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The Mission of the ABA and PT Podcast is to record and document the work and journeys of major contributors to ABA and Precision Teaching, and thereby stand for incorporating standard measurement and the use of the standard celeration chart into our work and lives. Our pledge is to honour those who have dedicated their life to this field such that my daughter and those that need it, benefit from science and all our field has discovered, that is at risk of getting lost. And the bottom line is that we all need it.
Episodes
Wednesday Feb 10, 2021
Wednesday Feb 10, 2021
Mandy and Aditi continue to examine Sam, a 9-year old client with autism with aggressive behavior. As OT's and ABA's have different assessment tools for fine motor development, this episode explores the goals and methodologies they use to improve Sam's fine motor skills.
ABA tests range from handwriting and the grip and pinch strength test while OT assessments use examples like the Silly Bug, the Superman extension pose, and core strength. These assess behavioral fluency and aims which are reflected in competent performance and higher-level skills.
HIGHLIGHTS
02:52 Shoutout to Elizabeth Haughton
07:09 Sam's case study: ABA assessment goals and tools
17:10 OT assessment goals and tools for fine motor development
31:58 Importance of Aims and fluency
GLOSSARY
Grip and pinch strength - A baseline assessment tool used for baseline data for intervention
Dynamometer grip and pinch strengthening tools - Tools that measure how hard a child can squeeze and pinch
Behavioral fluency - The fluid combination of accuracy plus speed that characterizes competent performance
Adduction - Showing up in novel skills that you have never trained before
RESA - Retention, Endurance, Stability, and Application
RESOURCES
Join our The ABA and OT Podcast Facebook Group to get access to the following resources:
Facebook group link: https://www.facebook.com/groups/397478901376425
EXTERNAL RESOURCES
Handgrip Strength: A Population-Based Study of Norms and Age Trajectories for 3- to 17-Year-Olds
Behavioral fluency: Evolution of a new paradigm
QUOTES
12:35 "The first part of our assessment was putting a pencil down and picking it up because that is a component of fluent handwriting is being able to reach out for a pencil and pick it up very easily without having to think about adjusting."
17:55 "For fine motor, the Bart's really good, but also I would do strengthening. I would look at his strength and range of motion. And most OT's know about strengthening tools but a lot don't use the measurement tool because we typically don't take baseline data."
25:25 "First, I would assess flexion, and this is called, you probably did this with Sam, the Silly Bug. So the child lies on their back, cross their arms over their chest, legs are bent, head lifted off the floor, and they have to keep this sort of crunchy, silly bug position."
35:07 "A count per minute by skill that, over time, we have worked out that when the skill is taught to that rate like a count per minute, you have that skill and you never lose it, or you get it back with just a little bit of practice."
39:46 "We want kids being able to form between 80 and 100 letters per minute so that when they come spell word, they're not thinking about how to form their A or Z, whether they're doing their Z backwards or not. So that's why aims is so important."
43:39 "If you want a child to do something easy and effortlessly, look at what fluent performance is for that skill and measure it."
Wednesday Jan 20, 2021
Wednesday Jan 20, 2021
Aggressive behavior in children can be a real challenge for therapists and family members. This episode examines the case of Sam, an extremely aggressive child, and the OT and ABA behavior strategies that worked and didn't work for him.
Mandy explains how she began her collaboration with an OT to work out a behavior plan for Sam and the steps they took to produce improvements. Mandy and Aditi explore the points of collaboration between the two professionals and how their interaction can be used as a learning tool for others as well.
HIGHLIGHTS
02:48 Shoutout to the Ask for Evidence campaign
03:37 Case study: Sam's aggressive behavior
14:28 Strategies with Sam: Where to begin
21:01 Strategies that needed fading out
25:45 Early teaching goals
29:58 Starting the OT and ABA collaboration
GLOSSARY
Light switch on and off protocol - A procedure of extinction on behaviors maintained by automatic reinforcement. This is commonly referred to as “sensory extinction.”
Red card, green card protocol - A procedure using two stimuli (red and green colored cards), conditioned via discrimination training, to reduce motor and vocal stereotypy in a youngster with autism.
Escape extinction - A procedure of extinction on behaviors maintained by negative reinforcement.
Variable ratio of reinforcement - In operant conditioning, a variable-ratio schedule is a schedule of reinforcement where a response is reinforced after an unpredictable number of responses. This schedule creates a steady, high rate of responding.
Signal - Directing eyes for instructional control
Behavioral Skills Training (BST) - A training package that utilizes instructions, modeling, rehearsal, and feedback in order to teach a new skill. Typically training is implemented not for some fixed time, but rather to some predetermined criterion.
The Big 6+6 - In the Precision Teaching world, there is a set of 12 discreet fine motor movements which are the components of more complex skills. Being able to accurately and quickly complete these movements can lead to the successful performance of more advanced and functional tasks like dressing, eating, bathing, playing with toys, and writing.
RESOURCES
Join our The ABA and OT Podcast Facebook Group to get access to the following resources:
EXTERNAL RESOURCES
Ask for Evidence campaign website
QUOTES
12:23 "We taught him, over time, how to use Minecraft and how to build things and that allowed us to engage with him. He just developed this amazing interaction and all of a sudden we had an ability to instruct him and compete with that aggression."
15:20 "Those items were always directed at a person, so straight away that tells you that it's not self-stimulatory behavior. His mother accounted to me, he'd never throw things when left to his own in his room."
19:03 "Once we had him waiting for about 20 to 30 seconds, we knew we would have the ability to 20 or 30 seconds of work. So we started to introduce some very very simple skills."
28:05 "Improving his eye ticks made the most dramatic improvement in his aggression because he wasn't being corrected so he wasn't getting negative attention from having to repeat tasks."
38:10 "We did a combination of her fine motor strengthening goals, we used her core strengthening goals, then we brought in the Big 6 as well."
Wednesday Jan 06, 2021
Wednesday Jan 06, 2021
Evidence-based practice can be a touchy subject for ABAs and OTs alike. Dr. Josh Pritchard of the Lodestone Academy shares his insights on collaboration and the strengths and weaknesses of single-case design versus group-case design.
Dr. Pritchard discusses the groundbreaking study that put standards in place for sensory integrations for children with ASD. He further provides ways that ABAs and OTs can improve their collaboration by using measurements to determine the effectiveness of their interventions.
HIGHLIGHTS
01:50 Introducing Dr. Josh Pritchard
08:54 Research and OT strategies: Challenges to collaboration
17:19 Evidence-based practice: Single case design vs group design
29:57 The Bedtime Pass
33:51 Discussing the study "Effectiveness of Sensory Integration Interventions in Children With Autism Spectrum Disorders"
38:49 Insights for OTs and measuring the effectiveness of their interventions
GLOSSARY
Single case design - Takes a single unit, many times a single person, or a setting or small group of people but treated as a unit, and use that unit as its own control, and involves repeated measures, and manipulation of a single, independent variable in specific patterns.
Group case design - Uses the same kind of control but using averages of the measurement across each group and compares using statistical analysis. The goal is to find statistical significance.
RESOURCES
Join our The ABA and OT Podcast Facebook Group to get access to the following resources:
Facebook group link: https://www.facebook.com/groups/397478901376425
EXTERNAL RESOURCES
QUOTES
20:36 "In single case, you control that by only changing one thing at a time and changing it in specific patterns to eliminate or minimize randomness or confound."
20:47 "In a group design, you do the same kind of control but the way you control is you take averages of the measurement across each group, and then you compare those and you use statistical analysis."
22:20 "We are an inductive approach so that's sort of bottom-up. We want to gather lots of data and look at it and discover patterns versus a hypothetical deductive approach, which is sort of top-down, come up with a theory and then try to just prove it. And if you can't disprove it, then it's good."
27:24 "The single-case design is good for the development, refinement, make more efficient a technology and then you can extrapolate that. I think this'll work for many. The group-design actually is good for telling the effectiveness and does it, in fact, work for most people."
43:17 "The challenge to the behavior analyst and the value of the OT, there's some stuff we want to change in life that's got the je ne sais quoi of, I can't say what that is but I can say when it's happening or not. And we got to dive in and what is that?"
Wednesday Dec 16, 2020
Wednesday Dec 16, 2020
Bedtime resistance and frequent night wakings are a source of frustration for many parents. This episode talks about the biggest mistakes parents make in establishing sleep patterns, as well as the Bedtime Pass, an effective intervention designed to address bedtime resistance.
They also discuss the case of Liv and her mum and how they used the Bedtime Pass to modify sleep behaviors. This case was particularly difficult because of the deteriorated relationship between mother and daughter. However, the Bedtime Pass was an effective tool in creating a positive outcome for better sleep and more compliance.
HIGHLIGHTS
01:56 Shoutout to the Association for Science in Autism Treatment (ASAT)
06:21 Mistakes with establishing sleep habits with children
12:47 Technology, blue light, and its impact on sleep
18:07 The ABC model of behavior
28:04 The bedtime pass: Explaining the study that established it
32:30 Discussing the case study of Liv
GLOSSARY
Reinforcement - Anything that happens after a behavior that strengthens that behavior or makes it more likely to occur again
Extinction - Removing pleasant consequences that have occurred previously
Extinction burst - The reaction to a stimulus that once produced positive reinforcements, but now ceases to exist
Bedtime Pass - An intervention to address bedtime resistance using a card with the child's name on it that can be redeemed for one thing like a glass of water, hug, or toilet visit.
RESOURCES
Join our The ABA and OT Podcast Facebook Group to get access to the following resources:
Facebook group link: https://www.facebook.com/groups/397478901376425
EXTERNAL RESOURCES
Association for Science in Autism Treatment (ASAT)
QUOTES
11:11 "If we don't teach kids to fall asleep on their own, they become dependent on some crutch, either parents or something else to assist them to go to sleep. And breaking that habit is extremely difficult."
14:12 "Blue wavelengths, specifically, which are brilliantly beneficial for daylights hours because they keep us alert. They boost our attention, reaction times, mood, etc., they have an equal and opposite effect at night."
22:22 "What all of our hundred years of science reinforces is it's what happens after a behavior or the consequence that determines whether it occurs again."
30:59 "In general, we know that behavior that has been intermittently reinforced is more resistant to extinction."
38:21 "Behavior rehearsal of any intervention that I do is to make sure that the child is practiced and rehearsed and it can be done in a really fun way. And you can do it as a game."
Wednesday Dec 09, 2020
Wednesday Dec 09, 2020
Sleeping challenges in infants and toddlers, especially those with ASD, can prove debilitating to parents. Mandy and Aditi discuss sleep patterns and disorders and give two perspectives on this complex yet essential aspect of life.
They share their personal experiences with sleep issues and define what sleep is according to sensory and behavior perspectives. Mandy and Aditi also explore how both fields approach interventions, the importance of documentation for effective intervention, and the ways to analyze factors like environment and habituation that influence a child's sleep.
HIGHLIGHTS
01:22 Shoutout to Dr. Patrick Friman
04:12 Personal experiences with sleeping challenges and methods
12:37 Discussing sleep: Two perspectives affected by culture and habituation
41:59 Integrating ABA and OT for sleep disorders
52:44 Differences between ABA and OT sleep interventions
GLOSSARY
Graduated extinction - Using longer and longer periods of time to attend to the child.
Faded Bedtime Procedure - Pushing back bedtime from baseline measurement and keep the child awake through any means possible for a longer period so they are more likely to go to sleep.
Escape extinction - The discontinuation of negative reinforcement of a behavior.
Sensory diet - The therapeutic use of sensory activity that is embedded in the daily routine.
RESOURCES
Join our The ABA and OT Podcast Facebook Group to get access to the following resources:
Facebook group link: https://www.facebook.com/groups/397478901376425
EXTERNAL RESOURCES
Behavior Analysts to the Front! A 15-Step Tutorial on Public Speaking by Dr. Patrick C. Friman
Sleep Assessment and Treatment Tool (SATT) by Dr. Gregory P. Hanley
Brief Infant Sleep Questionnaire (BISQ) by Dr. Avi Sadeh
Applied behavior analysis measurement, assessment, and treatment of sleep and sleep-related problems by Dr. James Luiselli
Occupational Therapy Practice in Sleep Management: A Review of Conceptual Models and Research Evidence by Eris C. M. Ho and Andrew M. H. Siu
QUOTES
12:56 "Babies sleep an average of 16 hours in 24 hour period and it's reported that between 20 and 30% of children experience sleep problems and 40 to 80% of children with developmental disabilities have sleep disorders."
18:57 "Perhaps the behavior of falling asleep is reinforced by sleep. In other words, what happens before sleep, from a behavior analyst, results in sleep and that component of sleeping is partly operant and the falling asleep is the end of a chain of behavior."
28:00 "As soon as you start reinforcing any behavior that might be either syncing or blocking sensory stimuli, you add a behavioral component as well."
39:30 "When you add in a bedtime resistance, it can come about by sleep onset delay, and then potentially you have a complex combination of both biological, circadian, and neurodevelopmental factors as well that are influenced but not solely attributable to environment and behavioral variables."
46:32 "Sensory disorders impact sleep differently. Sometimes it might be the routine leading up to bedtime which is dysregulated or perhaps the child is so overstimulated from the day that they can't settle down to go to sleep."
Wednesday Nov 25, 2020
Wednesday Nov 25, 2020
ABAs and OTs look at early learning from two very different lenses. Mandy and Aditi define terms according to their sciences and give their insights on the case of Stella, a premature baby.
They take a closer look at the sensory and behavioral aspects of early motor development and the roles of classical and operant conditioning. Mandy and Aditi also explore tactile defensiveness, habituation, and desensitization which are all used to accelerate early learning and therapeutic outcomes.
HIGHLIGHTS
01:27 Shoutout to Dr. Kimberly Berens
08:38 Debunking myths: ABA's only deal with ASD clients
11:45 Two perspectives: What does early learning look like?
19:35 Reflexes: Learning through respondent and operant conditioning
27:55 Sensory processes in preemies
38:25 Case study: Interventions with Stella the premature baby
GLOSSARY
Primitive reflexes - Unlearned behaviors that are automatic responses that are essential for survival
Reflexes - Purpose of the reflex is to provide a baby with an internal alarm system to protect from danger
Little Albert Experiment - A study that looked at fears or phobias in conditioning in infancy (Pavlovian conditioning)
Tactile defensiveness - A pattern of observable behavioral and emotional responses which can be aversive and negative and out of proportion to certain types of tactile stimuli that most people would not find painful.
RESOURCES
Join our The ABA and OT Podcast Facebook Group to get access to the following resources:
Facebook group link: https://www.facebook.com/groups/397478901376425
EXTERNAL RESOURCES
"Blind Spots: Why Students Fail and the Science That Can Save Them" Book by Dr. Kimberly Berens - https://www.amazon.com/Blind-Spots-Students-Fail-Science-ebook/dp/B08HNJYW3T
QUOTES
15:54 "Behavior analysts believe that things unfold by exposure to the environment and by consequences delivered to those behaviors."
16:21 "For OTs, the developmental milestones serve as a general guideline or roadmap, if you will. They aren't necessarily a benchmark because we know that every child has their own timeline and trajectory."
30:40 "Learned behavior occurs through experiential learning while unlearned is more of a combination of biology and sensory experiences that occurs very early on."
35:47 "We know that there is a biological basis for sensory processing differences which can lead to poor processing of sensory information and, in turn, results in atypical perceptions of pain and discomfort."
49:04 "I think we can empower parents if we make it very specific what we're asking them to do and teach them to take data to see if what we're prescribing is working or making it worse."
Saturday Oct 31, 2020
Saturday Oct 31, 2020
What is the impact of sensory and behavior on early survival skills? Mandy and Aditi begin with a case study on Aditi's son Tristan who was diagnosed with failure to thrive.
Mandy and Aditi also refer to a behavioral feeding program where differential reinforcement was used alongside other interventions to build adaptive eating repertoires. They also talk how a collaborative sensory and behavior approach can develop a hypothesis and the need to exercise caution when using profession-specific terms to avoid miscommunication.
HIGHLIGHTS
04:36 Shoutout to Margo B. Holm
05:45 Case study: Tristan's early feeding problems
12:57 Differentiating sensory and behavior: Interoception and Dead Man’s Test
22:49 Early feeding behaviors and the sensory hypothesis behind it
30:14 A behavioral feeding program for failure-to-thrive infants by Larson, Ayllon, and Barrett
42:12 Key takeaways
GLOSSARY
Interoception - The perception of sensations from inside the body and includes the perception of physical sensations related to internal organs like the heartbeat, respiration, and satiety.
Dead man test - If a dead person can do it, it's not behavior. If a dead person can't do it, it is behavior. Examples: laying still, falling down stairs, being noncompliant, sitting in a chair.
Unlearned (respondent) behavior - Behavior that a baby does not need prior learning to engage like survival mechanisms (feeding, suckling).
Differential reinforcement - Promotion and strengthening of behavior we want to see again and weakening what is reinforcing behavior that we want to reduce.
Punishment - Something that reduces a behavior.
RESOURCES
Join our The ABA and OT Podcast Facebook Group to get access to the following resources:
- Early Feeding - Failure to Thrive Glossary of Terms for ABA & OT
Facebook group link: https://www.facebook.com/groups/397478901376425
EXTERNAL RESOURCES
https://www.researchgate.net/publication/270026479_Our_Mandate_for_the_New_Millennium_Evidence-Based_Practice - Our Mandate for the New Millenium by Margo B. Holm
https://nebula.wsimg.com/3783318e9b2543b7e5a133adb3b0bafb?AccessKeyId=1133D4CF8F18F0339400&disposition=0&alloworigin=1 - The Dead Man Test by Ogden Lindsley
https://www.sciencedirect.com/science/article/abs/pii/0005796787901136 - A Behavioral Feeding Program for Failure-to-Thrive Infants by Karen L. Larson, Teodoro Ayllon, Drue H. Barrett
QUOTES
08:38 "My OT brain started going okay, I have ruled out all medical issues, so what's next? Then I was like there's got to be a sensory facet to this. This is when I started thinking about interoception."
21:44 "Since receiving and reacting to sensory responses, whether it's intrinsic or extrinsic, a dead man cannot do, therefore all sensory responses would actually be considered a behavior."
34:41 "They cautioned that the use of music alone was not recommended and that the adaptive eating was consequated by food and social attention primarily and while music was to mask the beginning of the feeding cycle, that it wasn't the primary reinforcer."
41:04 "We use terms that are very specific and defined but they also often have a common meaning as well such as another term that behavioral analysts use is punishment which often has a really negative connotation."
42:14 "The key takeaway, it's really about coming up with a sensory behavioral approach to develop a hypothesis. In this case with the baby, an infant who is in failure to thrive."
Saturday Oct 31, 2020
Saturday Oct 31, 2020
Mandy and Aditi discuss why professionals from the two fields find it difficult to be friends. The hosts debunk the biggest myths of their practices and explain the reasons behind this stereotyping.
They also perform a role-play and introduce the ABA and OT Ice Breaker that members from either profession can use to open a conversation that fosters collaboration and leads to positive results.
HIGHLIGHTS
06:27 Honoring Dr. Jose Martinez-Diaz
13:52 Myth 1: OT and ABA have different guiding theories
16:42 Myth 2: ABAs don't need the expertise of anybody else
20:57 Myth 3: Behavioral intervention results in robotic skills that don't generalize
23:25 Myth 4: OTs don't base on evidence or measure data
26:38 Myth 5: OT's are all about sensory,
30:17 Myth 6: ABAs don't consider intrinsic factors
33:13 Myth 7: ABA is all about discreet trial
35:28 Role-playing the ABA and OT Ice Breaker
Ice Breaker questions:
1. "That's how my session looked. How does your session look, Mandy?"
2. "What are the underlying component skills for handwriting that he's missing to assist us to get him to form those letters?"
3. "I can definitely expose you to some of those and if it's something you can incorporate into your session, I think it would be a win for both of us."
4. "I'm excited at those measures that you have, and I say measures because that's what you're recounting to me. I'm excited that we can measure some of those things and provide interventions and look at response."
5. "Mandy, would you be open to another thought here? When I work with Sam..."
6. "Is it behavior that I've reinforced in some way? Is it both? Is it just one? Is that something that you and I could really tease out and figure out?"
RESOURCES
Join our The ABA and OT Podcast Facebook Group to get access to the following resources:
- ‘The OT & ABA Icebreaker’ : questions to get the collaboration started.
Facebook group link: https://www.facebook.com/groups/397478901376425
EXTERNAL RESOURCES
Interprofessional Collaborative Practice between Occupational Therapists and Behavior Analysts for Children with Autism - https://www.researchgate.net/publication/336314593_Interprofessional_Collaborative_Practice_between_Occupational_Therapists_and_Behavior_Analysts_for_Children_with_Autism
Calkin, A.B. Inner behavior: Empirical investigations of private events. BEHAV ANALYST 25, 255–259 (2002) - https://doi.org/10.1007/BF03392063
QUOTES
20:05 "It's a myth because in fact behavior analysts with their interactions with their own governing bodies are required to refer to experts in specific areas beyond their area of practice."
21:35 "Poor application of the science of medicine might misdiagnose or prevent recovery from heart failure just like the poor application of behavioral science might prevent skills from showing up where they are needed."
26:21 "I do think OTs can do better with data even though we have a different time frame that we work in. There's a huge push in OT to take data."
28:04 "Now in the US, OTs are becoming a lot more cognizant of behavior and not just sitting there blindly and saying okay, it's sensory and that's it."
31:04 "Some behavior is either impossible or very difficult to measure so it looks like we're disregarding it. It's just that we care so much about measurement and improvement."
34:01 "Unfortunately, in this country, the understanding of ABA is seen through repeated discreet trials with young children with autism. And this is not the science of behavior analysis and this is not applied behavior analysis."
36:00 "You have to get really comfortable saying things like 'thank you for that idea or tip' to the OT or ABA."
Saturday Oct 31, 2020
Saturday Oct 31, 2020
In this debut episode of The ABA & OT Podcast, Mandy and Aditi discuss the goals of the podcast which center on inter-professional collaboration, education on challenging behavior, and having conversations on the wealth of intersections between the two fields.
Mandy tells the story of her daughter's autism which sparked her interest in applied behavioral analysis (ABA). Similarly, Aditi also shares her journey in occupational therapy (OT) and her goal to treat her son's ADHD. The two then discuss how they realized their common goals and agreed to start this podcast.
HIGHLIGHTS
00:31 The ABA & OT Podcast: What it is and what it's not
05:41 Meeting Mandy: Her journey to understand her daughter's autism
13:55 Meeting Aditi: Her quest to treat her son's ADHD
16:19 Realizing a common goal and starting the podcast
RESOURCES
Join our The ABA and OT Podcast Facebook Group to get access to the following resources:
- The History of ABA and OT complete with links and videos
Facebook group link: https://www.facebook.com/groups/397478901376425
QUOTES
01:28 "Like so many things that are valued but difficult to attain, such as fine wine or even marriage, effective teamwork, collaboration is an art as much as it is science. It requires a great deal of practice, patience, and nurturing to flourish."
03:26 "What does it mean when she says Johnny needs proprioceptive input? Or when a behavior therapist discusses the importance of differential reinforcement? Whether you're a behavior therapist or an OT, we want to make your life easier."
11:28 "The consequence matters. In other words, what happens after a behavior determines if it's going to happen again."
18:20 "As I start to read more and learn from you, I start to get really excited about the underpinnings of OT, and really, how our vision is the same and that is to engage people in meaningful pursuits and to help people overcome obstacles."