-Authors Casey Barron and Anika Hoybjerg introduce the MOTAS.

By Anika Hoybjerg, PhD, EdS, BCBA-D, LBA and Casey Barron, BCBA, LBA

When working with individuals with autism or other related disabilities, it is common to use an assessment to measure current skill levels against typical developmental norms, or to measure skill acquisition over periods of time. There are several assessments that are commonly used, some of which are The Verbal Behavior Milestones Assessment and Placement Program (VB-MAPP), The Assessment of Basic Language and Learning Skills (ABLLS), The Assessment of Functional Living Skills (AFLS), and Essentials for Living (EFL).

These assessments have paved the way for individuals to receive individualized treatment, give a starting place of where to begin teaching, and record progress over time.

However, while useful, these guides are not comprehensive across the lifespan, and are often used when it is no longer age or developmentally appropriate. Additionally, the scoring within these assessments (with the exception of EFL) does not account for generalization and maintenance of skills, which can make it difficult to accurately measure an individual’s true progress. The Meaningful Outcomes Treatment and Assessment Scale (MOTAS) was designed with some of these limitations in mind and seeks to address these needs.

Meaningful Outcomes Beyond Early Intervention

The MOTAS is appropriate for individuals ranging from age 5 through adulthood. It contains nearly 1,200 goals across 20 domains to comprehensively address skills that an individual needs to communicate wants and needs, gain independence, increase quality of life, build relationships, gain employment, and pursue opportunities of their choosing. The skills and domains were selected intentionally to ensure that any time spent on goals from this assessment would lead to increased opportunities for the individual. To ensure that no goal or domain is worked on to just “check a box” or fill a grid, a “Meaningful Outcome” has been provided for each domain and subdomain in the assessment, describing why that specific set of skills is important, and what can be gained by working on and addressing those skills.

Domains are comprehensive in covering skills for an individual who is just starting to learn these skills, and become progressively more complex. Additionally, nearly every domain includes goals related to safety, problem-solving, and flexibility.

Unique, Easy-to-Use Scoring

In addition to comprehensive skills and domains, the MOTAS has a unique scoring system that measures whether an individual has gained independence in a skill, whether they have generalized the skill to multiple environments and multiple people, and whether they have maintained the skill over time. The scoring system is easy to use while still offering a comprehensive look at the client’s progress:

0 – Not applicable

1 – Pre-skill: Has not yet demonstrated the skill

2 – Prompted: Completes the skill with prompts

3 – Independent: Independently engages in the skill without prompting

4 – Generalized: Completes the skill with multiple people and in multiple environments

5 – Maintained: Completes the skill without daily teaching and instruction, while also maintaining generalization of the skill (i.e., it is truly mastered)

Focus on Individualized Care

The MOTAS should be completely individualized to the person you are working with. This is highlighted in the instructions and throughout the assessment. Structured interviews were created to be used with the MOTAS in order to create a treatment plan that is unique to the client, and meets the needs of the client, family, caregivers, and other professionals. These interviews are called the Levels of Optimum Performance (LOOP) Interviews. Three versions of this interview are included in each booklet. One interview is designed to be used for caregivers, another with other professionals who work with the individual (such as an occupational therapist or a speech-language pathologist), and the third interview is designed to be used with the client themselves (the LOOP-C). The LOOP-C was designed in collaboration with multiple autistic individuals. They provided feedback and insight on the phrasing of questions, whether questions should be included or omitted, and provided suggestions on how to conduct the interview in a way that is comfortable for the individual being interviewed.

Working with the DSM-5 and Insurance

Another defining feature of the MOTAS is the inclusion of the diagnostic criteria for Autism Spectrum Disorder from the Diagnostic and Statistical Manual of Mental Disorders- Fifth Edition (DSM-5). Professionals who provide services to individuals with autism may be required to submit authorizations and treatment plans to insurance companies, many of which require that treatment goals align with the diagnostic criteria for autism. By providing this criteria within the assessment, professionals can be sure to align goals with this criteria, saving time for both the professional and the payor. 

As with any assessment, implementers hold an incredible responsibility in selecting the appropriate assessment for their client. Using the MOTAS is not simply about gathering data or observing behaviors; it’s about understanding the unique way to meet an individual’s needs, how their future is shaped, and increasing opportunities for independence.

About the Authors

Anika Hoybjerg, PhD, EdS, BCBA-D, LBA
Dr. Hoybjerg is the CEO, founder, and owner of Autism & Behavioral Intervention (ABI) (a clinic-based ABA center in Draper, UT), ABA Education Center, and Integrity Billing. In addition to founding and leading these companies, Anika has worked in public schools and in private sectors with children and families for over 20 years. Anika is a Doctoral level Board Certified Behavior Analyst (BCBA-D) and a Licensed School Psychologist. Anika has a Bachelor’s degree in Human Development, a Master’s Degree in Curriculum and Instruction with an Emphasis in Autism, a Master’s degree in Human Exceptionality, an Ed.S in School Psychology, and a Ph.D. in Applied Behavior Analysis. Anika is currently pursuing a Master’s degree in Neuroscience and Trauma. Anika has presented at regional, national, and international conferences on a variety of topics relating to kindness in ABA services, autism, collaboration, and assessments.

Casey Barron, BCBA, LBA
Casey is a practicing Board Certified Behavior Analyst in Salt Lake City, Utah. She has been working in ABA since early 2015, spending several years first working as an RBT then as a BCBA in academic, home, and clinical settings. In addition to her work as a practicing BCBA, Casey works as the clinical director of an ABA center that has supported hundreds of children and where she oversees and trains staff members and future BCBAs. Since becoming a BCBA, Casey has presented at regional and international conferences on case studies from her own clinical practice.

By: Different Roads to Learning, Originally published February 14, 2019

Unemployment rates in the autism community are alarming, but the number of individuals entering the workforce only continues to grow. This presents an overwhelming challenge for special educators tasked with preparing learners for what is often an uncertain future. Vocational training is essential as learners with autism approach the transition to adulthood.  With this in mind, Nassau Suffolk Services for Autism (NSSA) introduced The Salad Shoppe in the fall of 2017.

The curriculum was developed by Kathryn Reres and Rebecca Chi, devoted special educators determined to ensure dignified and purposeful futures for the eight young adult students in their classroom. The focus was to create a program that would provide functional tasks for each learner based on their individual skills, interests and IEP goals. The result was an innovative vocational training curriculum that highlights the strengths of each participant, introduces new skills into their everyday lives and serves as a profitable social enterprise. 

The Salad Shoppe model requires multiple steps to be taken over the course of two days, including: Tracking and counting money, taking inventory, creating shopping lists, purchasing, food preparation, converting a customer’s order form to food assembly, delivery and clean up. This comprehensive list ensures that every learner has the opportunity to perform a task that is meaningful and functional to them. (The staff at NSSA are reaping the benefits too! Fresh, healthy, personally-delivered lunches each week have been a huge hit.)

In partnership with Different Roads to Learning, the creative teachers who designed The Salad Shoppe for NSSA are sharing their expertise with special educators everywhere. The published curriculum will allow teachers to implement The Salad Shoppe in a way that will best function for the learners they serve. Now more than ever, there is a crucial need to provide young adults with autism with the tools they will need to take on the competitive workforce. The Salad Shoppe is a cutting-edge curriculum that has opened new doors for educators, learners and parents and will continue to change the landscape of vocational training.

Developed by  Kathryn Reres & Rebecca Chi, with illustrations by Brian Mannion, in partnership with NSSA and Different Roads to Learning

By Nahoma Presberg, MS, BCBA, NYS-LBA

One of the core characteristics of autism spectrum disorder is an abnormal approach to social skills. The DSM specifically uses the language “persistent deficits in social communication and social interaction across multiple contexts.” While this may seem straightforward, social skills are an incredibly complex concept to dive into. There are considerations like culture, age, status, and personal preference that all contribute to how people choose to interact in our social world.

Social skills are also incredibly important! Being able to effectively interact with the world around you impacts virtually every other aspect of life. When we’re thinking about teaching people social skills, there can be a lot of pressure to get it right. Let’s take a look at some recommendations to help re-imagine teaching social skills from a neurodiversity-affirming perspective.  

Ways to teach social skills in ways that are affirming:

1. Include the client in decision making. We might teach someone a social rule and the impact that it might have to not engage with that social rule. Then we can help that individual think about times when it might be important to follow that rule and times when it is less important. Small talk is a great example of a social norm that may not always be necessary, but can be a useful skill in the right circumstances. 
2. Lead with consciousness about mental health. Self-image can be so challenging, especially when you’re closely examining how people interact with each other. It can feel alienating to know that you’re not clicking socially and that there’s some secret code that everyone else seems to know. Be kind!
3. It’s better to have one really good friend than 10 friends who don’t actually really like you. Prioritize quality relationships and helping your client find people who appreciate them for who they are instead of helping them fit in as a less authentic version of themselves. 

Ways to teach social skills that are not affirming:

1. Over-emphasis on social scripts. Social scripts serve a function in a number of specific instances. However, genuine social skills come from a place of authenticity. Be conscientious about when they are useful, and when they might actually get in the way.
2. Forcing specific leisure skills on someone because of their age, gender, etc. It can be useful to have hobbies in common with the peers around you. However, if it’s not a genuine interest, it is going to be difficult to use that hobby to develop genuine friendships anyway.
3. Over-emphasis on the reduction of quirky behaviors in the interest of someone “fitting in.” It is true that sometimes certain behaviors can be off-putting in public and may impact someone’s ability to seamlessly navigate a social environment. However, this should not be the primary focus of a social skills program.

These strategies are just the tip of the iceberg. Autistic individuals have been providing a lot of feedback to therapists in recent decades about what supports feel useful and which ones feel alienating. As you continue to learn about social skills programming, I encourage you to learn directly from the people who are receiving the therapy. Happy programming!

About the Author

Nahoma Presberg, MS BCBA NYS-LBA, is a Board Certified Behavior Analyst. Nahoma obtained their master’s degree at the University of Rochester in Human Development. They have been working with clients in their homes for the past 6 years but has over a decade of experience supporting children with developmental disabilities. Nahoma is passionate about neurodiversity affirming care and thoughtful programming that helps every client thrive.

For more information about Nahoma, you can visit their website at https://www.nahomapresberg.com/.