mindfulrambles.blogspot.com/2018/02/whats-function-sensory.htmlThe term “sensory” is frequently referenced in both the world of Occupational Therapy and Applied Behavior Analysis, two worlds that have historically relied upon differing technologies and principles. The alignment of two unique but prominent fields in pursuit of understanding the word “sensory” indicates that there is great value to be discovered in unearthing the collaborative potential between BCBAs and OTs. This article considers the definition of “sensory” from both perspectives, highlights the differences and similarities, and identifies a common ground from which we can understand the role all things sensory play in behavior. We conclude by offering five strategies for enhancing collaboration between BCBAs and OTs in pursuit of a comprehensive, evidence-based approach for working with children with sensory needs.
Sensory Defined: The primary disparity between the behavior analytic and occupational therapeutic understanding of the word ‘sensory’ lies in its’ definition. In the world of Applied Behavior Analysis, the word ‘sensory’ refers to a possible function of behavior, meaning that the behavior occurs for sensory-related reasons. Behaviors maintained by sensory functions are further divided into two categories. First, a behavior might feel good to an individual, so he or she frequently engages in the behavior in order to experience a pleasurable physical sensation; the presence or absence of other people is irrelevant. Or, a learner may engage in a behavior to alleviate pain or cope with a stressful situation, also independent of the presence or absence of others. Given this, Behavior Analysts approach treatment by first ruling out possible medical causes and then identifying functionally equivalent, appropriate replacement behaviors for instruction. In contrast, the word ‘sensory’, as considered from a Occupational Therapy perspective, focuses on arousal and regulation. When an individual is in a state of low or high arousal, OTs believe that the brain is unable to organize all the sensory input it receives from the environment appropriately, thus resulting in the demonstration of sensory-seeking behaviors. OTs look to balance arousal levels through self regulation. Sensory strategies are implemented with the intention of changing levels of alertness to reach a state of sensory integration, in other words a state where the individual is able to organize the input received from the environment. Occupational Therapists find that with the ability to self-regulate comes greater development in other domains of learning. Identifying Commonalities: Although behavioral analytic and occupational therapy professionals embrace differing methodologies and principles, as described previously, it is important to recognize commonalities between the fields that can be used to build a collaborative foundation. First, both OTs and BCBAs value individualized treatment approaches with a recognition that each person’s triggers, behaviors, and environment are unique and must be viewed as such in order to achieve progress. In addition, both professions analyze the environment in order to inform treatment decisions while carefully considering underlying biological and medical variables that may be impacting the client. BCBAs and OTs both work with a similar goal of achieving socially significant change by supporting their clients to lead the happiest, healthiest, and fullest lives possible. Perhaps most notably, BCBAs and OTs alike are dedicated to a code of ethics and constantly seek to align their work to the standards outlined by their professional organizations. Given the increasing number of individuals who have achieved both credentials, there seems be great value that can be drawn from a collaborative, teamwork approach. Members of a comprehensive team can enhance and improve practice by adopting beneficial strategies developed by occupational therapists and implementing them in a behaviorally sound way. Fortunately, you don’t need to have both credentials to achieve this goal. By following the steps outlined, teams can embrace sensory interventions in an evidence-based manner consistent with the beliefs of both occupational therapy and behavioral science 5 Strategies for Enhancing Collaboration Between BCBA’s and OT’s
Conclusion Sensory-based approaches represent a “hot topic issue” in the fields of Occupational Therapy and Applied Behavior Analysis. Professionals with differing backgrounds and philosophies often find themselves working together as members of comprehensive teams to support children with disabilities. In order to improve outcomes our learners, BCBAs and OTs must develop a common, evidence-based understanding of sensory interventions that compliments each other’s fields, particularly since the use of such practice is mandated in both the BCBA’s and OT’s code of ethics. According to BCBA’s code of ethics, “clients have a right to effective treatment (i.e., based on the research literature and adapted to the individual client). Behavior analysts always have the obligation to advocate for and educate the client about scientifically supported, most-effective treatment procedures (Professional and Ethical Compliance Code for Behavior Analysts,” p.8, 2016).” Similarly, according to OT’s code of ethics, “OT’s use, to the extent possible, evaluation, planning, intervention techniques, assessments, and therapeutic equipment that are evidence based, current, and within the recognized scope of occupational therapy (“Occupational Therapy Code of Ethics,” p.2, 2015).” By enhancing collaboration and sparking conversation between BCBAs and OTs, we can develop these truly effective consultation strategies, which directly translate to improved practice across professions and and progress amongst shared clients. References Behavior Analyst Certification Board (2016). Professional and Ethical Compliance Code for Behavior Analysts. pp. 1-24. Retrieved from https://www.bacb.com/wp-content/uploads/2017 /09/170706-compliance-code-english.pdf AOTA (2015). Occupational therapy code of ethics. American Journal of Occupational Therapy, vol (69), pp. 1-8. doi:10.5014. Photo Credit: Mindful Rambles mindfulrambles.blogspot.com/2018/02/whats-function-sensory.html No Copyright Intended.
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Summer comes and goes in the blink of an eye and before you know it you are filled with mixed emotions with the start of the new school year. On one end you are looking forward to regaining some structure and predictability, but this may be overshadowed by the unknowns the new school year will bring for your child. Questions fill your head. Will my child “work” with their new teacher? Will their teacher understand them? Will my child finally find a compatible peer and maybe even get invited to a playdate or party? Will my PPT team help create an IEP that truly reflects my child and works off of their strengths? Taking on all these thoughts on at once can feel overwhelming, but it does not have to be.
Fall is a fresh start. Whatever happened during the previous school year, good or bad, should be used as a learning opportunity to create new goals- new goals for yourself as a parent, new goals you would like your child’s team to meet, and new goals for your child. Creating a plan or identifying steps you can take to make progress towards those goals is essential. A plan will serve as a road map during the school year to help keep you, your child's team and your child on track, should you feel like you are heading off course. If you have not already recognized it, you are your child’s most influential advocate and you will likely find yourself actively immersed in this role at some point during the school year. There are 10 behavior analytic strategies parents can use to set themselves up for advocacy success this year and help alleviate some of the stress and feelings of uncertainty associated with the daunting task of feeling like you are sometimes swimming against the tide. Afterall, in the words of Antoine de Saint-Exupéry, a French writer and aviator “a goal without a plan is just a wish.”
Photo Credit: Clipart: Numbers 1-10. Retrieved from: http://www.clipartmasters.com/numbers-1-10-clipart-Hh5XQQ.html. No Copyright Intended. As the new school year approaches so does the opportunity for a fresh start. While you prepare for the new year of advocacy, set new goals, and reflect on your approaches, successes, and obstacles from the year before, it is important to understand the fundamentals of successful advocacy from a behavioral perspective. Doing so will only enhance advocacy efforts in improving quality, and types of services delivered. So, what does behavior have to do with it? Well behavior is defined as anything a person (living being) does. In order for the advocated services or changes to occur, it requires people to engage in behaviors that align with those changes or services. For example, if little Johnny's parents want more frequent communication with the school to better help Little Johnny at home, they can verbally advocate/request that. In order for more frequent communication to occur the staff member/teacher must engage in a series of behaviors on a schedule of some sort, agreed upon between family and teacher, such as write a little note and put it in Little Johnny's backpack at the end of the day every Friday. So how does helping to understand behavior increase the likelihood that the advocated behavior will occur more often in the future? To understand this, is it important to have a basic understanding of the behavior principal called reinforcement. In simple terms reinforcement when delivered after a behavior will increase, reinforce, or strengthen that behavior. In other words that behavior will continue to occur in the future and may even occur more often so long as it meets that outcome some of the time. Different things are reinforcing to different people. Some people love to hear praise while for others praise may be embarrassing/punishing. The way to know whether what you are doing is reinforcing or not is to look at the behavior, is it continuing and increasing or is it decreasing or not occurring at all? How does this help Little Johnny's teacher to write that note every Friday? Put yourself for a moment into the teachers shoes. School days are hectic and teachers are stretched thin in many directions with deadlines looming over their heads constantly. Say a teacher agreed to write that weekly progress note and send it home. A little thank you or verbal praise for that specific behavior from time to time when delivered to the teacher for their efforts can go a long way. It serves several purposes. One, its a genuine thank you that makes the teacher feel appreciated (something teachers don't hear often enough) and second it's also a reminder to the teacher of how helpful and important those communication notes are. Thus the chances that the teacher will remember to send those notes on a regular basis or perhaps even send them more often vs forget from time to time will increase. Understanding behavior and reinforcement are essential to successful advocacy practices and therefore improved outcomes for individuals. There is an old saying that you can catch more flies with honey than with vinegar. Think of the honey as reinforcement and the vinegar as punishment. Can you to get people to do what you want or need for an individual by engaging in punishing behaviors (undermining peoples professional expertise, threatening law suits, talking down to people, etc.) when advocating? Sure you can. Will the quality be the same? Probably not. This is not to say that in some extreme instances when all other measures are exhausted more intense advocacy practices such as due process aren't needed, however resorting to these from the get go damages relationships. And even if you do go the more extreme route, you still need to have those relationships in tact as the process can take time and the individual being advocated for still needs the best care possible. So in preparation for this new year of advocacy take care to remember that you are one part of the team and teams produce better outcomes for the individuals they serve when they are united rather than divided. As the school year starts, whether you are a parent, a teacher, an advocate, a lawyer or other related service provider take some time to get to know the other members of the team and work on building relationships with them over time. Dole out positive reinforcement in the form or praise, notes etc. to acknowledge the hard work team members put in. Make sure you are specific in praising or reinforcing the exact behaviors you like and want to see more of, so that when it comes to a topic of need where not everyone may agree, team members will be more open to compromise and or finding creative solutions that satisfy the individuals needs. Therefore improving outcomes in the long run. Photo Credit: SUFY. Puzzle Advocacy Picture. Retrieved from: http://www.sufy.org.au/2015/09/18/test-blog/ No Copyright Intended. Through Collaboration, Trust, and Science.Our mission is to impart meaningful socially significant change through collaboration, trust and science. So what does that really mean? Well since we're Behavior Analysts, defining behavior and language that labels behavior is what we do. So here goes..
Collaboration- The act of working together toward a common goal by identifying one another strengths and creating a plan that utilizes those strengths toward an identified socially significant outcome or goal. There is a big difference between collaborative work and parallel work. In parallel work, each discipline provides their prescribed treatment or recommendations without consideration for how it will work with treatments prescribed by other professionals. In collaborative work, professionals come together, bring their recommendations to the table and utilize each other's strengths to complement the interventions of the team as a whole. If collaborative professionals disagree, they work hard to find a common ground. Trust- The act of doing what one verbally states or agrees to do compounded over time. Trust is a two way street. It involves the behavior of an individual as well as other individuals impacted by the results of that behavior. For example, If I schedule to meet a friend for lunch at 12 pm on a given day, fail to show up, fail to let them know about the change, or fail to provide a good reason for not showing up, trust in performing that behavior (keeping lunch dates)is broken. On the other hand if I show up each time when I am supposed to, notify the friend of any delays etc, trust is built. Each time I show up on time adds to a history of instances that demonstrate I was trustworthy to meet at a certain time. Trust is a series of behaviors performed over time that align with a set of verbal rules. That's it! So the answer to building trust is to follow through with engaging in behavior that aligns with those rules. Science- The activity of systematically observing and studying the make up and behavior of the physical and natural world through an objective lens (Dictionary.com/Science). The science of ABA specifically studies behavior and the environment through an objective lens (defines behavior in a manner that any number of people observing it can agree on what they are seeing), identifies variables influencing behavior in the environment and aims to change disruptive, non-preffered and inefficient behavior by making changes to the environment influencing it, in an effort to improve the quality of life of the individual or group of individuals. Let's take a look at a very simple example. Sarah screams several times during the school day. The team working to help Sarah is perplexed and cannot find a cause to her behavior, especially after the doctor ruled out any possible medical causes. Upon further observation of the environment and data collection, a pattern is identified. Sarah's screams are perfectly timed with the loud school bell ringing. The team decides to have Sarah wear noise cancelling headphones, putting them on 1 minute before the bell rings and taking them off when the bell is done ringing. Sarah's screaming behavior stops when she is wearing the headphones during the bell but continues anytime she does not have the headphones during the bell. Her behavior was not unpredictable after all. She did not scream to be disruptive, or because she was a bad person. Her screaming was a form of non verbal communication. That's just it. All behavior is communication whether verbal or not. Studies indicate that only 7% of communication is verbal. The other 97% is non verbal and composed of both body language (55%) and tone of voice (38%), yet the focus primarily remains on the the 7% verbal communication in explaining behavior (Yaffe 2011.) The science of behavior focuses on understanding both verbal and non verbal communication, giving special attention to non verbal communication and how it is influenced by the environment around it. Ever been in a room with someone who says they are excited about something you are sharing with them, but their body language and facial expressions say something different? What does that say about how they really feel? They sure aren't excited? Why not? Are you resharing the same story for the 1000th times? Are they jealous because its something the really wanted to do themselves? There could be many reasons, but their behavior certainly speaks louder than their words, and it is affected by things happening in their environment. Collaboration, Trust, and Science work together to bring meaningful enhancements to advocacy practices and therefore socially significant changes to the individuals we all advocate for. Yaffe, P. (2011). The seven percent rule: fact, fiction, or misunderstanding. Association for Computing Machinery. Retrieved from: http://delivery.acm.org/10.1145/2050000/2043156/a1-yaffe.pdf?ip=67.83.150.105&id=2043156&acc=OPEN&key=4D4702B0C3E38B35%2E4D4702B0C 3E38B35%2E4D4702B0C3E38B35%2E6D218144511F3437&__acm__=1533135752_0ce817ee14 a214f845607e15e29b8bb3 Photo Credit: Handshake. Retrieved from pixabay.com |
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