A Lifelong Journey: ABA and Support for Autistic Adults

All right here we go. We don't call this show "Ransomal" it has to be said with Justin and Joe. Joe! Welcome back to it has to be said with Justin and Joe. We are honored today to have two of our favorite colleagues, two people who we just love hanging out with, and two all-stars in the field of applied behavior analysis and they are. I'm Dr. Peter Gerhard. I'm the executive director of the Epic School and Epic Inclusive Beauties with our adult program and adjunct faculty at Indicott. And I'm Dr. Shana Berry. I'm the founder executive director of Meaningful Hope. It's a consulting and continuing ad company and I also work closely with Dr. Gerhard as well as adjunct faculty at Indicott College. You probably have seen both of them around. They are on the talking tour talking about a variety of things including meaningful curriculum working with autistic adults. They are two all-stars in our field but before we get into the podcast, Joe has some of the boring details that we have to do. Yeah, yeah. I get to do all the fun boring things so welcome to hearing the boring things. If you're interested in CEUs for this episode or any other of the episodes, just head on over to autismpartnershipfoundation.org/podcast and you'll enter in the opening and the closing words. So make sure you pay attention to those. So the first or the opening word for this episode is going to be start START and then we'll give you the closing word closer to the end. So thank you for both of you for being here and taking the time out of your busy talking tour schedule. I feel like every time I see a conference advertisement on social media or through an email blast, both of your names are somewhere associated with it. And that's great because you have lots of wonderful information to disseminate. So the more that we can get you both talking, the better. So and I appreciate you being here to share some of this information as well. Like Justin said, both of you have talked a lot about meaningful curriculum, especially across the lifespan for autistic individuals or autistic adults. Maybe we should start there. What makes curriculum meaningful? Because I feel like a lot of people feel like, well, I'm using meaningful curriculum, right? It's from this book or someone told me to do it. But that might not necessarily be the case. Do either of you want to talk a little bit about that? Jenna, go ahead. I knew you were going to direct me to start. So we have kind of a working definition of meaningful essentially where just when we say meaningful, we mean individualized, inclusive of individual needs and kind of just focused on what's truly individualized and meaningful for their individual lives and focus on kind of building an independent future. So essentially, a lot of the curriculums out there or curricula out there can be meaningful. It's just we want to make sure they're specifically uniquely meaningful for each individual. One of the things we talk a lot about is whether or not a particular curriculum goal has any value to this individual. Like will they really ever use it? Once they finish, once they quote-unquote master it or have acquired the skill, will maintain this point of their repertoire. And so many times we see people being taught things that just they're never going to use. So they never stay in the repertoire. Yeah, I think Peter always says like applied means useful. So even when we're talking about applied paper analysis, we have to be thinking that is this useful paper analysis? Is it going to be a skill that's going to really matter for the rest of their lives? So things like the diet of the octopus or state birds or state flowers, you're saying that's not meaningful, right? Absolutely, not meaningful or interesting for that matter. I think in a lot of times we always try to say to the disclaimer is like it could potentially be meaningful if someone's on a developmental path. So if they're on a path to catch up to same age peers, if same age peers know that information, it could be helpful to catch them up to same age peers to get them in a general education path. But if they're not on that path, we want to make sure we're kind of pivoting at the right time to focusing on skills are going to really matter in adulthood. Wouldn't it be nice though, if same age peers didn't have to know the diet of the octopus or state birds because that would be nice. That would be nice in their life. Yeah, a couple other things to take down the Gen Ed curriculum is the whole another. Yeah, that's the whole other thing. Maybe we can talk about that at a different time. Yeah, we'll have you on to talk about Gen Ed curriculum. Another podcast. Yeah, I appreciate you guys saying and I know Peter you've been saying it for years and I'm glad that some behavior analysts are now finally catching up to what you guys are saying and talking about meaningful and applied and individualized. I guess my first question is how do you guys go about determining that? How would you tell the people listening to determine what is individualized, how they can create that curriculum for the learners that they work with? Peter is pointing to Shayna right now. So I'm going to let Shayna, we're just going to assume Shayna is going to take off unless Peter starts talking right away. So you said how do you go about finding out what specifically? If I'm a BCBA and I'm having a learner of any age, how would I go creating this meaningful curriculum? Because it's Joe alluded to, I think a lot of people go to this book or they take the VB map or the Ables or Ables or whatever and say, okay, this is what we're teaching and I guess as you guys both think that doesn't always result in a meaningful, applied individualized curriculum. So what steps of the process would you guys go about to do it? I think we talk a lot about like talking to the families a lot too and making sure that we're involving them and all the steps of the process in developing an individualized curriculum. So kind of asking them what's most important for you, what's most important to your family, what's going to make their life better and really starting there, depending on what setting you're providing services in, but especially if you're providing home-based services or something where the parent and the family are going to be really involved. I think that's a really good place to start. And then thinking about if the skill is going to be needed long-term and adulthood, we talk about the criterion of ultimate functioning a lot from 1976 or '79 from Brown and colleagues of essentially if you can't do the skill with someone else, have to do it for you and adulthood. So that's kind of a really good kind of test that we talk about a lot like how important is this? Will someone, a paid staff, a parent going to have to do this for them long-term and adulthood for the rest of their lives? It's kind of a good place to start, we think. Yeah, and I have a particular advantage having worked with adults for so long and thought, how come nobody taught you this? Like how did you get to be 30 and not know how to wipe your butt after a bell? Like how is that even possible? And so I get to look backwards a lot and say, oh, he's he's this and this and this and we did develop and it's in the book, make it meaningful, which will be out by the time this is broadcast, essential skills that are critical skills is what they are so that we can list like toilet training, eating, bathing, shower, self-care, go through like and these are those things that you just need in real life, you know, and it goes into more complex skills all the way up into self-advocacy. But the other thing is we don't do just we do yearly IEPs because we have to, but we also do five year plans for our students. So we sit down with them, their family, anybody who wants to be part of this and say, okay, he's 12, when he's 17, what is he doing? And from that vision, we can then backwards, Shane, almost the skills that he's going to need for the life that actually has been envisioned for him. Yeah, and when we do the backwards planning, like Peter's talking about, we have a lot of ways that we've identified to kind of develop those long-term goals, depending on the age of the learner. So if they're, you know, over age 10, we look at different categories like where are they living, where are they working, what are they doing for fun, what relationships are they a part of, things like that and then backwards plan. So every short-term goal should be tied in some way to a long-term vision, like what's the point of it? It should have a purpose long-term and we should be re-evaluating the purpose at certain points throughout their lives to how are we doing getting to that long-term goal and kind of backwards planning and checking in and talking with the whole team, including the family, to see how are we on track to meeting those long-term goals. So if I'm understanding correctly, the backwards planning is almost picking an age in the future and thinking about the skills that are going to be necessary for this individual at that age with wherever they're going to be, and then thinking backwards from there in terms of where they are now and how we develop the skills that are going to be necessary for where they are or where they will be at that age, is that right? Right. Yeah, absolutely. When you first said backwards planning, it made me think, well, we need more future planning too and thinking, which really the backwards planning is the forward thinking and being proactive in developing those skills, but it's in relation to a particular point in time. And I think as both of you are talking about how we determine if something's individualized or useful, it made me think, well, most people that practice what we call ABA would say all ABAs individualized. That's one of the finding characteristics of it. So anybody that's practicing probably thinks that what they're doing is individualized just because they're doing some procedures that have been based within ABA or have come from the science of ABA. But it's really not. I think the guidance that you all are providing in terms of how to determine if something's individualized is much different than how individualized goals and procedures and targets are are kind of talked about in the field. And I think the main difference is that future point in time and they're working backwards. I really like that. And you said five years. Is there any reason to go maybe beyond five years? Yeah, five years is just an arbitrary point. With our younger students like say ages seven to 11, we do three years. But then once you start to get older, we hit that five-year mark. And it really also gives us the opportunity to say that the child is seven and isn't fully toilet trained at home. But I can say, listen, when he's 14, do you still want to be wiping his butt? Because if that's part of your life vision, then that's where you're heading. If that's not part of the vision, and it's a wake-up call a lot of times to families. That because three years is not a long period of time. So we really try to make it as impactful all around as possible. Yeah. And in our book, we do refer to them as futures plans and futures planning. And we have we have it kind of divided as early learners futures planning and then older learners futures planning. So the cutoff is about age 10. And after age 10, we really want to have the long-term vision be adulthood. And even though it's kind of arbitrary because adulthood is, you know, 75% of your life. But we want to be thinking about the transition and getting them ready to graduate or whatever it is transition to adult services. So we want to start thinking about adulthood after about age 10. So with additionally having the five-year, three-year and one-year plans, kind of the final endpoint, at least in terms of thinking about transition to adult services, should be adulthood. And the problem is that a lot of times practitioners aren't thinking about adulthood until their 1920 and they have two years to last. So we want to really be thinking about that much earlier around age 10 minimally. So, I mean, as you guys are talking, it reminds me of what I think is one of the bigger tragedies in our field today that we all face. And that is just the low expectations we have for our students and our learners. And I remember going to conferences and watching videos and people just like really excited about about behaviors that they're engaging in that the student could be in such a much better place. But it's mean that the team had what I feel is low expectations, didn't push them as far as they could be. So I think one, for example, Peter, since he brought up a bunch of wiping your butt, it's like that they are just the diapers and they're okay with that. And that's the fineness of emphasis that they can do it independently. Or I see other on social skills a lot of times, you know, that they'll just tolerate being in the room with people versus, you know, actually interacting and having those expectations. Maybe you don't meet those expectations, maybe you do, but at least, at least pushing yourself to meet those expectations or pushing the team to meet your expectations. So I'm wondering when you guys are doing your one year, five year, seven year, 15 year plan, whatever your plan is for the given learner, how do you guys help guide the team or how would you help guide the team to really reach those high expectations so that that every learner you're working with is reaching their fullest potential. Well, one of like the guide posts is that I tell families what I want you to do in this process is take high expectations, but then multiply them by 1.5. Like we want to have something that's potentially out of our reach to achieve, for that exact same reason. The other thing that we challenge for families to do is to come to grips with this idea of safety in the community. You know, everybody thinks that if they're alone for 15 minutes and a 7/11, that's when the person's going to come in and rob the store and take sausages and like do all the and it's not going to happen. It's just not, you know, or that he's going to open up a bag of Doritos and start eating him in the store. And I'm like, as long as he pays for him, I don't care. I'd rather have him be independent than not. Like that's the choice that often boils down to it. I mean, I think that's the scariest part for a lot of families I work with is being able to accept the fact that, you know, there's a reasonable level of risk that we all accept to be part of our society. And they need to come to terms with accepting it for their son or daughter. And we can build in a series of fail-saves, but we continue to make people dependent on us as opposed to independent of us. Yeah, and the research supports too that one of the biggest predictors of outcomes for people on the spectrum is parent expectations. So I think we have a real, I think this is just something I rant about responsibility to educate parents on what adults it is and what the expectations need to be and kind of what the options are out there and what the realities are, what their child's going to transition to. I'm saying there's a lot of rose colored glasses on that we're going to transition to another adult world that has all of these magical supports and services and resources and all of these things are the realities that aren't just available. So I think we really need to educate parents on how many skills their child's going to need to be as independent as possible and adulthood so that they can advocate for the right skills to be taught when they're a child so they can get as ready as possible. Well, and that might give a little hint at what my closing word is going to be since everybody knows what the starting word was now but we'll see. I try to keep people on their toes. I love these points and Peter the Doritos opening a bag of Doritos in the store and eating them made me think like I have a toddler now. He's one and a half and every time we go to the grocery store he opens food while we're going to the grocery store and eats it and nobody has a problem with it because we pay for it when we get out. So it's interesting how expectations kind of shifts depending on the context and the individual and all those types of things. It just made me chuckle just a little bit like we do that every time we go to the grocery store and nobody has a problem with it. So yeah, I completely agree as long as you're paying for it like what's the big deal? What's the problem there? I know sometimes our parents think that they'll get in trouble with the person behind the counter but we take a lot of time to make the person behind the counter part of the plan so that he knows this person by name. You know, so when he comes in if he does do that and we say you know he might open a bag of Doritos but we'll pay for it or he'll pay for it. Don't worry about it. So that way it does happen if it does happen it's no there's no issue. You know because you know you might expect a one and a half year old to open the bag but you wouldn't expect a 22-year-old to do it. There you go. Yeah that's a good point. Yeah. Sometimes I open a bag of chips when I was still in the market. Yeah, it's absolutely. I open dietcokes. I know that you do so. Well and now they have Starbucks at the openings of all grocery stores so everybody goes and grabs a drink and a snack to go through the grocery store. It's almost they it's almost becoming commonplace for things like that to happen. But it also makes me think given what you had just said about working with the cashier and everybody and more people being involved in the plan I feel like when we talk about independence it's almost like this binary thing. You're either independent or you're not where it could be viewed more as like a scale of independence and moving along the scale of independence. What do you all feel about that? You agree it should be binary, not so binary? No it should be a continuum. And I think minimally we need to make sure that people are less dependent. And I think also you know similar to the low boss 80 87 was it low boss 87? Particle you know indistinguishable from peers like that became sort of the grail but when I talk about adults and independent you know they're not the same word you know and I need to explain that to people often that I'm saying he's independent at this skill but he's not necessarily independent driving car you know it's all of us are like that though like there are far more skills that they don't have than that they do have you know thankfully I have this one skill that I can make a living out because otherwise I'd be really screwed. I love that point you know looking at individual goals behaviors and skills in terms of their independence as opposed to you're just overall independent or you're not independent at all. I think that's that's probably not an approach that a lot of people take when they're looking at skills on on an individual skill basis. Yeah we talk a lot too about interdependence and how none of us are truly independent in our environments but we're independent in some way but we're able to independently seek out the supports we need to get to get by so you know all of us need help if we're in a cash if we're in a store we need to ask someone who works there where something is or we talk about if you need your car to be fixed you can call the mechanic or look up someone who can fix your car but most of us can't do that completely independently so that idea isn't necessarily a hundred percent independent with everything but being able to function enough as an adult where you can seek out the supports that you need to to get by you know mostly independently. I love that and I love that as a skill to target too like identifying where you need assistance with and how to access assistance when you need assistance. I'd I'd contend that there's probably a whole lot of people within our field that don't have that skill you know it's like the knowing what you don't know skill. Absolutely. We even talk about a lot like smartphones is like the number one interdependence tool like it's just a bottomless pit of interdependence like we all rely on our smartphones for practically everything so why are we requiring people on the spectrum or other disabilities to have more independence than we might expect of ourselves or typical peers that same age. I can't agree that we all rely on our smartphones except Dr. Tracy Parker if you're listening you don't know your smartphone because you refuse to get one. Do they still make phones that aren't smart? Yeah she has she had a flip phone because no tags no looking up things she goes to a library if she needs to something versus what will Google this is just not to Tracy Parker in case she's listening. So this independent stuff you know it also reminds me this whole thing reminds me of a conference Peter and I were at and I forget who the lead speaker was but he showed up late so I decided to go first so I didn't have to follow Peter because it's very tough to follow Peter at conferences so I just wanted to get it out of the way so I'm not the person having to follow Peter and Peter you're in the conference you're making about talking about meaningful skills or applied skills and talking I think your example was like in a registered they don't have them count out money anymore just not them swipe a credit card or debit card or prepaid debit cards and you know it was great talk and then we had to all do a panel at the end then some lady rose her hand and said like well how do I help my my seven-year-old doesn't have this skill this skill this skill this skill all the functional independent skills needed how do I help them on like my out on their algebra test and you very gracefully much better than I would have done I've been like I said just listen to what I said for the last 50 minutes but you you back to a functional I'm wondering I see out there a lot of cookie cutter approaches a lot of not creating independence not making it meaningful probably I think your books and how to make it meaningful is that the title of your book that will be out a lot of the programs are probably make it unmeaningful is the reality of what I'm seeing how do you work with that when you go in your consulting to a home or a school program or someone's coming to you and you see so many goals that are not going to create that independence and making and making their lives better like how would you work with that because I know a lot of our listeners are consultants to school programs or clinic programs and they probably encounter that on a day-to-day basis and want to make it meaningful but probably don't have the best approach up how to accomplish that well I'll tell you my little cheat with things like that is I try to get people to complete the sentence like read the goal to me but then end it with in order to I knew you're going to say this because and if you can't finish that then it's a stupid goal you know it's really that like if you can't find some application of that you know then why are you wasting his time and I think that that's the biggest sin we commit and special education in private analysis is we waste students time you know yes they they are graphs look great but he didn't learn anything worth jack and I think that that's horribly depressing that that's what we're using this amazing science to do I and I feeling I think I was going to add is kind of when we're talking about like how to design goals in terms of how to teach the skill to one of the big things we talk about is context so teaching and teaching the skill in the context where it's ultimately going to take place and using materials and environments where the skill is going to actually be used and I think we can look at our science too and there's a lot of research and data to support that teaching a skill in one context is it doesn't mean it's going to generalize to another so I think when Peter saying in order to if the if the point of the skill is in order to generalize to somewhere else in some other environment with some other skill or some other material we need to be rethinking it to recognize that you know data doesn't support that that's going to happen so we have to really be teaching in a way that's going to really matter a long term if we're teaching a lot of times there are well intention goals and if you ask someone why they're teaching something they'll say oh because oh why are you teaching you know cathode shift skill in a classroom with a token board well because you know purchasing is a really important skill he'll need when he's an adult but data doesn't support that that's one's going to lead to the other so I think that's really important too. That's a that's a wonderful point and you know heaven forbid we actually teach the skill that's going to be needed in the context within the context in which the skill is going to be needed I feel like someone in back in 68 gave us some recommendations about that but I who knows who those three people were and it's just a great point we find ourselves teaching meaningful skills in non meaningful context and awful lot and I think part of that is the constraints on our field or where you're working and that might be the only way in which you can but it's a wonderful point that you need to start thinking about how you can program the generalization if you can't actually teach it in the in the context in which the skill is going to be needed. Shayna knows that one of my behavior and analytic fantasies which is sad that I say that if it comes out of the series of books with that title it is sad Peter it is sad I know but I want to teach microwave use at like a best by like because I want to have 17 different microwaves that I could teach this could use all because there are commonalities that I could then target the commonalities and so he could figure it out you know because otherwise there is no one microwave you know and that's what we tend to teach to just one exemplar exemplar exemplar it's like a reindeer so it's it's much more important to look at this this generalization of acquired skills than even a literature shows you know I think I think I'm getting a new microwave soon so I'll send you my old one so you can see your collection so you don't have to go to the best by I feel like I don't know go ahead no please I was just going to say one of the critical skills we talk about is problem solving too so I think one of the important skills we need to teach in terms of programming and for generalization if we want to occur is like figuring out what you need to do to figure out a new exemplar so like we in the travel and we've done like there's all different kinds of toilets and we like we talk every time that we see a new style like we have the problem solving skills to figure it out like how to how to get this to work even if we've never seen it before so I think that's that's what makes that kind of skill critical well and definitely a situation in with observational learning isn't going to be beneficial right we rely on that an awful lot for for our clients and our learners and in the bathroom is not a time in which you want to use that skill uh there's an article in Washington Post a couple weeks ago about the most difficult thing about traveling is learning how to use the hotel shower because air like sometimes a like three knobs and levers you have to like but it's all problem solving eventually I figured out but uh I was in one hotel where you have to turn in the knob one way another knob the other way the other way and I was looking at I talked to my wife and I was like did they really design it like this like what's the point like right apparently like but then and also to like rely interdependence like you could call the front desk like we were somewhere and in our hotel rooms like you had to put the key card in in this thing to get the electricity to work in the room or something so we that's how it is that's how it is in Europe just so you know well at least you have interdependent skill to realize okay I can't figure this out I've tried I've done some problems solving but interdependence I can call and be like wise there no power you know so I understand that in the context that we talked about it's individualized and meaningful and what will help them in their long term success and the reality as Peter you've said multiple times is most people go in this field are working with little kids they're not going into the adults and you know even teenagers I think they want the cute little you know 18 month olds and three year olds and seven year olds uh and stuff like that and when I think of curricular curriculum I think about domains like you teach language we teach social skills learning how to learn academics adaptive I'm wondering what advice you've have in it for practitioners that work with the younger populations on where would you put emphasis like should there be so much emphasis on academic skills or more emphasis on social behavior adaptive knowing that you know you're working with a three year old you don't know what the outcomes going to be when they're 15 16 and 17 right and I think it's for me it's like kind of an equal mix between at that point with academics um social and adaptive behavior because you can have all the adaptive behavior no you can have all the academic skills in the world but unless you have adaptive behavior you're not going to be able to use them right so you know and social skills do or how you get into the situation where you can use you know all of this knowledge and that you've acquired along the way you know or knowing what situations you can do that in so I don't think any one is more important than the other um I just know most of the academic knowledge that I still have is like trivia you know I can't factor by no me equation I can't um do the area of a triangle I can't I don't know all the state capitals you know but I can tell you you know I can tell you what you're the lowest article came out you know great because I'm gonna get you laid right there that'll be a good thing you're doing something that I'm not because uh just knowing that year hasn't helped me out at all yeah me neither it isn't in many ways a useless skill um we talk a lot to about like two different curricular paths like developmental and adaptive and how they kind of um go in different directions but how essentially at a certain point you have to pivot to the adaptive route so we talk about how like when you're on an adapt uh developmental path the purpose of that path is to catch up to same-age peers so I think it makes sense to be on that path up until a certain point where it's kind of decided amongst the team or you know we don't know for sure of course but kind of having a discussion of when is it time to kind of that not be the purpose of instruction to catch up to same-age peers to be indistinguishable indistinguishable from peers and to kind of get into gen ed classrooms the purpose of which is to graduate high school go to college potentially but at a certain point so we have in our book we talk about double digits time to pivot so at around age 10 if they haven't you know essentially caught up to peers we suggest pivoting to a more but an adaptive focus of those skills are going to really matter into adulthood do people have trouble and with the pivot like I imagine a 10 parents would be very have a lot of trouble saying oh they're going down this path and this is their future like uh what what have you experienced with that and and how would you how do you guide practitioners to be compassionate and caring when you're making such a big pivot well honestly I um because parents know what I do and how I think um for the past 10 years it really hasn't been an issue um but um I just I would always point out that the you know the value of life was being able to do things in life to go places and enjoy things and go to a good restaurant and go to like you know and you don't need that red moby dick to do that you know there's a lot of skills that are essential to a quality life um and there are a lot that aren't that are what we tend to focus on unfortunately you know there have no functional relevance at all to this person's life um but for me like I said most of the families they work with know my orientation so they just kind of leave me alone in that area I think if you're not peter to like building rapport with parents like I don't think you should go into a conversation and be like okay they're 10 that's it you know we're giving up on academics and I think you want to be building that rapport and that relationship with them leading up to that point and kind of trying to educate them as you go like how this is so important and what we're teaching matters long-term and getting them to understand you know what adulthood is what what is going to entail how they need to be prepared and and just getting them to understand that leading up to that point I don't think you'd want to do it like abruptly or anything I like that if you're not peter uh peter walks into the room with rapport uh but I also imagine to to circle back that the the backward thinking uh would probably help uh especially if you start that at a early age all right let's think about where uh Joe's going to be three years from now let's think about where Joe's going to be five years from now um because depending on the the skills that are developed and what happens throughout that that course of treatment or intervention where you're going to end up in five years probably will will differ and and be a little bit different so if you're already preparing parents to think about that think about the future it might be easier to have these conversations whenever they're whenever they need to be had whether it's at 10 uh or at some other age uh uh I I don't want to pivot too much away because I think this is a wonderful conversation we have but we focus a lot on how to identify the curriculum and and how to develop the curriculum how to ensure that something's meaningful we haven't talked about how to teach it at all uh and so I imagine that there's some people that are listening and if you are listening and you're sitting here and you're like oh my goals are not meaningful and I'm crap uh and I need to rethink my entire career please don't do that uh you're in the exact right place to learn about these things right our science progresses our interventions progress we progress as individuals so uh don't be too down on yourself if you're listening to this and you're rethinking your entire career or contact Peter and Shayna and see if you girls aren't impressed with that meaning I'm sure that we can solve it do you help make it better so yeah their personal phone numbers are five five five uh but and I I I often try to put myself in if anybody's listening to these how I might feel as a listener and I feel like sometimes the topics that we talk about make you rethink what you're doing and that's a good thing not necessarily a bad thing uh but I do have any suggestions about how to target some of this meaningful curriculum is it anything beyond what we already have any skill sets that we would need to develop beyond the typical kinds of things we're associated with using to teach skills well you know one of the things that I strongly recommend is before anybody writes a TA for a skill that is in the community that you go out in the community and observe that skill being done you know or you do it yourself because we're so fluent at these skills that what we just try to write them down the steps like we usually miss two or three and then we add in ones it just aren't relevant you know so go out and see what the actual contacts the environment demands um and then you can write your individualized curriculum for this particular kid right Shannon there reminds me of there's a sorry there's a viral video probably I don't know a few years ago about teachers that asked their students to write a task analysis for making a peanut butter and jelly sandwich and the teacher followed those directions specifically as they were written down and nobody ended up with the peanut butter and jelly sandwiches like put the peanut butter on the sandwich they're just grab the container and set it on the sandwich and the kids with laugh and it made me think about the task analyses within our field and we should really put them to that same test yeah when we talk a lot too in terms of how to teach when we're doing like our talks and stuff so we usually say too so of course we want to make sure what we're teaching is using evidence-based procedures obviously but we also talk about the context in which the skill is being taught which we already kind of talked about and also the intensity of how you know how often you're teaching the skill so that it will actually be mastered and then efficiency so making sure we're teaching the skill essentially in the easiest way possible so that it's more likely to be mastered especially with the community-based types of adaptive skills that we talk about a lot for a number of reasons related to resources and you know things like that some of which are outside of our control we end up giving kids one opportunity a week to practice these community-based skills and we pretty much know that you know you need an intense level of instruction to teach skills to individuals with autism or related disorders but we're giving them one opportunity a week it's just not likely ever going to be mastered that way and efficiency in terms of just teaching skills in an easier way there's a lot of research to support that teaching skills in an easier way it's just more likely to be mastered so not spending years teaching skills you know in a really difficult way like you talked about counting money and that's just kind of one example of making one much more efficient by using a credit card gift card apple pay and all these efficiency shortcuts that you know typical adults are using constantly so yeah well and even like uber and lift and those types of things in terms of driving I mean how often do we use those things and teaching that as a skill is very meaningful I saw a story not too long ago that lots of students now are not interested in getting their driver's license because of how immediately available ride share apps are and different types of things like that and it makes complete sense yeah we take advantage of all the technology that we can like we have students ordering on door dash for their lunch you know you can be non vocal verbal and still order a really cool lunch on door dash you know and then it gets brought right to you you don't have to you know we also go out to restaurants a lot because we don't want to just say use door dash but anything that's available to the quote unquote typical population we want to see how we adapt it to our guys I would love to work with one because there's like probably two dozen now these meal delivery companies that send you the like the parts of the meal and you have to put it together you know but let's come up with one that has really simple picture directions for kids with intellectual development with disabilities right so now you know they have everything they need they can cook their own meal independently a lot of support goes into that box but you know it just seems like a much simpler way to achieve that desired outcome which is him making his own dinner right so built in TA that typical people need to cook them you so why can we not use that for individuals with disabilities it's a wonderful point we used hello fresh for a little bit that's one of those services yeah they definitely need some assistance in in how they're writing up how to cook the things that they're sending because I I used to be a cook in a kitchen in my younger days and so I feel like I know my way around just a little bit but there were times where I was like what the heck was I supposed to do and win so I think just in general they could benefit from working with the behavior analyst to help develop with those recipes and those tasks look like yeah so if you're listening to this and you're interested hello fresh if you're listening to this and you want to partner and research send us some food sponsors now yeah exactly yeah if you want sponsor right it has to be said with Justin Joe to let us know hello fresh well we'll gladly take your sponsorship I guess you know a question I always ask because I think it's coming up now and it probably comes up towards teenagehood uh adults I think or it isn't easy so I'm not going to talk about once you're a legal adult but a legal age is what do you guys do if you're client the autistic teenager autistic child has one goal in mind and and it's not beneficial to their long-term health that are long-term emotional or physical how do you as navigate that going on I can give an example if you need to please I think you know one I think at least in social area that the children don't want to interact that they don't want to interact with peers they just want to be left by themselves and we're starting to see signs of loneliness and depression in in in in in the child and we know there's a link between interacting with people and decreasing loneliness and decreasing depression I think that would be a prime example of that like what do you do if they're making goals if they're choosing not to engage in behaviors um and it's and you can see negative outcomes happening it's not good for their overall well-being what how do you guys handle that the science just say no there's their thinking right now that's what it is well I think we sometimes assume that this set of skills whether it's social communication are easy like I know I've done it like just tell me what you want like you know but that may be one of the highest effortful things for this person to really do even though the skills and his repertoire you know engaging in that vocal verbal behavior while being social at the same time um I just think for some of our kids it's just a challenge so what we tend to do is look at how do we sort of peel back the levels a little bit like let's start much smaller and then build the social interactions up from there so we're shaping it into more and it's almost always focused around what they're interested so like he doesn't have to talk about behavior analysis to me he can talk to talk about dinosaurs to me because I like dinosaurs too having said that that's an overly simplistic interpretation of what how I think I would would address it um yeah sorry Peter okay um no I was just gonna say I think to so option we in terms of just the social skills thing like people get into like oh that's a you know a symptom of the diagnosis of autism is social deficit they're not interested why are we gonna force it I think sometimes we need to just search a little harder to find what the specific nuanced social interaction is that they want because I think a lot of times it's not that they don't want to be socialists we haven't found you know exactly what uniquely is you know what they enjoy about being social like I had a client years ago who loved talking about the foods that I hate so he could so we had a whole conversations about that and he loved that and looked forward to that and I think then you can shape that into something else that's more maybe age appropriate or socially appropriate for a peer to develop a friendship kind of thing but I think it just takes some creativity a lot of the times yeah and I think it's also a great example of something I was gonna say earlier um I hear a lot of people say like well he can't learn that or he can't do that and my whole thing is you don't get to say that like he'll tell us if that's the like you're saying you can't teach it that's really what you're saying when you when you say those things um I've always been happily surprised when people doubted what a kid can do and then we decided to try and teach it and you know and they got it you know it's where the biggest limiter on individual progress sometimes you know because we refuse to teach stuff based upon our biases and histories and so I think that's a significant issue and it's a wonderful point and I think especially as we start to work with clients or individuals as they age we're starting to talk about potentially some more complex skills and we're moving away from those like simple discrete like perceptive labels expressive labels where a lot of people that's their their bread and butter when we start to get into things like social skills or even adaptive skills out in the community we're starting to talk about some more complex skills and I think there's just a general scarcity of resources and trainings available for people to teach those those skills and especially for skills that you might do perfectly and not be successful like Peter I think one of the the Peterisms that your sharks talk about is the dating example like you can do everything perfect on a first date and not get a second date so I think there's so many limiting factors when we start talking about some of these skills it's a it's a it's a wonderful point and and to to Shanna's point about the uh that we tend to talk about well social deficits so it's just part of the autism diagnosis like so they just don't want to be social but we know that that's just not the case uh but we do know sometimes we don't want to be social right uh like we don't want to go to that party we don't want to go to that dinner and we can exert that skill because we've developed the skill set uh to be able to make those determinations and I think it goes back to to what you were saying earlier in terms of the the skill set to determine assistance level of assistance like how could I get help with something it's also determining what do I want to be social and and what do I not want to be social and and what are the consequences of me choosing not to go to that dinner party or me not to go to that social hour or happy hour uh who do I want to be hopeful with you know exactly yeah yeah yeah who do I want to be social with and where do I want to be social with them too yeah and how long do I want to be social before like my batteries up and I like want to leave so well and even that the skill set to be able to determine how to like graciously remove yourself from a social situation uh you know or knowing if you can get away with the Irish goodbye uh just ditching out without telling anybody right we we I'm assuming I mean I do that I probably shouldn't in some context but I imagine everybody's familiar with that at at some level you're you're not the worst one of our colleagues who do that fair point fair point Dr Julia Ferguson so one thing we're doing this year this season I don't know if we call it a year season so whatever Joe tells us to call it uh is that at the end of the episode we ask we've asked everyone a question a singular question maybe Jessica Kalki has told you what that question is but we ask a singular question uh for both of you guys to answer and it can be about this topic or it can be about really anything you like it to be so it does not have to be specific what we talked about but what is one thing in our field that has to be said that you want to be said that you want to say that everyone needs to know what's one thing in our set field that has to be said Shayna you're first views Peter Simon well and I can give you both some more time to think about your response because it's such a big question I'll jump in with the boring logistics so you can just you know ignore what I'm saying right now and think about your response I had I had one actually but oh well then take it away I I put the boring stuff afterwards then so people can hear well maybe I should have taken more time but I was what came to my mind first was just um children with autism become adults with autism so I think that's one of the main things we all need to be thinking about is that whatever age group you're um working with you're working with the future adults if they're not an adult already so I think that's really key and and I think the realization that in general we don't fully understand positive reinforcement and how to use it um I think it's the most powerful least understood tool in the behavior analytic arsenal um and I still see people like say I just reinforced them and he hit me that's because you gave him like 14th Dorito of the morning you know and the only way he can get you to stop engaging in this repetitive behavior of force feeding him Doritos was to hit you and it worked you know we don't it's it's it's just a incredibly complex phenomena and I think it's taught a simplistic way and and supplied in very simplistic way you know so that's my thing that has to be said stop sucking at delivery of positive reinforcement spend the whole another hour talking about that right well now we we have a whole another episode just based on that stop sucking at positive reinforcement uh well I appreciate you both for saying the things that need to be said uh and and coming and and sharing your time with us I think everything that was said across this I don't know yeah a week hour wherever we are right now um was was things that needed to be said in addition to what you just threw out what a wonderful way to end it so thank you both again for being here now I'll give the boring stuff uh so if you're interested in CEUs for this episode or in the other episode please visit www.optismpartnershipfoundation.org/podcast and you can get your CEUs there just put in the opening and closing word the closing word is early e-a-r-l-y again the closing word is early thank you both again uh for for being here and yeah and we'll see you next time on it has to be said with Justin and Joe