I would like to start this off by saying that I love applied behavior analysis (ABA). I can talk about ABA all day, everyday. I see the world through the lens of Skinner’s three-term contingency (Cooper et al., 2019). I will take mental “ABC” notes in my head so I can hypothesize a function for why my partner will quote every word from Disney Pixar’s Toy Story, which the data suggests that it’s automatically reinforced. Behavior analysis can be an incredibly helpful tool to dig deep into the “whens” and “whys” a behavior is happening, and I’ve seen the changes it can make in the lives of families.
Behavior analysis is just that. Analyzing behavior, finding patterns, and then being able to predict when those behaviors are going to happen again. But what happens when behavior becomes unpredictable, or no matter how much you reinforce it, your kiddo still struggles with heel-to-toe walking? Things like word articulation can be observed and measured, but is pronunciation really a behavioral challenge, or is it something physical? Like every other practice, behavior analysis has its limitations, despite how devastating this is for me to admit.
This is why collaboration is not just advised, but is required when practicing behavior analysis (Behavior Analyst Certification Board, 2022). Now, if you look up “collaboration, ABA” on any search engine, you’re probably going to find a lot of evidence to show that we have not always been team players when it comes to “group assignments,” so to speak. While I know it’s not just us, I can personally say that I haven’t always been the most open to modifying my strategies based on another provider’s recommendations, especially if what I had in place seemed to be working.
However, just “working” isn’t the best method sometimes. There can be other more efficient ways of developing new skills. I had an opportunity to work alongside an occupational therapist (OT) named Casey a little bit ago, and not only was she an amazing OT, but she was a great teammate. We met often to create programs and goals that complemented each other, and we’d sit in on each other’s sessions to make sure we were both on the same page.
I will never forget the day I was talking to Casey about the difficulty I was having with teaching our mutual client one specific object imitation target: stacking Lego blocks. From my perspective, the action didn’t seem difficult. I had many same-aged clients who could do it without issue. Casey told me she’d try it in her session with him, but I wasn’t sure what difference it would make. We tried fading our prompts, using the highest preferred items, teaching naturalistically, but nothing seemed to work.
Surprisingly, our client was performing the skill not even a week later with no problem. Why is that? Casey was having him practice crossing midline, or moving one arm across the center of his body. When you cross your body’s midline, both sides of the brain need to communicate with one another and work together (Lee, 2024). The isolated practice of crossing midline had incredible and lasting effects for this learner.
This doesn’t mean that we would have never seen an improvement by continuing the strategy we were using. Maybe eventually we could have gotten there, but we would never have addressed the real skill deficit. Casey didn’t just teach him to stack Legos. She worked with him on a foundational skill that would help him throw a ball, use a writing utensil, open a lunchbox, and so many other activities that will give him more independence. In ABA, that’s what we’re all about.
Recently, my colleague has been collaborating with a kiddo’s speech provider. My colleague was thinking about introducing a new goal to help improve this client’s articulation, since he recently has been exploring new words. The speech therapist worked with the team to identify which speech sounds were attainable for a child his age. This perfectly complemented our objective as ABA clinicians to create not just socially significant goals, but also attainable goals.
Will there be times that you disagree with other providers? Definitely! Does that mean you shouldn’t continue to work together? Of course not! At the end of the day, we are all on the same team. Everyone’s experience and education plays an essential role in our clients’ lives. If you don’t understand why another provider is recommending something, ask about it! Broaden your horizons, open yourself up to another perspective. Cross midline. Be a team player. Find ways to integrate behavior analysis and other therapies together for a multidisciplinary approach.
Everyone brings something important to the table, and it’s time to make some room.
Visit acclaimautism.com to explore how we combine expert care and teamwork to create lasting change for your child.
References
Behavior Analyst Certification Board. (2020). Ethics code for behavior analysts. https://bacb.com/wp-content/ethics-code-for-behavior-analysts/
Cooper, J. O., Heron, T. E., & Heward, W. L. (2019). Applied Behavior Analysis (3rd Edition). Hoboken, NJ: Pearson Education.
Lee, J. (2024) The importance of crossing the midline +9 activities to try. NAPA. https://napacenter.org/crossing-the-midline/
Morgan Lyons – Lead BCBA
