As a BCBA in Adult Services, I have provided a service called “Therapeutic Consultation” which is training, teaching, and modeling behavioral interventions for care providers to implement. I was here, there and everywhere but not anywhere for too long.
I began to wish that I could clone myself so I could spend more time with clients AND their staff. Also, my treatment plans began sounding redundant to me: “increased engagement, increased structure, verbal praise, shaping, extinction/differential reinforcement, etc”. This made me wonder if an overall systemic approach might just work.
I realized that this meant creating a program for group homes as a whole. Then once I devised the program, I needed to spend quantity time with that group home implementing it WITH them, getting their input and feedback. Then following the implementation, I would continue to provide routine training and support. This program would be modeled after the successful Elm Street Project in Student Services.
Enter the Pilot Program.
As with any new idea, there is uncertainty and fear of the unknown, but the group home selected as the Pilot House came to the table with open and trusting minds and I am forever grateful for that. The House Manger and I both made a serious time commitment to each other and to the program itself.
I believe the easier a program is to follow, the higher chance you have of it being done right (treatment integrity). The Pilot Program had only two parts: an assessment and a visual schedule in the home. The Assessment of Functional Living Skills (AFLS) was conducted by the staff and I and served to identify adaptive behavioral skill deficits in our clients’ repertoires. Then I helped the staff developed their own visual schedule which outlined certain adaptive skills to target. The visual schedule was broken down into general categories (hygiene, meals, outings, etc) and provided both group and individual target skills. It was meeting our clients where they were! I stressed, though, that this visual schedule was a guide and that it did not need to be followed 100% of the time with 100% of the clients. It had to be natural, and that was very reassuring for the staff.
Fast forward 3 months…we have all learned so much from the Pilot Program – too much to list here. But the overriding lesson we learned was about time. The more time you take to teach a client how to do a task, the longer things take. Then you see your days start flying by and you notice your clients are busy. Busy learning.
Here is what the staff have to say about the Pilot Program:
“I have seen a tremendous difference in that the guys have a lot less maladaptive behaviors and appear a lot happier & calmer! The staff also seems more positive.” – House Manager
“I can honestly say that the ABA program has dramatically changed my view of my job… The ABA program has taught me patience and understanding…I had to teach myself (I am still learning) to SLOWWWW down and move at their pace…I truly enjoy my job now knowing that I am not just “keeping them alive and healthy” but that I am actually a teacher now.” – Residential Staff
“I believe the ABA program has made a big impact on our guys’ lives; they are becoming more independent, learning more household skills, more attentive to activities and an improvement in the community. The program has made me enjoy my job more; it’s making me feel like I’m making a huge impact on the guys’ lives. I think ABA is a great program with reachable goals.” – Residential Staff
“… I was just amazed to hear all the new and fun things the guys are engaging in as well as all of their new interests…I love ABA!” – Case Manager
The below data reflects our clients’ adaptive skills acquired in the 3 months of the Pilot Program. Note: client #5 did not exhibit the same level of learning that his peers did as he was dealing with major medical issues (now resolved). Although unfortunate, this phenomenon speaks to the efficacy of the program. Note that in some cases, adaptive skill repertoires were doubled and beyond! The sky is truly the limit and this program is here to stay!