Written By: Dana Reinecke, PhD, BCBA-D
Two people examine some graphs together. They discuss the trends and variability in one graph, and troubleshoot ways to improve the pattern so that the child engages in a higher rate of mands (requests for desired items), with the expectation that this will reduce distress and improve independence and participation in family and school activities. A child scoots by (literally, on a scooter), through the kitchen, giggling while another child jogs behind, also giggling. The two adults stop to watch the kids for a moment, and exchange a smile and then return to their discussion.
Would it be surprising to know that one of the adults is a BCBA? Probably not. The graphs and discussion kind of give it away. Who is the other adult? An RBT? A consulting BCBA? A trainee who is engaging in some unrestricted supervision activities? Any of these make sense, but in this scenario, the other adult is the parent of both children, one of whom is receiving ABA services to increase manding.
This scene is a common one for BCBAs working with children, who regularly and comfortably consult with a parent or caregiver of each client regarding many components of programming (for the purposes of this article, the term “caregiver” will be used to include parents and anyone else who may take on the roles described here). These components include type and results of assessment; goal selection; choice and definitions of behavior targeted for increase or decrease; strategies used for effecting behavior change; and as described above, data analysis and outcomes. Ideally, there is also the opportunity to share celebrations of accomplishments, discuss the impact of treatment on the whole family, and address any other areas that may overlap with the BCBA’s role in the family. This regular sharing of information can be approached as a partnership, entered into by people who care about the child, in the best interests of that child.
Partnership is a two-way street, requiring both the professional and the caregiver to prioritize and facilitate the relationship. Depending on the funding source, there may be a third party impacting time and availability of resources for this relationship. Even with limited formal “hours” for working with caregivers, however, the development of a partnership is a necessary and rewarding piece of any effective behavioral programming. As in any partnership, negotiations must occur to arrive at the ideal situation for both parties. Let’s take a look at some areas of consideration.
- Scheduling is an obvious important piece of the partnership. The caregiver and the behavior analyst should establish a mutually agreeable, regular time for connection, with clear boundaries that will help to maintain professionalism and manage both parties’ expectations. Caregivers might not be able to connect during their work day, and BCBAs might have families of their own to spend time with after hours. Working together to identify times when caregivers are able to speak with the behavior analyst without work or other family demands helps to reduce missed opportunities to work effectively together. Similarly, the professional party should be clear about when they are and are not available, so that caregivers can plan accordingly to be available and ready with questions and points for discussion.
- In addition to when to meet, the place for meetings might be negotiable. If telehealth (video or phone conferencing) is possible given the funding structure, this may add a layer of flexibility that can be beneficial to both caregiver and provider. If telehealth is not available, it might be appropriate to think creatively about where meetings happen. For example, the caregiver might welcome the opportunity to meet outside the home, so that they can freely discuss concerns without their child hearing. Alternatively, if the professional can meet in the home, that might allow for better participation of more members of the family.
- Means of communication is another important area to consider. HIPAA-compliant email or texting services may be more efficient and helpful for some caregivers, or may present a burden for those who are not as comfortable with technology. Both parties may be comfortable with phone calls, but there should be some guidelines around when phone calls might not be answered or if it is preferable to schedule phone calls at mutually agreeable times rather than “cold calling.”
- The areas around which partnership occurs should also be a topic of discussion, especially at the beginning of the working relationship. The caregiver rightly should expect the BCBA to be the “expert,” but only in the area of behavior analysis. The caregiver is actually the expert in their child, so they should expect to have a big role at every stage of assessment and intervention. The professional’s role is to provide guidance and advice, based on their prior experience, education, and the published best practices in the field. It is up to the caregiver, however, to provide sufficient information, guidance, and input to the professional so that programming is tailored to best meet the needs of the child and the family. It is also often up to the caregiver to carry out interventions and provide generalization opportunities to complement formal sessions.
With mutual respect, partnership occurs easily and naturally. One way to facilitate partnership is to approach each other with curiosity and humility. The caregiver should assume that the behavior analyst has valuable information to offer, and the behavior analyst should assume the same about the caregiver. Another important way to build partnership is to communicate openly and honestly. If the behavior analyst proposes goals or interventions that are not comfortable or possible for the family, the caregiver should freely express their reservations. The behavior analyst needs to make space for this feedback, and be receptive to it. The caregiver should also be receptive to the behavior analyst, and assume that recommendations are based on best practices and in the best interest of the child and family. Finally, even the best partnership needs to be nurtured. Providers and caregivers should create opportunities to check in with each other about their relationship, and to make adjustments as needed regarding expectations and needs.
The provider and the caregiver will be much more helpful to the child they both care about together, than apart. The little kid scooting around his house is lucky to have a team of people working together to help him live happily, safely, and independently, and the team is lucky to have each other in this important work.
About The Author
Dana Reinecke, Ph.D., BCBA-D is a doctoral level Board-Certified Behavior Analyst (BCBA-D) and a New York State Licensed Behavior Analyst (LBA). Dana is a Core Faculty member in the Applied Behavior Analysis department at Capella University. She is also co-owner of SupervisorABA, an online platform for BACB supervision curriculum, forms, and hours tracking. Dana provides training and consultation to school districts, private schools, agencies, and families for individuals with disabilities. She has published her research in peer-reviewed journals, written chapters in published books, and co-edited books on ABA and autism. Current areas of research include use of technology to support students with and without disabilities, self-management training of college students with disabilities, and online teaching strategies for effective college and graduate education. Dana is actively involved in the New York State Association for Behavior Analysis (NYSABA).