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- [00:00]
Diana Perry Cruz
Foreign.
- [00:14]
Robert Perry Crews
Hey, everybody. Welcome to ABA Inside Track, the podcast that's like reading in your car, but safer. I'm your host, Robert Perry Crews, and with me, as always, are my fabulous co hosts.
- [00:25]
Jackie McDonald
Well, hey there, Robert Perry Crews. It's me, your friend, Jackie McDonald.
- [00:30]
Robert Perry Crews
Why, my friend, you're here.
- [00:32]
Diana Perry Cruz
And it's me, Diana Perry Cruz, also presumably your friend and your wife.
- [00:37]
Robert Perry Crews
Well, we'll see.
- [00:38]
Armando Bernal
We'll see.
- [00:39]
Robert Perry Crews
Well, everyone, welcome to our show where we talk about behavior analysis and behavior analytic research, and every week we pick a topic and discuss it at length. And this week we decided to take two great topics we thought would just taste great together. We wanted to talk about ascent. We wanted to talk about pecs. And we said, you know what, let's just, let's just put them together. Let's just see what happens. And magically when we did that, we were joined by a special guest. It happens that way sometimes. You just, you throw it on the Internet and the Internet gives you something special back. I don't know if it's AI related, I don't know. But we're very happy to be joined to talk about mostly the ascent part, but also, you know, pecs as a component of ascent, as well as a number of other ways to be thinking about our ascent practices. But we're very happy to be joined today by Armando Bernal. Armando, thank you so much for coming on the show.
- [01:28]
Armando Bernal
Thank you for having me. It is such a wonderful experience and I'm just happy to be here. Beautiful.
- [01:34]
Robert Perry Crews
So, Armando, this episode sort of came in following kind of a talk you did at Stone at the Stone Soup conference. And you had a really excellent overview slash call to action article that we'll say the name of it in a minute because we've been forgetting to do that on recent episodes.
- [01:51]
Armando Bernal
Sorry, listeners, that's my bad.
- [01:53]
Robert Perry Crews
But on the idea of the neurodiversity, kind of affirming applied aba.
- [01:58]
Armando Bernal
Yeah.
- [01:58]
Robert Perry Crews
And then when we reached out about being on the show, you brought up another article related to pecs and how that can be part of the ascent process. And it was very fun reading both articles because one was a very like heady, deep, soul searching discussion thinking about practice, and the other was kind of a nice standard. Here's a great way to use pecs in a way. Actually, I hadn't thought about doing it
- [02:17]
Armando Bernal
that way, but I love it and
- [02:19]
Robert Perry Crews
I'm going to do it. Let's just say I already have a little tiered conversation, social skill presentation. And I didn't directly cite it because it's for teachers and they don't always love my citations, but it's going to get mentioned in there. And already kind of got put into. Into the stew of that presentation. So very excited. But love to hear a little bit more about sort of like kind of your own journey as a behavior analyst and how your interest in this topic enough to know co. Co publish an article came to be.
- [02:44]
Armando Bernal
Yeah, yeah, no, thank you again. So initially I started out. So I was diagnosed with autism at the age of three. Doctors told my mother that I might as well learn sign language because I was never going to be able to speak. And once the doctor said, best of luck to you, mom, I have a hundred other patients just like you, I have to give this diagnosis to. My mother looked at my father and my sister and said, I don't know what that doctor is talking about, but he is not living with me past the age of 18. And so with that. Right. She didn't have access to applied behavior analysis therapy or a whole lot of other therapies. It was the 90s where I grew up, so it wasn't a part of the movement that it is today. But she did have access to the free public library and was able to find several books on different kinds of interventions, ways to work with autism and different areas such as that. And with, in my personal opinion, just a belief that I can still accomplish anything, despite what a medical doctor or other professionals may tell her. I've been able to get to where I am today. I became a special education teacher and then eventually became a behavior analyst and then went through the gamut of kind of roles where it was assistant clinical director, site manager, things like that. And eventually decided, along with my amazing sister, to say, why can't we just start our own thing? Why can't we be able to help out other individuals? Because what we came through again and again, whether it was her as a special education teacher herself or myself as a behavior analyst, we were meeting parents that said, my child's life is over before it begins. There's nothing else I can possibly do. And as a typical behavior analyst and a company, I was only able to take on certain amounts of kids or certain types of kids, if you will, that was based on the kind of culture or procedures of that business. And so with my company, Autism International Consulting, we said, we'll take on anyone that needs any kind of support because that's what would we would have wanted when I was a child. So we see all ages, we take all insurances, including Medicaid I was growing up on the Medicaid system as well. And in the state of Texas, it is very rare to find individual companies that take on Medicaid. There's only maybe a handful of us and with the all ages as well, we have a big division on what our company does at Autism International Consulting, where my literals are focused more on listening skills or visual skills, communication skills, the typical ABA strategies. Whereas for my olders, we focus more on working on keeping inside thoughts inside rather than making them outside thoughts, as well as focusing on job building skills, relationship building, social skills, and just independent living as a whole as well. That's excellent.
- [05:23]
Robert Perry Crews
And Armando, kudos to your mom. I really thought the parents saying, you know what, fine, I'll go to the library and learn a bunch of, you know, learn a bunch of useful. I thought that was like a movie trope. It's like shorthand for how do we. How do I get this character up to speed on knowing things?
- [05:36]
Diana Perry Cruz
But it is very montage.
- [05:38]
Robert Perry Crews
I know. Yeah, it is. It is amazing. No, that's. That is. That is a. Is a viable option at certain times. Not.
- [05:44]
Armando Bernal
Oh, yeah, no. Funny enough, there was some montage music that was playing throughout my entire life and just skipped a couple of chapters here and there. Absolutely. But it's, it's just been the case with my mother. She's been quite the fighter her entire life and I think I've really adopted that kind of mentality from her as well.
- [06:00]
Robert Perry Crews
That's amazing. I know. And, and folks, pro tip, as a parent, you do a montage to skip some of the gross parts. And it's, it's a lot easier than everyone says.
- [06:08]
Diana Perry Cruz
Just, it's the best way to get in shape as well.
- [06:10]
Robert Perry Crews
Yeah, I know. Really?
- [06:11]
Diana Perry Cruz
Yeah.
- [06:11]
Robert Perry Crews
Why does everyone complain? It's like so easy. Get the music. You just get a little get away. They get a bigger way and you're like, you're done. It's awesome.
- [06:21]
Diana Perry Cruz
Anyway, you want me to tell you
- [06:23]
Armando Bernal
what articles are before.
- [06:24]
Robert Perry Crews
Before I forget to ask you. No, before I forget to ask you to do it. You should do it. What are we talking?
- [06:29]
Diana Perry Cruz
Yeah. All right, so we have. Our topic is Ascent and pecs, two flavors that go great together. And we have one article for each. So our largely Ascent related article is Neurodiversity Affirming Applied Behavior Analysis. That was written by Alan Mellon, Syed Johnson and Bernal and published in behavior analysis practice 2024 as well. And then our PECS article, sorry. Is teaching children with autism to initiate and respond to peer Mansion using Picture Exchange Communication System I. E. Pics. And that was written by Doherty, Bracken and Gormley and published also in Behavior analysis and practice 2018.
- [07:10]
Armando Bernal
Excellent.
- [07:12]
Robert Perry Crews
So, Armando, why don't we start with kind of the bigger picture article that you co wrote. And I know it's, you know, mainly about kind of ABA causing harm, the neurodivergent critique. But I love in your article you really do a good. Not, not so, you know, welcome to school, let's sit and listen, you know, drone on. But a great overview of all of the ways that American legal system, educational system, societal systems have supported really ableist practices, not just in the autistic community, but in the disability community as a whole. And it's really hard. I mean, I guess you can. I mean you probably could do it very easily because you've written on the subject. But to really talk just about kind of the neurodivergent critique without also discussing just the general ableist movement sounds wrong, but just the ableist push of, you know, the majority society in America. So do you mind giving us kind of the. The brief overview? I mean, as long as you want it to be. But you know, we have a lot to talk about so of kind of where a lot of these concerns and these just really harmful practices have kind of come from through, you know, American history.
- [08:25]
Armando Bernal
Oh yeah, yeah, no, absolutely. And really quickly, regarding the article, just like a fun like back story of all of this. I remember that I was texting Dr. Allen about just the neurodiversity movement and how things are going, and she finally called me and I was like, in the middle of the grocery store, grocery shopping. And she was like, you know what? Why don't we just do something about it? I was like, heck yeah, let's go ahead and do do something. So we were able to get Dr. Mellon, Dr. Syed and just everyone else to be able to particip this. And you know, it really came from this mentality because I speak on it a lot of my presentations on how I. There's no real evidence on where it really started from otherwise. But I have an anecdotal story that I typically discuss and I try to have open conversations with whether it be y' all or anyone else that's in the. In the audience that I do believe that there is some kind of anecdotal relationship between the growth of social media as well as this growth in this. What you had called a movement. Right. And so we see a lot of the times in social media as this was growing that as you create more shocking stories or more kind of personal transparent stories, you get more views, you get more attention, you get more likes, comments, whatever it may be. And I want to stress you before I keep going, that anyone that speaks on any kind of trauma or experience that they had with Aba, especially in the 80s and the 90s, they should be honored and respected. But at the same time it needs to be noted that these are anecdotal stories that have now become more so over generalized on what everyone in the analysis practice can do. But we see that social media rose to popularity at the same time as individuals were finishing up possibly their aba within the 80s and 90s, early 2000s. And so as we see this growth, we see more stories on I had this traumatic experience happen in aba, I had this traumatic experience happen with this kind of professional or practitioner. And people listen, people hear that, right? And they hear these things and they say, oh my gosh, my child has autism, or my child did this or that. I don't want them to ever go through something like that. And so there's this fear that is encapsulated and also this growth of our own children. Now as a father, I have an 11 month old going on 12 months in one year and I have the same fear, right? If something was to happen at a daycare near my house, I may say, well, I don't want her to go to this daycare or that daycare because I want to make sure she's safe. But what I try to stress here, right, as well when I have this conversation is a analogy that I want to bring to people's attention. So let's say we go to a medical doctor and this medical doctor does not fit the same ideals and beliefs that we ourselves believe in. Would we then say to ourselves, well, you know what? I am through with Western medicine. I am never going to have it ever again. We would likely not say these things and instead we would say, let me find a doctor that fits my ideals and beliefs. And so I do recommend that to a lot of my audience and the other individuals that I am speaking with and say, look, I'm not everyone's cup of tea, right? I'm diagnosed autistic. I own Autism International Consulting, the only autistic owned ABA company. That may not be for everybody and that's okay, right? I want to make sure that the people I'm working with are very comfortable and relaxed. And so it's the same way throughout the nation, right? Find somebody that fits your ideals and beliefs before we go into over generalizing trauma to every practitioner there is, if that makes sense.
- [11:45]
Robert Perry Crews
So, you know, I appreciate kind of that, that extra context, the social media, just the voice is being, I guess, amplified to some extent through social media. Not necessarily through having a message that we should not be listening to or that should not be shared, but just through the kind of it bleeds, it leads mentality of like a lot of platforms of as things come out, if they sound scary, if they sound like, oh, that's news I don't want to hear about, or that's I should be worried about. It's like, well, here's some more information that proves, quote unquote, that that's actually the way the world works, rather than this is an individual experience that we should take heed of, pay attention to, and then appropriately respond to, but may not be everybody's experience.
- [12:27]
Armando Bernal
Right. I'm so sorry. And really quickly with it too, there's a. In addition to this dynamic, I see a lot of the times a parent or whoever it may be, say, oh my gosh, thank you for telling me this. Is there other avenues I should take or are there other concerns I should look out for? And I don't see a lot of support there. And so what I think a lot of practitioners should definitely do is, is remain open in that. Right. Even though that these were anecdotal stories, it definitely opened up a wound that needed to be talked about, that needed to have an open conversation about. And I think, hence, this is where, number one, my article comes from, with, along with Dr. Mellon, Dr. Laura, excuse me, Dr. Allen, and everyone else. But also just a broad scope of what should be done in the growth of the practice itself. And instead of looking at old guards or saying things such as, like, we've always done things this way, right? Looking at the future and saying how can we develop the field in a way that is appropriate for the individuals who are serving while also including them into the practices that we provide.
- [13:27]
Robert Perry Crews
Armando, kind of the bigger, I guess, in terms of responding, because I know one of the concerns, certainly if I were, say, a parent of an autistic child in the 90s, in the 2000s, in some of those time frames where ABA was sort of like the game in town, but not necessarily in the way that I think all of us would like to see, have seen ABA practiced even back then, there would have been a sense of, well, you know, I understand that you were sad about it, my, my child, but look at all the skills you have now, or look at all the Things you can have now. And similarly, a lot of practitioners, like you mentioned, maybe more of the old guard practitioners. Yeah, yeah, but we didn't know any better then or we were just trying to meet these needs and how were we supposed to know that all these things happen and kind of a defensiveness that can come from, from, from that nature. Do you ever, I mean, I'm sure you talk about it, but like, when, when you notice people getting defensive, maybe when you're bringing up this as a real, you know, real concern that we should be listening to changing practices, do you typically respond to that defensiveness or do you sort of veer off and like, let me pivot to the, you know, like the calls for action in the paper, like, what's your typ?
- [14:32]
Armando Bernal
Right. So I try to keep it as open as I possibly can. Right. Because we aren't going to see realistic change in the field as a whole unless we can have open conversations. And that's why you see, thankfully, a lot of the old guard saying, yeah, you know, we didn't know any better in this way. But they're not saying, but I'm still going to do things the old way anyway. We're seeing a lot of individuals say, now, hey, I did things XYZ way, and that's my bad. Let me go ahead and fix this and learn from these mistakes or learn from these concerns and do better. Right. And that's why we see things such as the do better movement in social media as well as in practitioners as a whole. And so I don't want to ever veer away from a conversation because I think that is when it gets scary, if you will, because we're not willing to have these open conversations needed to have realistic change. And something I try to typically say to, to maybe put people at ease in the conversation is say that the only way that a science remains a science is that if it continually changes with the times of the day, instead of saying, well, we did this back in the 80s, so this is how it's always going to be. That's not a science anymore. That's just plain practice at that point. Right. And so when people get defensive, I try to say, like, hey, I'm not judging, I'm not saying anything at all. It's okay that this occurred so long as you are understanding that we can do better now in the future. And I think that's what we're starting to see in the ABA field. And funny enough, so when I started having these more and more conversations, I read a book That I found in just like a free used library section called, called the Forbidden Experiment. And this is a tangent, it's a wonderful book. But it's about in the 1800s, there was, in the French rural area, they found a wild boy, if you will, quote unquote, wild boy. And they said, the French government said, hey, what if we were able to change this wild boy into a civilized individual? And they would use something called shock therapy treatment. And in my mind, just from past controversy experiences such as, like electroshock therapy was what was used. And I was like, okay, you know, it's going to be the same old, same old. No, shock therapy for them was if he did something that was inappropriate, they would hold him out of a fifth story window and shock him to never do it again. And those kind of things, Right. Are very easy for us to speak on and say, that was terrible. That's a travesty.
- [16:48]
Robert Perry Crews
And it is.
- [16:48]
Armando Bernal
Right. Don't get me wrong. But it's easy to say that now in present day, whereas back in the 1800s, these are people again, just simply trying to say, I want to do better. I'm trying to help this boy in their own minds, if you will. Right, right. And it's the same thing. As I've grown in this kind of field, I've been able to speak to amazing individuals. And one person in particular was Dr. Andy Bondi, who is part of the pec system, and we'll go into that later, but he mentions back in the 80s, the 90s, 70s, right. It was more about, yeah, we didn't know any better, but what was the alternative here? The alternative was to put them into some kind of specialty home or specialty kind of institution and forget about them. Right. And so they were just simply trying to do their best. So it's, it's important, I think, for practitioners to understand that it's easy to look back in the past and say, how could this have ever happened? But at the same time, I'm sure in no doubt the same way that my practice is 20, 30, 40 years from now, people will look at what I say, did or say and say, oh, my gosh, I can't believe that ever happened as well. And again, that goes back to science being a science. You learn from it and you grow from it.
- [17:53]
Jackie McDonald
No, what they'll say for you is, oh my gosh, she was a revolutionary, perfect.
- [17:59]
Armando Bernal
One can hope, right? Yeah. What could hope?
- [18:02]
Robert Perry Crews
Sometimes you feel like you just like, I just want history to be like, oh, yeah, I don't think that guy did anything that terrible. I don't know.
- [18:08]
Armando Bernal
Right. Maybe if I can just montage right over to the future, that'd be great as well.
- [18:14]
Diana Perry Cruz
But the same is true of the language that we use. Right. So, you know, the things that we said in the past, we don't say those things anymore. And that could very well could be true of things that we are saying right in this moment. Right. Like the terms that we consider to be the best terms, we may change our minds in the future. And part of, you know, part, like you're saying, it's science because it's being shaped via consequences and via the cultural, you know, synthesis and process that we are all a part of as part of this community. So if we're not responding to that, then it's not operating like a. Like a living, breathing process, right?
- [18:52]
Armando Bernal
Yeah, yeah, exactly. Yeah, yeah. And it's something. So at Autism International Consulting, we try to focus on our science regarding social appropriateness. So to your point, it is very fluid. What was okay and acceptable in the 80s and 90s, early 2000s, is not what's acceptable today. And so when we work on different kinds of targets, criteria, whatever it may be, we focus on, hey, what is social appropriate? What is. Excuse me, what is considered socially appropriate right now in this moment? That is what we're going to work on. Right. And so in the 90s, early 2000s, for me, it was more about being, how do we fit in? How do we get to be just like everybody else? I personally, and I try to be very transparent in this, that I was really ashamed of my autism because I didn't want to be different. Because if you were different, you were bullied, you were going to be made fun of. And now in this day and age, we can look at the newer generation and they'll say, oh, I have adhd, I have autism, I have depression, anxiety, and it's so much more open than it ever was before. And with that comes a lot of gratitude, at least for me, because I'm seeing significant change. We're seeing a lot more people being able to get the services or the help that they're needing that I would have wished for myself in the 90s or the early 2000s as well. Yeah.
- [20:10]
Robert Perry Crews
So when we kind of look at this, you know, this change in sort of our. Our behavior as practitioners are being more or less supportive of our clients. You know, one issue that we often will look at is sort of like, well, my ethics said this, or the best practice was that when we kind of look at where the Ethics code is now. And so you're thinking sort of about the, you know, the calls to action, sort of the ways that we can push forward are, you know, the length, language we use, our ascent based practices. Where do you see the ethics code in terms of meeting the time? Is it still just like it was flexible enough that we're good to go? Are there some areas where you're finding like, you know, this isn't specific enough. So the average practitioner without the right guidance might still make some obvious mistakes in terms of how they're being or not being, I should say, supportive of their clients.
- [20:55]
Armando Bernal
I do. So it's really a struggle for me because the ethics board and the rules that we are following as practitioners has been incredibly helpful to understand how to better support the individual clients we're doing or how to partner with the parents. But it's difficult for me to remember that it wasn't until the early 2000s that they added the wording of ascent into their ethics, that they added that kind of understanding of what it is. So I do believe there is still necessity and adaptability that needs to be done within the ethics and to grow in it. Because, yeah, it's really easy for us to say, oh, well, this is obvious, this is something that everybody should already be doing. But we can just like we can't overgeneralize what has happened in ABA in the past. We can't overgeneralize that. Every practitioner is going to look at the ethics and say, let me go one step further and try and help out through ascent, self advocacy, transparency. We need to make sure that it is black and white, clear as day. This is the expectation because that is how we can get all practitioners to, to change into this kind of modern way thinking rather than focusing on, well, this worked for me 20, 30 years ago. I'm going to keep doing it this way as well.
- [22:09]
Robert Perry Crews
Yeah, it is nice. Tough to talk about ethics in a way where there's just. I want a little more specificity. But if it gets too specific, it's actually not helpful anymore. Because what if something happens that I isn't exactly the same as in this situation? And it took me many, many years to be. I think I'm finally comfortable with the ethics code. Jack, you'll be happy to hear I'm finally comfortable with it now. I'm sure they'll come up with another one, you know.
- [22:32]
Diana Perry Cruz
Right.
- [22:33]
Armando Bernal
Soon enough.
- [22:34]
Robert Perry Crews
And then I'll feel really behind again. Yeah, the guidelines.
- [22:36]
Diana Perry Cruz
Yeah, I really liked though, in the, in the Allen et al paper. The tables in there that broke down. And maybe I'm jumping ahead, Rob, because I don't. Not in charge of question, but I broke down choice and then ascent and talking about, like, let's, you know, let's not just say, like, oh, we should make sure we provide choices. Oh, we should make sure we're, you know, gain, gathering, ascent. Of course, everyone's like, yes, yes, yes, we need to do those things. But if you don't know, like, what that actually means or what it might look like or how what you're going to do if everything isn't going, like, perfectly, to plan these tables break down in further detail. Well, what does it mean when we say give choices? What would that might actually look like in this variety of contexts? And how can we assure that we're doing that from client perspective first and foremost, and then the same for a set? So that, to me, I mean, it's a fantastic paper all over, but those components really, I think, can help give people who are reading it who need some additional, like, steps, and we all kind of need those additional steps some more, you know, solid examples of what that might actually look like. So in terms of. We're talking right now about, like, you know, cultural, like, progression of our field, right? And every little bit where we're pushing people to think differently than they were before or providing them with the opportunities to start to incorporate that into their own practice. Like, that's how the field progresses. So to me, those sections of that paper were really illustrative and people should check them out.
- [24:05]
Armando Bernal
Yeah, no, I know. I really appreciate that. And it's. And I'll take something. It's from the call to action, but I'll push on it a little bit more from call to action. Number two, where again, talking with Dr. Bondi, one thing that he likes to say a lot is that really the goal is just to make. To help our patients become as happy or as miserable as the rest of us. And so we need to make sure that we treat them as such, right? We want to make sure that they can just be as independent as possible, to be able to make friends, to be able to live their life how they want to live it. And that is really the significance here, right? When it comes to the neurodiversity, acceptance, and a movement toward that kind of growth is to just remember that these are humans just like anybody else, and they have dreams and goals and expectations for themselves. And if we can partner with them and get them to be involved in what is being done, then we're going to see more realistic change. And I think if we just say, hey, you're going to do this, because in the VV map or other kinds of assessment, you're expected to do this, so we better do it. That's not what this field should be about. We're not trying to teach the test, if you will, or teach on paper. It needs to be more about how. How can I give you the skills, the goals, the targets, whatever it is that focuses on things that you love, that you enjoy, that are going to give you a kind of realistic and, and appreciative life that you can have to. To just. And at the end of the day, be happy. So. And that's. That's the main goal here.
- [25:32]
Diana Perry Cruz
Yeah. And also live life fully as well. Right. So in a recent episode we were talking about like the dignity of risk and like having the opportunities to experience something that might be a little bit dangerous. Right. Or to have your heart broken or whatever it could be, because that's part of life and.
- [25:51]
Armando Bernal
Right.
- [25:52]
Diana Perry Cruz
Limiting the opportunities for that for someone with a disability is. Is ableist as well, and not permitting them to live life as fully. So.
- [25:59]
Armando Bernal
Right. Right. There's.
- [26:00]
Diana Perry Cruz
Don't know how things are going to turn out always.
- [26:03]
Robert Perry Crews
No. And there's this.
- [26:03]
Armando Bernal
There's this older stereotype and basically I don't hear it nearly as much as I used to, which is great. But this ABA creates robots kind of individual. Right. And it's never or should never be anything like that. It shouldn't be about. I need you to say, what do you want? My turn. Like this thing. And this is all they do. Right. It needs to maybe start there as a basis to give them some level of communication. But at the end of the day, getting them if they eventually learn how to tell me, no, I don't want to do this. No, I don't want to eat this. Awesome. Thanks for telling me. Because now we're having dialogue, we're having conversation that can be really develop a person's personality and individualism again. That's. That's really the goal, I think, or hopefully should be the goal of applied behavior analysis.
- [26:45]
Diana Perry Cruz
Yeah.
- [26:46]
Robert Perry Crews
Now, Armando, the paper has three calls to action, certainly around the areas of dignity, identity and social validity. Now I feel like when we just talk about those big headers, I really appreciated how in the paper it's not just like, here's some big thought pieces. It. It breaks down into kind of a more subclass of like. And actually here are actions that one can take. Here are areas we need to learn more about. But I am curious how, because you could have probably made like if you really wanted to, you probably could have been like seven calls to action. How did you know? How did you all get together and say, let's condense it to three? Was it a thought more of. Let's just think of these kind of big concentric circles with more that will add into each one. Did you originally have 50 and you had to cut out a bunch of them for space? What was that process like?
- [27:34]
Armando Bernal
And it's funny enough, there are different kinds of areas that Dr. L and Dr. Syed more specifically, I've known them for years now that we've had conversations on, let's do an article, let's do a book, let's do this and that and that. And so I want to say that this is just one of many things that we want to create that finally was able to get published and come into fruition. Right. But with it, I feel like this needs to be, or at least considered for other practitioners listening here as a starting point. This is not meant to be something where this is the be all, end all and this is all we need to talk about and we're done with neurodiversity movement, things like that. Right? It's definitely a start because and I say this in other presentations I've done where if you look at, whether it be like Google Scholar publications or whatever it is, and you try to search for neurodiverse kind of interventions or neurodiver dirt, excuse me, Neurodiverse accepting ascent based practices. Right. There's maybe like three that pop up in the field and one of them that pops up is this article. And so that's a big problem. Right. And so we want to focus on how do we get this to be a starting point to hopefully encourage your listeners, encourage other researchers, practitioners to say, I want to do more in this area of approach. I want to be able to make, if you will, a track that can be done at a ABA conference or at other kinds of conferences that is all about neurodiversity or neurodiverse movements and things like that. So it's definitely a work of love for sure. I definitely can't take any credit at all. This is the brilliant minds of Dr. Syed Alan and everyone else on this wonderful paper. It's. It's just, you can take some joy. Yeah, it's just a real joy to see this actually being talked about finally. Because if it wasn't for everyone on this paper seeing this as a passion piece. I. I don't think that we would be able to get to this point.
- [29:46]
Jackie McDonald
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Diana Perry Cruz
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- [31:03]
Robert Perry Crews
Hey everyone, Sorry to pause our conversation with Armando, but I wanted to remind our listeners that Aba InsideTrack is ACE and Kwaba approved. By listening, you're able to earn one learning credit. All you need to do is finish listening the show and go to our website abainsidetrack.com or click the link in your podcast player. When there, you're going to be able to take a little quiz about what you learned in this episode, as well as enter in some key code word information. These are special guest code words. The first one is Self Advocacy. S E L F A D V O C A C Y Self Advocacy. It's the process in which one would advocate for themselves to speak up for things that they need or would like to be different. Much like much of what we're talking about today. Self Advocacy all right, let's get back to the show. Now when, you know, all of you were sort of, you know, getting the manuscript together, discussing what was going to go into the manuscript, I know one thing that came up a few times. I don't know if it was always, you know, it certainly was never the explicit goal of any one section, but discussing the idea of identity, looking at areas of ascent so kind of related to dignity, related to choice, really discussing the need for having those practices across both the members of the autistic community who are, you know, you know, very fluent in vocal verbal communication. They're able to use social media, get out, kind of, you know, tell people directly. These are the things that are important to me and the population of autistic individuals who don't have those communication skills and the need to teach those communication skills. Was there ever a concern that by like hyper focusing on one area, you know, either of again, not that there's two groups of individuals that, you know, we're talking about a huge range of individual strengths, areas of need, but was there ever a concern that you were, the group was kind of moving more towards one than the other, like looking more at individuals who are posting on social media versus individuals who are receiving, you know, full time care.
- [33:01]
Armando Bernal
Right, right. I think it, it starts really easily to see that what a lot of this can be is trying to have the alternate discussion because we have one side of the individuals that are on social media that have that capability to say their side, but there's, there was no one speaking on that other side. There's always going to be two sides of that conversation. So just having someone out there to say like hey, here is another outlook or other perspective that we want you to take into consideration in addition to what is already out there. Right. And having it again as that starting point because there wasn't really anything going on at that point. There was just people saying hey, this is bad or ABA is bad or whatever it may be, and us saying, well that's not quite true. Right there. There may be some practitioners that misunderstand the use of ABA or misunderstand how to apply certain interventions and, and practices, but by no means should this be overgeneralized. And let's go ahead and look into how can we support a growth in the field while also considering both sides, whether it be those that are able to be on social media, but also those that just can't be as well. And I feel like it's also similar to how children are initially raised as well, that they don't have the ability to speak for themselves yet. And so as a parent or as a guardian, we're having to say that, hey, I'm going to be on your side, I'm going to defend you in such and such way until you're able to defend yourself. And so we're going to focus on perspective here and then once we're able to understand, you know, you can do things this way or that way, then that's up to you. Again, to your point about, you know, this is life and this is how you want to run it, that's great. We Just want to make sure that everyone is able to have a seat at the table and. And have this kind of open conversation as well.
- [34:52]
Robert Perry Crews
Now, one thing in the article, I kind of wanted to just kind of get your opinion on it because certainly talking about ascent, talking about pecs, we're talking a lot about choice. We're talking about understanding, you know, context. We're talking about making sure individuals can advocate for themselves. And that kind of brings up a couple points. We can kind of go through them maybe one at a time when we talk about this, but certainly the idea of autonomy, I think we all, yes, let's push for more autonomy, but that's not necessarily the same as independence. And I know for me, I've learned to discriminate. What's independence? What's autonomy? And sometimes you can get it all. Sometimes you're going to have to sort of pick and choose for this individual based on their needs, you know, their strengths. One might take more precedence than the other, at least to start. But I find a lot of individuals that if something can't be done, quote, independently. So if there's a sense, well, a person has to be there, or there has to be a visual or a technology that the individual uses that some folks sort of throw their hands up and they're like, well, they'll never be independent at it, so what's the point? And they're just like, I'll just hover near them and speak for them for the rest of their lives. I guess that that somehow is better than if they had an AC, you know, electronic AC device or used PECs, or had to use a visual checklist or something like that. How do you typically describe the difference between autonomy, independence, and how the two are not exactly the same, but can sometimes be married together? Like, how do you talk about that with people?
- [36:14]
Armando Bernal
Yeah, no, it's great, great question. I think it also, it goes back to what we were just talking about with the last question as well. When it comes to belief, I would say, in the sense of if, if we sit there and we say, this child, this teenager adult is never going to be able to be independent for themselves, then that's it for them, right? Then that individual child, a teenager adult, is going to say, well, then I guess I'm never going to be independent. You know, mother knows best, guardian practitioner best at that point. And that is the difference. Again, when we go back to the beginning of the conversation with my mother, right? If my mother said, hey, that doctor's right, I'm going to have to Learn sign language and he's never going to be able to speak. I'm just a baby, I'm just a child at this point not knowing any better. I'm like, yeah, I guess I don't know how to speak in this situation. Right. But it's about belief. And that's where I think that practitioners, guardians, parents, whoever it may be, can really change the overall future of an individual. So if we have to give an individual an AAC device to provide their wants and needs, that's fine, right? But we don't go into it and give them the AAC device and say, hey, that's it for you. You know, I hope you can say my turn. I hope you can say more. That's all we're going to learn. No, let's keep it moving. Let's keep going to the next scene, the next thing. Let's go from my turn to want my turn, I want my turn to, I don't want that. Mom, what are you doing? What are you talking about in this kind of situation and having these kind of conversations. I have a. Currently one of my patients is a old and he is the star of his soccer team, but he uses an AAC device and you can have full on conversations with him with either his vocalizations or his AAC device. I've been on panels with adults that use AAC devices that I'm just blown away by what they are saying to me and I'm just shocked, right? Because again, these individuals have someone in their life that is saying, I don't care what a doctor may say or disability. They may say you have, it's not a disability to me and it certainly shouldn't be a disability to you. And the same with my own diagnosis, right. I try to have all the patients I work with understand that it's not the disability or, excuse me, the diagnosis that makes you who you are, it's what you do after that diagnosis. And so if we can get more practitioners to believe in that and say like, hey, yeah, they may not have sign language or vocalizations, utterances, AAC device with them, but you know, I'm going to find out what their baseline is and I'm going to take that and run with it and I'm going to try and get them to be as independent to a point where they don't need me, then that's wonderful. Right? And there's this movement that we can discuss further, but it's the profound autism movement. Right? And that's where I get a lot of conversations in is like, well, what do you say about my child that has XYZ concerns? I don't know if they're actually going to be able to take care of themselves. And I get it, right, because they may be older, they may have a lot of issues, concerns, whatever you want to call it. But I think, again, it's focusing on what is the baseline criteria here. What is it that they can do independently? And that's fine now that we have found that, what is the next highest thing that we can do independently for them or teach them to be independent? And it's a lot slower upward movement in that process. But it can happen because if we look at what ABA really is, it's just simply the learned behavior approaches of things. And if we can hopefully provide some kind of prompting or supports, if you will, we can see independence in a variety of different kinds of knowledge or prerequisite skills, if you will.
- [39:45]
Diana Perry Cruz
Excellent. Yeah, I always give my students the example, like, what if you needed to fix your dishwasher or something like that.
- [39:53]
Armando Bernal
Yeah.
- [39:53]
Diana Perry Cruz
Can you do it by yourself? Well, you might be able to, but you can't do it unless you look it up, right? So maybe the first thing you would do is you would go on YouTube and you would, I don't know, maybe, you know, don't. Don't fix your dishwasher at home, folks, if you're not qualified.
- [40:09]
Armando Bernal
But.
- [40:11]
Diana Perry Cruz
But maybe you would look at a video and maybe it's a simple fix, right? And so you'd watch a video and then you could attempt to do it yourself. So would we call that, you know, needing additional supports? Well, hardly anybody in this world knows how to take a dishwasher apart without looking at something, right? So it may be the case that you can find those supports in your environment and then do it. Then you have a choice as well if you want to actually do it yourself or call someone to come help you. But the skill there is make like, kind of like that decision tree, right? Like, can I do it myself? Where do I look to find that information? Do I decide if I can't do it? And then who do I. How do I get help? Right? So, like, to me, like, that is a much broader definition of independence than just saying, oh, you have to be able to, you know, do X, Y or Z skill with no additional visual supports. Well, we all use visual supports, right? I can't go anywhere without Waze, and I can't remember my schedule without looking at my phone. And those are visual supports too. So let's think A little like more like more big picture here when we're talking about what are our accommodations, what are supports and why we shouldn't vilify those?
- [41:25]
Armando Bernal
Right? I think sometimes, unfortunately, and again, I speak as this, as an autistic individual myself, that sometimes the neurodiverse individuals have it a lot harder than maybe the neurotypical individuals that they're held to maybe a higher standard that just should not be because they're being looked at from that kind of microscopic lens of what skills, what tiny skills do you not know that I need to work on? And the neurotypical individuals are because they don't have that same kind of support system, if you will. And that shouldn't be happening. We should just focus simply on, do you have the skills that you need to be independent? If you don't, what are those? And then how can I develop those so you can be independent? End of story, I'll see you later kind of situation. And why, for at least the patients at Autism International Consulting, we don't try to keep them forever. We want them to be with us six months, a year, two years, whatever it may be, get them the skills they need and say, you know, mom, dad, guardian, best of luck to you. You have everything. We believe in you. We're here if you need to come back. But we want you to feel like you can take care of this yourself. Whereas other maybe individual companies or whatever may say, oh, I'll keep you 10, 20, 30 years. That should never be the case. We should be a kind of come and go service where they can get what they need and head on back into life. But know that we're here for them when they need us.
- [42:53]
Robert Perry Crews
So we've kind of talked about, you know, advocacy, we've talked about dignity. Let's talk a little more specifically about ascent. I think that'll kind of lead us into talking a little bit more about how pecs can be a part of that. Again, I'm guessing at this point because I feel like ascent has been the word of the day in BCBA practice for the past three years. You're doing the screaming word of the day, Jake. Sorry, I didn't conky the robot tells you to do that.
- [43:18]
Diana Perry Cruz
When did you get here?
- [43:21]
Robert Perry Crews
But where, if anyone, is sort of like a center. I missed all those talks or I haven't read any of those papers. Armando, do you mind kind of giving a quick discussion as to the importance of ascent, both in kind of research in treatment practices as behavior analysts? Like, why is this something you should be paying attention to as a reader, as a consumer of the scientific literature, as a consumer of best practices.
- [43:45]
Armando Bernal
No, yeah, no, absolutely. And that's something I think that we go into, into heavy detail regarding the. The article that we've been discussing throughout this presentation. But more specifically for those that want kind of that Cliff Notes error. Right. Is going to be that ascent is simply, in my own anecdotal way, is getting the individual to be involved in what is happening within their programming, their treatment plan, whatever it may be, as far as you possibly can be. Right. Whereas in the historical references, it was more of you're going to do as I say because I said so, and that's end of story. Some kind of piece of paper, some kind of higher power told me that you need to learn this. So this is all we're going to work in. Right. And that's where we get into these kind of traumatic areas like eye contact or I'm going to block your stimming or things like that through the stereotypes. And we've. We've moved past that. Thankful. At least my practice has and other practices I know have as well. Where we get into. Let me talk to you about what is important or what you're going to need to have in order to be independent and we can move forward in that kind of lens right now. I think at the same time to kind of veer off from the ascent aspect a little bit, that we have individuals that are taking ascent and kind of running with it and forgetting all other kinds of criteria that's needed to see a successful individual. And that's a concern as well. I think there needs to be somewhere that we meet in the middle to get through this. An example of what I'm saying is kind of taking it and running with it is we're working with an individual and it's lunchtime and you say, hey kiddo, your. Your mom, your dad, guardian brought you a sandwich. I need you to eat this. And they say, I don't want this sandwich. And they throw it and they say, well, I want to eat candy for lunch. And you're like, hey, thanks for telling me. I'm going to give you your candy for lunch now. That's all that matters. That you, you told me that that's a scent and that's. That's just not going to be acceptable. Right. And I try to get a lot of either my practitioners to understand this or the parents that do this deep dive into a scent and to understand. Let's, let's play that out right If I was at my job and I said, hey, you know boss, what you got for me today? And they say, you need to do this report and it's due today, tomorrow. And I say I'm not doing that. And then I just throw that paper away. I'm not going to have a job. I'm going to be at the job at that point, right? And so we need to remember again, when we go back to that, the social validity aspect of the paper is what is going to keep this individual successful in their life. It's certainly not going to be the ascent that says, I'm not going to eat properly and I'm going to do what I want, right? It's going to be the ascent that says, hey child, do you want to play shoots and ladders or Candyland today? I know that I need to do, I need to work on Candy Land with you. And the child says, I don't want to do Candyland, I want to do shoots and ladders. And then I say, why not let's do shoots and ladders then? Because at the end of the day, the target is just something that the BCBA put in because they needed to put something in, right? But if you're still working on that kind of prerequisite skill in a different way, what does it matter, right? If we go left instead of right, if we go and see the monkeys instead of the zebras at the zoo, it doesn't matter because we're getting to the ascent, which is more so about back and forth conversation back and forth, kind of buy in from both parties than anything else in that way. And I hope that helps, helps the listeners here understand a better insight into what the ascent should be at least.
- [47:11]
Robert Perry Crews
Yeah, I, I liked your description of that a lot, Armando. And it really kind of, it's something I always am thinking about when it comes to ascent. And a lot of, in a lot of environments like I work in schools and a lot of kids engage in different types of non contextually appropriate behavior due to the work they're being asked to do. And it being a big and a lot of times I'd sort of get into, I don't get into fight about this with teachers or principals, but the sense of like everything they're learning is stupid. This curriculum is dumb. You are not providing the correct level of services for this child based on where their current skill levels are. So they're not assenting to any of these things. I would say there's not a cent. They hate being here every they're Bored, they're frustrated. And well, it comes down to one of those, like, well, it is one of those things you just have to do. And maybe just dodging that, that argument from now on and just kind of getting more into, you know, moving away from the idea of like, well, all the other kids are just sucking it up and dealing with it and looking at it more like, let's talk about the why any of this is important. Like, if you had to tell me why and you have to do it without using the phrase because it's the law or because I was told I have to, how many of the tasks you're about to ask your kids to do, your students to do, would you actually be able to do that for? And the ones you can. Great, everyone should have to do that. That is, you know, it is important that children learn to read if they're able. I mean, so ideally they are presented with opportunities to at least look at books, to look at signs, look at visuals, because that's an important skill. But you know, trigonometry, who cares? Or like, the way you're teaching may be less important than the what you're teaching. So don't worry about it looking exactly like this. I'm curious if that would help or if that would just make them more mad at me of like, I don't have to answer your questions, I don't assent to this conversation anymore. And then I'll backwards it.
- [48:56]
Armando Bernal
It goes into. I think that there are certainly strategies that can be done that can help these individuals participate. Right? Because that really is. At the end of the day, what we're looking for here is just the participation and then also an understanding of what this kind of expectation is going to be. So with, for me, at least in my practice at Autism International Consulting, it's going to be choice making. Right. We can do, do you want to go to the left or the right? Do you want to go to the space station or the galaxy room? In this way, our theme is space. That's why I say these. Anyway, with it, it also comes into like the same thing with teachers. As a special ed teacher, it can be, hey, do you want to write about option A or option B? Do you want to write with pencil or pen? It doesn't matter to me what you write about or what, how you write it. Right. Because I'm going to be able to gauge. Do you understand the concept by doing certain kinds of activities with you and to your teachers? I would, I would say something similar. Right. It's about getting creative at that point where we can either die on this hill and say, listen, kid, you're going to do it this way and this way only. And we're going to have a big tantrum. I'm going to have to call your mom, you're going to get suspended or whatever it is to, hey, look, we are learning this. This is a part of, for in Texas, it's called like teks. So this is a part of the teks, the criteria that you're having to learn in your school. But you know, do you want to do a advertisement? Do you want to write a paper about it? Do you want to do a billboard about it? These kind of presentation power. A song, if you will. Like, I've seen that. And that gauges so much more interest by the child because they feel like they are in charge of it than just saying it's this way or no way. And it's, it's hopefully getting more practitioners, more teachers engaged in that way to see success in their classrooms and, and clinics.
- [50:49]
Diana Perry Cruz
Yeah, yeah. So it's like, it's the difference between the topography of the skill and the function of the skill and how it's going to serve that student long term. And most of those things, like you said, Rob, like the difference between reading and trigonometry, unless you're gonna, what do you use trigonometry for? Building bridges?
- [51:06]
Robert Perry Crews
I don't think you really use it for anything.
- [51:07]
Diana Perry Cruz
Slicing cheese maybe.
- [51:09]
Robert Perry Crews
I don't know. It's a myth.
- [51:09]
Diana Perry Cruz
Unless it's, unless you actually have a use for trigonometry, it's probably gonna come down to a cusp skill. Right. Is this a skill that's gonna produce access to additional reinforcers in additional settings? And if so, then we have justification for, you know, continuing down the path of teaching that skill. And if not, then it's likely superfluous and we can get at whatever the end result of that skill was going to be in a multitude of ways. And so I love your point about, like let you, you choose, right? Like you choose how we work on this skill. But we all kind of have to, you know, help students, I think, identify like what are actually going to be the useful skills. And that's going to be determined through identification of cusp skills. Right. Prerequisite skills and then what that student's interests are. And there's a little, sometimes it's like a little bit of, you know, fortune telling that you're attempting to do and saying like, I think that this is an area that's going to benefit you and you seem interested in it or you seem interested in like some components of it. So let's sort of work toward it. And that's always a challenge is if my student has limited communication, how am I determining what their preference is? Right. And how am I going to then incorporate that to moving them more toward areas that I anticipate we're going to continue to see interest in. And it's like the chicken and the egg, right? I want them to tell me what they want, but I got to also be able to teach them how to tell me what they want. And that's, you know, Bannerman all over again.
- [52:41]
Armando Bernal
I, so I did a program called the Core Cadets at a university here in Texas, Texas A and M University. And they started, start with the freshmen being called like followers. It's a followership in the sense of starting to understand expectations and what are the typical procedures or policies that need to be done. And then once the followership year is over, the freshman, they go into the software, it then turns into more of a guidance or a leadership if you will, of okay, now you're leading the next step and then you keep growing in that way. And I, I, I treat it very similar in that way. Whereas we, we provide the followership from the individuals that may not have communication or may not have these kind of social skills initially. Right. But as soon as they get to a point where they're able to provide their wants and needs effectively, then I'm hands off and I can say, hey, now we're having open self advocacy movement and conversation with you that moves forward in that. So, and I can see it more so in my company because we have my littles that may, you know, have their communication as tantrum or their communication is aggression or whatever to my 13 year old that I'm talking to about what do you want to be when you grow up? Okay, well we need to do X, Y, Z here. He didn't start that way, right. He started off with I'm, I'm going to tantrum, I'm going to vocal protest, I'm going to do these things. So he had a follow and understand look, these are the rules of conversations or these are the things you have to do to like get people to essentially like you, if you will, to have these kind of conversations with. And now we get into where I can say, hey man, we got to do this. And he's like, no, I don't want to do this, I want to do this first. And like, I don't care which way because he's his own person at this point. Yeah. And if we can get the patience to. To be that way, you know, the client or whoever it may be to a point where I can say, hey, you've learned what you've needed to. To provide your wants and needs to me, then I don't need to tell you what the expectation is. You can tell me then that's perfect. And I think sometimes it's hard for practitioners to let that go of saying like, I've been holding your hand this entire time and I need to continue to guide you. Otherwise you're gonna, you know, exaggeratedly like hurt yourself. If you will quote unquote to a point of saying, like, hey, you've learned what you've needed to. To kind of walk. And now I'm gonna be next to you in case you fall, but you're still going to fall occasionally or you're gonna walk alongside me down this path. And I hope again that helps your. Your listeners understand this kind of understand.
- [55:05]
Robert Perry Crews
And when it comes to getting from that, you know, preschool age up to the 13 year old who's able to add on it, let's do this versus that. I guess we could, you know, we could see if this is maybe where the pecs conver. The pecs component comes into the. Into the conversation. And so Doherty at all. I know we're more talking about Doherty at all from the. What we can learn from it and then use in the process. Because as a paper, excellent paper, cool study. It is. It is. Very much though I don't want to belittle this paper, which I like already said, like, I took the core idea. I'm going to be sharing it with people in like a week because I love it. But at the end of the day, it's two studies in which two least favorite.
- [55:43]
Diana Perry Cruz
When I hate when one paper has.
- [55:45]
Robert Perry Crews
I'm gonna let it slide. I'm gonna let it slide. Doherty and friends, you know what?
- [55:50]
Diana Perry Cruz
You gotta pass because it was, you know, we're like, first we're gonna teach the.
- [55:53]
Armando Bernal
They never make perfect.
- [55:55]
Robert Perry Crews
There's no excuse.
- [55:56]
Diana Perry Cruz
Whichever way.
- [55:57]
Robert Perry Crews
I'm gonna be flexible and say the content was good enough that I'm gonna let it go. All right. I'm gonna like Elsa gonna let it go. And it really was having, you know, autistic preschoolers use pecs both as listener and speaker in a man and respond to man procedure.
- [56:14]
Diana Perry Cruz
Okay, you said it.
- [56:15]
Robert Perry Crews
Which definitely is one of those studies. You're like, wait, we haven't done that study before. That feel. Why? Yeah, that. Of course that makes sense with people. With the peers.
- [56:21]
Armando Bernal
No, no, no.
- [56:22]
Robert Perry Crews
The peers is the. But even with the peers. I mean, come on. I've been in special ed for a long time. I know we need to teach children to ask children to do things and then have those children resp. They've been asked to. But it's on the VB map. It's like a key component, but we're like, just assume it happens. What are we doing? I don't know.
- [56:40]
Diana Perry Cruz
Train and hope, bro.
- [56:41]
Robert Perry Crews
This is number one. They didn't even train it. They just hope.
- [56:46]
Diana Perry Cruz
Just hoped.
- [56:47]
Robert Perry Crews
But anyway, Jody and colleagues, they did it. There it is.
- [56:50]
Diana Perry Cruz
Very nicely done.
- [56:51]
Robert Perry Crews
Great study. Definitely read it. Like I said, I'm going to be telling people we are replicating this one if we're not already, you know, in a tiered system of how are we teaching children to communicate with each other? Because we usually just do step one, communicate to anyone, and it's an adult. That's good enough. Right. But coming back to looking at pecs in Ascent, why is that something that probably hasn't gotten as much focus as it should in. In your opinion, Armando?
- [57:14]
Armando Bernal
Yeah, no, I think it's super interesting. So, like I was telling you guys earlier, I've been able to really collaborate and connect with Dr. Bondi, as well as his family and. And his company, Pyramid. And that was something that we had an open conversation about where there is transparently. Right. This open controversy of how, you know, I'm never going to use pecs or all of these things. And Dr. Bondi was saying, like, look, this is likely because there are these kind of bad apples, these bad eggs, if you will, that are taking it and saying, I'm not going to follow the procedures that I learned in my. In the classes that were taken by pecs. I'm just going to do it this way, this kind of behavioral drift, if you will. But it's been around so long that the behavioral drift has gotten worse and worse and worse to a point that it's kind of spread in a way that it's just not kind of manageable where we have these individuals that are doing things inappropriately or not the correct way. And it's, you know, it's very disheartening and saddening to hear because Dr. Bonnie has created something incredible, if you will, from. From this pec system along with his wife. And to see it kind of twisted is unfortunately something I'm seeing similar with aba, where you. We have this ability to change all kinds of behaviors. And if we do it in an inappropriate way. Right. And it gets found out, if you will, then of course that's going to spread and people are going to say, I don't want to do aba, I don't want to have this kind of conversation, this kind of concern. But now there's this argument on is pecs a sin? And I think it goes back to what we were saying earlier. If we have a child that has, or teenager or adult that has no form of communication themselves. Right. What's the alternative here? Right. We can either have them become aggressive or tantrum or do all of these things that may unfortunately end up getting them in jail one day or giving them the actual chance of being able to provide their wants and needs in an effective manner that people can actually understand and eventually have conversations with. Right. So it's, it's again determining, like look, what are we going to decide here? And for me it's fairly obvious. Right. I'm going to go with the system that has paper upon paper of evidence based research that says like this can help individuals succeed to having a practice of well, we should let them have self injury because that is them expressing themselves. I think that is dangerous and harmful language that should not be followed upon.
- [59:33]
Robert Perry Crews
Right.
- [59:33]
Armando Bernal
Whether we see it in social media or not and focusing on what can actually be done in real time and good. And to, to go a little bit further in this before we have again more conversation into this. This is a system that's seen now throughout the world with pecs. It's in multiple countries, it's in multiple areas. And you know, my company is called Autism International Consulting because we provide support internationally and we have parents, companies, practitioners are saying there's nothing for them in their country. There is no other support system outside of them. And you know, for pecs to go in there and say, hey, I'm here to support and help, I think that's a wonderful gift, if you will, for these individuals that don't know where else to turn as well. So I hope that again helps your listeners.
- [60:16]
Robert Perry Crews
Yeah, yeah.
- [60:18]
Diana Perry Cruz
I mean the PEX is, is advantageous because it is a lower tech option and not everyone has access to an iPad or Proloquo2go, which, you know, something
- [60:30]
Robert Perry Crews
or a charged version of this.
- [60:32]
Diana Perry Cruz
Yeah, right.
- [60:33]
Robert Perry Crews
Technology.
- [60:33]
Diana Perry Cruz
And it's advantageous because the symbols are relatively universal. So one doesn't have to know, you know, the signs in order to be able to communicate. So to me it's great for both of those reasons. And then I, I know that, you know, part of the controversy I guess is that in order to teach PECs, very often if your student doesn't have an established imitative repertoire, then you may need to use some type of additional guidance. And because it's intended to be, you know, you start with manding, then you're sort of assuming what it is that they want, right. And you have to like help them to make that choice, but it doesn't need to stand in opposition to choice making. And I think that you're right. It's a simplistic view to think that. So people need to learn more, I guess, about, about what the process and what it is. And the, the piece that I really love about the PECS system is the correspondence check. So even if you, you know, help a student to request for something before, you just assume like, yep, I told you to hand me the LEGO picture and you hand me the LEGO picture and now I give you the legos, right. There's another step in there which is, oh, if you want it, go ahead and take it. Right. And so there's a built in check in there to see if the thing that they were requesting is actually something that they want that they demonstrate to you by, by taking the item. And that piece is, is really important because then you're not assuming about, about what they're asking for. And if they don't take the item then you say, okay, let's start over here. We know something went wrong in this exchange and I haven't actually, I'm not actually helping teach you to request something that is desired. I made an assumption that was incorrect. Right. And so that correspondence check piece to me is, is really important maybe doesn't get talked about a lot.
- [62:26]
Armando Bernal
Yeah, it's, I, I, I think too, in addition, it's a, it's a guidance system, right. It's teaching them another language, if you will as well. Because it's, there's two parts of this one with the physical kind of prompting that is required here. I don't see it any different than you learning how to play pool and not knowing how and somebody having to get behind you to teach you how to hold the pool stick properly or even in golf and holding the golf club properly in this way kind of thing. It's getting to understand what that expectation, what that procedure is. And once they do do, that's why there's multiple levels of PECS where we can start transitioning away from the physical guidance. And now we're getting into less prompting and less and less coming into Play here. And with it is, is that other part of it. It's this guidance system of, okay, this is how you ask for things. This is how I understand what you're asking. This is how you're making sure I understand that. And let's move forward from there. And to your point, this check is so important because now we can say, okay, that's my fault, I'm sorry, let's go ahead and try that again, if you will. And it is the give and take. If we were just saying, hey, you said Legos, so now you're going to get the Legos, and that's all you're going to get for the day. Like that's a problem. But we're not doing that right. We're a level system of growth here for both the teacher and the learner in this way. And in addition, with Pyramid, they are providing options and avenues to email their company personally or join their Facebook group. If you've done the classes and say, hey, I have questions on this. Because it's about trying to get it done the right way, rather than what we have seen in the past of people taking what they've learned and saying, oh, I think I can make it a little bit better. Well, that's not your call to make because you're not one. The creator of it. But you've only taken maybe level one class. That's not what this is about. If you have. If you think you can make it better, maybe see if they've already done it in level two or level three before you try and make it yourself. Yeah, that's funny.
- [64:27]
Robert Perry Crews
Usually people don't mind if you email and you say, I had an idea to make something better. What do you think? They're not going to be like, how dare you? Don't have any ideas. Read the manual as is. I'm sure they'll say, we did that, or that is a great idea. We're actually doing it. A lot of times you hear that? We're actually doing some experiments and some research on that right now. You know, love to, love to hear your. If you tried it. Here's our protocol. If you want to give it a go. Yeah. Usually there's collaboration.
- [64:52]
Armando Bernal
Yeah. Yeah.
- [64:53]
Robert Perry Crews
So, Armando, when we, when we talk about specifically kind of the Dougherty, the. The peers manding and responding to each other, I mean, do you see that as a part of a scent that we're often missing? Because usually I think of ascent. I'm thinking of ascent to engage in the learning that I, as the teacher, I'M about to teach. Are you interested in that? But I don't always think about the idea of, oh, well, at some point I need to make sure that the individuals who are, you know, I'm trying to teach a skill are able to, you know, use that skill in their community, which for school age children is going to mostly be with other children. I mean, do you see that as, hey, we need to remember ascent as part of the social process with young children who may struggle with communication at this, at their age or due to some of their challenges, you know, or is that something that, you know, maybe sometimes you add that, sometimes you don't. Like, what are your thoughts?
- [65:46]
Armando Bernal
Yeah, yeah, no, absolutely. And I think to your point earlier as well, where it's, it was assumed like, oh yeah, this is just gonna happen, like these kids are gonna be kids and they're gonna figure it out as they go. And that's, you know, not the case. I think that's the same kind of mentality that people may have thought of like, oh, well, like this neurodiverse paper with Dr. Allen, like, oh, everyone already knew that already. Like, and that's not the case, right? In the same situation. So when it comes to like the, the social validity of why like this, this matters is, I think a lot of the times us as adults as a whole, we think like, oh, if they can do it with us and they've got it, then they're going to be able to take care of it for themselves. But I mean it's, it's very similar to what we see in other scientists where if they can do things with an adult or they can do things with this XYZ person, then we assume that they're going to be able to do it out in the natural environment. That's just not the case. Right. So we need to make sure that it can be generalized to those peers. Because the goal should always be, I see them again six months, a year, two years and they never see me again because they can start making friends and they can start doing that. But if we don't know that, right, if they're doing so well with us and we don't test it out with the peers, then they're going to get into the world and fail. Essentially, if we don't give that practice at Autism International Consulting, we focus on a very open concept where all the kids can see each other, they all play together and we have times where the, the adults are hands off, we're in the room and we're just like looking at our data or what have you. But we're giving these kids the opportunity to practice what has been taught to them and see if they can really actually apply it to one another. Because if they can't do it in that kind of safe clinical setting, they definitely won't be able to do it in the school where we're trying to transition them to. And if they can, then now we know, okay, this needs to be a big point that we need to focus on in the future in order to get them into where they need to be, which is that school system.
- [67:35]
Robert Perry Crews
Yeah, I've always found the. Sometimes, you know, I work with individuals, whether teachers, whether it's parents and there's that push of. I demand that they be in a classroom with their same age peers all day because that's how they're going to learn to interact with them. And rather than say, listen, they're missing a bunch of prerequisites, skill, which, which probably doesn't sound too dissimilar to really, you know, to a parent or teacher as sort of what, you know, your doctor told your mother of, like, this is never going to happen. Sorry, you know, I'm just going to, I'm just going to sideset that and say, that's a great point. Let's make sure that we work on those skills and can we make sure we have the time to work on those skills? Maybe not necessarily in the busiest possible. Let's not do it in the cafeteria where I can't even hear anything. Let's do it somewhere else for a bit. How does that sound? Let's just make sure the skills there.
- [68:19]
Armando Bernal
Right.
- [68:19]
Robert Perry Crews
And then don't have to worry about the setting because we know the setting is going to be successful for that, for that client. So I do, I do. I'm very excited. We got this. Got to talk about this paper. Thank you.
- [68:30]
Armando Bernal
Yeah, yeah. No, no. And it goes into like timelines as well, because I think one issue that my mother had at the time was there was no end date here. It was basically like, you're going to have to take care of him the rest of his Life. You know, 70, 80 years, whatever it is, best of luck. And that's it. Right. Whereas for in the school systems or in the clinical settings, the parents say the same thing to us. They say, well, how long are they going to be here? You know, a couple weeks, six months, whatever it may be. And I can say, hey, let's reevaluate in XYZ time. During this time, I'm going to work on XYZ material and we can figure out if this works. That's where the parent trainings, these, these, the guide parent guidance trainings that we do supports this, right? The. The parent comes in and we say, hey, this is how they're doing with this target, this target. It's been some time. And we'll say, okay, so what do you think, Mom? Should we keep them a little bit longer? Should we try the school system? And if you can't allow the parent, the guardian being a part of that conversation, or eventually the child being a part of that conversation, we're doing something wrong. We need to make sure that there is open dialogue of a pathway out of the clinic or the pathway out of this kind of safe environment into the more naturalistic setting to make sure that they can be as successful as they can be.
- [69:47]
Robert Perry Crews
I think that's a good place for us to move into the next section of the show, the dissemination station. Appreciate Dec again, took a breath, really made sure to get it out there,
- [70:00]
Jackie McDonald
wanted to get it there. I got us here personally. I am the engine.
- [70:08]
Robert Perry Crews
So, Armando, when it comes to everything we've discussed today, it's a, it's a, it's a broad set of skills. So, you know, the question of, like, what's the one thing that somebody should do, you know, or for us to be like, everyone make sure, number one is make sure you have your, your clients working on PECs and talking, you know, using PEX's communication between two peers to. That may or may not be very useful information. You may not have any clients who are using pecs. You may not be trained in pecs.
- [70:35]
Armando Bernal
Right.
- [70:36]
Robert Perry Crews
So. And just saying, like, use Ascent practice is also not so helpful because someone might say, it sounds good. I don't know what that means. So where are the areas? Let's. We'll leave it a little more broad, but where are the areas that practitioners really should be doing their reflecting, doing their professional development, doing their program updates? When it comes to answering this statement, I want to be better at helping my clients advocate, and I want to make sure I have a scent in everything I do. Like, where might you suggest they sort of start generally?
- [71:10]
Armando Bernal
Right, right. So to that point, a question that I just. It gets wrapped in my brain every single day, and it's interesting, I guess for me, because I'm a business owner, is that I'll have my therapist practitioners ask themselves, you know, just about every day. At the end of the day, ask yourself, did I do a good job for my patient or did I do a good job for my company. And again, as a business owner, I want to say you should say you did a good job for your company. I'm kidding.
- [71:37]
Robert Perry Crews
You want to make sure that you
- [71:39]
Armando Bernal
say I did a good job for my patient because that is what matters. Right? You want to make sure that the patient received the guidance they needed, that we're looking at making sure we're not over treating them and saying they need 35, 40 hours when they only need, you know, XYZ amount of hours. We're making sure that we're not just kind of rote memorizing. I want my turn, I want all done things like that. Just because a piece of paper or some assessment says to do it right, we want to focus on how do we get these kids, these teenagers, these adults into a life that they can be proud of, into a life that they can say that I did it, I am successful. Right. So when we talk about like what to consider, that's a big question for me. And especially as a business owner, I want the therapist practitioners that I hire to, to ask themselves that and say I did a good job. And I can see that my patient has learned to self advocate that they can defend themselves in the world, that they can be their own person rather than having to accept some kind of way that society wants them to be. And it said remain the individual that we're, we're hoping anyone that we're working with or even that my mother wanted me to be right in this situation. That kind of guidance is what has really driven my sister and I's dream of Autism International consulting and, and to, and further it along to hopefully other parents, practitioners, therapists that have worked alongside us to see that kind of guidance. So I hope that's something for a lot of your individuals that are listening to focus on regarding ascent and self advocacy.
- [73:14]
Robert Perry Crews
Well, that sounds great. And then I guess finally, you know, I know as someone who's thinking deeply, putting these, putting these actions into practice every day, what's sort of the question that you're still, I don't want it to keep you up at night. That's, that sounds too, that's too extreme. But, but that you're, you know, as you're doing presentations, as you're writing, as you're talking, as you're, as you're training your staff, that you're sort of having the back of your mind of like, man, I really wish either I or somebody was figuring question X out because it would totally make this process that much better.
- [73:44]
Armando Bernal
Yeah. I think for me and it's, it's something I'm trying to like motivate Dr. Allen and you know, a spoiler for, for future.
- [73:51]
Robert Perry Crews
Right.
- [73:51]
Armando Bernal
We're trying to get more things going but like, I really want more researchers to say like, look, we've done the research, we, we've looked into it. We've got an insight from autistic individuals. We believe XYZ intervention is something that is Neurodiverse affirming that this is something that can be used to better support this kind of self advocacy, transparency movement that we're looking for. It bothers me that when I'm making presentations and I'm trying to justify my presentation by adding in articles that have, you know, these names attached to it and there's really not a whole lot, it kind of doesn't help support my argument and maybe sometimes the things that are obvious aren't obvious to everybody. And if we can get more articles like the Dougherty or ours out there in the world, then we can see real change to hopefully better these individuals that we're working with. And I like to say too, if anyone has any questions, would like to work together, collaborate, they can reach out to me. I try to be as open and transparent just like you guys did. They can reach out. We have Instagram @autismintl, we have my website@autismintl.com and feel free to say hi to, give me ideas or if you want to help push this movement along of getting more Neurodiverse articles out there or calls to action, please do so. I'm happy to help wherever I can.
- [75:13]
Diana Perry Cruz
That's awesome.
- [75:13]
Armando Bernal
Excellent.
- [75:14]
Robert Perry Crews
Well, Armando Bernal, thank you so much for coming on ABA and said track. It was a lot of fun talking about this, about this subject. Your paper was excellent. It was a great summary. I always sort of love of coming back into the thought process and the history of, you know, breaking down the Ableist movement. So it's always great to have, you know, someone doing those big think pieces and action pieces and then I'm thank you for bringing Doherty to my attention. I'm loving that, really appreciate it. So thank and thanks also for sharing your kind of contact information where people could reach out if they have more questions.
- [75:46]
Armando Bernal
Yeah, absolutely. Thanks for having me all and, and best of luck to everyone pushing this along. I appreciate all of you and big shout out to everyone that helped the Neurodiverse paper get published and all that. So thank you so much.
- [75:58]
Robert Perry Crews
One more time, a big thanks to Armando Bernal for coming on today. And talking with us about this very, very important topic for all practitioners to be not only aware of, but also to be continually thinking about ways to improve their skills, which will also improve the experience that our clients have when working with us to learn socially relevant skills for them. But before we wrap up the show, let's go to our last section. Pairings.
- [76:26]
Diana Perry Cruz
Ah, yes, time for pairings. Pairings is the part of the show where I tell you about past episodes that you might want to check out if you enjoyed this one. We have several episodes to mention here. I'm going to tell you that if you want to learn more about pecs, you can listen to episode 329 where we discussed pecs with Judy Southey, who's a speech pathologist who trained under Andy Gandhi. Also, the episode we just had, the last episode I'm going to reference. I don't know if I've ever done that before, but we talked about pure mediation. And I feel like the Dougherty article that we talked about today could have. Could have been one of those as well. And then certainly we've talked about Ascent and neurodiversity in a variety of other episodes. Those include episode 236, ascent and self Determination. That was with Haley Steinhauser and Alex Kishbaugh. Episode 331, Operationalizing Ascent, episodes 268, 280 and 281, which was our neurodiversity series with a variety of guests including Kate Chazen, Brian Middleton, Michelle LaFrance and Alex Estrella. And then two episodes on ableism, numbers 295 and 305. We talked about Ableism in a variety of contexts there. I also like to recommend a snack to go with this episode or the other ones if you want to circle back. So our snacks today are two flavors that go great together. I have three examples. You could certainly have your own. But these examples are chocolate and peanut butter. Yeah, always good, right? Fig and goat cheese. Delicious. And finally, carrots and ranch dressing, because I love ranch dressing.
- [78:08]
Robert Perry Crews
What about hummus if you don't want ranch?
- [78:10]
Jackie McDonald
Carrots and hummus. Yes, because it's healthier, Diana, you know.
- [78:15]
Diana Perry Cruz
But I love ranch.
- [78:16]
Robert Perry Crews
You know what's really gross? Carrots and chocolate.
- [78:20]
Diana Perry Cruz
No, that's not a flavor that goes together. But I thought about it for one second.
- [78:24]
Jackie McDonald
This sounds gross.
- [78:26]
Robert Perry Crews
Carrots and maple syrup.
- [78:26]
Diana Perry Cruz
Although. Have you ever had chocolate hummus?
- [78:29]
Jackie McDonald
Yes.
- [78:29]
Armando Bernal
I don't know.
- [78:30]
Jackie McDonald
It's not my favorite.
- [78:31]
Diana Perry Cruz
Pretty good.
- [78:32]
Jackie McDonald
It's not my favorite, but it's better Than chocolate sun butter.
- [78:40]
Armando Bernal
That sounds awesome.
- [78:40]
Diana Perry Cruz
Yeah. Okay. Okay. So we don't recommend those things, but we do recommend these. Or you can make your own pairing. And I would recommend them if you
- [78:49]
Jackie McDonald
can't eat chop, if you can't eat peanut butter. Right?
- [78:52]
Diana Perry Cruz
Oh, the chocolate. Yeah, yeah, yeah,
- [78:56]
Jackie McDonald
yeah. If you can't have Nutella, I mean, it's.
- [78:59]
Diana Perry Cruz
Yeah, yeah, it's there. All right. And that was pairings. Please enjoy.
- [79:03]
Armando Bernal
All right.
- [79:04]
Robert Perry Crews
Thanks, Diana. So that brings us to the end of our episode today. Thanks everybody for listening. If you have not, please subscribe to the show either on Apple Podcasts or wherever you like to get your podcasts. You can also subscribe on our Patreon page, patreon.com ABA inside track. You can subscribe there for free if you want to get all of our episodes there. But if you're interested in even more ABA InsideTrack content, including our quarterly polls and our yearly book club poll where you get to choose both episodes that we do every season, as well as all the books that we're going to be doing in the upcoming year that's coming up very soon, you're going to want to subscribe at the five dollar level and or ten dollar level. At those levels you also would get access to the listener choice episodes CES for no additional charge. And at the 10 level, you get access to those book clubs right when they come out. So you get the freshest book club possible, as well as 2 CES as a thanks to us for being a listener. There's some other fun goodies, like discounts in the store as well, but that's all@patreon.com Aba Inside Track. We also have an email, Aba InsideTrackmail.com and our website, AbainSideTrack.com where you can find links to all of these articles. You can find those in your podcast player as well. And you can purchase ces. And speaking of purchasing ces, you can't do that unless you know the second secret code word, which is transparency. T, R, A, N, S, P, A, R, E, N, C, Y. Why? Because you can see through it. Transparency.
- [80:32]
Diana Perry Cruz
They're those things that you write on, then you put them on the overhead.
- [80:35]
Robert Perry Crews
Oh, yes, that also could be if you are over the age of 40. Maybe you thought of the overhead projector and the transparencies. Otherwise you said, I don't. That sounds like the worst technology, like a mimeograph or something. Or carbon paper. Remember those?
- [80:52]
Armando Bernal
Remember when?
- [80:54]
Robert Perry Crews
Anyway, transparency. All right, some final big thanks again. Big thanks to our special guest Armando Bernal. Thanks to Dr. Jim Carr for recording our intro outro music, Kyle Sturi for interstitial music, and Dan Thabot of the podcast Doctors for his amazing editing work. We'll be back next week with another fun filled episode, but until then, keep responding.
- [81:15]
Diana Perry Cruz
Bye bye Bye.