Underneath the Bursts

Underneath the Bursts

This past week I wrote to you about setting boundaries with our children. In my blog, I wrote about the importance of boundaries for the emotional development of children. I also wrote to you about my own struggles in setting boundaries as a mama. One of the main reasons I struggle with setting boundaries for my own children is the (out)bursts that come with it.

It just so happens that as a clinician one of my primary areas of specialization is problem behaviors (the bursts). It’s what I went to graduate school to study over a decade ago. Over 10 years later and I can tell you the science of reducing problematic behaviors hasn’t changed. My own journey applying clinical skills at home, of course, has not (well, not totally). Today I’d like to write to you about both.

ABA & Bursts

Let’s start at the beginning with ‘burst science.’ Applied Behavior Analysis teaches us that social behaviors, both positive and negative, can be broken into units that can be studied. In studying units of behavior, BCBAs are able to identify the function of behaviors (why behaviors occur) and missing skills in the child they are studying. When it comes to reducing problem behaviors, behavior analysts are looking for why the behavior is occurring. This involves looking at what is happening before the behavior and what happens after the behavior.

While studying the environment before bursts occur, BCBAs look for a deficit in the child’s environment. What are they missing? Studying environments after bursts allow BCBAs to see if the child’s problem behaviors filled the deficit. If they did, the child is successfully using the problem behavior to get their needs met. This means the problem behaviors are being reinforced and will continue to occur. Magic I’m telling you. Magic.

You see, by studying what a child is seeking in a specific environment you can create interventions that fill the child up with what they are seeking to immediately decrease the problem behaviors. This isn’t a long-term solution, but it creates a short-term solution to make the days easier for the child and their families. While the child is being satiated BCBAs work on teaching new skills surrounding the child’s needs. This always looks like teaching functional communication skills, how to ask for exactly what you need.

Sometimes teaching specific skills can look like teaching patience and tolerance to ‘no’ when what the child wants isn’t good for them to have all the time. For example, if a child is throwing tantrums to get access to candy it’s damaging to have non-contingent candy all of the time. But if a child is tantruming for positive attention, we can fill them up without having to teach tolerance to no. Though we might have to teach waiting because sometimes mama (or papa) is busy.

The key to this remedy is to also remove reinforcement when a child is using their problem behavior to get their needs/desires met. If, in the scenarios above, the BCBA is providing candy (one piece) every 30 minutes and within 15 minutes the child hits to get access to the candy the BCBA cannot give the child the candy. If they do they will reinforce the hitting and take the motivation away from using words. It is here, in this little sweet spot of the behavior intervention, that bursts occur. Let’s talk about that.

Why Do Bursts Occur?

Underneath the bursts for children (and adults… more on that later) is fear that their needs/desires won’t be met. The bursts occur because, in the child’s mind, that very thing they want could become unattainable, their need won’t be met, and they will have to experience negative emotions. Dealing with both the fear of a need/desire not being met alongside psychologically negative emotions is tough stuff for a child. This right here? This is the hard part for parents and the sweet spot for teaching emotional resilience and intelligence.  

As a mama, I know firsthand how easy it is to give in. To not want to deal with the temper tantrum, the screaming, and the crying. We are human beings and crying children is not comfortable. When we give in as parents at a given moment it provides immediate relief to ourselves and our children. It also perpetuates the very behaviors we don’t want to see more of and does not teach our children how to deal with the big emotions. 

About a year ago Henry and I were at Dametrius’s football game and Henry wanted candy from the concession stand. I had packed snacks and knew sugar was on the menu later so I didn’t want him to have extra candy. I leaned down and told my little son, “no, not now we’ll have dessert at dinner”. Of course, in public, a full-on tantrum occurred. At that moment I thought how perfectly aligned this example was. You see at that moment I could have made a concession at the concession stand by just giving in. If I gave in Henry would happily watch the game and I wouldn’t have to be teaching Henry to breathe and tell me how he feels. But giving in also meant teaching my son to numb his emotions with food and that screaming works. So I stood my ground and worked with Henry.

You see under the bursts, as we are teaching boundaries. As children burst, their hearts need to know they can ride through negative emotions and still be safe on the other side. That nothing bad comes from feelings and that needs can be met in new ways. To me, as a clinician, I know that working through the bursts creates long-lasting, positive, change. As a mama, teaching my children to ride what is underneath the bursts is more valuable than any concession I could make at any given moment.

Xoxo,

Jessie

Boundaries on the Home Front

Boundaries on the Home Front

Last week I wrote to you about my own journey in boundary-setting as a business owner and woman. This week I’d like to dive deeper into boundaries and talk to you as both a mama and a clinician about boundaries on the home front.

As a clinician, not only do I have extensive knowledge about early childhood development but one of my areas of expertise is reducing disruptive and dangerous behaviors. I spent the first five years of my career in Applied Behavior Analysis working in early intervention and on crisis cases.

I can see my young self now, rested for the day, walking into a therapy session and teaching things like how to work through a tantrum. I worked with each family on their own values and expectations of their child, observed the needs the child was trying to get through their tantrums, and taught consistent consequences to the family as well as adaptive skills to the child. In the range of adaptive skills I often taught language (use your words), patience, tolerance to hearing ‘no,’ disappointment tolerance, and expression of feelings. Each family and child was unique but the structure of the treatment was similar and based on boundary setting.

Learning Boundary Setting as a Mom

Fast forward about 8 years to when I became a mama and my son Henry became a toddler. Henry was (and is) a strong-willed child. I remember writing in his baby journal “I didn’t know babies came out like you…” because Henry was (and is) so vocal about how he sees things and how he wants things done. As a mama, I tried to also be a BCBA and use the same tried and true treatment structure with Henry. State a boundary, follow through with the boundary, use your words, and teach new skills. Easy right? No. Hard no.

Throughout my journey into motherhood, while I love my boys above all else, I have struggled with both postpartum depression (Henry) and a toxic home environment because of domestic abuse.  Toss in three boys who all have varied needs, wants, desires, and voices and the stress of setting boundaries felt impossible. You see, the thing with setting boundaries is that when you first set them children tend to resist them. Boundaries feel like a “no” to children (often they are) and the “no” feels like something for them to rebel against. As a parent, you have to be ready for the explosion as you set expectations. I’m going to be honest here; I could not weather the explosions so I became a, “yes mama”. Ugh.

Boundaries by Example

A year ago when I left domestic abuse my children & me. We were living in a psychologically frightening environment and I knew, no matter how much I wanted their dad to get help, that I couldn’t stay any longer. I set the boundary that I would not live in an abusive environment and modeled this incredibly important boundary for my children. 

Yet as the last year passed my small children had so much change in their little worlds. While some of my “yes mama” tendencies went away, some remained. Want a new toy? Sure. One more piece of candy? OK. TV time? You got it. This also worked the other way and when my children behaved in ways I didn’t love (not staying in bed, dumping their food on the floor, screaming for things) I would spend time making empty threats (one more time and then…) and eventually give in. While home life was much calmer as a single mama and my children were happy with me, I knew I had to reset, buckle in, and teach boundaries.

You see, without boundaries children don’t know which behaviors are OK and which ones are not. Without boundaries, they don’t learn how to navigate unpleasant emotions and what to do with their unpleasant emotions. They also don’t learn how to behave in social situations and can become impolite, spoiled, and disruptive.

Keep in mind that little children are still children. It’s basically their job to overreact while testing boundaries early on. It’s our job as parents, however, to shape their behaviors in positive ways. Yes of course I want my children to be happy but I also want them to know how to navigate their own inner and outer worlds. Boundaries are the way to teach this.

Maintaining Boundaries

As the fall came so did a new peace in our home. I set some simple boundaries for the boys I knew I could follow through with and continued to teach them how to navigate their emotions. I spent time making sure the values I set were in alignment with my values and that I was ready for tantrums when they came. The boundaries I set were for good listening, respect, kindness, and understanding “no.” 

My children have become calmer overall after the initial, “holy crap” boundary bursts. Boundaries tell them what is OK and what is not so they don’t have to guess or use tantrums to figure a given situation out. When they don’t like the answer they know we can hold space for them to be sad or mad. It’s a win-win. 

Me? I have a ton of compassion for the woman I was in early motherhood and know I was doing the very best I could at the time. I also am incredibly grateful that I’m in a space to apply my clinical skills to mommyhood. One day (and boundary) at a time.

Xoxo,

Jessie 

Having Priorities Helps Children With Autism

Having Priorities Helps Children With Autism

One of the challenges of modern life is the lure of having it all. We believe that if we can just manage our time, our child with autism can have the best experiences at school, at ABA therapy, with friends, and at home with family. When we’re spread too thin, though, we don’t benefit fully from anything. But when we learn to prioritize according to our values, we may not feel regret about making difficult choices and doing less.

Letting our values guide our choices is an unfamiliar concept for most of us — and it requires a little self-exploration to determine our priorities. But the rewards can be huge.

How COVID-19 Affected Priorities

Despite COVID’s continued impact, families are beginning to have more options for kids with autism. In-person school might be slotted in next to ABA therapy, and the combination can radically alter evening routines as everyone in the family also needs to take time to prepare to do it all again the following day. Here, families may struggle to decide which treatments to pursue for their child.

A family may see major benefits with ABA therapy but also recognize that COVID-related disruptions were very hard. Many parents think their child will benefit from going back to school, yet they don’t want to lose ABA therapy and they also want to have family time.

In a situation like this would a family benefit from having some of everything? Or would fewer activities that allow for richer experiences be better? In a lot of cases, efforts are not necessarily concentrated enough to have positive outcomes in any of the choices.

A tough decision is easier when a family can figure out what they really value. Evaluating what parts of in-school therapy, clinical therapy, and at-home therapy can help families decide what is most important for their child.

Developing Priorities for Children with ASD

As with everything else in life, values are not necessarily constant. This means we can adjust behaviors and choices to align with shifting values.

Determining our values can help steer us toward more fulfilling outcomes, even on a day-to-day basis. If your child is working toward learning to tie their shoes independently, for instance, repetition will help them achieve this more quickly. The downside to a lot of repetition is that you aren’t able to get other values-related tasks done. Putting the things you value most at the front of your list can help tackle important issues first.

The beauty of a values-based approach to lifestyle choices is that each parent’s values are personal and specific to them. There’s no comparison or measurement of personal values, so no guilt should be involved.

For example; if a parent can better approach each day when there’s no lingering laundry to fold, they’re not prioritizing laundry over children. But they are placing value on having an uncluttered mind so they can be more present in the moments that really matter.

ABA Therapy from IABA Consultants

If you have questions regarding autism treatment, education, or plans using ABA therapy, we are here for you! Our goal is to make sure no family is turned away due to financial constraints. Our therapy team would love to talk to you. Find the location closest to you and give us a call. We’re here for you.

Originally Posted as Values Can Help Clarify Choices With a Child With Autism, Chicago Parent, September 17, 2021

A Decade of Work, A Decade as a BCBA

A Decade of Work, A Decade as a BCBA

Over the course of the past year, I’ve been writing to you about standing in your own worth, your truth. I’ve taken you down many paths in the forest of life and shared both challenging and joyful paths that I have walked down. Through writing to you about personal experiences I have healed and still seek to heal further. Life is full of encounters and experiences that can deliver this; for us to hold each moment of being human in our hearts to live a life of freedom. 

What I haven’t written to you about in detail is my career and the work that started my journey. This past week I was recertified by Board Certification as a Behavior Analyst for a fourth time marking a decade as a BCBA. This summer I will celebrate a decade as a BCBA entrepreneur as the owner of Instructional ABA Consultants. It was emotions and injustice that brought me to my career and success. This week I’d like to share my professional journey.

Starting a Career Helping with ASD

My work in the field of autism began fifteen years ago when I was obtaining my bachelor’s degree at the Ohio State University (OSU) in human development focusing on early childhood. I was curious about how environments shaped the developmental outcomes of children. During my time at OSU, I worked in their preschool program and was a home-based therapist for two children with autism using applied behavior analysis (ABA).

This was back in the early 2000s and in both cases, the children were accessing services but their ASD symptoms were not being treated. The ABA program I was working under was state-funded and both children I worked with had high levels of physical aggression. Neither child had a treatment plan that actually alleviated the aggression. I was passionate about the kids and knew from my undergraduate work that environments mattered. In the fall of 2009, I began my master’s degree in Applied Behavior Analysis at The Chicago School of Professional Psychology.

My choice to begin a master’s degree stemmed from a desire to understand why aggression, as well as other aberrant behaviors, occurred in children. I also wanted to understand how applied behavior analysis treated autism symptoms in early childhood. During my master’s degree, I worked as an early childhood line therapist and joined the Illinois Crisis Prevention Network (ICPN) as my internship. I had to work during my degrees to pay my bills and at the time was focused on nothing outside of my career. I was thirsty to learn so I could create change for children.

Working at the ICPN

As I began working on the ICPN I was introduced to adults with mental illness and developmental disabilities. I quickly fell in love with the population and saw how lack of access to quality treatment affected their lives. In spending the first five years of my career focused on children I had never really thought about where they would go when they grew up. I had never thought about the adults with disabilities who had never gained access to care as children themselves. Most of the adults I served at the time had been raised in state-run institutions. Through my work with the adults, my eyes were opened to not only what happens immediately with small children with autism who do not have access to care, but also what can happen in adulthood.

During my time at the ICPN, I worked to gain my associate certification first and followed it up with BCBA board certification. I was given the opportunity of a caseload of clients (from children to geriatrics) who needed immediate crisis support; first under supervision, then as my own caseload. During this time I was wildly in love with my job but fiercely angry at the lack of care my clients received.

As a young woman, I cannot tell you the number of parents’ hands I held as we talked about their child’s (young or adult) experience that led to a crisis. The stories they told me both broke my heart and filled me with a fire to change their experience. Time after time the constant theme that led to a crisis was lack of intervention due to either a lack of funding or an unethical & uncaring therapy team. I worked with each client and family to stabilize their loved ones from crisis to community-functioning. Without access to outside care of the crisis team, success was usually not sustainable.

Changing the Game

In 2012 I decided to change that. I had met my own personal mission to understand aberrant behaviors and the impact of the environment on childhood development. Now, I know through science that the environment is the key predictor of outcome. I also knew that applied behavior analysis provided a scientific approach to at-risk symptoms of autism as well as behaviors.

With my own hands, through applied behavior analysis, I was able to change the outcome of lives for the better. I wanted to open a private practice that used these skills to close the gap in services based on funding sources. I also wanted to challenge my field ethically to create a place where all of our clients received quality care. A decade ago this was not the case. Even today ABA has mountains to climb regarding regulating quality care for all families.

It’s been a decade since I sat for my boards and I still have a fire burning in me fueled by what our science can do to help serve clients who otherwise would not have access to therapy. I went from just me to five locations, across three states, with a team of professionals who have the same passion. Each day I wake up knowing that we (not just me) are creating lasting change. Learning to run a company is for a different blog but as a BCBA I know I have a decade to be proud of.

To the next decade of service. Wherever we may go.

Xoxo,

Jessie

Having Priorities Helps Children With Autism

In-Home ABA Therapy Benefits

Many parents of a child with ASD wonder what the best therapy method for their child is. In-home therapy (in tandem with other recommended programs) is a critical part of the development of any child with ASD. 

In-home ABA therapy can be conducted by a licensed therapist or the parents on a daily basis. Let’s take a look at how in-home ABA therapy works and how it can benefit your child’s development.

In-Home ABA Therapy: How it Works

A huge benefit of in-home therapy is the comfort for both parents and children. If you sign up for professional in-home therapy, an ABA therapist will come to your home to work with your child. This minimizes driving time by seamlessly fitting therapy without travel into your everyday routine. In-home ABA therapy is very useful for families who have issues with transportation.

Buying therapy materials for professional in-home ABA therapy is not necessary. The therapist will use in-home materials & toys the child already has access to. ABA therapy tools for reinforcement can be almost anything: toys, snacks, social praise, etc. 

ABA therapists assess what each child likes during every session. Reinforcement tools are an essential part of ABA therapy. These tools are used to help reinforce good behavior and teach a variety of different skills like communication, play, and peer interactions.

Certain behaviors may often occur in the home, making it important to change them in a familiar setting. Resisting instruction for daily tasks or problem behaviors with siblings during playtime are things that may not happen in a clinical setting. 

BCBAs make assessments to pinpoint why problem behaviors happen and develop intervention strategies to treat problems as they occur. This gives many opportunities to target problematic behaviors and help change them.

During in-home sessions, an ABA therapist observes everyday interactions between the child and family members in real-time. This allows the therapist to provide quick feedback to parents on different approaches to creating parent-conducted treatment outside sessions.

In-home therapy can be used for toddlers, teens, and adults with Autism. Younger children from ages 2-5 who spend most of their time at home may benefit the most from in-home ABA therapy. A BCBA creates a treatment plan that best suits a child’s needs at home, allowing therapy to start in a familiar environment.

ABA Therapy & Family Support

Another advantage of in-home therapy is that parents and siblings can get involved in a child’s development. All family members are recommended to be active participants during in-home ABA therapy. This includes visiting relatives, grandparents, caregivers, and other regular visitors. 

ABA therapists can provide support to families who want to learn more about their child’s therapy program, treatment, and development. Family engagement has been actively demonstrated to increase progress when everyone implements ABA therapy strategies outside professional sessions.

ABA therapists can guide families on how to use ABA therapy to increase appropriate behaviors while reducing problematic ones. At-home ABA therapy also helps develop sibling relationships by working on age-appropriate skills. Social activities with siblings like playing, sharing, and interacting can be strengthened by ABA therapy. Peer interactions are also encouraged among friends and close relatives.

ABA Therapy & Independent Living at Home

Independent living skills are best taught and reinforced at home. Personal hygiene skill reinforcement at home provides a natural environment for children to develop skills. Important tasks like brushing teeth, washing hands, washing face, are best reinforced where they regularly occur. 

Independent living tasks are typically broken down into smaller steps with reinforcement being provided after each step is accomplished. Repeating the individual steps of a process followed by completing the process as a whole every day will help a child learn to be self-sufficient.

For early learners, in-home ABA therapy can also include daily routines. Things like toilet training, dressing, learning to tie shoes, can be taught and reinforced on a daily basis. Parents can select times that work best. Talking to your child’s BCBA can help you develop an effective schedule that will benefit your child.

Older children and teens will have different needs than younger kids. Tasks for older kids may include organizing or cleaning their room, preparing meals, and learning how to communicate (both verbally and through phones or other electronic devices). 

Peer interaction for teens, things like board games, video games, or social outings with friends, can be very beneficial as well–just make sure to talk to all involved parties about any specific needs beforehand. Knowing what situations or places your teen is comfortable with can help set up a successful social outing.

Designing a template for how to develop social outings for your teen with their BCBA beforehand may help you avoid any undesirable situations. An ABA therapist can also help develop skills for situations where a teen must interact with others.

ABA Therapy from IABA Consultants

If you have questions regarding autism treatment, education, or plans using ABA therapy, we are here for you! Our goal is to make sure no family is turned away due to financial constraints. Our therapy team would love to talk to you. Find the location closest to you and give us a call. We’re here for you.

Sources

Achieve Beyond Pediatric Therapy