-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.