ABA Inside Track – Bonus Episode 35

Compassionate Care Conference at UCP 2024
Release Date: December 23, 2024

Episode Overview

In this special bonus episode, the ABA Inside Track team shares their experiences attending the “Contemporary and Compassionate Approaches to Support Individuals with IDD” (Compassionate Care Conference) hosted by Upstate Caring Partners in Utica, NY. The episode features a sample of informal interviews with poster presenters, highlighting practitioner-driven research and applied behavior analysis (ABA) innovations focused on compassionate and values-driven care. The host and guests discuss practical hurdles, lessons learned, and new technologies for improving ABA outcomes, all in the lively atmosphere of a grassroots conference.

Key Discussion Points & Insights

1. Conference Setting & Cultural Shift in ABA

• Host’s Purpose (00:13–02:57):
  • The conference brought together diverse professionals striving to advance compassionate care in the field of ABA.
  • ABA Inside Track hosted a panel on “creating cultural shifts in behavior analysis”, engaging both previous and new guests.
  • Informal poster interviews are used to showcase practitioner-driven research, including early-stage and boots-on-the-ground studies.
  • Notable attendees included Megan Miller, Natalie Williams Awadea, Mary Jane Weiss, Didu Raj Raman, Hillary Laney, and others.
  • The event fostered connections and highlighted progress in compassionate care practices across different regions.

2. Poster Conversations – Practice & Innovation Highlights

A. Conditioning Faces and Voices for Communication

Victoria Beeman

• Topic (03:23–06:12): Using PFASBT (Practical Functional Assessment & Skill-Based Treatment) to condition learners to attend to human faces and voices, a precursor to more effective communication.
• Approach & Outcomes:
  • Two learners initially did not attend to faces/voices even during reinforcement.
  • Traditional pairing methods failed; PFASBT led to major gains in attention to faces and voices.
  • Key jump in “observing response probe” scores pre-/post-intervention (from 12/50 and 6/50 to 40/50 and 30/50).
  • Involving parents in data collection revealed carryover at home, increasing social validity.
• Notable Quote (05:45):
  “They were like, he’s looking at us... we’re talking to him and he’s responding... So much social validity.” — Victoria Beeman
• Practitioner Reflection: Lessons learned would change her current approach for more targeted face/voice conditioning.

B. Shifting to Vocational Curriculum with EFL

Tara Hyatt

• Topic (06:15–09:07): Transitioning from academic to vocational skills using the Essential for Living (EFL) curriculum; observed impact on independence and well-being.
• Approach & Outcomes:
  • Switch emphasized life skills (stocking cafeteria, coffee carts, laundry, gardening, cooking), increased student engagement/happiness.
  • Essential Eight and Behavioral Health Index (BHI) scores showed improvement after shift.
  • IEP goals were restructured using EFL measures to increase real-world relevance.
• Notable Quote (08:51):
  “I was skeptical at first, but then once I saw how all my students really had deficits... it didn’t make sense to focus on those academic skills when they didn’t have basic skills they needed to be successful in life.” — Tara Hyatt

C. Clinical Risk Assessment Tools for ABA

Meg Bro

• Topic (09:22–16:47): Development of a dynamic Google Form/Excel tool to objectively categorize client risk and streamline clinical decision-making for trauma-informed care and administrative oversight.
• Approach & Outcomes:
  • Tool automatically assigns clients to risk tiers (2B to 4D) based on behavioral severity, use of restrictive practices, staffing ratios, etc.
  • Integrates a three-tiered support model, requiring foundational plans, directorial review, deadlines for behavior reduction, and escalation procedures.
  • Increased support and collaboration between supervisors, enhancing “being a good boss” rather than blaming clinicians.
  • Positive feedback, though full adoption variable (“referenced in meetings”).
• Memorable Moments & Quotes:
  • (13:14): “I actually selfishly wanted this as a director... This gave us an opportunity to see, okay, what have you not been potentially. Okay, and where can I identify that you might need more support?”
  • (16:11): “We wanted it to be easy enough to access. It took about two minutes to fill out the Google forms.”

D. Scaling Skill-Based Treatment (SBT) in Public School Classrooms

Melissa Walsh

• Topic (16:51–24:48): Implementing Skill-Based Treatment (SBT) for students with autism across 22 school districts, including gen ed and autism support settings.
• Approach & Outcomes:
  • Seven students across three districts, notably a kindergarten student who increased participation from 10% to nearly 80% and 99.3% reduction in problem behaviors.
  • Adaptation included dyads and creative leisure/EO manipulations (e.g., “Don’t Wake Daddy” game, “shopping” in school).
  • Collaboration with teachers; one gen ed teacher successfully ran SBT during classroom activities with provided prompts.
  • Social validity high; adaptation for student needs promoted (e.g., integrating peer support).
• Notable Quotes:
  • (17:43): “She is just amazing. I'd love to clone her. Her little guy actually was at about 10% participation at the beginning. We got him up to almost 80% and... 99.3% reduction within the Gen Ed classroom.” — Melissa Walsh
  • (21:06): “The adults are more impacted than the kids are.” — Melissa Walsh
• Lessons Learned: Creativity needed for HRE (Highly Preferred Reinforcers/Environments); encouragement of peer involvement; buy-in strongest when admin/teachers see impact; all students progress differently.

E. Technology-Supported SBT at Scale

Hillary Laney (Centria)

• Topic (24:50–36:31): Using a custom-designed app (Care Connect) to standardize, scale, and oversee SBT (Skill-Based Treatment) interventions organization-wide.
• Approach & Outcomes:
  • App allows clinicians to graph and monitor session data, mastery progress, fidelity, and move through intervention steps as needed.
  • Supports decision-making, provides prompts, and allows for supervisor oversight without stifling practitioner artistry:
    • Users can override app recommendations; actions are logged for supervision.
    • App’s flexibility increases training efficiency and reliability, not rigidity.
    • Data shows mastering SBT steps typically does not require excessive trials.
  • Entire organization is trained in SBT paradigms, with foundation plans as Tier 1, SBT as Tier 2, and intensive consultation as Tier 3.
• Notable Quotes:
  • (30:25): “This is my child. His name is Apple. It's only available on iPads anyway. But... There's almost no decision that this makes that someone couldn't override.” — Hillary Laney
  • (31:34): “You cannot have this skill-based treatment process without artistry. The two are mutually exclusive.” — Hillary Laney
  • (35:25): “We don't want Tier 2 to be the kitchen sink. Because in the kitchen sink, people are making decisions that are not aligned with our values.” — Hillary Laney
• Scaling Reflection: Standardized, tech-supported processes help maintain values-based implementation and effectiveness across a large organization.

Notable Quotes & Memorable Moments

• “So much social validity. They were like, he’s looking at us... we’re talking to him and he’s responding.” — Victoria Beeman (05:45)
• “It didn’t make sense to focus on those academic skills when they didn’t have basic skills they needed to be successful in life.” — Tara Hyatt (08:51)
• “The adults are more impacted than the kids are.” — Melissa Walsh (21:06)
• “This gave us an opportunity to see, okay, what have you not been potentially. Okay, and where can I identify that you might need more support?... Our goal was being a good boss.” — Meg Bro (13:14)
• “You cannot have this skill-based treatment process without artistry. The two are mutually exclusive.” — Hillary Laney (31:34)
• “We don't want Tier 2 to be the kitchen sink.” — Hillary Laney (35:25)

Timestamps for Important Segments

• Conference overview and panel topic – 00:13–02:57
• Conditioning faces and voices (Victoria Beeman) – 02:57–06:12
• Shifting to EFL/vocational curriculum (Tara Hyatt) – 06:15–09:07
• Risk assessment/clinical decision tool (Meg Bro) – 09:22–16:47
• SBT in public school classrooms (Melissa Walsh) – 16:51–24:48
• Scaling SBT and the Care Connect app (Hillary Laney) – 24:50–36:31

Takeaways

• Compassionate, values-driven shifts in ABA practice are tangible and occurring at scale, from individualized classroom adaptations to organization-wide technology solutions.
• Poster presenters provided real-world stories of iterative problem-solving, skepticism transformed by data, and the importance of social validity and flexibility.
• Standardization and technology do not eliminate practitioner artistry; instead, they can provide the scaffolding for consistency while nurturing clinical judgment and individualized care.
• The field is moving toward scalable, compassionate approaches that retain fidelity, empower practitioners, and improve client outcomes, as highlighted by diverse voices and innovative solutions at the Compassionate Care Conference.

For listeners unable to attend the Compassionate Care Conference, this episode offers a dynamic portrait of the evolving landscape of ABA, with direct practitioner insights and examples of practical compassion in action.