102: The Controversy of ABA: A Discussion with an ABA Practitioner

If you heard our episode from a couple of weeks ago, you know we discussed Applied Behavior Analysis (ABA). Today, we are looking at the controversy surrounding ABA, why many people are in favor of it, and why many people oppose it. My guest, Taylor, is a BCBA, a board-certified behavior analyst, so let’s discuss this topic and learn more from her.

Show Highlights:

  • An explanation of ABA and the role of a BCBA

  • The language of ABA: desired behaviors, undesired behaviors, behavior contrast, punishment, replacement behaviors, injurious behaviors, tantrum behaviors, etc.

  • Taylor’s story about going to an ABA conference

  • The historical harm that ABA has done to autistic children

  • The dehumanizing aspects of ABA

  • Is the goal of ABA to make an autistic child seem less autistic?

  • Therapies covered by health insurance for an autistic child: speech, occupational, and ABA

  • The side of ABa that no one talks about

  • ABA: helpful, traumatizing, or distressing?

  • Taylor’s path to becoming a BCBA

  • An autism diagnosis does NOT mean that you need ABA.

  • A look at a typical ABA session (even though each session is highly individualized to the needs of each person)

  • Taylor’s top three things that can be done to better serve autistic people

Resources and Links:

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Get KC’s book, How to Keep House While Drowning

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  • KC 0:05

    Okay, so hi,

    Taylor 0:06

    Taylor. Hello.

    KC 0:08

    Okay, Taylor, I asked you to be on the show because you're a BCBA. And actually, somebody recommended you, because in talking about autism, one of the things that I want to kind of cover in the landscape of things was ABA because like, as a parent, it's kind of the first thing that you're given. After that it's like, here's the diagnosis of autism. Here's a pamphlet for ABA. And because I have spent so much time on tick tock around other like autistic adults, I had heard of ABA before and almost always in a negative light. And so I was sort of pushed into this situation where, okay, there's kind of almost like two sides of people talking about this. And I kind of wanted to give like a little bit of a layout in these conversations of, of that landscape. But one of the things that occurred to me is that I don't really even know what ABA is, like, I know what it is in terms of how people have talked about it. Like I've heard people talk about it that love it. And I've heard people talk about it that hate it. But when they describe it, they describe results. So they'll say I love ABA, because my son used to not talk at all. And now he can ask for a glass of water, or you'll have people say, I can't stand ABA, because it's really traumatic. And at the end of my ABA, you know, I couldn't do anything unless, you know, I was on a rewards chart, and I was so afraid of making mistakes. But I realized that I don't even really know, just from an objective standpoint, what ABA is and what it looks like. And that's kind of what I'm hoping that you can talk to us about today.

    Taylor 1:44

    Yeah, so roots of ABA stands for Applied Behavior Analysis, but at the root of it, it's the science of learning and behavior, right. And so when people say, Oh, I don't like ABA, they really mean the application of ABA and how people are applying it. If you get pulled over by police officer get a ticket. That's ABA, right? Our job pays us money. That's positive reinforcement. That's ABA. So ABA happens whether we want it to or not. So when people are saying that they don't like ABA, they really just mean the way an individual applied. There are sites of applied behavior analysis. And it's effective, because if we take data on everything on the behavior, so there's always a graph, we always are supposed to put, you know, the behavior, right, and so and to be a BCBA, right, we were trained in it, we studied it, we had to pass this really difficult tests, do it and be certified to be able to do it with health insurance and everything like that. But it's just the science of behavior. So it was hard getting on tick tock, I've considered getting off tick tock because it has such a negative stigma, and I get so many comments and just negative energy. And I want to talk about how you can be ethical and kind while practicing a pay behavior analysis. But I see the same thing. I see a wall people that had really bad experiences.

    KC 2:56

    So how long have you been a BCBA?

    Taylor 2:59

    I've been in the space in 2021. So just hit two years in January. And

    KC 3:03

    what is BCBA stands for? Yes. BCBA stands for board certified

    Taylor 3:07

    behavior analysis. So it's the highest level you can be a BCBA D, which is somebody that has a doctorate, but BCBA is the person that can assess. So what happens is an individual gets a autism diagnosis, and then they get sent to a BCBA that person can assess the individual and then say whether or not they need ABA or not how many hours they need, what programs, we should be working on stuff like that. I think the key is that just because you've been recommended to get ABA does not necessarily mean that you need ABA, I think that's a big issue. Doctors kind of just say, hey, go get a slice, you know, see what they say. And a lot of these students will just automatically start doing services. And a lot of the time I turned kids away, I'm like, You know what, they're fine. Like, they don't need help. They're perfectly capable, you know, they're not engaging in any behavior that's injured to themselves or others, or attending school. Like there's no issues. And a lot of times, sometimes parents are the ones that fight me to want ABA. And they'll be like, you know, he does this, like when please tell me that he's having a lot. And I was like, well, he's allowed to harm like, and so a lot of the thing is, are we targeting a behavior because somebody finds it annoying? Or are we targeting a behavior because it really is going to benefit that individual, and it's going to get them to be more independent. And I think that's where a lot of the issue is, is that BCBA says target behaviors that may seem annoying or frustrating. But their kids like my son is two and oh my gosh, he is frustrating, but he's too like that's it's typical kids are supposed to be frustrating.

    KC 4:43

    Okay, and how much schooling did you have to get to be a BCBA? Oh, my You have to have a bachelor's degree. It doesn't have to be in anything specific or just a bachelor's degree.

    Taylor 4:53

    Do you have to have a bachelor's degree but your master's degree is what really matters. There has to be something correlated. There's a few of them I listen psychology, it can be in psychology, education, I think social work. And then of course, applied behavior analysis. So my degree is in psychology. So then if it's not in ABA, you didn't have to go to coursework. So I had to do a year of coursework after I received my master's in psychology just in straight applied behavior analysis. And then after, while you were doing your coursework, they just upped the hour. So when I did it, you only had to get 1500 hours of supervision. Now you have to get 2000 hours of supervision under a BCBA. After you do all of that, then you submit your package, they review everything, and then you have to take this very difficult test. It's like four hours, I think the pass rate, I think is like 60%. And if people pass it the first time, after you do that, if you pass, and you get your certification, and then every two years, you have to restart, you don't have to test but you have to have it's called CPUs, do you have to get 32 continuing education units for the rest of the time that you want to hold your certification?

    KC 5:57

    And when a kid goes to an ABA clinic or center? Is it always BCBAs administering ABA? Or is there like a lower level of people that do that also?

    Taylor 6:09

    Yes, so there's a lower level, the registered behavior technicians RBTs. This is another issue that a lot of people have with this field. And then RBT can literally just, it's just 40 hours of training, they have to have a competency exam done by a BCBA. And then they have to pass a test as well. It's not as an extensive test, it's I think the test is like 90 minutes or something. And then they have to be supervised by BCBA. But it's only 20% of their total hours worked. They need to be supervised by BCBA. That is the minimum by the board. So a lot of the issue in this field is when I was an RVT, I'll be completely honest, it was in 2019. I never saw my BCBA I had to figure everything

    KC 6:48

    out. That was my next question is like what is supervision mean? Does it mean because so like, I'm a master's level, licensed professional counselor, and supervision, I think when people hear the term supervision, they think about like, literal, like the other person's in the room, but what I know of supervision is like, No, I was in the room alone with clients, I just like somebody was technically over me, that I had to consult with and things like that, okay, so. So

    Taylor 7:13

    they do mean, you have to have at least two face to face meetings, and one of them has to be a direct observation of you interacting with the clients. So there is seminars around that, it's just, it doesn't happen that much from what I've seen. So whenever I call out to do supervision for an RBT, they're like, Wow, I'm so surprised to see you. Because I know my last PCB Aidells. Like this is literally like what we're supposed to be doing. And then the fact that the RBT is just, it's just a high school level individual, there's a lot of treatment. infidelity is what we call it in terms of what the BCBA says, and then how the plan is administered. So for a lot of my cases, I don't RB keys are hard to come by, especially out here in California. So for a lot of cases where you're doing the programming, which is nice, because then I know what's being done the way I can tell, but it's hard because a lot of health insurance doesn't allow you to work on things outside of the session. So like, if I want to graph something, I have to actually go to the kids home and just sit on my computer, or I have to do outside of the session and paid because I think it's a little cruel to show up to a kid's house and then just ignore them and be on my computer.

    KC 8:18

    And let me tell you, tailor, I think that what we're talking about now, it's an issue that I've had for a long time and not just related to ABA, there are a lot of industries. And situations where I see this, I see it in an occupational therapy where like, you'll go to occupational therapy, and you'll have an occupational therapist do this huge robust assessment. And then you'll come back for a session, and it's somebody else, and then that person's working with you. And then I sort of realized, this person is not an occupational therapist, they haven't been trained as an occupational therapist, they don't have the education as an occupational therapist, they've not been tested as an occupational therapist, they're like, a different. And when I say lower level, I don't mean it in a derogatory term, like, Oh, you're underneath, but I just mean in terms of education and training, a lower it's like a technician who has been taught how to do the exercises. This also shows up in addiction recovery, where you go to rehab, and you're gonna have maybe one hour a week with a licensed therapist. And then you're gonna have lots of groups that if there are clinical group, they're supposed to be run by a licensed therapist, but your day to day interactions with staff that are sort of running the daily flow are typically technicians meaning they have maybe a high school diploma, they don't have any special training outside of what that job on site gave them. And I feel like there's a lot of issues in the addiction world that really break down to the people administering some of these interventions are not equipped to do so. So that's interesting thing that you bring up. Okay, more questions. So If I was a parent coming to you saying like, Hey, I kind of understand what you've said the purpose of ABA is, which is like to extinguish behaviors that we don't want to see anymore. And is it also true that we want to increase behaviors? We're not seeing? Is that part of it?

    Taylor 10:16

    Absolutely. Yes. Yes. So we want to essentially, we want to increase behaviors that we call them desired behaviors. I don't really like the term desired. But that's just kind of the language that we've been using. So we want to increase desired behaviors and decrease undesired behaviors. Now by undesired behaviors me personally as a BCBA. I mean, injurious behaviors, you know, I have clients that bite themselves, bang their head against the wall, stuff like that, I'm not going to I know we have this whole argument on tick tock about eye contact, I don't care if a client makes eye contact with me, I just hear if you're responding to your name, in terms of if I call you, there's some indication that you heard me whether you cheat turns your head, something like that, because that's a safety concern for little kids, especially, you know, self stimulatory behavior, and all of that I don't target it, unless it's something that's interest, something that's really serious or dangerous. So hand flapping, rocking, humming all of that. I don't target but some BCBAs do, because some of them consider it quote unquote, undesired behavior. So that is, the issue is that there's no parameters when we become a BCBA. And it's interesting because ABA has been tied to autism. But really, it's just behavior in general, it's just been so tied to autism, when you're receiving your education and applied behavior analysis. They're not teaching you about developmental disabilities, I'm not teaching you about autism and this and that they're just teaching you about the science of ABA. So individuals applying it sometimes don't understand, like, they don't understand child development, they don't understand ASD, and they need to research it a little bit more, I think. And I wish it was kind of in our coursework a little bit, because you could literally get an undergrad in ABA, a master's in ABA, go take the test and be fine, and not have any education,

    KC 12:01

    and never have any education on what autism is. Unless

    Taylor 12:06

    you took it as an elective, or you took it in. So I thought I'd have like a really good path because my undergrad is in child development, my master's in psychology, and then I have, honestly, ironically, the least amount of education I have is in applied behavior analysis. I only have a year of it. Wow,

    KC 12:21

    I'm gonna have to sit with that. But I mean, that's also I think, true of some other places, too. Like, I don't know, how many occupational therapists have education and autism. Yeah, right. Well, and it's something that I've noticed sometimes is like, we the training and techniques, but not necessarily in the disorder that you're treating. Okay, so I have so many questions that I'm trying to like shell for a different time, because there are other questions I have now. Okay, so that was one of them. So if I were to say to you, okay, if all ABA is is like behaviorism, like offering rewards for desired behavior, and punishments, or consequences for undesirable behavior, well, that just sounds like a like parenting, like what a lot of people do for parenting, right? Like, hey, you know, if you don't clean up the dishes, you can't have TV today. So what is ABA doing that parents can't do, right? Because I could do that at home, like, Oh, if you bang your head, I'm not going to give you your iPad, like, so how is that any different.

    Taylor 13:19

    So a lot of the time, what I've seen is parents are worn out and tired, and they need a lot of more specialized, like structured information. So a lot of the clients I work with, it has to be very artistic, very literally. So you can't say, oh, you know, make sure that you're good at school today. Like what does good mean? Right? Like, I don't know what God I feel like I'm good, or you need to. So it's a lot of us first and statements. So you need to do this. And to do this, um, a lot of visual schedules is what a lot of my clients need an example. I'm working with one client that are working on community outings. The last time we had a community outing, he went up to this pregnant woman said, Why is your belly so fat, and then touched her? Which, you know, thankfully, she was nice about it. But you know, it's not we're trying to teach them to not go up to strangers, because we'll go up to strangers say hi, I'm so and so I live here, this is my phone number, right? It's a safety issue. And also not to touch other. So I had to make a whole visual of, you know, keeping your hands to yourself all of that. So a lot of the time, a lot of the parents I've worked with kind of feel like, well, I shouldn't have to tell them that. It's like, well, you have to, and a lot of my clients need additional praise, more praise than a neurotypical child would need, which is also fine. But a lot of the time they're siblings, right? And they're comparing the two Well, I didn't have to do this with child a, why do I have to do the child B and explain to them like, you're gonna have to do a little bit extra to help them and honestly, half the time when I'm telling the parents this, they're just like, Oh, that makes sense. And I'm like, Wow, I'm getting paid to tell you this. Like yeah, it's, it's what I'm telling is not some super complex thing. It's, hey, every time your kiddo you know, cries for candy at the store and you gave them that candy, you actually just reinforced them. And so now When you stop doing it, they're going to have a huge behavior and you can't give in. And you can't care about what other people are saying or how other people are looking at you. Because, you know, you can't give them candy every single time you go to the store, things like that, or a lot of the time, a lot of parents don't think about negative attention. So some kiddos who engage in behavior to get a verbal reprimand, and they do it more and more, and their parents are like, I keep yelling at them. Why do they keep doing this? I'm like, because they want you to yell at them. They want that. I mean, clearly, if you keep doing it, and you keep yelling at them, and they keep engaging the behavior, you're actually reinforcing it. So actually, you have to take that verbal reprimand away, it really comes down to the way other people were parented. I go through this all the time with my son, we don't like to, we don't spank our kids or anything like that. But I was saved a lot as a child and rewiring yourself while you're parenting is a lot and then rewire yourself while you're parenting. A child that's on the spectrum is probably even a lot more. But it is really just helping them be parent. So

    KC 15:57

    you mentioned spanking, and that's something that I have experienced with as well. We don't spank our kids. And I feel like that's been like a kind of a parenting hot topic lately, especially around, you know, whether or not parents should be spanking. And so my question about it is like, from what you're describing right now, like, it seems like spanking should work, though. Like if the goal is to put in a consequence, to like, make the person not do an undesired behavior. Like let's talk about just any kid, right? Like, let's say your kid is, you know, writing on the walls, right? And you spank them, like, eventually that kid would stop. So then why would we say that spanking is not? Okay, good to do that got the result? Yeah,

    Taylor 16:44

    I have two reasons. My first reason is that personally, I just think it's a little cruel to hit somebody that's smaller than you that can't hit you back. Don't allow them hit you back. And a lot of the time, it's called behavior contrast. You know, we you spank a kid at home, you know, they listen at home, go to school, when the teacher is going to do right, the teachers can't spank them. So then you see a contrast, you see them being really well behaved at home, because they know hey, you know, if I get caught, mom and dad are gonna spank me at school, I can do whatever I want. Nobody can sneak me here. And then we always use we call it punishment in the field of ABA. But in terms of punishment, it's something that decreases the frequency of the behavior, it doesn't necessarily have to be spanking or something like that. It just means it decreased the feature frequency. And so that is a last last last resort in the field of ABA. Because for one for it to be effective, you have to punish every single instance of the behavior. And it's impossible to catch every single instance, let's say drawing on the wall, right? There's going to be times when they sneak away draw on the wall, and you never saw it. And then they got away with it. So they kids and not even catch us adults, they learn to do it in situations where they're not going to receive that punishment. There's a lot of issues to with spanking is are you spanking the child? Because you're trying to get them to stop doing it? Or are you spanking them because you're so angry, you're actually relieving your frustration on the child, which then would technically be free and positive reinforcement. Every time I'm angry with my kid, I spank them. I'm no longer angry. So now I'm more likely to spank my kid because it makes me less angry. So spanking is a lot more about parents and adults not processing their emotions correctly, and then taking it out on their children. In my opinion, I'm not shaming we spank their kids. I'm just saying, in my opinion, that's what it is. Because I do I touch myself. And I think that I'm like, Wow, if I was younger, and wasn't, if I was like five years younger, I would spank you right now. Because I'm so angry. And that's how I was raised. That's what I saw my parents do. But I'm like, Nope, we're not going to do that. Like, it's okay, I need to take a deep breath and walk away a lot of the times. Again, with ABA, I'm teaching the parents coping skills along with their kids, because yeah, you need to take

    KC 18:56

    a deep breath walk away. And it also seems like you know, if you spank a kid, like, clearly, you could make anyone do anything if the punishment was harsh enough, but if they're then going to school, and like, you know, they do the behavior there or whatever. It also seems like there's a difference between like a quote unquote, punishment that just makes them not do the behavior, versus something that like teaches them a skill that makes them not do the behavior.

    Taylor 19:27

    Exactly. That's that we call those replacement behaviors. But yeah, so our goal is we can't decrease their behavior without creating another behavior in terms of behavior. A lot of the time in this field, we say behavior in terms of we really mean maladaptive behavior and desired behavior. But if I'm going to teach somebody, you know, stop screaming for attention. I also need to teach them what to do instead of screaming for attention, you know, raise your hand tap on their shoulder call someone's name instead of screaming, so we can't just look at a bat I'd say this is gonna go down. And we're going to kind of Schmidt like, we can't just do that you need to replace it with something else,

    KC 20:06

    I have to say like, I'm really struck by, first of all, I really appreciate you in this conversation and you sound like a really wonderful provider. Thank you what. And I would need to say that first because I don't want what I'm about to say to seem like it's about you. But one of the things that I'm really struck by is the difference in language between the things that I've learned in my own continuing education, journey around behavior, and just the language that ABA uses when you talk about punishment. So you talk about maladaptive behavior, and you talk about undesirable behavior, you know, I kind of come from the school of thought, where like behavior is communication, and that there's a valid need behind almost every behavior, and that we really have to understand the need and get the need met, and focus on like a relationship that allows that child to do something else so that they don't have to do this other behavior. And I also come from a very, like neurodiversity affirming context. And like, I still remember going through the process of autism diagnosis for one of my kids and the amount of clinicians that when they began to talk about it would say, doctors, clinicians, whatever would say like, Well, I see some red flags. Well, there's definitely concerns. Well, there's a little bit to be worried about, like every behavior, every word, every term that described her autism was, yeah, it was like, it's all bad, it's all desirable. And it kind of also gives the sense like the wording about like, punishments and maladaptive and thing, and I might be alone in this, but like, it makes me feel like we're talking about a child, that's just a bad seed. Like, they're just a bad kid. And we need to, like, intervene and make them not be able to do these behaviors anymore, so that they won't do these behaviors anymore.

    Taylor 22:08

    Yeah, I don't really like the language we use in terms of it's just very clinical is what it it's very objective.

    KC 22:18

    But it's not it's not objective, because I'm using clinical language too. And I would say that that language is not objective.

    Taylor 22:26

    Yes, it's, I would say it's lack of emotion, really. And that's like, what we're taught is when, like, at the end of every session, we have to do notes of what happened. And we're not really even supposed to say the client was happy, or the client was sad, because that's like, you know, how do you know how do you know like, when he was smiling all day, we have to say, you know, client was smiling throughout session, and our client, you know, was falling asleep throughout session client had an increase of tantrum behavior. It's just very, I don't know, like lack of emotion. It's like, when I read a book, I'm like, wow, this is great. And then when I go to work, I just feel very, like doctory, almost about how I have to describe things.

    KC 23:03

    Well, even like the word tantrum, like, the word tantrum has, like very specific connotations for people that are different than meltdown, or different than sensory overload. Right? And like, I know, like, so when you said injurious behavior, I felt like that was a perfect example of like a truly objective descriptive like, yeah, it's just injurious behavior, like something that leads to danger or even like unsafe behavior, like a behavior that's unsafe. So I'm curious, like knowing the sort of some of the pushback that people have had about ABA. Do you think that some of it is that you get providers that are not trained on autism, and trained on behaviorism applied behavioral analysis? We have always seen in our culture, I think autism through the lens of deficit, you know, what's wrong with this kid? And so you know, you're going in with this sort of cultural idea what's wrong with this kid? That's not really being challenged, but you're not learning anything else about autism, you get trained and how to do behavioral analysis. And then most of the interventions kind of get pushed on to somebody that maybe has a high school degree or diploma. And then the language being used is sort of reinforcing that. Like, my job is to, like, fix these bad behaviors. I mean, it's sort of like it seems like those variables put together can be a pretty dangerous combination. Yeah,

    Taylor 24:38

    and I think it really has to do with how the because the BCBA is basically like the leader in terms of this treatment program, I think, has to go off of how that BCBA presents the case to the RBT. And really what the BCBA expects, because I just got a new RBT on a case and I've never worked with them before and I was like, My kiddo, she's only three. And I don't know how you operate. I'm very naturalistic. I'm very Playland. Back in the seat at the table, she's not going to be like food is not going to be used as like a reinforcer or anything like that.

    KC 25:13

    Is that common with ABA? To use food as a reward? From what

    Taylor 25:17

    I've seen, typically No, I usually don't use food for anything. The only thing I've ever used it for is really like an m&m for like, pooping on the potty or something like that, which is pretty, at least from my understanding typical that parents do. From what I've seen, no, and it's even in our taxes, like you shouldn't use food as a reinforcer, because for one, it's creating an unhealthy relationship with food, you know, you shouldn't think that food is reporting in that term.

    KC 25:40

    That's wild, because I feel like anecdotally, I hear that all the time. I

    Taylor 25:44

    know. And so that's why it's hard for me, because I see people talk about it online. But then when I'm out here, and I mean, I'm only exposed to so many BCBAs. So I don't know what is happening. But it says, you know, don't use food as a reinforcer. Also, it's like, you could have some weight issues as well, as you're keeping you give them like candy and all this stuff. I do remember when I had speech therapy in the early 2000s. And yeah, they gave me gummy worms for when I said are right. So it just depends. But yeah, I do think it has to go back to how the BCBA presents the case and what they expect. And if they have a history of even working with kids, because I see a lot of I get a case from like the BCBA left, and I get the I take over the case, I look at the goals and it's like a three year old and the expectation is that they're complying with 100% of instructions. And I'm just like, what, three year old? What human being complies with 100% of instructions? Like nobody does,

    KC 26:38

    I see that like, we end up holding an autistic child to a higher standard, we would even hold a neurotypical child like, especially with like language, like it's normal for little kids to say want milk instead of like, I would like the milk.

    Taylor 26:52

    Yes, yes. Like, you know what they mean? Just

    KC 26:56

    give them the milk. Yeah. And it's unfortunate that it comes down to how the BCBA is presenting the information because it doesn't sound like there's anything in their education that would teach them how to present it in like a person centered way. Like you seem kind of like the exception. Like it's people who step out and take it upon themselves to learn about neurodiversity to learn about autism. Was it you that had the really interesting Tiktok? Where you'd gone to a conference?

    Taylor 27:23

    Oh, my gosh, yes.

    KC 27:26

    Will you tell that story? Because it was kind of an eye opening thing from you. So

    Taylor 27:31

    I went it's called kalaba. I've never been the first one happened. I think on my son's birthday, my first my son's first birthday, so I wasn't going to go. And then so this was the second one that I was a BCBA that I could go to. It's in SoCal. Well, it changes every year, but this year was in SoCal. And it's about like 500 bucks just to get in the door, like 100 bucks to get your CEUs versus continuing education units that we were talking about. So this

    KC 27:54

    is just an ABA conference. Yes.

    Taylor 27:55

    Yeah. So they open to everybody, like there was other people that weren't, you don't have to be a BCBA to go, anybody can go but But who's gonna pay that much money, right? So we go and the first guy, so they have like these keynote speakers, and then there's like other little speakers that you can go see, and you have to pick which one but the keynote speakers everybody's seeing at the same time. And the first guy was like, Hey, guys, I guess he was the president. And he said, Hey, guys, don't make any of the volunteers cry this year, because you guys make them cry every year. And I immediately start looking around, like, who am I next to? Why are you guys making people cry? What are you doing to the volunteers that make them cry every year? I was like, Okay, this is weird. The next keynote speaker talked about how, you know, African Americans have a harder time basically, in the United States, and specifically talking about education. And you know, how children aren't learning how to read and people were blaming the kids, you know, it's their fault. They're not learning how to read. No, nobody's teaching them how to read. And I'm just sitting there like, and people are like, looking like very intently. I'm just like, Okay, another keynote speaker was talking about self stem, and talking about how we should stop targeting self stimulatory behavior and how you know, the autism population is saying, Stop making us do this. There's a function to this behavior. And I'm just sitting here like, yeah, like ABA. It's called the four functions of behavior. And essentially, every behavior has a reason for it. And so easiest one is C. So it's sensory, which is the self stem. I like the way it feels escape or avoidance, which means I'm trying to get out of something, a tension, obviously, I want the tension and tangible which is like candy, food, money, anything that's like something I can physically hold. So we already know that there's a function to the self stimulatory behavior. So why would you try to decrease it? I don't understand. But they're saying that and then I remember he said something along the lines of autism or people with autism are whole people, and they should be treated as such. And I'm telling you, everybody stood up and it was like a standing ovation. Like he said, like he just explained like the, like gravity. And I'm just like, yeah, they've always been hold people. And I just keep looking around like, I paid this much money. For this information, this is not just common sense to you guys. It was alarming to me and I was I felt bamboozle people were saying other BCBAs were commenting and saying, you know, there's other ones that actually teach you stuff like actually show you studies. And there were some, like keen, like other speakers that were giving me some studies about things. But the fact that the keynote speakers that was the narrative kind of shows that this is what the BAC B, which is our board is trying to tell provides what to do, essentially. And the fact that that wasn't common sense. It almost reaffirmed everything people are saying on Tik Tok that I haven't experienced because, you know, I see a lot of comments about some really bad BCBAs. I'm just like, are you making this up? And then when I had to go to that conference, and then that was the narrative, I was like, no, they're probably telling

    KC 30:53

    the truth. It made me really emotional to hear that because like, the idea that somebody would be giving services to my kid, and like, not see her as a whole person with like, valid needs, and that she's some sort of like, not human like it, that's really stunning to me, like, first of all, I applaud even the idea that they're trying to listen to the Autistic community in saying that, but you're right, like, why isn't that the basis of I mean, master's degrees? That's what was, yeah, you shouldn't go through a whole master's degree and then have to be told at some CTU like autistic people are real human people hold people. That's wild.

    Taylor 31:38

    Yeah, I was like, why is this news to you guys, so

    KC 31:43

    and then let me also say, I think that even the word attention, like really grates on me, and that's from my own experience working in addiction, because like, we in the addiction industry, are notorious for, I think, dehumanizing clients, by way of Oh, they're so entitled, they're just attention seeking. When in reality, like you said, like, there's very real human needs going on behind those behaviors, they just have ways of trying to get those needs met, that are not working for them, and that are creating problems in their lives and kind of staying in the way. And I once heard someone say, and it was actually a teacher, because they're talking about kids, because that language gets thrown around with kids a lot. Oh, she just wants attention. She just wants attention. And if you give her that attention, she'll keep doing it. So you should ignore them. Oh, she just wants attention. And I heard this teacher say one time that like, the word attention has a now has like a derogatory connotation. And she challenged the teachers to replace the word attention with the word connection. And she would not let them use the word attention anymore. And so instead of saying, like, today, Jeremy, like, threw his chair across the room. Well, why do you think he did that? Well, I think he was just looking for attention. She required them to say, Well, I think he must have been looking for connection, and like, humanized those kids. Yes,

    Taylor 33:07

    yeah. The language is very dehumanizing. And I had a someone that was pursuing their BCBA. And I was working with me when I worked at a clinic, and one of the kids was upset, and it was at the clinic, and he was younger, and I was upset, and he was crying. And I picked him up, and I gave him a hug. And like, let him sit on my lap and like we talked and stuff, and she was like, I have never seen a BCBA ever do that. And I was like how the child you've never seen it before you have the child. She's like, well, he's seeking attention. And I was like, Yeah, and you can give it to him. Like if he's a child who's upset his caregiver is on their way. But they're not here. Yeah, I think the caregiver was like running late. And so he saw all the other kids leave and was waiting. So he's a kid that's upset. And then she was like, Well, I was always taught, you know, if they're seeking attention, you and it's not appropriate, then they have to ignore it. And I was like, it's appropriate for a child to be crying when their caregiver is late, and they're waiting for them. And you know, they might not understand that they're on their way. Because it didn't have a high level of functional communication, like vocal communication. And then she was like, oh, and then like, not just being a human being, I've been told so much. Oh, you're just soft, because you're a mom. That's what they would tell me. Like, that's why you're so nice to the kids. And I was like, No, I'm nice to the kids because they're kids. And they're going to be adults soon. And they deserve hugs. It's okay to hug. Like I've had people say, Is it okay, if I give the kid a hug? Like RBTs? And I'm like, yeah, why would you lie? I don't understand their kids. Yeah. So yeah. So I

    KC 34:39

    don't know how much you have, like learned about this. But I did want to ask you the question like, What is your understanding of like the historical harm that ABA has done to autistic children, and now autistic adults? Yes.

    Taylor 34:52

    There's one big case I think it's in Florida that they teach us about where they just it was almost is like an institution kind of thing. I think it was like decades ago. That's the number one. That's one that they talk about. But I've heard of old old school, referred BCBAs, where even BCBAs right, because the board is new, I think it came out in like the 90s. So it's new. But before that when people were treating children with autism, you know, hand flopping, they would tie their hands to the table, or they would tie them to the chair. I think this is also back in the day where they were also literally allowed to, like hit kids with rulers and stuff like that as well. They did stuff where they would like physically restrain the kids for engaging in self stimulatory behavior. And so I think that slowly faded to terms of you know, don't restrain kids. But from what I've seen, it's a lot of people almost call it like, over programming, where you made this kid do this so many times that it's like, embedded into their head, like they respond like, like you teach them greetings, and the child would be like, Hi, my name is so and so. And then you'd be like, Okay, how's your day? Hi, my name is so and so like, you did it so many times for that kid that they just, that's all they know, they just repeat it and repeat it and repeat it because a lot of the field unfortunately is tied to health insurance. And health insurance doesn't want to pay for things. Unless they're seeing a change in a lot of language, especially TRICARE I can't I work with TRICARE. And I can't stand the way they describe their the clients and the assessment tools that they have to make me and the parents fill out. The questions are so derogatory, one of them is like this the child repeat things annoyingly, like a parent's is what they have. And we have to say like yes or no, does the client have tantrums for no reason. And I was like, nobody does anything for no reason. So just the language that TRICARE uses.

    KC 36:49

    It's it sounds like a really like dehumanizing system, like you take someone, you put them through school, they learn about behavior, they don't get any education on autism, they don't see autism as whole people. And then they have to fill out assessments that compare them to animals, and say that they do things for no reason. And you know, you're sitting with this child who maybe does have behaviors that you find annoying, that you find frustrating. And one of the problems that we had a lot in the addiction treatment centers that I worked for is that, you know, you get someone who has a high school diploma, and maybe they themselves just got sober recently, and like they themselves don't have great emotional regulation skills. And now they're in charge of giving interventions to someone else who doesn't have good regulation skills, but one of them is in a place of power. And just like you sort of talked about with the spanking like, it seemed to me like so many times, they were enacting an intervention that looked correct on paper, but they were coming from a place of like, I'm frustrated, you aren't supposed to be doing this. And I have more power than you. So I'm not going to allow you to have this thing. There was a story one time that I saw on Tik Tok of a woman who had asked that her child and the like special education plan, she had put like no food rewards. Like she didn't want that as a part of his education. And there was a teacher that ignored that. And she didn't know it. And for during this semester, or for several weeks, every time he would get a question, right, she'd give him a Skittle. And if he stayed in his chair, he'd get a Skittle. And like, that was the easy way for her to manage this autistic child. And once the mom found out about it, she put a stop to it. And it only happened for a few weeks. And she says that, to this day, four years later, when her son makes a mistake, she hears him under his breath. When you talked about being like over programmed. That's what it made me think of,

    Taylor 38:57

    I think people don't realize how I guess important, but how easily we could influence a child and how that's going to last like the rest of their lives. And you have to make a choice, like, yeah, there's some of my clients, I could do a program that's gonna be effective, and it's gonna decrease something or increase something. Sure. And it's going to look great on paper health, and TRICARE is going to be so happy with me, but it's going to have damaging effects for the rest of that child's life. And as a BCBA, you have to choose, you have to pick your battles, you have to choose what's really important and something that we have to target no matter what. And for me, that's that injurious behavior because I worked with group homes as well of that adults who didn't get ABA who people let you know, engage in, obviously, and now it takes three people to restrain the guy because he's trying to knock himself out by beating his head against the wall. So there's certain things that we have to target but as a BCBA, you have to figure out which ones are the most important and what might have damaging effects. And looking at you know, 10 years ago would I have thought Have forcing people to make eye contact would have had damaging effects. No. But now research shows and everybody's saying it does. So then stop doing it. Like that's it. It's easy. So,

    KC 40:08

    So research is now showing that forcing autistic children to make eye contact when they don't want to is harmful. Yes, I've

    Taylor 40:16

    read articles. I don't know if they've been peer reviewed. But I've read articles, it's saying that it triggers a flight, a fight or flight response and the individual and forcing them to do it. So I'm like, Okay, well, what then?

    KC 40:27

    So one of the more like, strong wording, things you'll hear people criticize ABA is that they will say ABA is abuse. And that is a very loaded term. And I don't want to go into that right now. But particularly because I often hear it from people that never went through ABA, so I'm like, Let's just hang on. That's, it's a lot to say that I'm not even necessarily saying it's not true in some cases that it created trauma. But it just, that's what I thought of when you said that where it was like, Okay, so the goal was to get this child to make more eye contact, which to me just kind of sounds like let's make this autistic kids seem less autistic. But maybe there was a different goal that somebody thought was a more noble goal than that. But so for people that don't know, like, the reason, you know, when we experience something, and that fight or flight kicks in, that is ripe ground for trauma, it doesn't mean that you get traumatized every time your fight or flight goes on. But every time there is trauma, there is fight or flight. And it kind of made sense to me for the first time, because obviously, when you talk about tying a kid's hands down, I'm like, well, that's abusive, but even the more subtle aspects of like, I'm forcing you to do this behavior, that is creating fight or flight. And also like creating you, like forcing you not to trust yourself, like do this thing that is harmful for you internally, because there's this external pressure on you. So it's either I don't want to look, but I don't want to lose my iPad, or I don't want to look but I do want that m&m. And it's like this weird splitting that you can really create in someone. And that fight or flight is going off. And I can see how that would be traumatic for someone and I can see how that would be abusive for someone, even though that was not the intention of probably the person giving that intervention. Okay, so going back to the other thing, I felt like you mentioned those two things together. And I feel like that illustrates almost perfectly like the two sort of sides. One of which is like you said, you know, the goal of ABA is about behavior. What behavior do we want? What behavior do we not want? There are many times where that over emphasis on just the behavior misses, like something more important. And so you know, we're applying these sort of like heavy rewards and punishments to try and elicit a behavior we want. And we end up harming the child, or we end up targeting a behavior that doesn't, why did we do that. And that makes sense to me why we would say like, there are other ways we can help this child with communication, there are other ways we can help this child with a stimulation or social skills or making friends. Because that's the other part is like, for a child that already has difficulty understanding social cues and using communication. And so you put that together, and that may be a child that struggles to connect, but then we put them in an environment where all the connection is based on doing the right thing, performing the right thing. And maybe I'm projecting a little because I went through such heavy behaviorism therapy as a child where that was kind of the result for me. And it seems like that's kind of what the criticism boils down to, is, you know, has heavy emphasis on just seeming normal at the expense of a child having quality of life. Yeah,

    Taylor 44:04

    and I so the one of the main things I teach now, the first thing I tried to teach a kid and call it the gate, told me no. And I took over a case and I was trying to go over a greetings with one of my clients and I was at their home and he was getting out of his chair, he walked to his caregiver, things just kind of clearly antsy. And I was like, if you don't want to do this, just say missing, I don't want to do this right now. And he repeated me and I was like, okay, and then we moved on in the mom was like, you're allowed to do that. And she was like all of the ABA have ever received, he would have had to sit at that chair and go through those greetings to get out of his chair. And I was like, why? If he doesn't feel comfortable with me doing the greetings and that goes back to what you were saying is I don't have a good relationship with with him right now. And we need to film that we need to focus on pairing and building that relationship and it goes back again. The issue is like, TRICARE sees it at Oregon I always say TRICARE cuz I'm Working with TRICARE but health insurance sees it yeah.

    KC 44:59

    But insurance, that's what the other part is like to get access to. So a lot of people don't know this. But if you have commercial health insurance in the US, and you have a child with an autism diagnosis, typically what that gives you access to the insurance will cover is speech therapy, occupational therapy and ABA. And what a lot of people don't know is that like your speech therapy is anywhere from one to maybe five hours a week, your ot could be anywhere between one to five hours a week. But ABA, you can get up to 40 hours a week. And so if you have a child that can't really go to school, or you know, can't function can't, you know, is hurting themselves, and they need that much therapy, that's your only option unless you are able to pay out of pocket for a different kind of therapy. So I just wanted to mention that because it's the health insurance that I think I don't think created the problem, but certainly keeps the problem going. Because their emphasis on show me the behavior change, not show me how this child is better able to communicate their needs, show me how this child made a friend today. So that's interesting. But then I want to go to the other side of it, because you said something that I think is really poignant. And I think sometimes gets lost in this conversation. You said, you know, there are adult autistic adults that maybe they're living at home, maybe they're living in a group home. And because they did not get access to anything that helped them either extinguish or redirect injurious behavior. They are now 35 year old 250 pound men who are being restrained by three people, because they can't not bash their head on the wall until they become unconscious.

    Taylor 46:59

    Yeah, and I think that's the side of ABA that nobody talks about, especially on tick tock is what happens when somebody becomes an adult, right, and what happens, like, you know, parents, typically, you know, the kids outlive the parents, too. So I understand, like, you know, every beaver doesn't need to be targeted. But we do need to do our best to make these visuals as independent as possible. Because eventually, they're gonna get pushed out to the real world, or they're going to be in these group homes. And the group hubs are lovely, I go, when I give them consulting advice, I help them out. But it's hard for some of them because their parents come and visit them, and then they leave. And then you know, the person is still there, because they can't handle their behaviors anymore. Like they can't push like, I can't have you be that aggressive, and my home, and you outweigh me at this point. And it is sad. It is sad. And it's hard. I've had some clients that are 56 years old, that still nobody took the time to teach them to go to the bathroom, and they're still in diapers at this point. And it's so much we call it a history of reinforcement. But it's so difficult at this point, to try to teach them how to use the bathroom when it's been six years of them in diapers. So it's difficult. And I guess in California, what's happening is they weren't in state hospitals, and the husband explained to me is there's been so much trauma associated with the state hospitals, that the governor has started shutting them down. And they're pushing them out to the community, because what was happening is, you know, they're isolating these individuals, instead of allowing them to be within the community. And that happened to me when I was a kid in school. I never saw any of those special needs students, they were in the back corners, like segregated, basically, from everybody. And I think a lot is changing in the world. And people are way more accepting of individuals that have any type of neurodiversity than we're trying to give them like all of my clients have community out of goals, where they just go out into the community, whether it's a park, Target, whatever, they just go out once a week, get out of the house, stop segregating people. But yeah, it does happen. And it's hard. And I don't like to talk about because I don't want to scare parents into it thinking that their kids going to end up in a group home. And I don't want to scare them into receiving, quote unquote, bad ABA or bad providers either. Because you have to pick as a parent, you have to pick and you have to see, hey, is my kid gonna benefit from ABA? Or are they going to be traumatized by the ABA, and it really depends on the provider. And I tell families do not pick the first provider just because they gave it to you. If you don't like them, tell them you want a different one, if you don't agree with them.

    KC 49:25

    You know what I also asked myself as a parent, though, and this is something that I think about with, you know, my own experience with behaviorism. But I've heard that before of that question about like, okay, is ABA going to be helpful to them? Or is it going to be traumatizing to them? And I think there's even like a third door, which is like, maybe it will be distressing to them. But it's the only way to prevent them from hurting themselves or running into the street or being killed. And I don't know that that's the case. Right? So maybe there are other ways but You know, I have to say, like, especially I think when we bring in issues of race, you know, a black autistic boy is not in the same situation socially when it comes to danger as a white autistic girl. And we unfortunately saw with Elijah that, you know, if you're going to be black boy acting strange in front of police that could get you killed. And I think that there's a lot of this space that sometimes I think there's a lot of very vocal things coming from the sort of low support needs adult autistic community, a lot of the late diagnosed community. And I think it's really valid. Like, I can't overemphasize how much that has helped me listening to autistic adults, but I think it does just by the nature of who can communicate and who struggles to communicate doesn't quite give you the big picture about like, what does the spectrum look like. And if you're a family, and I think also, it's like, we can have theoretical conversations about like, this is ideal for a child, this is not ideal for a child. But then as a parent, you go in go, oh, wait, but my insurance will only pay for ABA. And, you know, we're a family of color, and my child is already at high risk of violence, and they're biting themselves until they bleed every time, you know, they have to be around the sound they don't like. And, you know, like, it's kind of like the realities of it are a little more nuanced. And as a parent, it's difficult to engage in those realities, when sort of like everyone's screaming at you from both sides, both saying like ABA is abuse, and then people being like you're abusing your kid by not putting them in ABA. And so let me ask you this. How do you and you've, I feel like you've answered this all along. But you know, when you're practicing? Well, first of all, knowing all of that, what made you want to be a BCBA?

    Taylor 51:59

    So it's a good question. So actually, one of my he's my cousin, but it's almost like my dad's best friend, not blood related, but his kid anyways, he's autistic. And so I think he's maybe like four or five years younger than me, I spent so much time with him. I always knew I wanted to work with kids. And I always wanted to work with kids that have developmental disabilities. So when I was doing my undergrad, I was looking at being a special ed teacher. And I'll be frank, I looked at how much they got paid. And I was like, I don't know, if the amount of work I'm going to have to do is worth that much money, because it wasn't that much. And we call that ratio strain in this field, but the amount of work and the amount of reward that I was going to get, I was looking at it, and I was like, that's not it. So then I was like, maybe I'll do you know, child psychology. So that's why I then started doing psychology during this time that was in the military. And so I did my time I got out of the military. And I was on indeed looking for entry level jobs. Because when I was in the military, I was a police officer, right, that doesn't translate. So I need an entry level job to restart. And I found RBT. And I literally had my master's degree already. And I applied to be an RVT. And I was like, Oh, this is great. I love this. And then I started pursuing it. It was great working under so many BCBAs because I saw what was really good. And I saw some really, really not great BCBAs. And I really learned very quickly, what kind of BCBA I want it to be and what things we could do, but they're just choosing not to do because of some weird rule that they kind of made up like, you know, you have to ignore all the attention seeking behaviors. I was like, but nobody said that nobody, nobody, the text didn't say that. The test didn't say that. Nobody said that. So it's almost like the stigma in this culture that some PCBs have and they call them bcva holes is what some people refer to us as because they can be very cold, clinical and unkind to kids. So yeah, that's how I got here.

    KC 53:54

    Okay, I have another question. But before, you know, one of the things that happens a lot when you talk about ABA is people who are pro ABA will often say, Well, you know, yeah, there are some bad BCBAs out there. But there are also some good ones like the issue isn't the system of ABA. The issue isn't the philosophy of ABA, like the issue is just, it's like any profession, there are good doctors and bad doctors, there are good therapists and bad therapists. To me. That seems like an oversimplification. Like I would agree that there are definitely I mean, I think one is right here on with me on the phone, right like there are BCBAs, who have made it their job to be informed to not do harm to understand autism. But I don't know Do you agree with me like is that too much of a simplification? I

    Taylor 54:44

    think a better comparison, honestly, as an African American, I'm going to say this would be to compare us to police officers. I think there are some really good police officers. And I think there's some really bad police officers and based off of the culture of being a police officer and And then we go back to the power that police officers have, some of them choose to do good with it. And some of them treat and dehumanize human beings and treat them like like trash. And I feel I don't even like telling people I'm obese, I took my tick tock down for like a month, and then I went to kalaba. And people were coming up to me, and they were like, You should bring it back, blah, blah, blah. And because I just didn't even want to tell people I was a BCBA. Because I don't even want to be associated with this like, negative segment. Like I have autistic adults coming in my I had to block one because she's like, you're an ableist this out in the third. And I'm like, I don't think you've watched three of my videos, you would know, I'm not an analyst, but they just assume because I am a BCBA. Just like when I see a police officer, I tense up and I get nervous around them. That's the comparison I would make. I wouldn't compare us the teachers or doctors because there's not a culture like there is at least to my understanding about teachers and doctors like there is for BCBAs Yeah, I

    KC 55:55

    think that what I've been learning feels like a really apt and frankly, I think it is kind of a nuanced comparison. Because, yes, like, I can find individual police officers that aren't going to be black people. And the police officer that stands outside of my kid's school and directs traffic is like a real human being. And you know, he might be doing the best he can to, you know, be just in whatever, whatever. And I know I'm oversimplifying the metaphor, so forgive me for that. But right, the system itself tends to create, like, you have to go so against the grain. And I think when you describe like, the way that BCBAs get trained the way things that they're not trained on the language that gets used the dehumanizing language, the gaps in skills, the lack of sort of affirming neurodiversity, and then the influence of the insurances. Like, it creates bad actors. But I also think that, you know, a lot of parents might be in the situation where ABA is the only kind of therapy they can access. And I think to your point, though, is that like, all hope is not lost. Right? And that there might be a time when a family decides the most important thing right now is that we extinguish this behavior, because it is so dangerous to this child, or to my other children, or whatever. And they might choose to use ABA. And it sounds like, you know, you can definitely find someone who can operate within that framework, with respect and without trauma. And so you were talking about some of the ways that you mitigate harm that you try to do those sort of things. So tell us a little bit more about that. Yeah, so

    Taylor 57:43

    when I get a new client, the first thing is I try to so by the time I get a parent, I already know that they had to talk to the doctor about everything that their kids going through, they had to then talk to the the case manager, they've had to fill out all these questionnaires. So the first thing I ask is, what are your child's strengths? What are some things you're really proud about your child? What are some things you know, that you're really happy about? Like, try to frame that conversation to be a little positive? What's something that you want to see more of? Right? And then I explained to them whether I can or cannot work on that one of my most recent clients, the parents say, hey, you know, is she ever gonna talk? Right? And I'm like, I can't tell you yes or no, I can't give you that information. I can tell you, I can do my best to like reinforcer for speaking. But I recommend you know, you get a speech therapist and a lot of people on Tik Tok don't realize that, like you're saying, a lot of families don't have access to all these providers, especially in California, my client, she's too, she didn't get speech therapy until she turned three. She's on the waitlist for a year. And we know how crucial language development is, at these early years, there is a waitlist for everything and California. It's like

    KC 58:51

    that here to tailor like I'm trying to get we moved to a different county. So I'm trying to get this county to do an assessment so that my kid can go to school, and they're telling me they're on a year long way.

    Taylor 59:02

    So that's what I do first, and then we talk about, you know, things that need we call them maladaptive behaviors, so anything, you know, behaviors that are occurring that you would like to see less of, and this is where as a DC, I have some tough conversations, some of the behaviors, I'm like, hey, look, I'm not concerned with that. And I tell them, and they're like, Well, I don't want to see it anymore. And I was like, I have had I told my mother, I was like, my job isn't to make your child neurotypical passing, right. That's not my job to teach your child all the skills that can make them as independent as possible for them specifically, right if your kids humming weather watching their iPad in the comfort of their home now I can target that because she was like very annoyed by like

    KC 59:43

    tell them to go to just weird because like kids are annoying kids are an omen on my like that is not a trait of autistic children. Okay, kids are annoying. My son

    Taylor 59:53

    is in the mama face. He will not stop saying mama and it drives me up a wall. I get overstimulated by noise the mama Ma'am, I'm so yeah, I have to have some real conversations. And I think this is the part as a BCBA. Where somebody CPAs but yeah, we're target that. Yeah, we'll target that for change, right. And you have to say no as a BCBA. Yeah. Can I target that for change? Sure. And can I create a program that's going to make that decrease? Sure, is not going to be frustrating, because there was some type of function and probably a self stimulatory function that I just removed from that client. So now I need to replace it. But why do I need to replace it? Right? Just let them be. So for me, less is more. I've seen reports had like 40 goals for kids. That's insane to me, like no more than like, 15 to 20 goals. And that's like a max, for me. Less is more. And honestly, the less goals you put on for health insurance, then the less work you have to really do as long as you're making progress on these little amount of goals. But BCBAs they like big numbers, big progress, and it's too much, it's too much while you're not going to teach a three year old 40 things in six months. That's a lot like why are you putting that pressure on yourself? So yeah, it's a lot of conversation. And it's a lot of back and forth. Sometimes I'm like, Hey, your kids fine. And I like while he does this, he has tantrums. And I was like, does he have tantrums and near typical level, right? Because kids have tantrums. Kids have outbursts, kids have meltdowns. They're human beings, they have emotions. And like, or is it happening at a high frequency? Is it happening five times an hour? Or is it happening for like six hours in a row? Right, where he's just upset all day long? Or is he having is he upset because you said he can revise things for dinner? Five minutes later, he's fine. If so that's pretty typical. Like I'm not going to. So I also don't hold on a lot of these days will hold on to kids just to Bill, I'm not going to do that. If a kid doesn't need ABA, the kid doesn't need ABA, I had a 15 year old, he came up to me was an assessment and I was doing this assessment in school pletely vocal doesn't have any mouth, self interest behaviors. And the parents were like, well, we just want him to make friends. And I was like, wouldn't take into a social skills group are

    KC 1:02:07

    taken to the park or taken

    Taylor 1:02:08

    to the mall I was like, and then the 15 year old was like, I don't really want to make friends. And I was like, well, then he doesn't have to, if he doesn't want to make friends right now, I'm not going to provide an ABA therapy as a woman and take him somewhere and force him to go talk to somebody and make a friend. Like that's just inhumane. Like if he wants to be a recluse and play his games and be left alone. Let him be. So a lot of the times it's parents putting expectations on their kids for what they want them to be,

    KC 1:02:37

    instead of just letting like the therapist and me is like, Okay, why don't you want to make friends because maybe he does not feel a need for those connections. He's got got enough connections in my life, or maybe, right, because he's a 15 year old, he does want friends. But he's now had so many negative distressing interactions with kids that have pushed him back picked on him, not including him, that he's just decided it's more simple to not want friends than to get my heart broken over and over and over and feel so weird, right? And it's like, Okay, if that's really the issue, then like you said, taking him to a mall and giving him praise every time he talks to someone is not going to

    Taylor 1:03:20

    solve that issue. And it's gonna be awkward and just weird like for me to do that with him. And I was like, go and I was like, as a parent, you can enroll him in something that he might not want to participate in. He really I really liked video games, and they like card games. And they have those like, gatherings where they play like Magic the Gathering and stuff. So those are the recommendations I made. I was like, enroll them in something, maybe haven't go see like a psychological therapist, but I was like, and it was at a clinic and all the kids at the clinic were like five and below. And I was like, I'm not gonna like he's not gonna sit here with five year old 15 year old and make friends. Like that's just not we call it client. That's not maintaining client dignity at that point in forcing him to walk around a mall with me is also not maintaining his dignity, because it's just weird. Stuff like that. So I do I turn families away. I'm like, I understand you've got an autism diagnosis, and the doctor said ABA, but it's literally just an assessment. It doesn't mean that you need ABA.

    KC 1:04:13

    What does a typical ABA session look like? Like if somebody has no idea they've never seen it? Or is there a typical, like what kinds of things might I see in an ABA session? So

    Taylor 1:04:24

    there should not be a go ABA session.

    KC 1:04:26

    There isn't ABA, as you said, there should not be a typical, yeah, it's

    Taylor 1:04:30

    individualized. So every child, every setting is going to be different. But I can talk about the three main setting. So the first is in home, right? So the that means the RBT and PCA, they come into your home and they run the session. Typically the first couple sessions, we call it pairing and that just means I'm not reading any program. I'm not seeing any demands. I'm just getting to know the kid right? We'll just play it's basically play pairing in other words,

    KC 1:04:57

    why don't have to call it something so we yours. Listen, when

    Taylor 1:05:01

    I'm teaching RVTs about ABA, I literally say I'm like a bunch of older, highly educated, Caucasian men came up with all this jargon, to overcomplicate

    KC 1:05:12

    it pairing pairing. It's like, okay, it blows my mind that like, we think that the problem is like autistic kids ability to interact with people, when clearly someone with no social skills at all was like, Hello, I'd like to pair with you just pair it with the specimen. So

    Taylor 1:05:35

    it's so much jargon. It's so much jargon, but it basically just means playing and getting to know the kid, right? That's gonna be with the

    KC 1:05:41

    first time God, why can't they just call it playing or rapport building

    Taylor 1:05:45

    rapport building as well, they call it rapport building.

    KC 1:05:47

    They're not a Bluetooth device. Yeah, I know. I know. But that's what

    Taylor 1:05:50

    it typically looks like. So it's just playing, right? Yeah.

    KC 1:05:57

    I have to have one other outburst about this. It is so bizarre to take something as natural and human as trust and connection and turn it into this cold clinical transaction is very transactional, the language I don't want you to pair with my kid, I want you to think she's cool. And like her and enjoy her and have you know, and I want you to connect with her not she's not a project. She's not a Bluetooth device. Yeah, that's

    Taylor 1:06:31

    why people say ABA can be manipulative. And I think it's based off that language. Like I'm playing with you. I'm pairing with your for the intent that you're like me. And after then we can work on these things later. But yeah, so that's what it will look like. It's basically playing and then your start running session. So I always advocate for net, which is natural environment teaching. That just means you continue to play with the kid, but you find natural opportunities to run certain targets. So let's say I'm teaching the kid to identify No, I'm sorry. I'm teaching the kid. Let's say I'm teaching the kid identify blue, right? We're teaching colors, natural environment teaching, I'd be like, Hey, can you hear me the blue dinosaur? And then they have a good time. So Oh, thanks. Yeah, that's cool. Cool. Done. Right. The other one is called dTT, which is discrete trial teaching. This is the one the internet hates, I am strongly opposed to it. And this is the one that internet hates. But it's basically I wish to have any stimuli. It's called stimuli. But usually, the kid I was sitting at the table was a token board associated, they have to earn a certain amount of tokens. And then it's very clinical. So there might be two pictures, ones, blue ones green, and it's like touch blue. They touch blue. Oh, that's blue. You got to token. It's very like you're saying it's actual, it's not as natural. No clinic should be all dTT are on that. Because some kids I've worked on, they don't want me to ask them questions. When they're playing. They're literally say I don't want it. They're literally say, Can we do this, and then I can play by myself, right? Some kids can do it naturally. And they want to actually just be playing the whole time. Some of them really want to earn a token really want to be done and left alone.

    KC 1:08:09

    Like for my kids, I don't want token boards used. But my kids love a quiz see exactly like they would love to sit there and be like, Hmm, flashcards, like I don't know, we're just kind of a nerdy family. But like, they genuinely really enjoy that. And they don't need a token board. They don't need like, extra stuff. They just think it's fun to learn stuff. And so they'll sit there with flashcards and go, Oh, that's the blue one, two, and three. I mean, you know what I mean, I've got a kid, like, Let's do math games. So I see what you're saying where it's like, some kids might like that, or might enjoy that some kids might get frustrated if you try to do it via play. Because they're kind of like, no, that's you're not letting me lead the play or whatever, right. And then some kids might be more frustrated at the table. So that makes sense to me.

    Taylor 1:08:55

    So yeah, that's why it should be individualized. So I've worked at clinics where it was straight dTT at the table, and you're causing more behaviors that way, like the kids having a meltdown, because you have these little kids who a neurotypical child would not be sitting at a table for four hours, but you expect a child with autism to be sitting at the table for this long, and they get to leave the table to play. And it's like they have to earn the right to play, which I don't prove up. So typically what I do if I'm doing in home, and if I happen to be doing dTT, I bring my own toys that I paid for, right? I control these toys that are mine, if you want to play with my toys, and we have to do this, if you don't want to play with my toys, that's fine. We'll come play with something that you want to play with, right? So that way, it's not like I can't control your stuff in your house. Like it's your stuff. You're not

    KC 1:09:39

    taking away their toy and saying you get it back when you tell me what blue is. That makes sense.

    Taylor 1:09:44

    I control access to my stuff. And if they're if they call it negate if they say for me if they say I don't want to do that, okay, what do you want to do instead? Well, I want to play with this. Oh, well, if you want to play this, then we have to do that. But if you don't want to, that's fine. We can go do something else. Right? And a lot of people have a You heard that, but it really comes down to if you want to get paid, you have to go to work, you can call out and do whatever you want. But if you will get paid and get a paycheck, you have to go to work. So it's just, it's teaching them like you have options.

    KC 1:10:13

    Well, my I will say that like, occupational therapists, will do that as well, like, you know, when they're working on maybe encouraging flexible thinking, and, and a child's doing the same thing over and over and over, you know, I've seen that occupational therapists say, Okay, let's say the kids putting the Paw Patrol under the hat, and then going to the kitchen, and then coming back over drawing on a board and then coming over and taking it out and putting it into the hat and kind of doing that over and over, I've seen occupational therapist go, Okay, I'm gonna take it out from under the hat. And I'm going to put it over here, like, I'm going to make a small adjustment. And let's see how she does with that. Let's see if that distresses her. And if it doesn't, cool, let's try introducing small changes to work on that flexible thinking to work on that emotional regulation. And they do it in a really respectful way. Like, I think, to your point of saying, like, there, it's not that anytime we're seeing behavior reinforcement, it's like, oh, that's bad, and traumatizing, you know, but you're saying that we're finding a way to work on the skills that will, you know, increase their quality of life, and we can do it in a way that

    Taylor 1:11:21

    different in not snatching things out of their hands. I always have never said anything, unless it's like scissors. You know, unless it's dangerous, of course. But you're not, you need to figure out another way to get something or get them engaged or take a break, like let kids have breaks. And I just remember being trained as an RVT. There, it's called a trial or trial is I'm presenting whatever it is that I'm working on. And I were being trained that I had to present, whatever I'm working on, like I target one time per minutes of a session. So if it's an hour session, I have to ask them something 60 times, which is insane. Don't ask me something 60 times at an hour, and I'm 29 years old. That's how I was classically trained. And I had to rewire myself to be like, this is a lot of questions like, can we just chill out for a little bit?

    KC 1:12:14

    So going back to let's like, okay, you can find good BCAAs. But what makes them good is that they're completely negating their training as a BCBA. So I know that's an oversimplification. But yeah,

    Taylor 1:12:25

    but again, I'm looking at my textbook right now, that was never in the text. Nobody ever said to do a trial a minute. Nobody ever said that somewhere, or somebody said that. And that was that was the culture of that job that it worked out. But I was like, who said that? That when he said you had to do that. So again, it's like when somebody somewhere made up all these roles that don't even exist, and now everybody's following them, will

    KC 1:12:48

    tell you this has been a really great conversation. Let me ask you this as your sort of parting question. What do you see as, like, give me like three things that you think that the industry as a whole needs to do to better serve autistic people? I

    Taylor 1:13:06

    think the first thing is RVTs needs to either be supervised more frequently in terms of the minimum requirement needs to increase. Right now it's at 20%, which is not that much, I honestly feel like it should be at 50 over 50%, that would be my first thing and in the education, whether or not to say that they need a higher level of education. But in terms of more training, 40 hours is not a lot of time, that's all they need is 40 hours. And that's not a lot of time, I think there needs to be a lot more training for RBTs. If these are the people that are actually implementing the programming, they need a lot of training. That's the first thing I would say needs to change. The second thing I think, is some type of different education required for BCBAs in terms of working with this population of individuals needs to be a requirement to I know it requires ABA coursework, I think it needs to require if you're going to work in the field with people with developmental disabilities, you need to have some type of education on that maybe some empathy classes to I'm not sure, I don't know, maybe I feel like everybody just needs to study a little bit of psychology to be a little bit, you know, more empathetic, that would be the next thing, I would say new change, and then just some type of education where BCBAs to identify biases within themselves. And to understand if they're targeting a behavior for change, like we said, because I find it annoying, or am I targeting a behavior for change, because it's going to benefit the individual. And I think we have to look at ourselves as BCBAs as human beings because there's certain things that we expect other people to behave in and other people to be, but we need to take that out and look at this individual and say isn't going to benefit them yes or not? Or am I just pushing on my bias onto them and what I think they should be what I think they should act, but I think they should like you know, or is it going to benefit them? And I think we would learn as a field. There's a lot of stuff that we don't need to be working on. We don't.

    KC 1:15:04

    That's such a hard one. Because like, especially when you think about the eye contact, like, I totally can picture what the reasoning was when the when it started, right? Well, well, it's about that we want them to have relationships. And you know, in order to have relationships, you have to learn to look at people, because that's how you know what I mean. Like, I can totally see the justifications you really do have to, like you said, be trained on looking for that bias, and keeping up with current research about, like, what are the effects of some of these applications?

    Taylor 1:15:37

    Definitely, yeah, I definitely think just being aware, looking into these things, and just kind of just being a nice person, I don't know how to tell people to be good people, but just be a good, nice person and just treat people with respect and kindness. And just be nice. I think it's weird when people say I have an a progressive approach to providing ABA, because I just feel like, it makes the most sense to me. I don't understand why you would do it differently. Yeah, people say you're very liberal. And it's like, well, am I liberal? Or am I just being nice to people in

    KC 1:16:10

    general by just showing basic respect to other human beings? Yeah.

    Taylor 1:16:14

    So it's odd to me that it's such a negative stigma. So yeah, I've literally like after that conference, I was like, what else can I do? I was literally contemplating just leaving the field. Because I was like, I don't want to be associated with these people. But then I was like, again, I'm just, I'm not trying to be the, you know, the change, you know, if I just leave, because I was like, I could go back to school and do something else. Because I was like, how do we even be a BCBA? Afterwards, those people.

    KC 1:16:41

    And to be fair, like the attitudes that you're describing, they could be anywhere, like, you could have someone who's an occupational therapist, who has all those biases, who is using punishments and rewards, who is targeting the wrong behaviors, I think it does seem to be more prevalent, with BCBAs and with ABA, but I also think that, you know, the other confusing thing is like, because insurance will only do ABA, I think, now you have a bunch of clinics and settings that are calling themselves ABA, but you go in there, and they're not really doing ABA. And so it's like, oh, this is maybe an environment that is going to be helpful to my kid. And then you could go to a place that says all we do is, you know, floor time or whatever, and you go in, and it's like, these are all the same interventions and approaches and biases and goals. And you know, so it's difficult, especially as a parent when you just hear ABA is great. Aba is abuse. And you're going oh, not only is that confusing, but then if you even come to your own conclusion about what isn't isn't good for your kid. You can't even go based on what they're calling themselves.

    Taylor 1:17:50

    I agree. Yeah. And I think a lot of the issue with ABA is like we call it socially significant behavior, right? That's what we're looking, what does that mean? There's no definition. And so with speech, right, it's literally like they have, like, whatever, I don't know if it's syntax or whatever. But speech, it's very clear cut what you should be working on, it's very clear cut, there's a speech delay or a speech impediment, and how to change that. And there's no type of issue with changing that, like you're trying to change their speech, maybe the way you do it. But for us, we're doing socially significant behavior. And that's so gray. And it's so weird, because they in ABA, they're always like, you need to be objective, you need to be measurable, but then they tell us to target socially significant behavior. And that's the greatest thing possible. So yeah, I think back in like the 80s and 90s, you know, eye contact was a big deal. And now we're seeing these autistic adults saying stop doing that, because that was really significant back then. And so I think just the way we treat people with disabilities has changed as well. And we're much more accepting and I think that's why the field has changed since then. I'm assuming it's hard because I'm so new. So. So it's also funny because people like, You're the problem with ABM like I just got here. I don't know what you're talking about. I didn't do all of that stuff. I was in school. I was in high school when that happened. So it's hard but yeah, I feel like people like my friends are like, you're the martyr of tick tock for BCBA it sounds like I'll be it if I need to be it's fine. Because I don't want parents to go on tick tock type and ABA see all the negativity and then they're like, I'm not gonna do it. Right. And if they just see one of my videos and say, Oh, it can be nice, you know, I might be changing a child's life. I've never even in a meet moving in to see you when I was a parent and I went on tick tock and research ABA. I would not put my son in it if I didn't know any better. Yeah, it's scary. Well,

    KC 1:19:41

    this has been a great conversation. I thank you so much for your time. I know it took him an hour and a half of your time, but it was such a good conversation.

    Taylor 1:19:48

    Thank you so much.

    Transcribed by https://otter.ai

Christy Haussler