Podcast Summary: ABA Inside Track – Episode 337: ABA and Down Syndrome w. Dr. Kathleen Feeley

Date: March 11, 2026
Host(s): Robert (Rob) Perry Cruz, Jackie McDonald, Diana Perry Cruz
Guest: Dr. Kathleen Feeley

Episode Overview

This episode of ABA Inside Track focuses on the intersection of Applied Behavior Analysis (ABA) and Down Syndrome. Dr. Kathleen Feeley, a leader in behavioral interventions for this population, shares her professional journey, discusses evidence-based strategies for supporting children and families, and highlights the unique considerations when applying ABA to individuals with Down Syndrome. The discussion addresses research gaps, behavioral phenotypes, strategies for skill acquisition and behavior management, and ways practitioners can develop their clinical competence with this group.

Key Discussion Points & Insights

1. Dr. Kathleen Feeley’s Background and Expertise ([03:13])

• Started as a New York City special education teacher, working with non-speaking children using augmentative and alternative communication (AAC).
• Pursued doctoral studies at the University of Minnesota, which allowed interdisciplinary behavioral and communication disorders research before the formal BCBA credential.
• Dissertation involved generalization gradients in learners with intellectual disabilities.
• Opened centers for children with autism and later with Down Syndrome, driven by noticed gaps in services and continued segregation in education.

Quote:
“I started my career as a New York City Department of education classroom teacher... I was working with many children who didn't speak... they had a very progressive AAC program... So my whole area of study was behavioral oriented, although I don't ever think I took a course on applied behavior analysis.” – Dr. Feeley ([03:13])

2. Why Specialize ABA for Down Syndrome? ([07:24])

• Despite foundational principles of ABA applying to all humans, their application must consider unique behavioral phenotypes.
• Children with Down Syndrome often present increased motivation for social attention and escaping difficult tasks, compounded by medical complexities (e.g., hearing/vision impairments, cardiac issues, low muscle tone).

Quote:
“Key areas—definitely motivating operations... medical complications... hearing impairment, visual impairment... increased likelihood of desiring attention and just wanting lots and lots of attention.” – Dr. Feeley ([07:57])

3. Social Stereotypes and Behavioral Phenotypes ([11:45])

• The term “stubborn” is commonly and problematically applied to children with Down Syndrome, rooted in historical bias and social attention as a reinforcer for non-compliance.
• Not a universal trait; reinforces the need for individualized assessment.

Quote:
“There's also in individual students a long history of getting a lot of social attention for being non compliant... boy, oh boy, it pays off to be stubborn in that quote, unquote, gotcha instance.” – Dr. Feeley ([12:15])

4. Lack of ABA Research Specific to Down Syndrome ([14:35])

• Early applied behavioral research often focused on Down Syndrome (“mongoloid” was the outdated term used).
• Academic focus shifted toward strengths, resulting in fewer intervention-oriented studies; many studies list Down Syndrome as a subcategory without breaking out results.
• Manualized ABA approaches for Down Syndrome lack widespread dissemination.

Quote:
“There’s a huge amount of literature focusing on the strengths... but what fell apart was that treatment for them. And there wasn't a whole lot of it.” – Dr. Feeley ([15:00])

5. Practical ABA Strategies for Down Syndrome ([20:39])

• Behaviors are frequently both attention- and escape-motivated (“runs to the door, looks to see if you’ll chase”).
• Antecedent strategies are underutilized but very effective—especially changing how requests are made, offering collaboration, and using high-probability sequences.
• Functional Communication Training (FCT) and prompt timing (ensure the prompt comes before problem behavior).
• Consequences: Withhold attention after errors/problem behavior to reduce attention-maintained responding.

Quote:
“The most impactful ways to respond is not to respond or just to turn away after a problem behavior occurs because any type of interaction is going to be reinforcing.” – Dr. Feeley ([23:59])

6. School-Home Collaboration and Setting Events ([24:36])

• Use tools like home-school logs or “Handle with Care” passes to communicate about rough nights/mornings or health issues. Staff can preemptively adjust expectations and reinforcement.
• Practical adaptations (snacks, naps, extra support) can forestall challenging behavior.

Quote:
“With the log, it would be great, right, if people read it and note it and you don't even have to say what it is... ‘Charlie didn't sleep well. So it’d be a rough one.’” – Dr. Feeley ([26:10])

7. Antecedent-focused Positive Behavior Support Plans ([29:58])

• Plans should break down factors into: setting events, in-the-moment antecedent strategies (e.g., choice-making), and skill-building strategies (e.g., FCT).
• O’Neill & Horner’s FBA model and state (e.g., NY) guidelines align with this approach.

Quote:
“This breaks down for us, like, three different areas that kind of fall on the antecedent side... would be so such a great exercise like provide to your BTs or teachers...” – Diana ([30:48])

8. Skill Acquisition: Teaching Communication ([32:34], [41:08])

• Adapting discrete trial training for requesting/vocal imitation, focusing on capitalizing on strengths (visual imitation, social motivation).
• Tactile prompts (desensitizing to touch on face/lips) used for teaching vocal imitation.
• High density of teaching opportunities, embedded naturally—not hours of trials, but strategic intensive practice.

Quote:
“One of the things we told families right away is to desensitize their child to touching their lips... so that hand up on their mouth was actually a prompt to vocalize...” – Dr. Feeley ([38:15])

• Strength of generalization: Once learned, skills like “bless you” are used broadly; social desire drives spontaneous application.

9. Addressing Social Responses and Infantilization ([33:50])

• Well-intentioned family/staff may excuse or reinforce inappropriate behaviors (“oh, you’re so naughty!”).
• Best addressed by comparison to age-matched peers and emphasizing inclusive settings with consistent expectations.

Quote:
“Well, what if Charlie walked in and pulled your hair like that? And right away it was like, ‘Oh no, he would never do that. He knows better than that.’ ...Therefore, let's look at all of the kids that are that age and are they doing it...?” – Dr. Feeley ([34:08])

10. Changes in Practice and Dissemination ([52:19])

• Increasing use of ABA for Down Syndrome in some regions—often driven by parent/BCBA advocates or local organizations.
• Barriers remain: limited training in ABA for Down Syndrome in most professional prep programs, and lack of strong research funding until recently.

Quote:
“I do believe we see an increase in it... oftentimes it’s a parent who is a BCBA or a parent who’s a special ed teacher... but I am not seeing as much as I would like to.” – Dr. Feeley ([54:01])

11. Building Clinical Competence ([55:58])

• Essential steps for ABA professionals:
  • Review existing research/manuals for ABA with Down Syndrome (esp. Feeley & Jones).
  • Understand medical guidelines for Down Syndrome.
  • Collaborate deeply with families and siblings; they are key partners.
  • Learn the behavioral phenotype and use that to individualize supports.

Quote:
“Read our work... getting a really good handle on the medical guidelines... I would spend a lot of time with families... because they’re the best teachers.” – Dr. Feeley ([55:58])

12. Research Gaps and Future Directions ([58:37])

• There is a need for more controlled, large-scale studies (e.g., RCTs) specific to ABA and Down Syndrome.
• Implementation science is a promising avenue—how to get effective interventions widely adopted, especially in inclusive settings.
• More research needed across developmental domains (not just behavior but also communication, object use, concept formation).

Quote:
“We know that reinforcement works. We know that functional communication works. Really shifting. How do we get preschool teachers that have had a completely different training to adopt these interventions? I think those are areas [for research].” – Dr. Feeley ([59:39])

Notable Quotes & Memorable Moments

• “The most impactful ways to respond is not to respond or just to turn away after a problem behavior occurs because any type of interaction is going to be reinforcing.” – Dr. Feeley ([23:59])
• “There’s a long history of getting a lot of social attention for being noncompliant.” – Dr. Feeley ([12:15])
• “Once they have the skill, boy, they use it. ...there's a lot of generalization.” – Dr. Feeley ([47:51])
• “It's not a universal thing... the key about a behavioral phenotype is there's an increased likelihood. It doesn't mean you'll see it in everybody.” – Dr. Feeley ([13:17])

Important Segments by Timestamp

• Dr. Feeley’s journey and expertise: [03:13]–[06:31]
• ABA and Down Syndrome: key differences: [07:24]–[10:49]
• Phenotype discussion (“stubbornness”): [11:45]–[13:42]
• Research history and gaps: [14:35]–[18:13]
• Intervention strategies (attention/escape motivation): [20:39]–[24:36]
• School-home logs and “Handle with Care” passes: [24:36]–[27:21]
• Positive Behavior Support Plan structure: [29:58]–[31:36]
• Skill acquisition: prompting, imitation, teaching strategies: [32:34]–[48:54]
• Generalization and social motivation: [47:45]–[48:54]
• Competence and next steps for practitioners: [55:58]–[58:10]
• Research recommendations and implementation science: [58:37]–[60:54]
• Contact for Dr. Feeley: [61:17]

Takeaways for Practitioners

• Focus on Antecedents & Motivation: Attention and escape are especially salient motivators; adjust strategies accordingly.
• Collaboration is Key: Involve families, communicate across home and school, and honor family expertise.
• Avoid Stereotypes: Recognize both the strengths and unique challenges of individuals with Down Syndrome without defaulting to social clichés.
• Evidence-Based, Not Autism-Centric: ABA is a science of behavior; learn to flexibly apply its principles beyond the context of autism.
• Seek Out and Advocate for Research: Much is still to be learned! Keep up with emerging literature, and advocate for inclusion of Down Syndrome in ABA research and policy.

Contact & Further Resources

• Dr. Kathleen Feeley: kathleen.feely@liu.edu (confirmed spelling in show: kathleen.feely@liu.edu)
• Key Publications: Feeley & Jones (2006, 2008), Feeley et al. (2011); see Down Syndrome Research and Practice, Research in Developmental Disabilities

Snack Pairing for This Episode

• Popcorn and an Icy – chosen as a snack “to share together,” reflecting the episode’s theme of social engagement and collaboration. ([64:00])

End of Summary