, they’re motivated. And that’s when learning really does take place at its maximum. So we want to gain the, that’s another question that we ask our families first is what motivates your child, what excites them, what do they enjoy? And working on those things, those activities, those items, whatever it may be. And obviously, we know especially with children with autism, every child is so different from the next. So what might be very exciting for one child might be very aversive to the next? So really building up that, that rapport with the client rapport with the family to get that information so that when we come in, we know, oh, he doesn’t like being touched at all, but he really likes Dora the Explorer. So let’s use a lot of that during our session. So those are some of the things that we might include, that we do include all the time during our session to make sure that the motivation is high so that learning can take place.
FRANCES ( 00:07:36): That is awesome. I’d love that. You said that because you focus on the individual child. I’ve heard, I know, I’m sure you’ve heard a lot of people are down on ABA therapy because they’re saying it’s forcing children to do things they’re not comfortable with and so forth. But from what I’m hearing, that’s not the case.
EVELYN ( 00:07:52): I’m so glad you brought that up Frances because it definitely is a misconception and being that I’m not new to the field and I’ve been in the field for 20 years, I do have an advantage of understanding at least where the families are coming from with that fear, with that misconception. Just going back 20 years ago when I was trained in ABA, it did look very different than it does today. So it was a lot of work at the table, needed me with the child for two hours. We were kind of trained into, force them to do different activities just because they had to learn how to be part of society, which definitely has moved that, that kind of way of teaching those techniques. We move more to natural environment teaching where we try to capture, we try to contrive situations within the the child’s general environment where learning can take place. We’re just maximizing those opportunities. And again, I learn, I learned very well with real life examples. If we come to a house and mom’s like, oh, you know what, I’m just gonna put away this baking activity. We were baking but oh your ABA therapist is here, we got to stop that and I’m like, no, no, no, no, no. Let’s talk about all the different skills that we could learn while we’re baking. There’s language to be learned, we can learn sequencing, we can learn about you know, labeling, requesting for items. How about following instructions, interacting with somebody else, taking turns. There’s unlimited amounts of learning opportunities that you can be doing with everyday situations in your home that we don’t need to bring in our flashcards and start working on, you know, different skills that I would have been doing 20 years ago, such as color identification, which yes, it’s important, but it’s not as important as some of those very functional skills that we want to incorporate during our sessions in a natural environment. We’re a natural environment teaching, right?
FRANCES ( 00:9:54): Which is great. Like I, I’m thinking back to my teaching days, which is a little more than 20 years ago. But I won’t say how long. But you know, the skill and drill that we used to do, you know, like and so, ok, you can skill and drill, they can do it right there in the classroom, but go across the street to the grocery store and then what?
EVELYN ( 00:10:14): That’s the real test, right?
FRANCES ( 00:10:17): So you’re teaching in the environment in the natural setting of where the skill needs to be.
EVELYN ( 00:10:25): Yes. And just for the families listening to this, we also want everyone to know it’s called natural environment teaching. So if they’re looking into different ABA programs and they’re really, you know, concerned, I don’t want that kind of discrete trial where everything is kind of robotic. They, that’s one of the questions that they could ask. The director straight out is, do you use a lot of natural environment teaching methods? Are your staff trained in natural environment teaching? So that you want to make sure that that’s the method, if that’s the family’s preferred way for their child to learn, that their staff are trained in that, and will be using that method in order to teach those skills. It skips over all that kind of, you know, the skill and drill that you just called it, it goes straight into generalization of the skill. So we just go straight into the natural environment, teach it in the natural environment so that we could skip that, that skill of having to learn first at the table in order to bring it home. So that’s the beauty of the home based program where we can go into the home, teach the skill and hopefully generalize it and maintain it within their home environment.
FRANCES ( 00:11:29): And it probably motivates the child more. Absolutely. You know, like with baking, like they know they’re baking cookies, they’re gonna get cookies at the end, they want to learn and participate.
EVELYN ( 00:11:39): Absolutely. And, and it’s interesting that you’re saying that they’re motivated. And again, Frances, like what we were saying before, for every child that’s so different. So for some children, baking is really exciting because they love cookies. Some children might not. And as BCBA myself, you can never take anything for granted. I mean, I love cookies, but that doesn’t mean that my client does. So you always, always assessing is this activity motivating for this child? And today right now because what might be working today actually might not be motivating for our child tomorrow. He might be on medication. He might have like really, his appetite might be down and baking for him today might not be so exciting. And always just reassessing is, is the activity that I’m doing or we call it a reinforcer. So is the reinforcer at the end really actually reinforcing for that child, this child right here right now and constantly reassessing that because it changes over time, it changes from child to child. And we just want to make sure that the motivation piece is always there in order. So like we said that the child can learn.
FRANCES ( 00:12:48): So it’s not like you evaluate a child at the beginning and like, ok, this is the treatment plan. This is the only thing we do and we need to go towards this goal. It’s just a living fluid, you know, adjust as necessary, fly by the seat of your pants.
EVELYN ( 00:13:01): Well, yes, but we definitely do have that, that report, report that we write at the beginning, it’s an initial assessment. That’s how we start our services. And insurances do require it at the very beginning to go in there for a BCBA, someone who’s a Board Certified Behavior Analyst come to the home, interview the parents ask them what, and it’s different than the assessment that they got in order to get that diagnosis. It’s really based on their skill level. So, hey, let, let’s go through some of these skills. Is your child able to do this? Did he master this skill yet? And if not, ok, let’s start here. Let’s start at this level and then build our way up if we’re working on social skills. Is your child able to do that or not yet? Ok, so let’s start at the very bottom. We do baseline. So some of it is built into that initial assessment just so we get a baseline of where our client is today so that we know which direction we’re headed and we’re not, it is fluid when we provide the services, but we wanna make sure that we are making progress. And then if we’re not, we take a step back and look at our data and be like, hey, you know what, we’ve been here in the home for two months and we haven’t seen too much progress in this area. What can we be doing differently? We definitely don’t want to be coming into the home every day. We know that time at this stage in life is of essence, we don’t want to be, you know, in a home, providing this level of service and at this intensity and not see that progress. So we’re constantly taking a look back at our data to make sure that the, you know, the behaviors are going in the direction that we’re intending for them to go. And then if yes, then we continue on and if not, we take a step back and say, hey, what can we be doing differently? It can be something simple as maybe it’s not motivating enough, maybe we might need to change our staff member there, maybe it’s just not a good match. There are so many variables that make the success successful. So we want to always be taking a step back. I know in our program in the Learning Tree where we, we have our BCBA’s taking a look at the data weekly to make sure that they are analyzing the data, making sure that it’s going in that direction. We also check in with the families on a regular basis to make sure that they’re seeing the progress on their end because it’s wonderful to see a client making a lot of progress during our session. But if it’s not being carried over into the home and the parents aren’t seeing those changes, we also need to kind of figure out why that’s happening and why we’re seeing that or, and really figure out what we can be doing differently to help generalize our skills.
FRANCES ( 00:15:32): That is amazing that you guys evaluate it weekly because it’s just, I mean, because you don’t, if you wait until, I don’t know, schools wait until the nine week mark. You know, it’s those whole nine weeks I don’t wanna say wasted. But if there’s been no progress now, ok, we need to turn. Not saying the schools need to do it weekly. Trust me from my teaching days. I try not to put more on the teachers but it’s, it’s like an added bonus that you guys evaluated uh sorry weekly. And I mean, ABA therapy is like supplemental to schools and IEPs. Correct?
EVELYN ( 00:16:05): That’s an interesting question for in, in general, the answer would be yes. There are a lot of schools that do implement ABA methodology in their school, which is great because the child is already used to having those programs being run. In a perfect world, it would be, you know, incorporated into the school so that we could be working on the same programs both in school and at home. And again, that would increase and improve our generalization of the skills and maintenance of the skills so that they, the child gets those skills at home, those programs being run at school and at home on a consistent basis. I’ll give you another example that might be able to clarify what I’m saying. If we’re sending a child that’s on a very intense toileting program at home and then we send them to school and the school kind of puts the child in a diaper and say, you know what, we don’t do toileting in school. You can imagine the effect that that would have on the success of our toileting program that we’re doing for three hours after he gets home versus, hey, if the school is on board and we can meet with them and they could incorporate the same program that we’re doing at home at school, chances are that client will make a lot more progress a lot faster than they would if we’re only doing it at home, but not at school.
FRANCES ( 00:17:20): Right? And so you work with the schools, right?
EVELYN ( 00:17:23): Very often in the ideal situation. Yes. And it depends on the school. And that’s one of our questions that we do ask our families during our intake process is, hey, will your school let us come in? We will be happy to come to any IEP meetings that you have or any team meetings again because we want everybody who’s on this child’s team to incorporate as many programs as they can. And we could work with them, we teach them, we train them, we share our treatment plans with them. So that they could ask questions and in an ideal situation which a lot of our families do have and our learners do have, we are able to incorporate and collaborate our care with other professionals as well. And that’s usually when our learners make the most, the fastest progress and the most progress.
FRANCES ( 00:18:07): Yeah, because it’s, it’s reinforcing and reinforcing in different environments. It makes sense because the repetition is what matters. But repetition, sitting at a desk constantly isn’t necessarily what we need.
EVELYN ( 00:18:20): Exactly. And when you’re talking about individuals with autism, we know that they have a hard time with generalization. So well, he might learn at home, he might have a harder time carrying over into school, whether it’s across different people, different settings, different materials, he might not be able to carry over those skills as easily as a neurotypical child. So we want to make sure that he gets that right away from all the different people in his lives and his whole village that’s working together with him. If everyone’s using the same method, the learning will take place much faster.
FRANCES ( 00:18:56): That’s great. And I heard you say two things: every day and three hours. How often is the therapy really happening? And for how long?
EVELYN ( 00:19:07): Pretty intense, right? That is a great question. And a lot of times we have families call to, to enroll their child or to register their child in our program and they’re not even so sure of themselves, of what this is gonna look like. Hey, my child has speech therapy therapy once a week, occupational therapy once a week for a half hour. So let’s get ABA therapy for a half hour. Some parents come in with that, just a misconception. And we do meet with each family at least virtually or on the, you know, or have a phone meeting with each family, to help them understand what ABA is about. So that they’re not just jumping in on a doctor’s recommendation. Let’s take ABA therapy without understanding what it’s about. And yes, Frances, like you’re saying, the intensity of the program, it’s pretty intense, the more consistent the services are being rendered, the faster the progress will take place. And again, back to that toilet training example that I brought, imagine if we’re only working with a child for a half hour in toilet training, I mean, how effective can we possibly be? Right. So, what’s considered medically necessary is determined or suggested by our BCB that goes in to do that initial assessment that we spoke about. She’ll go in there and she’ll do an assessment, a thorough assessment on the on the learner to find out what the skills are, what we need to work on and give a general suggestion of what would be considered medically necessary in that situation. To make it more, you know, hands on for those of you who, who are listening today and for you, Frances, most of our clients are getting anywhere between 10 to 40 hours a week. So, it’s a lot, depending on the age. Yes, depending on the age of the child and depending on their availability during the day. So, if a child’s going to school where they don’t allow outside providers to come in, they’re only available after 4:30. Right. And they go to sleep at seven. So even though what would be considered medically beneficial for them might not be possible given their busy schedule, but we try to do whatever we can in order to provide that level of service even after school. And again, to carry over those skills when we do our coordination of care.
FRANCES ( 00:21:16): Yeah, I’ve had clients say that their child’s in ABA for 2 to 3 hours. Monday through Friday after school, like basically home from school till bedtime. But, and I’m assuming it’s the same with you. I remember, but the ABA therapist works on bath time, works on feeding. So you’re still going through your normal routines. But then the ABA therapist is helping to work in the skills needed.
EVELYN ( 00:21:42): Absolutely. And incorporating, it takes like trained staff, all of our staff are either Registered Behavior Technicians or Board Certified Behavior Analysts. It takes those trained professionals to be able to capture and contrive those situations in their home environment so that we can work on communication, language. All those skills can be worked on from the minute that the child comes home all the way until the end following instructions, be able to complete a task, focus, focus and attention. So all those skills can be incorporated and it doesn’t have to look like therapy. So it doesn’t have to look like, oh, well, you’re not allowing your child to be a child because like again, we said, we incorporate whatever he’s doing anyway, in his routine, we’re going to stick in our goals of language and communication in there so that he’s able to learn while doing everything that he would normally be doing as a child. We’re not taking away their childhood and taking away those opportunities. We’re not gonna be like, oh, don’t play with your siblings outside on the trampoline because you’re in the middle of ABA session that would kind of take away what we’re out there to get. So we want to work on those. If he’s going outside and the neighborhood children are outside playing a ball game, we’re gonna be really focusing on social skills and social interactions out there. And when he comes back in and mom says, well, it’s bath time, then we’re gonna learn independent skills, learning how to wash himself, learning how to follow a task, learning to become more independent, et cetera.
FRANCES ( 00:23:06): That’s so great. That was going to be my next question is like, well, when do they get to be a kid?
EVELYN ( 00:23:11): You know what was coming? Because that one always comes. That’s usually a parent’s number one or number two, concern when they call us is wait, are we gonna allow my child to still be a child? And the answer is absolutely yes. And if you’re ever in a situation, the nice, the beauty of an ABA therapist coming in at home is that parents and family get to see it. So if at any point, you feel like, hey, this is a little bit too intense, my child’s crying through it. He’s not happy. These activities are not fun for him. It feels like almost like he’s not being a child, then you could always just monitor that and reevaluate that when your therapists are there because chances are if you’re monitoring it and your child’s happy and you see the way it’s being incorporated, families are calling us to increase services, not decrease them. Because they see that it’s working, the child is making progress within the natural environment. So definitely, I understand the family’s, you know, fear at the beginning. But they usually get as soon as we do our first check in with them and say how services are going. They’re like, oh, it’s amazing, you know, he’s really learning. He loves when the therapists come and he’s actually learning how to communicate better and interact with his siblings better. So definitely we are able to see the success of the program in that direction.
FRANCES ( 00:24:24): Because it, it brings the peace and harmony to the home because it’s, it’s, it’s challenging for everybody, you know, when you have a neurodiverse child that, you know, that needs a lot of attention, oftentimes, siblings or spouses kind of suffer and don’t get the attention because all attention needs to be on that child. And what came to mind is that when you’re doing it in the home, I’m assuming like the family is there and can learn some of the techniques so that they can practice them on the weekends, right?
EVELYN ( 00:24:56): Absolutely. You bring up another great point that we didn’t even speak about yet. Part of what we provide at the Learning Tree ABA is, is weekly parent meetings. We used to call them parent trainings, but then I decided that’s not a good word for it because the parents actually know their child better than we do. So why are we calling it parent training? I like to call a parent meeting where we meet with the family and we’re able to go over the child’s progress concerns and from week to week it changes. You know, the summer’s coming up and we want to prepare for that. And our winter program is gonna look very different than our summer goals and programs and different ways and activities that we can incorporate it. So we want the families involved. We want to say, hey, how’s it working for you? I know during session our learner is performing at this level. Is he doing that with you too? Oh, no. And why not? Let’s see what we could be doing differently. We’ll incorporate the family during our session, whether it’s a sibling, a younger sibling, an older sibling, parents, neighborhood children, whoever it is in order to enhance the learning that can be taking place, we want to incorporate everyone. So again, even if it’s a neighborhood child, just learning how to interact with that child might be very beneficial. Instead, you know, you say, oh he has a hard time with this. Can you help him, you know, figure out how to do that? And teaching everybody in that child’s village on how to help him make that progress can be extremely valuable as well.
FRANCES ( 00:26:24): I love hearing this because it’s truly what the child needs, you know. I didn’t even think of like, do you go out in the community? And apparently you do you know at least outside playing with the kids, it’s let the kid, what I’m hearing is to let the child live the child’s life and you come in to help with the skills while the child is living the child’s life.
EVELYN ( 00:26:47): That’s a perfect way to say it. And I love hearing from our families when we do our check ins like, you know what? It was amazing. We went to Target the other day with our behavior technician and we worked on, you know, following a list of things that he needs for school and we put it in the cart and he was able to interact with the other people on line. He was able to wait on line patiently. He actually had to go to the bathroom in the middle and was able to use the public bathroom, which is something that he was never able to do. I mean, there’s nothing more rewarding as either a director or BCBA or a behavior technician hearing those words when you’re really changing the lives of these children in their natural environment where the parents were like a few months ago, we would never been able to dare step into a big store like that without having a complete meltdown. We would have had an accident there. He would have been melting down. He would have been so embarrassing. We would have had to carry him out. It would have been a disaster and hearing that he was able to gain those skills. Go with his behavior technician, able to follow, you know, sometimes we prepare him, we do a social story to help prepare him what to expect in the store. Have a plan in place that we could do this trip successfully, maybe for a very short period of time, buy one thing and then leave and then the next time, buy two things and then leave and being able to build up on those skills on a, in a hierarchy, very systematic approach to be able to go soon with the family for 20 minutes to the store and be able to perform just as successfully. So that would be like the story of the day that would make us feel like everybody just like shake your pompoms or that was a huge success for everybody.
FRANCES ( 00:28:26): This is why we do what we do.
EVELYN ( 00:28:28): Exactly.
FRANCES ( 00:28:30): So that’s great to hear also that you go out to the community and wherever the family needs, and going on. So like I know you were saying that it’s all individualized on the child’s needs. Are there specific programs that might be included in a child session?
EVELYN ( 00:28:47): Oh, absolutely. So that’s part of the treatment plan that we spoke about at the beginning, we do an initial assessment, part of that initial assessment, what’s included in that is a list of different skills. Most of them are within the domains of communication, social functional skills that we want to incorporate on, on a very individualized level. And we put, we include it in that treatment plan. And again, like we make sure that each time we’re there, we’re not just playing with the child, we’re actually working on those skills and those skills, behavior technician actually takes data on every time that he or she is there. Mom can also incorporate those programs after we leave. And no two treatment plans that we have here at the Learning Tree look exactly the same. That’s because none of our learners are exactly where the other one is at.
FRANCES ( 00:29:40): I love that you say that because it was I I saw so I’m trying to remember where it was on social media the other day. But something describing autism about like how it’s a category trying to stuff all these kids in when in actuality, it’s like, they’re like snowflakes. No two are identical.
EVELYN ( 00:29:56): Exactly. It’s amazing to see. And I don’t think I could ever, sometimes people ask me as a BCBA, can it ever get boring? Can it ever get tedious? And I’m like, are you kidding? Like every single time I come to a client’s home, it’s so cool to hear how every child is so different, what they like, some of their stereotypical behaviors, it just sometimes it’s really cool. Like every, every child is just so different what, what their magnets towards, and being able to even use those stereotypical behaviors in order to not only decrease, like we want to decrease them, but we also want to work in a way that hey, if he likes fans and he has this obsession for fans, we can use that also as a motivating tool of like, hey, let’s do this and then we can look at the fan together. Those are some of the things that we could incorporate some of those like those splinter skills or those very specific interests, we could include them in our, in our program to help motivate our child, to learn and to even build up that rapport with the child.
FRANCES ( 00:30:55): That just triggered a memory from when I was teaching. I had a child on the spectrum, that when I started, he used to sit in the classroom like this and I started bringing him to the office and we discovered he loved watching the light from the, the copier going back and forth. He would just like kind of stand there and watch it. So it became, that became his reward. We would go, but he had to say hi to the, you know, to the secretaries. And once he said hi, they’d go copy something for him.
EVELYN ( 00:31:25): You see Frances, you were, you were providingABA therapy even without knowing it. So look at you.
FRANCES ( 00:31:33): I would say it was even before it was technically ABA therapy, but it made sense, you know, like it just, you know, everybody was like, how did you get him to do that? You know, like because you look at the child, see what the child likes and, and make it work.
EVELYN ( 00:31:51): And if you’re teaching the child how to count, let’s say, instead of counting, you know, little manipulative things in the classroom, go over to the copy machine and count how many times that light passes. Chances are he’s gonna learn how to count a whole lot faster and doing something that he really likes versus something that he doesn’t. So those are very important examples that not only for children on the spectrum and not only ABA, you know, just that’s how learning takes place.
FRANCES ( 00:32:18): In the natural environment. I remember there was an episode I think it was CNN that a friend and I were on and well in the audience on, but it was, they were talking about like, recess and taking away recess and she was an educator also and both of us were like, what do you mean? That’s where all the skills get applied, you know, like learning to count, learning to recognize letters of learning to, you know, whatever. If you don’t actually put it into place.
EVELYN ( 00:32:50): Exactly. Unfortunately, that’s pretty common. You know, that way of thinking of, well, if he misbehaves and we’re just gonna have to take him away from his friends versus wait one minute. Like that’s what he has to learn most. Let’s let’s be proactive, let’s set this up for success so that when he is out in the playground, he can be successful, learn those skills so that we see a decrease in them because chances are, if I turn to the school and I’ll say, well, listen, you’ve been taking him out of recess every time he misbehaves. But can I ask you, did those, did those targeted behaviors go in the direction that you’re like? Is it working, is what you’re doing even effective? And if it’s not, then why are we continuing? Let’s take a different route. So that would be some of the things that we would suggest to a school like, hey, this is what you’ve been doing, but has it been helping? And really having the data to back us up really helps us and gives us the fuel to tell the school. Hey, listen, we have the data to back us up. It hasn’t been working. The behaviors are exactly where they were three months ago. Can we try something else and be proactive?
FRANCES ( 00:33:49): Right. And that’s, I, you know, the former teacher administrator in me is like, because it was so set up the child needs to be punished. You know, the child needs to be suspended. It’s, it’s, they broke this rule. And like to me, suspension was like the worst thing ever because how is that going to improve behaviors? Kids want to stay home, you know, a lot of times. So they’re gonna misbehave even worse to get sent home for more days. Exactly. Yeah. Come in. Why are they misbehaving and let’s, let’s address that.
EVELYN ( 00:34:23): Ao you bring up another very good point. That’s something that we always work on as a BCBA, is really, we call it the function of the behavior. So, like you’re saying, Frances is why is the child doing what he’s doing? So, for all we know, sending him home from school is actually inadvertently reinforcing the behavior. And we want to always take a look as wait. And that’s usually the first question I asked, like, why do you think he’s doing what he’s doing? Is he doing it for attention? Is he doing it to escape a demand? Is he doing it because he wants a tangible? Like, what is, why is he doing it? Or maybe he just doesn’t have the skills to do what he needs to do. And that’s something that we need to teach. But being able to determine that function of behavior is key for helping us determine how we can respond next time in order to see those changes of behaviors that we’re looking for. So that’s a very important thing that we do also is try to determine that like, why is he doing what he’s doing?
FRANCES ( 00:35:21): Which is the, the functional behavior assessment that the schools do and then the behavior intervention plan, which unfortunately were usually not that great because most of them are not BCBA’s, you know, it’s a teacher doing them and they’re not trained.
EVELYN ( 00:35:35): Right. And that’s something that we do do is really work with a teacher at their level. And I always, you know, I have a team of BCBA’s wonderful BCB’s and registered behavior technicians working with me. And that’s something that I tell them is also like we got to meet our families where they’re at, we got to meet the staff members in the school where they’re at. So if they’re not ready for a 50 page behavior plan, they don’t give that to them, they’re not ready to implement it. It could be, they don’t have enough manpower to be able to implement a one on one. But what can they do that can be successful as well, might not be ideal but can be successful. And we will train the school whatever we feel like they can implement, given whatever they have available for them. Because I always say for the most part, we’re all on the same page. We all want to see our learners go in that direction. We all want those skills to be built up. We just have different training. So let’s meet together, let’s collaborate. Let’s be open with each other. See what can work. Because at the end of the day, we all want the same thing.
FRANCES ( 00:36:34): It’s so great that you recognize that because like as a teacher, if somebody came in like, oh here’s a 50 page report, you need to implement all that. Most teachers are gonna throw it in the circular filing cabinet, you know, like that’s the end of that. Whereas, but if you go in with a, hey, we discovered this technique at home is working really well. Do you want, you know, let’s see. Do you want to see if we can make it work in the classroom and how we can adopt it? I think almost every single teacher is gonna be wide open to that suggestion.
EVELYN ( 00:37:00): And Frances, I’m not even sure if you realize what you just said, telling the teacher that this has been successful in the home is actually the motivating piece that they need to hear. Just like our learners need to have that motivating piece teachers do, they don’t want you to just throw a report at them. I mean, I’ve taught in classrooms too. Nobody wants extra work. We all know that. So telling them, hey, this has worked for your client if you, I want, I want those behaviors to go down just as much, if not more than you do. So let’s work together. This has worked for us at home. Do you want to see if it could work in school, too? Great? Do you think that this is possible for you to implement in the classroom? No, why not? Ok. Not a problem. It’s too distracting maybe for the other students. I get it. Let’s do something that isn’t a little bit less distracting whatever it is that the teacher is honest about that might get in the way and working together with them, keeping that motivating piece for them as well because everybody needs that little carrot dangling in front of them. Like, why am I working so hard? Well, it’s because he has made progress like that at home. So if we just put in that much effort, it might actually go far in the classroom.
FRANCES ( 00:38:03): Yeah, that’s true. We all need the carrot. This has been so great. I feel like I could talk to you all day, but I know we have time limitations and so how can people reach out to you? Like if people are like, huh, this might be right for me and my child. What do people do? How should they reach you?
EVELYN ( 00:38:22): So they can always reach out to me directly. I’m at the learningtreeABA.com. We have our website https://www.thelearningtreeaba.com. I also have email, my email address is Evelyn @ thelearningtreeABA.com, but I would say start off with the website, you’ll have that information. There’s lots of great programs out there. And that’s something that if the families are, I think we brought up so many different points of different things that the families can ask whatever provider they go to. There’s so many different questions that they could ask beforehand to make sure that their model, their techniques match up with what the families are looking for. So at least I hope that even if that’s the only thing that families might have gained today is what to ask, before they just jump into something that they don’t know so much about, at least we give them those valuable tools. But if they want to reach out to Learning Tree or have more questions for me, they can definitely follow up. I would say start off with our website https://www.thelearningtreeaba.com. And I’d be happy to answer any questions they might have.
FRANCES ( 00:39:23): And all the links are going to be in the notes. This is great. Like it, it to me, I’m like, wow, you just gave everybody the list of stuff, whether you’re the right fit or not to any ABA therapist of what you should be looking for to make sure it’s the right fit because not everybody is gonna fit together the right way, the same way, right? So, thank you so much, Evelyn. This has been absolutely wonderful. I really appreciate you taking the time to come and be on my show and provide our listeners with just more information of what’s out there and what can be done.
EVELYN ( 00:39:54): Thank you for having me.
VOICEOVER ( 00:39:56): You’ve been listening to Stress-Free IEPTM. With your host Frances Shefter. Remember you do not need to do it all alone. You can reach Frances through ShefterLaw.com where prior episodes are also posted. Thank you for your positive reviews, comments and sharing the show with others through YouTube, LinkedIn, Apple Podcast, Spotify, Google Podcasts, Stitcher and more.
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