Behavioral Seismology

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AFAB, autism, BACB CEU, behavior, behavioral seismology, cusp emergence, Cusp Emergence University, Dr. Kolu, ethics ceu, health, hormones, mental health, neurodiversity, PCOS, perimenopause, PMDD, PME, PMS, supervision CEU, trauma

Article in series on TIBA (trauma-informed behavior analysis) by Dr. Teresa Camille Kolu, Ph.D., BCBA-D

For many people including up to 90% of autistic women, our behaviors, moods, and medical symptoms worsen every month in the luteal phase of the menstrual cycle. But why? This may baffle even the most highly trained OBGYNs and behavioral scientists, let alone parents, caregivers, staff, and clients receiving behavioral services.

To Dr. Kolu, behavioral seismology is the scientific study of cyclical changes in a person’s experience that result in predictable (and potentially damaging) disruptions in an individual’s behavioral environment. Predictions about cyclical needs could be used to reduce the risk of damage and injury to clients and others related to hormone-behavior interactions. People can experience an increase in behavior needs, emotional needs, medical needs, and challenging interactions between all three, but it can help to know and be able to predict when they will be most at risk.

For individuals assigned female at birth (and relevant to anyone who loves, cares for, or conducts behavioral support for someone with these characteristics) , Dr. Camille Kolu discusses these four distinct behavioral risk profiles as ways to help make sense of the predictable disruptions that can occur regularly and monthly for up to 2 weeks at a time (as in PMDD) or for several years (as in perimenopause). The 4 risk profiles include the following:

PCOS or polycystic ovary syndrome
PMDD or premenstrual dysphoric disorder
Perimenopause and
PME (premenstrual exacerbation).

These 4 profiles are each accompanied by a pdf fact sheet downloadable as a resource in the new course on Behavioral Seismology from Cusp Emergence University. In each PDF are characteristic risk factors; biological signs; medical, behavioral and other symptoms the risk profile makes more likely; a to-do list for providers; and notes on expected interactions between behavior and the medical diagnosis. For instance, in PCOS, a client in behavioral services might experience self-injury related to the predictable pain during ovulation or food related behavior challenges that are related to the characteristic insulin resistance. In PMDD, a client in behavioral services who also has autism might experience sudden explosive outbursts in the second half of their menstrual cycle.

What are some of the benefits of becoming a healthcare or behavioral provider more informed about behavioral seismology?

Information can help to demystify behavior needs, as we put them into the context of an individual suffering with medical issues that need treatment. As a case example, one of Dr. Kolu’s patients had a diagnosis of PCOS (polycystic ovary syndrome) and took related medication. However, the behavioral team thought of that diagnosis as completely divorced from their behavioral treatment, and had never been trained on (or requested support to learn) what specific behaviors were anticipated and when they would get worse. As a result, the behavioral team had written goals that were inappropriate and inflexible. In most of the risk profiles we discuss in the Behavioral Seismology course, behaviors improve for the first two weeks of the cycle, when reinforcers are more potent. In the luteal phase of the cycle, a behavior targeted for reduction is likely to come raging back, as several things occur: one of the most significant is that aversive stimuli are temporarily more aversive! Another is that conditioning processes (such as extinction) are affected by hormone levels; for someone with trauma, the things we call “conditioned fear stimuli” or reminders of bad things that happened in the past, seem more present and potent during the luteal phase. Could these changes affect behavior? Absolutely! What if we ignored these biological realities and expected clients to simply do better and better on their goals in a linear trajectory? Could this be demoralizing for them and frustrating for caregivers and uninformed providers?

We can be more flexible in goal writing, more appropriate in support, more predictive in funding needs, and more compassionate in treatment, when we truly take someone’s medical needs into account. This is the point of the Behavior Analysis Certification Board (BACB)’s Ethics Code Item 2.12. For providers interested in taking that code seriously, Behavioral Seismology (4 CEUs total) provides an ethics CEU focused on treating behavior in ways much more contextually appropriate.

Other things you’ll find in the course:

4 pdf risk profiles
An aversive stimulus tracker template (and filled out example)
A Cyclical Needs Conversation Guide for providers
A tool called “Rethink Your Language” (using the example of how the word “aggression” can cause impactful changes in someone’s life)
Insulin Resistance Handout (with information about how this condition intersects with each risk profile discussed in the training)
Information on how autism intersects in surprising ways with several of the risk profiles (and a tool called “Acting on Combined Risk”)
A Cyclic Behavior Support Plan Template
The Cyclic Systems Support Checklist (for companies and teams making these changes in their processes)
A video script for the 8 videos accompanied by printable handouts
Full references for over 70 published articles (including ones by autistic providers on lived experiences of individuals affected by both autism and hormone-behavior interactions
Thought questions
Thoughtful intersections and objectives to apply ethics codes to understanding the ethical implications of information in each chapter
and much more.

Want to learn more? Take the course, contact Dr. Kolu to let us know you want to attend one of our live training sessions on Behavioral Seismology, or see the references below.

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Behavioral Seismology References by Topic

Introduction to behavioral seismology:

Beltz, A. M., Corley, R. P., Wadsworth, S. J., DiLalla, L. F., & Berenbaum, S. A. (2020). Does puberty affect the development of behavior problems as a mediator, moderator, or unique predictor?. Development and psychopathology, 32(4), 1473-1485.

Graber JA (2013). Pubertal timing and the development of psychopathology in adolescence and beyond. Hormones and Behavior, 64(2), 262–269.

Negriff S, & Susman EJ (2011). Pubertal timing, depression, and externalizing problems: A framework, review, and examination of gender differences. Journal of Research on Adolescence, 21(3), 717–746. doi: 10.1111/j.1532-7795.2010.00708.x

References for PCOS:

Cherskov, A., Pohl, A., Allison, C., Zhang, H., Payne, R. A., & Baron-Cohen, S. (2018). Polycystic ovary syndrome and autism: a test of the prenatal sex steroid theory. Translational psychiatry, 8(1), 136.

Dan, R., Canetti, L., Keadan, T., Segman, R., Weinstock, M., Bonne, O., … & Goelman, G. (2019). Sex differences during emotion processing are dependent on the menstrual cycle phase. Psychoneuroendocrinology, 100, 85-95.

Dumesic, D. A., & Lobo, R. A. (2013). Cancer risk and PCOS. Steroids, 78(8), 782-785.

Evans, S. M., & Foltin, R. W. (2006). Exogenous progesterone attenuates the subjective effects of smoked cocaine in women, but not in men. Neuropsychopharmacology, 31(3), 659-674.

Evans, S. M., Haney, M., & Foltin, R. W. (2002). The effects of smoked cocaine during the follicular and luteal phases of the menstrual cycle in women. Psychopharmacology, 159, 397-406.

Katsigianni, M., Karageorgiou, V., Lambrinoudaki, I., & Siristatidis, C. (2019). Maternal polycystic ovarian syndrome in autism spectrum disorder: a systematic review and meta-analysis. Molecular psychiatry, 24(12), 1787-1797.

Mulligan, E. M., Nelson, B. D., Infantolino, Z. P., Luking, K. R., Sharma, R., & Hajcak, G. (2018). Effects of menstrual cycle phase on electrocortical response to reward and depressive symptoms in women. Psychophysiology, 55(12), e13268.

Sakaki, M., & Mather, M. (2012). How reward and emotional stimuli induce different reactions across the menstrual cycle. Social and personality psychology compass, 6(1), 1-17.

References for PMDD:

Browne, T. K. (2015). Is premenstrual dysphoric disorder really a disorder? Journal of Bioethical Inquiry, 12, 313-330.

Ellis, R., Williams, G., Caemawr, S., Craine, M., Holloway, W., Williams, K., … & Grant, A. (2025). Menstruation and Autism: a qualitative systematic review. Autism in Adulthood.

Epperson, C. N., Pittman, B., Czarkowski, K. A., Stiklus, S., Krystal, J. H., & Grillon, C. (2007). Luteal-phase accentuation of acoustic startle response in women with premenstrual dysphoric disorder. Neuropsychopharmacology, 32(10), 2190-2198.Ford, 2012

Freeman, E. W., & Sondheimer, S. J. (2003). Premenstrual dysphoric disorder: recognition and treatment. Primary care companion to the Journal of clinical psychiatry, 5(1), 30.

Gingnell, M., Bannbers, E., Wikström, J., Fredrikson, M., & Sundström-Poromaa, I. (2013). Premenstrual dysphoric disorder and prefrontal reactivity during anticipation of emotional stimuli. European Neuropsychopharmacology, 23(11), 1474-1483.

Halbreich, U., Borenstein, J., Pearlstein, T., & Kahn, L. S. (2003). The prevalence, impairment, impact, and burden of premenstrual dysphoric disorder (PMS/PMDD). Psychoneuroendocrinology, 28, 1-23.

Kulkarni, J., Leyden, O., Gavrilidis, E., Thew, C., & Thomas, E. H. (2022). The prevalence of early life trauma in premenstrual dysphoric disorder (PMDD). Psychiatry research, 308, 114381.

Obaydi, H., & Puri, B. K. (2008). Prevalence of premenstrual syndrome in autism: a prospective observer-rated study. Journal of International Medical Research, 36(2), 268-272.

Protopopescu, X., Tuescher, O., Pan, H., Epstein, J., Root, J., Chang, L., … & Silbersweig, D. (2008). Toward a functional neuroanatomy of premenstrual dysphoric disorder. Journal of affective disorders, 108(1-2), 87-94.

Sacher, J., Zsido, R. G., Barth, C., Zientek, F., Rullmann, M., Luthardt, J., … & Sabri, O. (2023). Increase in serotonin transporter binding in patients with premenstrual dysphoric disorder across the menstrual cycle: a case-control longitudinal neuroreceptor ligand positron emission tomography imaging study. Biological Psychiatry, 93(12), 1081-1088.

References for Perimenopause:

Ambikairajah, A., Walsh, E., & Cherbuin, N. (2022). A review of menopause nomenclature. Reproductive health, 19(1), 29.

Arnot, M., Emmott, E. H., & Mace, R. (2021). The relationship between social support, stressful events, and menopause symptoms. PloS one, 16(1), e0245444.

Avis, N. E., Crawford, S. L., Greendale, G., Bromberger, J. T., Everson-Rose, S. A., Gold, E. B., … & Study of Women’s Health Across the Nation. (2015). Duration of menopausal vasomotor symptoms over the menopause transition. JAMA internal medicine, 175(4), 531-539.

Constantine, G. D., Graham, S., Clerinx, C., Bernick, B. A., Krassan, M., Mirkin, S., & Currie, H. (2016). Behaviours and attitudes influencing treatment decisions for menopausal symptoms in five European countries. Post Reproductive Health, 22(3), 112-122.

Cusano, J. L., Erwin, V., Miller, D., & Rothman, E. F. (2024). The transition to menopause for autistic individuals in the US: a qualitative study of health care challenges and support needs. Menopause, 10-1097.

Duralde, E. R., Sobel, T. H., & Manson, J. E. (2023). Management of perimenopausal and menopausal symptoms. Bmj, 382.

Guthrie, J. R., Dennerstein, L., Taffe, J. R., & Donnelly, V. (2003). Health care-seeking for menopausal problems. Climacteric, 6(2), 112-117.

Hamilton, A., Marshal, M. P., & Murray, P. J. (2011). Autism spectrum disorders and menstruation. Journal of adolescent health, 49(4), 443-445.

Hoyt, L. T., & Falconi, A. M. (2015). Puberty and perimenopause: reproductive transitions and their implications for women’s health. Social science & medicine, 132, 103-112.

Karavidas, M., & de Visser, R. O. (2022). “It’s not just in my head, and it’s not just irrelevant”: autistic negotiations of menopausal transitions. Journal of Autism and Developmental Disorders, 52(3), 1143-1155.

Kling, J. M., MacLaughlin, K. L., Schnatz, P. F., Crandall, C. J., Skinner, L. J., Stuenkel, C. A., … & Faubion, S. S. (2019, February). Menopause management knowledge in postgraduate family medicine, internal medicine, and obstetrics and gynecology residents: a cross-sectional survey. In Mayo Clinic Proceedings (Vol. 94, No. 2, pp. 242-253). Elsevier.

Moseley, R. L., Druce, T., & Turner-Cobb, J. M. (2020). ‘When my autism broke’: A qualitative study spotlighting autistic voices on menopause. Autism, 24(6), 1423-1437.

Moseley, R. L., Druce, T., & Turner‐Cobb, J. M. (2021). Autism research is ‘all about the blokes and the kids’: Autistic women breaking the silence on menopause. British Journal of Health Psychology, 26(3), 709-726.

Namazi, M., Sadeghi, R., & Behboodi Moghadam, Z. (2019). Social determinants of health in menopause: an integrative review. International journal of women’s health, 637-647.

Ohayon, M. M. (2006). Severe hot flashes are associated with chronic insomnia. Archives of internal medicine, 166(12), 1262-1268.

O’Reilly, K., McDermid, F., McInnes, S., & Peters, K. (2023). An exploration of women’s knowledge and experience of perimenopause and menopause: An integrative literature review. Journal of clinical nursing, 32(15-16), 4528-4540.

Pinkerton, J. V., Stovall, D. W., & Kightlinger, R. S. (2009). Advances in the treatment of menopausal symptoms. Women’s Health, 5(4), 361-384.

Pinkerton, J. V., & Stovall, D. W. (2010). Bazedoxifene when paired with conjugated estrogens is a new paradigm for treatment of postmenopausal women. Expert opinion on investigational drugs, 19(12), 1613-1621.

Polo-Kantola, P. (2011). Sleep problems in midlife and beyond. Maturitas, 68(3), 224-232.

Roth, T., Coulouvrat, C., Hajak, G., Lakoma, M. D., Sampson, N. A., Shahly, V., … & Kessler, R. C. (2011). Prevalence and perceived health associated with insomnia based on DSM-IV-TR; international statistical classification of diseases and related health problems, tenth revision; and research diagnostic criteria/international classification of sleep disorders, criteria: results from the America insomnia survey. Biological psychiatry, 69(6), 592-600.

Santen, R. J., Stuenkel, C. A., Burger, H. G., & Manson, J. E. (2014). Competency in menopause management: whither goest the internist?. Journal of women’s health, 23(4), 281-285.

Santoro, N. (2016). Perimenopause: from research to practice. Journal of women’s health, 25(4), 332-339.

Williams, R. E., Kalilani, L., DiBenedetti, D. B., Zhou, X., Fehnel, S. E., & Clark, R. V. (2007). Healthcare seeking and treatment for menopausal symptoms in the United States. Maturitas, 58(4), 348-358.

Wood, K., McCarthy, S., Pitt, H., Randle, M., & Thomas, S. L. (2025). Women’s experiences and expectations during the menopause transition: a systematic qualitative narrative review. Health Promotion International, 40(1), daaf005.

Zhu, C., Thomas, N., Arunogiri, S., & Gurvich, C. (2022). Systematic review and narrative synthesis of cognition in perimenopause: The role of risk factors and menopausal symptoms. Maturitas, 164, 76-86.

References for Behavioral Perspectives on Topics in Hormones and Behavior:

Altundağ, S., & Çalbayram, N. Ç. (2016). Teaching menstrual care skills to intellectually disabled female students. Journal of clinical nursing, 25(13-14), 1962-1968.

Ballan, M. S., & Freyer, M. B. (2017). Autism spectrum disorder, adolescence, and sexuality education: Suggested interventions for mental health professionals. Sexuality and Disability, 35, 261-273.

Barrett, R.P. Atypical behavior: Self-injury and pica. In Developmental-Behavioral Pediatrics: Evidence and Practice; Wolraich, M.L., Drotar, D.D., Dworkin, P.H., Perrin, E.C., Eds.; C.V. Mosby Co.: St. Louis, MO, USA, 2008; pp. 871–885.

Carr, E. G., Smith, C. E., Giacin, T. A., Whelan, B. M., & Pancari, J. (2003). Menstrual discomfort as a biological setting event for severe problem behavior: Assessment and intervention. American Journal on Mental Retardation, 108(2), 117-133.

Edelson, S. M. (2022). Understanding challenging behaviors in autism spectrum disorder: A multi-component, interdisciplinary model. Journal of personalized medicine, 12(7), 1127.

Gomez, M. T., Carlson, G. M., & Van Dooren, K. (2012). Practical approaches to supporting young women with intellectual disabilities and high support needs with their menstruation. Health Care for Women International, 33(8), 678-694.

Holmes, L. G., Himle, M. B., & Strassberg, D. S. (2016). Parental sexuality-related concerns for adolescents with autism spectrum disorders and average or above IQ. Research in Autism Spectrum Disorders, 21, 84-93.

Jain, N. (2024). Effect of hormonal Imbalance on mental health among young women.

Klett, L. S., & Turan, Y. (2012). Generalized effects of social stories with task analysis for teaching menstrual care to three young girls with autism. Sexuality and Disability, 30, 319-336.

Laverty, C., Oliver, C., Moss, J., Nelson, L., & Richards, C. (2020). Persistence and predictors of self-injurious behaviour in autism: a ten-year prospective cohort study. Molecular autism, 11, 1-17.

Mattson, J. M. G., Roth, M., & Sevlever, M. (2016). Personal hygiene. Behavioral health promotion and intervention in intellectual and developmental disabilities, 43-72.

Moreno, J. V. (2023). Behavioral Skills Training for Parent Implementation of a Menstrual Hygiene Task Analysis. The Chicago School of Professional Psychology.

Rajaraman, A., & Hanley, G. P. (2021). Mand compliance as a contingency controlling problem behavior: A systematic review. Journal of Applied Behavior Analysis, 54(1), 103-121.

Richman, G. S., Reiss, M. L., Bauman, K. E., & Bailey, J. S. (1984). Teaching menstrual care to mentally retarded women: Acquisition, generalization, and maintenance. Journal of Applied Behavior Analysis, 17(4), 441-451.

Rodgers, J., & Lipscombe, J. O. (2005). The nature and extent of help given to women with intellectual disabilities to manage menstruation. Journal of Intellectual and Developmental Disability, 30(1), 45-52.

Shors, T. J., Lewczyk, C., Pacynski, M., Mathew, P. R., & Pickett, J. (1998). Stages of estrous mediate the stress-induced impairment of associative learning in the female rat. Neuroreport, 9(3), 419-423.

Wegerer, M., Kerschbaum, H., Blechert, J., & Wilhelm, F. H. (2014). Low levels of estradiol are associated with elevated conditioned responding during fear extinction and with intrusive memories in daily life. Neurobiology of learning and memory, 116, 145-154.

Veazey, S. E., Valentino, A. L., Low, A. I., McElroy, A. R., & LeBlanc, L. A. (2016). Teaching feminine hygiene skills to young females with autism spectrum disorder and intellectual disability. Behavior analysis in practice, 9(2), 184-189.

References for Conclusions (Menstruation as a Vital Sign; Insulin Resistance and Hormones; Premenstrual Exacerbation)

Click to access MenstruationAndMenopauseAtWork.pdf

https://casadesante.com/blogs/pcos/pcos-fmlapcos/pcos-fmla

Is PMDD a Disability? Workplace Challenges and Accommodations

Click to access discipline-q-a.pdf

Disciplining Students With Disabilities

https://www.prevention.com/health/g43724095/best-period-tracker-app/

Akturk, M., Toruner, F., Aslan, S., Altinova, A. E., Cakir, N., Elbeg, S., & Arslan, M. (2013). Circulating insulin and leptin in women with and without premenstrual disphoric disorder in the menstrual cycle. Gynecological Endocrinology, 29(5), 465-469.

Diamanti-Kandarakis, E., & Christakou, C. D. (2009). Insulin resistance in PCOS. Diagnosis and management of polycystic ovary syndrome, 35-61.

Eckstrand, K. L., Mummareddy, N., Kang, H., Cowan, R., Zhou, M., Zald, D., … & Avison, M. J. (2017). An insulin resistance associated neural correlate of impulsivity in type 2 diabetes mellitus. PLoS One, 12(12), e0189113.

Kolu, T. C. (2023). Providing buffers, solving barriers: Value-driven policies and actions that protect clients today and increase the chances of thriving tomorrow. Behavior Analysis in Practice, 1-20.

Kuehner, C., & Nayman, S. (2021). Premenstrual exacerbations of mood disorders: findings and knowledge gaps. Current psychiatry reports, 23, 1-11.

Lin, J., Nunez, C., Susser, L., & Gershengoren, L. (2024). Understanding premenstrual exacerbation: navigating the intersection of the menstrual cycle and psychiatric illnesses. Frontiers in Psychiatry, 15, 1410813.

Sullivan, M., Fernandez-Aranda, F., Camacho-Barcia, L., Harkin, A., Macrì, S., Mora-Maltas, B., … & Glennon, J. C. (2023). Insulin and disorders of behavioural flexibility. Neuroscience & biobehavioral reviews, 150, 105169.

Ueno, A., Yoshida, T., Yamamoto, Y., & Hayashi, K. (2022). Successful control of menstrual cycle‐related exacerbation of inflammatory arthritis with GnRH agonist with add‐back therapy in a patient with rheumatoid arthritis. Journal of Obstetrics and Gynaecology Research, 48(7), 2005-2009.

Vollmar, A. K. R., Mahalingaiah, S., & Jukic, A. M. (2024). The Menstrual Cycle as a Vital Sign: a comprehensive review. F&S Reviews, 100081.

Yu, W., Zhou, G., Fan, B., Gao, C., Li, C., Wei, M., … & Zhang, T. (2022). Temporal sequence of blood lipids and insulin resistance in perimenopausal women: the study of women’s health across the nation. BMJ Open Diabetes Research & Care, 10(2).

Understanding Values: The Connection to Context and Action

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Posted by kolubcbad in adults, BACB CEU, Behavior Analysis, buffers and barriers, children, collaboration, Uncategorized

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ABA, ACT, assent, buffers, committed action, garden, gardening, nature, permaculture, values

Why are values meaningless without contextual understanding, and committed action? And what’s the connection to Homer Simpson?

The question is found in both behavioral and permaculture applications. If you caught my talk at Stone Soup ABA 2024 sponsored by Lake Ridge Community Support Services, you heard a permaculture example (e.g., the seemingly value-based statement “if you value native plants, root out all invasive species”). This loosely parallels the concept of “just ignore junk behavior and reinforce what you DO want” in behavior analysis.

Is it always best to rip out non-native plants? For behaviorists, is it always appropriate to ignore and let “junk behavior” wither and die?

Maybe part of the problem is our misuse of the concept of “always”.

Now, I was fortunate to grow up with a witty, smart as a whip, biologist mom. She cared about the earth (more than my teen feelings of embarrassment, which I outgrew thanks to her bold example) and called out high school boys who littered right in front of her. She took us to Earth Day events even when we were one of the only families there (and, consequently, I WON the Earth Day Fishing Tournament, having been the ONLY entrant in my class). She wore the same Big Bend hat for decades, was a master gardener and a proud member of our local Native Plants Society, and championed native plants.

But she evolved with knowledge, like a true scientist does, and she would value the principles of permaculture that I’m learning about now.

Do we need to remove this thing, or understand it first?

For example, now we ask questions before we pull things out. Why is this plant here? Why does it grow, when almost nothing else is growing? What special features does it have that makes it thrive in a barren space of edges where the beautiful native plants we wish were here… AREN’T?

We appreciate the many interlocking functions of the thing we observe before us. What is it doing for the soil? Is it taking up space and time in an important way, holding the soil in place where it would have eroded due to habitat loss faced by the native plants leaving? Is it providing habitat for insects, birds, shade loving plants or others who need it?

If I say my value involves loving native plants but I mindlessly remove non-natives without considering THEIR roles too, I risk failing both natives and non-natives.

OK… what’s that got to do with Homer Simpson? Well, look. I want you all to be able to use the buffers. And one exercise I provide to teams or families new to them, is a little fun challenge: see how many you can use today. Why, go ahead and think about a single HOUR. How many can you use? For instance, Homer is… eating a sandwich (nutrition(ish) buffer)… while in bed… (sleep buffer?) with Marge (relationship buffer)… maybe this is helping his mental health and stress relief. Maybe they’re going to get in some exercise later this evening.

But here’s the thing. You need values, AND you need inter-relatedness among the buffers. We care about intentional connections, not simply combinations.

Homer’s always missed something. He loves Marge, but he often doesn’t think about her experience at all. He’s getting some buffers in, sure, but you know what happens almost immediately in this episode?

“Marge, I’d like to be alone with the sandwich for a moment.”

When we’re self-serving with our buffers, or mindlessly try to “get them all in” (or put them on someone else’s schedule when they haven’t provided their assent (see the BACB Ethics Code and its descriptions of it or learn more here) or even their INPUT), we’re not really embodying that value of fostering interconnected buffers.

Something I recommend is picking a buffer that guides your others… and anchoring committed actions to the OTHER buffers that reflect back that first one. (Interested in this? Work with or care about teens? Check out The Thriving Adolescent, for concrete suggestions and examples around selecting a value and identifying committed actions that reflect those.) For those of us in relationships, maybe it’s the idea that most of all, you want to value and protect the nurturing relationship. Then the other buffers can be designed around actions that reflect this. I know when I do this, I eat well because I’m making loving healthy meals for and with all my family members and we’re eating together. So, my nourishment is enmeshed with theirs and I’m no longer skipping meals, angrily lashing out because I’m hungry or protein deficient, or angry about having to come up with yet another meal idea. I could write a paragraph about each buffer and how it can all relate back to the nurturing relationship I want to foster with my close family members.

When Junk Isn’t Necessarily Junk

What does this have to do with junk behavior? Well, just like non-native plants wouldn’t be there if natives were all thriving. When the environment fosters the conditions which give rise to a healthy balance between plants, people, animals, insects, and the land, it works. And you can often think of many features of so-called “junk” that make it useful for someone else!

When something is rooted out… to make space for development, or there’s a huge loss of a predator, or an introduction of a new animal, etc… other things wander in. Before you trash them, notice them. Maybe they’re playing a role you need to notice, watch a while, understand.

When we change behavior with a plan, a transition, a death, whatever intentional or unintentional changes occur… other things wander in. So often we look only at how we can yank it OUT, without considering why it’s there, what purpose it’s serving. In the terms of buffers, is it temporarily helping someone to tolerate distress? To eat when there’s nothing else? To get rest or escape from their aversive environment? To take up space in their repertoire because there is a lack of meaningful things for them to do, see, say, hear, etc?

Someone wouldn’t use a whole lot of “junk behavior” if their needs were being met, they had tons of skills to communicate effectively, they had meaningful things to do all day and loving listeners to help them spend their time with purpose. (Look at this beautiful way to meet needs WITH “junk” instead of wasting it, and buying yet more building materials!)

The Next Step

Anyway, I hope you enjoy thinking about the buffers today and remembering it’s up to you to do all three: identify your values, understand your context, and design meaningful, committed actions that get you closer to those values. One step closer is enough today. Maybe your step is picking the buffer that most aligns with your core values and operationalizing that one right now! 😊

Ready to take Today’s Next Step? Pick ONE buffer below and operationalize it. That means, jot down what it would look like for you to engage in things that reflect your values in this area. What would you wake up and do, and do throughout the day, if your actions in this buffer area really reflected your values?

Need more info? Try taking the free (and jargon-free!) course on cuspemergenceuniversity.com, or dive a little deeper if you’re a behavior analyst by taking one of the others there.

I love you more than biscuits

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Posted by kolubcbad in adults, Autism, Behavior Analysis, children, Community, Cusp Emergence University, CuspEmergenceUniversity, TI-ABA, TIABA, TIBA, trauma, trauma-informed behavior analysis, Uncategorized

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love, mental health, parenting, relationship, relationships

Another article in the trauma-informed series by Dr. Teresa Camille Kolu, Ph.D., BCBA-D

In relationships we do rituals.

“BLECH!” Startled, I looked down at my sweet, expressive daughter with a true disgust face. Everybody laughed. I was kinda mortified but I laughed too. The woman at MeOhMyCoffeeAndPie (you HAVE to go) had just answered her question with “it’s sauteed onion” when my kid asked “what’s the scone flavor today?”

Ok, I guess she wasn’t expecting that.

I was too caught up noticing this awesome tiny, framed quote by the display case. As a young reader I LOVED Larry McMurtry, see, who wrote Lonesome Dove and a whole lot more. He and I both went to UNT (decades apart, of course) where he gave us a wonderful author meet and greet (early 90s for me, when this kid was not even a twinkle). The coffee and pie shop had quite appropriately chosen to frame this gem of a quote: “She made great biscuits, but her behavior was TERRIBLE”.

My daughter and I were out doing a ritual Saturday thing. My mom used to sing “Come Saturday Morning” with me (we had the sheet music, so it was right up there with “Country Roads” and “The City of New Orleans” in my book). And sometimes we would spend time just us, and I would look at her hands and sing this song in my head. Saturday mornings, for a couple precious hours, are time when my daughter doesn’t have to share me with her little brother, and she pays me back by asking me questions I can’t answer. It’s at this time I learn that even 5 year olds wonder things about God and the universe, have nightmares, they can have crushes, they have fears, they might still want to hold my hand.

I LOVE biscuits but I love her even more. I love her more than her behavior, even that sort of behavior that makes you want to fire the babysitter just so you’ll never have to greet that face that saw the terrible behavior you thought your kid would never do in public and after all, you are a behavior analyst! (Do I think it’s easier because I’m a behavior analyst, my new friend asked recently? Heck no. I personally think it’s harder. But I do think being a parent has made me a better behavior analyst.)

So in relationships we do rituals, like setting up meaningful goodbyes when we leave the room, or when rhythms change and we won’t be spending as much time together anymore. If not, we leave devastation.

When I watch animals grieving each other’s deaths… especially horses and dogs… I notice how fully present they are for the goodbye.

And I am always grieved to consider the implication: such a meaningless slog of goodbyes without reason, or participation, we inflect this on clients when caseloads shift; when a therapist moves; when a client with certain behaviors moves into Hall B, so we just HAVE to abruptly move Client A into Hall D, so they won’t antagonize each other and never mind Client A will never again see her best friend client, or even the janitor—who was like a mother to her and had been there for 12 of the client’s 15 years in this mental facility again.

We often have to make hard decisions, but we should ask questions (“what really hurt your feelings this past week? Today?”) because in relationships we apologize when we’re wrong.

When we realize we hurt others, we shift so that we won’t keep doing the hurtful thing.

My mom remembered the pain of being hurried as a child. I knew that, and I forgot it. I remembered it again this month when I was going through an exercise I was making for a new workshop we will offer at cuspemergenceuniversity.com. The exercise has us grownups go through questions that reveal the triggers for us – the things in our everyday situations that make us more likely to react swiftly (often in a hurtful way) to the others around us. And I realized two things: being hurried doesn’t feel good to children, and hurrying children doesn’t feel good to adults. So what do we do? This week, maybe you will notice a ritual that is always done with urgency, and think, how does this feel? What would this feel like if I slowed down? Now, the harder part: What would it take for me to build in space around this… ten extra minutes before it, so that we don’t have to experience this, every single time, in hurried mode? I tried this, and my children really love it, although I won’t hear about it from them. Their lingering hugs (mama, don’t let go first!) and their wonder as we have time to look around the yard for a new flower before we buckle our seatbelts… the absence of urgent reminders and exasperated sighs… perhaps even a reduction in tense moments when I’m about to lose it and yell. These changes are rewarding enough for me to keep doing this. Because I love them more than biscuits.

Yes, rapport is often transactional. Although it was by design at first, it doesn’t always have to be that way. I talk about this just a little bit in my buffers article, in the relationship section. And in the trauma sensitivity course we talk a little about how to be more sensitive to what folks go through (including your staff) so that YOU can be a little less harsh, a little more supportive, around things you didn’t even realize were hurting the other person.

In relationships, we apologize; we give freely; we do things uncontingently (yes, I know you won’t be able to look that up, and there’s a reason- we talk about it more on instagram and it bears more attention); and we are generous with things the person really needs, like time, kind words, and those little rituals that they consider special. Have you ever worked with a therapist the client really adored? Or a professor beloved by their students? I remember two. The professor is loved and really loves. She gives generously of her wisdom, time, and appreciation for students. (You wanted to ace her class and reflect what you admired in her, even as she whispered the things that made you more of yourself, more creative and passionate and able to grow confidently in the direction of your dreams.) The other person I remember is a therapist who had kids riding on her shoulder at recess in our mixed school for kids with developmental differences and peers. And those folks taught me that you can have instructional control when it’s time, and still have fun with the people who look up to you. Rapport IS often transactional. But the relationship doesn’t have to be.

Thanks for reading.

Oh… and I personally think, in the Longmont area, that Lucille’s has the best biscuits.

And OhMeOhMyCoffeeAndPie has the best lemon bars, if you’re wondering.

I love you more than biscuits, daughter of mine. And I love you even when your behavior is terrible.

What are some relationships between buffers and triggers?

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Posted by kolubcbad in adults, Autism, BACB CEU, CEU, children, Community, continuing education, Cusp Emergence University, CuspEmergenceUniversity, enriched environment, TI-ABA, TIABA, TIBA, trauma, trauma-informed behavior analysis, Uncategorized

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autism, barriers, buffers, buffersandbarriers, children, cuspemergence, CuspEmergenceUniversity, family, kids, motherhood, parenting, parents, TIBA, trauma-informed behavior analysis, triggers

Another article in the TIBA series by Dr. Teresa Camille Kolu BCBA-D

In Chapter 8 of our course on Trauma Sensitivity, we cover the concept of “triggers” and what we can do about them. We cover this mostly from a responsive perspective in the course and use the following operational definition: “Triggers are historically meaningful stimulus complexes or relations between them. In their presence, behaviors or response patterns may be temporarily more likely to occur.” We continue with the big idea from Chapter 8 of that course, “One of the most supportive actions we can take is to stay mindful and do what needs doing in the moment”.

However, another huge thing we can do in helping someone through those triggering events or moments is to plan ahead. Below are some questions we ask our clients and their family members to answer, if they are interested in exploring this. Read on if you’re interested in some examples (we share a brief example of a dyad’s answers, where one member is the 5 year old kid, and the other is a parent). (Oh, and it may be helpful to check out the IPASS (find it in our RESOURCES tab)- this is a little tool we use for folks to go through their sensory environment for clues about triggers, if they need somewhere to start.)

Questions:

1.Name a person you love or a primary relationship you care deeply about.

2.Name an action that you do that shows compassion with them.

3.Name some things the person also does… that REALLY get under your skin.

4.Name an environmental situation or trigger that happens right before it is HARDEST to keep your cool.

5.List some things you start to notice when you’re feeling about to blow up/ lose your cool/ start doing actions that are inconsistent with your values to that #1 person.

6.State things you do to calm down in those moments that REALLY work or are most likely to work.

7.If you DIDN’T act to calm down and things kept getting worse, state the action(s) you would be likely to use next in the presence of that person.

Growth statement: Write your plan to prevent the triggers (3 and 4 above) from leading to actions that are inconsistent with your values (e.g., 7), by doing (6) as soon as you begin to notice things about your insides or the outside environment (5).

Ready to see this in action? Below are some parent answers. Keep in mind that neurodivergent parents often have neurodivergent children (or, looking backward, that neurodivergent children often have neurodivergent parents, whose qualities might not be appreciated until later, in the context of exploring diagnoses with their own children). Have you ever seen a mom struggling with her own misophonia exactly at the same time her child uses loud repetitive noises? Talk about triggering (for and to each other)! But stay hopeful and in the moment, because as hard as it is to be the thing in your loved one’s environment that sets them off, it’s lovely to be the person in their environment who can really understand where they’re coming from.

Parent Example: Answers to 7 questions, above

1.I love my kids.

2.I love it when I am able to use kind words and a calm voice with them.

3.Sometimes my kid makes repetitive noises, does not listen or interrupts me, or doesn’t follow instructions.

4.It is most difficult to keep my cool with my kids when I’m running late somewhere and my kid is not following instructions or is not doing something the “right” way.

5.I start to notice my face getting hot, my neck and face muscles are strained, and my breathing is shallow and fast.

6.If I splash water on my face, relax my muscles, stop and hug my kid, and breathe deeply, it helps to calm me down in the moment.

7.If I skip that step above, I usually proceed to raise my voice and may even shout or say things I don’t mean (things that are not kind and compassionate).

Parent Growth plan: “When I’m late somewhere and it’s really noisy, it’s especially important that I start to notice when I’m using shallow breath, the noise around me is increasing, or I’m noticing everything “wrong” my kids do and nothing right they’re doing. Right then, before I talk to my kid, I need to immediately try some of my calming strategies I listed above.”

OK, now for the kid’s answers.

1.I love my mom and baby brother.

2.I love it when I am able to keep playing, share, have fun.

3.Sometimes my mom tells me to stop doing something I love or tells me how to do something better or my brother takes my stuff.

4.When mom yells or my brother takes my stuff or we have to leave my game or book, it is most difficult to keep my cool.

5.I start to notice my face getting hot, my movements are jerky, my chest hurts, and my breathing is fast.

6.If I hug my mom, splash water on my face, stop and do some jumping jacks and then sit and breathe, it helps to calm me down in the moment.

7.If I skip that step above, I usually yell, hit my brother, or shout “NO! I WON’T!”.

Growth plan my parents can help with: When I’m being asked to stop playing or to do something that interrupts my flow, notice when I’m breathing faster and having a hard time talking. You can help by giving me a hug, doing some jumping jacks with me, and sitting with me and helping me to breathe.

At this point, we ask the parent some meaningful questions to help them make sense of what we’re noticing. And often this is uncomfortable (but becomes exciting and doable) as they first think, “oh, but won’t we be reinforcing escalation?” No, we’re turning it off.

Parents or caregivers, did you notice…

-Whether your having a hard time makes it harder for you to help your other person with THEIR hard time?

-Whether your hard time perhaps CONTRIBUTES to their hard time?

-Whether your triggers are echoed by the ones that seem to affect your kid or client? (e.g., are you teaching your other person to struggle with the same thing you struggle with, without your meaning for this to happen)?

-Whether your triggers might be easier to manage at a period of time when you (or both of you) are well fed, rested, and exercised?

What happens when a BCBA-D gets lessons from domestic violence specialists? 6 strategies to take to heart

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Posted by kolubcbad in adults, BABA, Behavior Analysis, boundaries of competence, collaboration, Community, conferences, continuing education, ethics, TI-ABA, TIABA, TIBA, trauma, trauma-informed behavior analysis

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BABA, BCBA, domestic violence, TIBA, trauma

(An article in the TIBA series by Dr. Teresa Camille Kolu BCBA-D)

One day this spring, Dr. Camille of Cusp Emergence sat down to answer a few questions, and learn a LOT, from Enasha Anglade of LaughLoveLive Again. (You can learn more about Enasha and her work on Episode 87 of the Behaviour Speak Podcast!) Enasha and her fellow researcher and BCBA, Stephanie, talked with Camille about how Enasha’s company and work applies behavior analysis to supporting individuals affected by domestic violence. (And did we mention this dynamic duo will be presenting at BABA this weekend?! Go find them if you’re there!) We also discussed some of the barriers people face in this special context. Not all barriers can be solved with behavior analysis, of course, but there are many things we can do to insure we are minimizing the ones we know about, always staying open to learn about the client’s experience and special context. Each of the headers below reflects an important point heard from Enasha and Stephanie and some thoughts from a trauma-sensitive and behavior analytic perspective.

First, be safe.

Interested in getting involved in working with this population? First things first: it’s really important to be safe for someone. This may seem like a no-brainer. In fact, providing a safe starting place for your therapy is where all trauma-informed support begins, even if (and especially when) your therapy is not treating the trauma itself, but solving problems or building skills or meeting needs related to it. However, there are so many ways behavior analysts violate this number one rule. We might do it unintentionally, such as when we go right to changing behavior instead of listening to a person’s experience and what they truly need first. While there are many trauma-informed resources out there on establishing safety and trust, you can also check out a course on building trauma-sensitive environments (starting with safety), or read a behavior analyst’s discussion on safety in Rajaraman et al.’s 2022 paper on trauma-informed applications of behavior analysis. But don’t skip asking the person how they feel safe and whether there are things you are doing or saying that contribute to their safety or their experience of danger. That’s right- behavior analysts can inadverdently present danger signals to our clients in many ways. When someone is in the middle of a dangerous situation, they are in survival mode and not ready to learn. We don’t want to trigger this for a client and we don’t want to make worse a situation that already exists for them. Being safe (and making sure our presence and therapeutic environment are safe) is not about helping clients avoid all aversive, challenging, or difficult circumstances. Our clients (especially in this context of domestic survivors) are already going through one of the difficult things in their lives. Coming for help and walking out of horrible situations may be even harder than what they’ve been through before… it will be unfamiliar, may be incredibly risky, and may occur at great personal cost to them. What they’re doing is brave. They’re already doing the hard thing. This is about taking their hand and really listening to what they’re going through.

2. Don’t be afraid to go there… but secure support for yourself so your client does not have to do the work for you

Speaking of listening to what they’re going through, behavior analysts can be bad at listening. Does that sound strange? Behavior analysts are great at observing, typically by nature and training… but we can learn to be better listeners, too. And it’s CRUCIAL in this work. Enasha notes that we are often afraid to be personal, to “go there” with our clients. For behavior analysts in the trenches of severe challenging behavior, we’ve often gotten our hands dirty, literally. But to understand our clients coming from domestic violence, being a witness to their story can be meaningful. Listen to your client. Listen long enough to hear. Listen enough to learn what they could benefit from, too. She may need a counselor recommendation, a connection to somewhere she can forge a meaningful relationship, or a tool that you can’t provide (but that someone you know, could). Their daughter may need help for something you don’t treat. Most important, listen to help your client, not just to facilitate your client’s progress with your program.

Related to “going there” with your client, make sure you are not a burden on THEM. If their issues trigger you, your session with them is not the time to discuss that. Of course, there’s nuance involved in learning to listen to someone, so it would be helpful to do any or all of these suggestions: secure your own therapist to go to if you are troubled; be prepared by using specific ACT and mindfulness techniques that keep you able to use your flexibility skills; help your staff debrief with pre-planned supportive interactions after difficult client visits; learn more about motivational interviewing (for a constructional approach from a behavioral perspective see Goldiamond’s constructional interview); and provide training for you and your staff from a trauma expert outside behavior analysis to answer questions about how to support someone disclosing difficult material).

3. Value relationship over rapport, but in the right way.

Your program isn’t everything. Behavior analysis doesn’t solve every problem (despite Skinner’s ideas about saving the world and articles by more contemporary well-intentioned behavior analysts interested in supporting human beings). But your relationship with your client might matter more than you think. And I’m using the word “relationship” instead of “rapport” on purpose. (This section could also be titled, “De-centering us, and behavior analysis, while putting a higher priority on that person and what they need”.)

Of course, if we were talking about real rapport, in the way the layperson uses the term rapport, we’d be talking about the same thing as relationship. The word rapport just means “a close and harmonious relationship in which the people or groups concerned understand each other’s feelings or ideas and communicate well”. But in behavior analysis, the word rapport typically connotes a more transactional process, one used as a procedure as a means to an end. Ultimately, many behavior analysts view rapport as a process one includes in the beginning of sessions or relationships with clients so that clients will be more likely to approach the instructor, and so that the instructor can deliver instructions, reinforcers and other environmental stimuli that encourage the client to change their behavior in specific ways the team has defined and prioritized.

Relationship viewed as an end is different. It has benefits beyond the program. It validates the person and prioritizes their needs. You might think of the way that with a relationship between two people who care about each other, we say goodbye when we’re done. We don’t just transfer off the case without letting the family know because we got a new job, or our hours were cut. However, we’re also not suggesting behavior analysts engage in dual relationships with our clients (an unethical and unhelpful practice to be sure!) What we’re really saying is to value the person over momentary instructional control, and treat them… well, like a person. We still need to be careful, and cautious, to preserve the integrity of precious boundaries. In other words, you are still not going to show up as your client’s “friend”, and you need to teach them, lovingly, how this will work in the beginning of your therapeutic relationship with them. You care about them, and you care enough to support them with their goals. That may include finding friends, or engineering environments that facilitate their making friends, but that’s not you; you’re the therapist. You can still be a good listener, care about your person, and support them without being their friend.

We can program toward the end the entire time, so that there is no disruptive surprise for the client at the ending of the relationship. I like to think about this as fading out interactions to a very low rate that is tolerable, and with programming additional sources of reinforcement for the client. Being the only person your client can trust wouldn’t be helpful; what if you were to have a car accident, move away, or have to reduce your hours? All those things happen, but if you plan from the beginning, you can insure they happen in more therapeutic ways. Be really careful to use ethics code guidelines on transferring cases, especially when you are working with someone in a sensitive and vulnerable situation like those surviving domestic violence.

4. Accept this: any behavior can be influenced both by its consequences in the moment, AND the relevant context and history.

When loud voices in the room ask “what does history have to do with behavior? Shouldn’t we just treat the function that’s controlling it now?”, it can be tempting for vulnerable behavior analysts to question themselves. Should I even be taking a trauma-sensitive approach? Should I take this person’s history into account at all? If it’s just paying off for them in the attention it produces, and we technically know about methods to turn behavior on and off using procedures based on consequences and arranging stimulus control conditions, what does it really matter?

Actually—in terms of bringing up trauma, or changing goals based on it—the answer may vary depending on what the client needs! CuspEmergence doesn’t recommend taking a trauma-informed approach when clients don’t need it. But those going through domestic violence all have been through trauma, by definition. As Rajaraman et al. (2022) states, “Responses to trauma may indeed vary from person to person; however, ACEs are well documented, and a preventative TIC approach would acknowledge their potential impact”.

We recommend behavior analysts working with survivors of trauma be intimately acquainted with the ways trauma relates to behavior, to medical needs, to subsequent challenges and needs, and to the barriers people face in moving on to healing circumstances. (See the sections nearer the end of this article for educating your team if that’s not your forte). And yes, behavior can be influenced by BOTH history (such as the trauma-related factors that were present when someone began to use behaviors that are now difficult for them and they want to change, even if those behaviors are NOW maintained by other environmental factors).

Because behavior is at any moment a function of the dynamic interaction between the local and historical context, it is possible that the intervention strategies identified during the functional assessment phase as “likely to be effective’ will need some modification when it is actually time to intervene. As Stephanie notes, clients affected by domestic violence may face unpredictable and changing needs. The needs of the client demand that the analyst be flexible and sensitive to the contingencies and challenges our client faces. We should be especially focused on tracking the ways we might be contributing (perhaps unintentionally) to coercive cycles of interaction for our client, perhaps hindering their growth by playing in to a power differential or offering choices using an architecture that WE don’t perceive as, but the CLIENT experiences, as coercive.

5. Identify the basic training your team will need. What are the most essential and meaningful training components your staff will need? Who provides that training, and how can you value it at the levels of culture, group, and individual?

What happens when most of the team cannot relate to the particular difficulties with which a client is struggling? They might recommend changes that are not feasible to the client; they might miss danger signals the client is sending based on what is happening around the client (and miss an opportunity to prevent harm); they might take personally or misunderstand the challenges a client is having and miss crucial chances to intervene appropriately; they might cause harm by actions intended to help; and so much more.

One team we know used to have a person on staff who provided this training because she had been through it, but her caseload is now too big for her to spend time with each new staff person. As the team grew, the personalized approach they were known for was eroded and eventually, the services they provided looked like most other agencies, and they were no longer meeting the individual needs of client families. However, they didn’t know it until they received feedback, because nothing had been intentionally changed; it was simply a product of drift that happened with the welcomed growth going on.

So one solution for teams with similar paths is to prioritize providing training from a reputable and experienced source, and doing that both routinely and in a way that continues to answer questions the new team members will have as they gain their own experiences and put their previous knowledge into their new context. In a subfield like domestic violence, this training needs to come from someone either outside of behavior analysis, or from someone whose training, expertise, experience and culture strongly intersects with that of the clients and their needs. If this person is not on staff, it is essential to secure regular training, as well as embedding this as a priority into the agency’s mission, core processes, values at work, and interacting with clients. Staff should not have to ask for designated and regular times they will be paid to access and discuss and apply the training (and receive appropriate feedback from someone equally experienced and trained).

6. Identify the most important kinds of support your clients will need that you cannot or do not provide. What kind of support is needed, who else provides it, and what would you like to be doing in 5 years if you removed barriers related to this support?

The first part (who else provides this?) is a logistics question. Prioritize finding those answers right NOW. If most of your clients receive behavioral support from you, but also need to be able to access certain other resources to survive, find out all about those resources and who provides them.

The idea is that you can position your agency in the middle of a network to which you can connect your clients. You do not want them struggling, alone, with something that could make or break their ability to come back to access your services or to implement them. We can start small, beginning with very simple connections you provide your client, such as a list of websites, phone numbers and connection names for partner agencies in your area that meet big needs (and funding options for those needs).

The second part (what would you be doing in 5 years if you removed obstacles?) takes more planning, but might make sense strategically depending on your clientele and their challenges. Some of the solutions could include creating a part- or full-time position of Resource Coordinator, hiring a social worker, or forging a strategic partnership with someone who fills this role for other companies and who knows your area well and can devote time to your own clients on a weekly or regular basis that makes sense for your client volume.

Do you do this work yourself? Contact us and add your essential strategies. Want to learn more? Find Enasha and Stephanie at BABA, listen to the podcast (Ben is in Detroit right now documenting BABA 2023!), follow ACES and ABA groups on social media, send us a comment and leave us your email below, or take a course on trauma sensitivity. We hope to hear from you soon!

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Have you ever taken an on-demand workshop?

02 Thursday Mar 2023

Posted by kolubcbad in adults, Autism, BACB CEU, Behavior Analysis, Behavioral Cusp, boundaries of competence, CEU, children, collaboration, Community, continuing education, Cusp Emergence University, CuspEmergenceUniversity, supervision, teaching behavior analysis, teaching ethics, TI-ABA, TIABA, TIBA, trauma, trauma-informed behavior analysis, Uncategorized

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BACB CEU, bacb ethics ceu, bacb supervision ceu, bcba-d courses, camille kolu, camille parsons, CuspEmergenceUniversity, ethics ceu, kolu, new course, on-demand workshop, supervision CEU, teresa kolu, trauma sensitivity, trauma sensitivity workshop, trauma-informed behavior analysis

For me, an on-demand workshop does several things: It can be taken any time; one can take it with a group and apply exercises with other people if desired; but since it’s on-demand, an individual will benefit even if taking it solo. It should be expandable if one wants to be able to sit with a chapter for a few extra hours because we simply love the content; there will be resources to grow with and come back to if one can’t do all the exercises right NOW. I’ve been on sabbatical a while; as I return to doing interviews, conferences, talks, and podcasts (including a new one we taped recently for the Atypical Behavior Analyst, with my friend Dr. Eddie Fernandez airing later), it is nice to be able to take something on my own time, when tiny folks are asleep, and I know many parents – and folks going through school and work at the same time – are in the same boat.

So after taking an on-demand online workshop recently, we decided to present some of our own new content in an expandable workshop format instead of the typical course, including several features. Our new Trauma Sensitivity workshop includes:

30+ exercises with the videos: Because this is an on-demand workshop, we present a TON of exercises packaged with the videos. Teams or individuals can easily do a chapter a week along with exercises for a truly transformative experience in your office or supervision setting. But if they choose to take it all at once in an afternoon, that’s possible too. So it’s customizable.
Scalable applications for team members, supervisors and supervisees: The new content (on leveling up the trauma sensitivity of our staff and client environments) is “scalable”, meaning we include applications for 3 different levels of staff: those in roles that are basic; intermediate; and advanced. Presenting it as a workshop meant that the team members “leading” the discussions and exercises benefit just as much as (but different from) the less advanced team members they are mentoring through it.
Supervision guides and chapter handouts: These come with every chapter video and walk the student through the material, from the main ideas we presented, to definitions for any new vocabulary, exercises, lists of Ethics Code items that relate, thoughtful discussion questions, exercises, and chapter resources and articles. Every chapter comes with its own handout and supervision guide to help BACB supervisors or team leaders support our coworkers and supervisees.

The two things I personally love most about this workshop are:

it addresses tough topics like moral injury with your team members and considering how this ethics area could apply to our supervisees but our clients too;
and we provide resources to follow up on big ideas like this one: there are some behavioral needs that medical providers consider symptoms of trauma-related concerns. (If folks are new to integrating trauma sensitivity in their supervision and client environments, we might miss this huge opportunity to make sure we do no harm by treating behavior needs that are actually related to new abuse.)

Wondering about the content of the new workshop? Here are the chapters (each has its own video, ethics intersections, resources, thought questions, and exercises):

Chapter 1: Principles of Trauma-Sensitive Care

Chapter 2: Interactions that could help or do harm

Chapter 3: Features of trauma-related responding

Chapter 4: Defining trauma

Chapter 5: Risks related to trauma

Chapter 6: Elements of a potentially trauma-related response

Chapter 7: Buffers

Chapter 8: Triggers (Then watch integration Scenario Video)

Chapter 9: Neurodevelopment

Chapter 10: Want to mitigate risk? Document it first

Chapter 11: Skills and Stress

Chapter 12: Healthy Collaboration

Above: Table of chapters from Trauma Sensitivity in the Behavioral Workplace, new on-demand workshop from Cusp Emergence

Did you enjoy this article? Come back soon when we’ll cover a few more related topics including: mentorship groups for those applying trauma sensitivity principles in their supervision sessions; how to get the most out of your workshop experience by doing exercises as a group or dyad; more info on a brand new all-trauma conference coming in April hosted by the formidable Dr. Gabi Morgan; meetups in Denver May 2023; and more!

Read below for final thoughts and some links if you’re in the market for values related CEUs: Recently, when my own CEU cycle was about to turn over, I knew it was time to take a course or workshop in something I could use NOW and am passionate about… so I went searching for three things: supervision CEUs; offerings from people I admire and from folks who literally wrote the books on leveling up mentorship and supervision and working with families; and opportunities to learn about values in a deeper way that would help me level up my own practice. That led me to a couple of great courses and podcasts; one of these opportunities was a workshop with built in exercises that could be taken quickly or over the course of a few weeks and included opportunities to network with other folks. It was a really lovely experience. Included are links to a couple trainings and podcasts from respected folks who continue to inspire, below.

https://podcasts.apple.com/us/podcast/the-journey-of-supervision/id1501568747?i=1000485543749

https://evelyngouldphd.com/news/events/20220915-acting-on-a-value-of-self-care-on-demand/

https://www.weareconstellations.com/current-workshops

And here’s the trauma sensitivity on-demand workshop: https://www.cuspemergenceuniversity.com/courses/trauma-sensitivity

Get ready to learn about ASD and trauma

11 Monday Oct 2021

Posted by kolubcbad in adults, Autism, BACB CEU, Behavior Analysis, behavior cusp, Behavioral Cusp, CEU, children, collaboration, Community, continuing education, contraindicated procedures, Cusp Emergence University, CuspEmergenceUniversity, Education and Trauma-Informed Behavior Analysis, learning, podcast, resources, risk analysis, risk assessment, risk versus benefit analysis, TI-ABA, TIABA, TIBA, trauma, trauma-informed behavior analysis

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By Dr. Camille Kolu, Ph.D., BCBA-D

Behavior analysts who treat people with autism probably know that ASD often co-occurs with trauma. But did you know that up to 50 percent or more of people with autism may have experienced trauma, that ASD itself is a risk factor for experiencing trauma, or that children with autism may be around 2.5 times more likely to experience foster care, itself another risk factor for trauma?

These findings are some of the reasons researchers (as well as research-practitioners, including those of us at Cusp Emergence) urge practitioners to adopt screening in order to support the huge group of people affected by both trauma and ASD (see Brenner, Pan and Mazefsky et al. on the need for screening, and special behavioral differences that occur in this population).

*ASD and TIBA: Our newest upcoming course on CuspEmergenceUniversity.com*

They are also just a few of the things you’ll learn when you take the upcoming course on CuspEmergenceUniversity on trauma and autism (coming Fall 2021). Other topics we cover include:

-client examples from both child and adult populations whose experiences include autism and trauma

-literature references helping practitioners discover more about what trauma related experiences people with autism may face

-how behaviors themselves can be risk factors for additional trauma

-behavior programming examples that may be counterindicated procedures depending on the individual needs of autistic people who faced trauma

-examples of ASD communication needs that have been particularly helpful to target when supporting this population after trauma

-behavioral cusps that can make a huge difference after trauma

-examples of worst case scenarios people face when trauma history is not taken into account for individuals with autism after trauma….

…and much more. We also cover how Cusp Emergence uses the SAFE-T model and Assessment (including our risk versus benefit tools) to be more supportive, mitigate risks unique to autism and trauma, and learn more about the whole person and their needs.

Just can’t wait for the CEU course on autism and trauma to be posted in the coming months? Tune in to The Autism Helper’s podcast. Dr. Kolu’s interview with Sasha Long, BCBA is live and we’re excited to share it with you!

25 Things I Want You to Know: Ways I use trauma to inform my practice of behavior analysis

26 Thursday Aug 2021

Posted by kolubcbad in adults, Autism, BACB CEU, Behavior Analysis, boundaries of competence, CEU, children, collaboration, Community, continuing education, contraindicated procedures, Cusp Emergence University, CuspEmergenceUniversity, Education, mental health, resources, risk versus benefit analysis, TI-ABA, TIABA, TIBA, trauma, trauma-informed behavior analysis

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behavior analysis, TIBA, trauma, trauma and behavior analysis, trauma-informed behavior analysis

This is the 21st article in a series on Trauma-Informed Behavior Analysis by Dr. Camille Kolu, BCBA-D

I often hear from educators and behavior analysts, “What do you actually do differently if your client has faced trauma, given your role as a behavior analyst?” In this bulleted series we’ll get there, but we’ll start with what I would want you to understand about myself as your client (or teammate!) who has experienced adverse experiences. Here we list 25 different things I want you to know. (As a hint, each thing we can understand about a person could be a bridge, if you choose to walk through this difficult thing to a shared place of understanding on the other side. We’ll explain in more detail in future posts, or you can check out our course library over at CuspEmergenceUniversity if you’re interested in expanding your boundary of competence). But first, if I were your client or team member – if my past involved trauma – I would want you to understand that now, with the presence of historical trauma,

I MAY:

have difficulties calming down when under pressure
have difficulties using “appropriate” behaviors even after years of programmed reinforcement for using them
have mental health concerns that have never been appropriately addressed because my behavior masks my needs
have medical problems that are going unaddressed because my providers have never asked me about my trauma history, despite it being a fact that it confers serious medical risks. (See the incomparable Nadine Burke Harris talk about her work on this, and the amazing takeaways, in her classic TED Talk– or see some of her research and outcomes on using screening tools)
be more likely to use certain “challenging behaviors”
and find it more reinforcing, even important, to use behaviors you would describe as challenging
use behaviors that are more resistant to change than you are used to as an instructor, therapist, parent, supervisor or friend
find certain interventions painful, difficult, or harmful
find some kinds of social interactions difficult or painful
have trouble controlling some of my bodily functions, but may not be able to describe to you why
experience “triggers” in the environment that you can’t see (but that an experienced provider could locate, document, and learn to help me explore or move with, as appropriate)
experience some times of the day, week, month, or year that are marked by aversive events for me that you won’t know about
may not be able to explain WHY this time is difficult or why I am using an “old pattern of behavior”
find it more difficult to perform, or to learn and remember new things than others of my age, skill level, or occupation – even if “on a good day” I can do this just fine. (By the way, have you read The Four Agreements? Do you know how important it is to take nothing personally and know that others are doing their best (and how critical it is for you to do the same)? If not go check it out.
use occasional behavior that is mistaken as “ADHD” or “ODD”, or more, but that is actually related to how I was mistreated
have been given misdiagnoses, treatments that didn’t work, or medications that made my problems worse or that interacted with each other in harmful ways that hurt my body and cognitive function
attempt to advocate but get ignored when I try to communicate pain, mistreatment, or a medical concern
be more likely to experience FUTURE trauma because of what I faced before
lack a reinforcing and useful repertoire (e.g., full complement of skills and things to enjoy), especially if I faced treatments that just tried to “teach me a replacement behavior” for a few challenging things I did, instead of understand and grow me as a person in the context of my own community, needs and desires for my future
be part of a long line of marginalized people or one of multiple generations exposed to trauma
have a chance to change our lineage… if you help

After all, I AM:

a human being with interests, feelings, and great potential for growth and joy
more likely to experience certain risks (I may be at greater risk of losing my educational or therapeutic setting, go through harmful discipline practices, be exposed to law enforcement interaction, for example)
in need of understanding, an informed supervisor and system of support, and someone who will document my challenges so we can work on them, but not emphasize them so much they ignore my strengths, needs and skills
capable of much more on my best day than I show on a hard day… but I am always doing “my best” at the time, given what I have been through and what I AM going through, and despite what it looks like

Taking these points as a starting place, future posts in this series explore what I NEED as a person who may have faced these things, and what I DO as a behavior analyst who cares. We’ll also share some of what I need from my supervisors or systems administrators! What would you add to this list? What are some of your action items?

Self-paced SAFE-T Assessment Training is here!

16 Tuesday Feb 2021

Posted by kolubcbad in adults, Autism, BACB CEU, Behavior Analysis, behavior cusp, Behavioral Cusp, CEU, children, collaboration, Community, continuing education, contraindicated procedures, Cusp Emergence University, CuspEmergenceUniversity, Education, ethics, mental health, resources, risk analysis, risk assessment, risk versus benefit analysis, supervision, teaching ethics, TI-ABA, TIABA, TIBA, trauma, trauma-informed behavior analysis, Uncategorized

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behavior analysis, behavior analysis CEU, CEU, continuing education, cuspemergence, CuspEmergenceUniversity, ethics ceu, SAFE-T, SAFE-T Assessment, SAFE-T model, SAFET Model, supervision CEU, TI-ABA, TIABA, TIBA, trauma, trauma CEU, trauma-informed behavior analysis

It’s finally here! We have learned so much from workshop attendees, trainees and supervisees in this area over the past several years, and appreciate the attendance, feedback and support of everyone who has taken the training or used a version of the SAFE-T Assessment. Coming on Monday, the booklet and training for assessing trauma-related factors affecting our clients of behavioral services, are available ONLINE as a self-paced course. This course provides a download of the new and expanded SAFE-T Checklist booklet, which contains several tools enabling the screening and documentation of over 200 trauma-related factors, and a Risks and Needs form to help teams understand (and document) how these factors confer risks (and converge in risk factors that must be solved or mitigated to protect our clients, teams, and ourselves). The booklet contains an extensive reference section and team supportive tools as you use your new knowledge to better align your team’s skillset with the Ethics Code, and the individualized needs of behavior services clients after trauma.

Several of our behavior analytic and collaborator clients across institutions, educational facilities and private companies clients have shared that learning to assess risk factors related to trauma, and to apply this information to their teams’ FBAs and risk mitigation plans, took their skillset to the next level – essentially affording them an opportunity to acquire an important behavioral cusp for their teams.

Some new components of the booklet include:

An optional buffer/ resilience score to assess whether protective environmental and therapeutic components of a client’s plan are in place (to understand some ways that trauma gives rise to medical and behavioral challenges and some buffering factors that can help, please see the book or scholarly articles by Dr. Nadine Burke Harris (e.g., Oh D.L. et al. 2018), who is the Presidential Scholar for 2021’s upcoming Association for Behavior Analysis International’s conference. She will address the critical topic of breaking the intergenerational cycle of adversity, and screening for ACES (adverse childhood experiences).
Table of potentially contraindicated procedures (cross referenced with items and risk clusters assessed in the Risks and Needs form)
Information about over 50 risk clusters (groups of related risks in the 6 assessed sections of the SAFE-T Assessment)
Cross-reference tables showing, for each item we screen for, the location(s) in the SAFE-T Checklist
Infographic on components of a trauma-informed FBA
Brief templates for Risk Versus Benefit Analysis and Risk Mitigation Planning
The IPASS (Inventory of Potential Aversive Stimuli and Setting Events) tool and instructions
References (organized by topics) covering over 40 areas or topics of literature related to trauma (including relationships of ACES to medical problems, ACT and intellectual disability, ACT and anxiety, foster care and adoption, the relationship of abuse to pain, drug use and trauma, and much more).

Time required: The course includes about 4.5 hours of video content in 12 lessons, each followed by a brief quiz.

Price (includes 4.5 CEU course and SAFE-T Assessment booklet download): $189.99

For $20 off through the end of February, use the coupon code “SAFET20”.

To register: cusp.university

Contraindicated behavioral procedures after trauma

08 Tuesday Sep 2020

Posted by kolubcbad in adults, Behavior Analysis, collaboration, continuing education, contraindicated procedures, Education and Trauma-Informed Behavior Analysis, enriched environment, mental health, praise, RAD, reactive attachment disorder, risk versus benefit analysis, schedules of punishment, TIBA, trauma, trauma-informed behavior analysis, Uncategorized

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contraindicated procedures, trauma, trauma-informed behavior analysis

This is the 20th article in a series on Trauma-Informed Behavior Analysis by Dr. Camille Kolu, BCBA-D

In medicine, contraindicated procedures are those that are withheld due to the potential harm they might cause to a patient. More and more, behavior analysts are interested in learning about someone’s history, in part to lessen the risk they will do a client harm.

We are tasked, ethically, to do no harm (and see the BACB Ethical and Professional Code item 4.02); to evaluate potential risks and side effects of interventions and to weigh the possible benefits of each (see 2.09 and 4.05); and to avoid using harmful reinforcers or those that require excessive motivating operations to be effective (4.10). For RBTs as well as those certified at higher levels, ethics obligates us to protect our clients from harm (see RBT Ethics Code section 2.02).

In our live webinars (please see CuspEmergenceUniversity.com where we list topics we train frequently on– any course you see there is available as a live webinar training or, in some cases, available as an on-demand training), we receive frequent questions like this:

What kind of procedures should be avoided when working with a new client after certain types of trauma? Are there certain procedures we should give more thought to after a client has been through challenges we know about? What do we do if so?

Given these wonderful questions, today’s post shares a few basic procedures that may be contraindicated – at least at first—given a specific combination of historical factors involving trauma.

Of course, it’s not black and white. Often this should just be the first step for the team, a conversation in which people consider potential for risk conferred by historical variables. The team can then make a more careful decision in order to mitigate possible risks and maximize the benefit of any procedures selected, along the lines of what our code suggests in item 4.05. Though each procedure below is potentially contraindicated at first, it could be appropriate later in treatment, or perhaps from the beginning- the point is that this should depend on an individualized risk versus benefit analysis of the other options available to the team, the client’s history and needs, the severity of the past abuse or neglect or trauma, etc.

For a client who has experienced previous food insecurity, food related abuse or neglect, and/or severe food deprivation:

One potentially contraindicated procedure is using edible reinforcers.

Notes: Here there are risks to the client, and also potential risks to the client’s relationship with their caregivers and team members. The conditions necessary to establish the motivating operation for reinforcement may be similar to previously neglectful or abusive conditions, or may act as conditioned motivating operations that make harmful behaviors temporarily more likely. In our history treating clients after these circumstances, we have also experienced something related to behavioral contrast in this situation. For example, a client who was provided edible reinforcement in their new applied behavior analysis setting then went home and used dangerous and surprising behaviors related to their neglectful history. The client’s foster family was caught off-guard by these new behaviors, but they could have been predicted during team education on how edible reinforcers might need to be avoided at first when conditioning new team members as reinforcing (and as instruction-related discriminative stimuli).

2. For a client who has been involved in previous sexual abuse (including when the client also makes allegations):

One contraindicated procedure is assigning a 1:1 without additional oversight.

Notes: Here there are risks to both the client and additional team members. When the team receives this case, it would be contraindicated to immediately assign 1:1 support without preventative measures such as training for the 1:1 and supplemental recording, additional oversight or whatever is deemed necessary.

3. For a client who has experienced medical complications from sexual or physical trauma (e.g., this could include incontinence, fecal smearing or related concerns, etc):

One contraindicated procedure is conducting toilet training without oversight from a medical professional, additional training or consultation by someone with expertise in this circumstance, etc.

Notes: In this situation, respondent and operant interactions can occur that are dangerous to treat without expertise; the client can risk serious complications and worsening medical problems; there is a risk of further conditioning the experiences of voiding (and related rituals) as aversive; there is a risk of occasioning behaviors related to the past abuse, or pairing aversive events with team members involved in the procedures; and more.

4. For a client who has experienced previous neglect or adverse circumstances (such as deaths of parents, removal from unsafe conditions, or experiencing war, dangerous immigration or poverty related issues), resulting in deprivation of basic needs and social interaction:

Some potentially contraindicated procedures involve attention related extinction, differential reinforcement of appropriate versus inappropriate requests, or time out from attention reinforcement.

Notes: In this situation, there are safer procedures to begin using that could avoid some of the harmful side effects of removing attention contingent on unsafe behavior. A child with a serious history of neglect may have used behaviors that can seem bizarre or out of context for typical child development, but that were critical to the child’s survival. At the same time, it may not be appropriate to pair new team members with procedures that were used in the child’s neglect, even if the “intent” is different. There are many procedures that can be used more safely, such as using enriched environments and fixed time schedules, to provide monitoring, insure high levels of safe attention, and begin to condition adults as neutral stimuli again, if needed, after harmful interactions with adults in the person’s past.

5. For a client who has been affected by physical and/or sexual abuse, behaviors and circumstances consistent with reactive attachment disorder, or multiple and changing caregivers in childhood:

One potentially contraindicated procedure might be contingent praise statements to establish compliance related behaviors.

Notes: In this situation, a client may have had a history in which adults could not be trusted, behaved inconsistently or inappropriately, or paired unsafe and harmful actions with typical caregiving behaviors. Clients who experienced this may initially present as lacking “a compliance repertoire”, but it may be contraindicated to attempt to establish and praise compliance, for several reasons. Some may be overly compliant, and lack self-help and self-advocacy repertoires that are critical to autonomy; if they are still going home at night after the school day to an unstable situation or multiple foster homes, to praise rigid compliance may increase the risk of further victimization or contribute to future abuse. At the same time, initial praise for compliance may damage relationships between the client and new caregivers who have not “earned” the right to praise the client’s behavior by establishing a history of consistency and helpful interactions. Furthermore, praise might already be conditioned as aversive for the client and could sabotage the caregiver’s attempts to establish a relationship or instruct appropriate behavior. (CuspEmergence.com has written elsewhere about praise here).

6. For a client who has been affected by neglect, and involved with law enforcement, suspensions and challenging behavior:

A potentially contraindicated procedure is least to most punishment.

Notes: Implementing punitive procedures (or procedures that educators assume to be aversive and are using to control behavior) in a “least-to-most” order is dangerous, especially after the interactions mentioned here. Any time punishment is implemented in a LTM order, we risk these outcomes: conditioning the aversive stimuli becoming more reinforcing, and more familiar; worsening the client’s behavior as they need to contact more and more of the supposedly aversive stimulus; pairing the people administering the punishment with aversive control, making it more likely the client will (to speak loosely) act out more and more for their high-quality attention; etc. (CuspEmergence.com has written about the potential pipeline from special education to prison here, in an article referencing some of these concerns and containing behavior analytic references.)

7. For a client with symptoms or diagnosis of trauma-related disorders or needs:

A potentially contraindicated thing to do is recommending or implementing applied behavior analysis without any mental health or trauma-focused treatment or input.

Notes: Behavior analysis (at least the kind I provide and teach about) is not a trauma treatment. We are also not a source of diagnosis for trauma. Instead, I work in a complementary way with a team and/or family that is interested in learning about risks related to trauma history, and how these risks affect the person’s behavior, needs, and supports. There are therapies that can provide trauma-focused treatment and aid a person to heal after experiencing difficult circumstances; a person may need these in addition to, or before, receiving behavior analysis to aid them in developing a safe, expanded behavioral repertoire. If someone trusts you with their trauma history, please be careful and supportive.

In closing, for a client with a specific conditioning history, the contraindicated procedure would likely involve aversive conditions and potentially medical or biological variables. Always consider items 3.02 and 4.08 from our Professional and Ethical Code, and discuss whether they apply to your case:

3.02 Medical Consultation. Behavior analysts recommend seeking a medical consultation if there is any reasonable possibility that a referred behavior is influenced by medical or biological variables.

4.08 (d): Behavior analysts ensure that aversive procedures are accompanied by an increased level of training, supervision, and oversight. Behavior analysts must evaluate the effectiveness of aversive procedures in a timely manner and modify the behavior-change program if it is ineffective. Behavior analysts always include a plan to discontinue the use of aversive procedures when no longer needed.”

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Contraindicated behavioral procedures after trauma