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Be a buffer, solve a barrier: Actively caring about harms caused by ACES

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Posted by kolubcbad in collaboration, Community, Education and Trauma-Informed Behavior Analysis, enriched environment, resources, TIBA, trauma, trauma-informed behavior analysis, Uncategorized

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barriers, be a buffer, buffers, nadine burke harris, preventative behavior analysis, preventive behavior analysis, solve a barrier, TIBA, trauma-sensitive behavior analysis

Between 1990 and 2018, countries spent between 2.67% (Europe) and 3.6% (USA) of their GDP to treat harmful behavioral, medical and other effects of trauma (Bellis et al., 2019). Evidence shows that several medical areas are impacted by ACES (adverse childhood experiences; see Nadine Burke Harris’ incredible TED Talk on ACES). These harms increase in a dose-dependent way, with higher number of ACES related to greater risk of medical harms (Anda et al., 2008). Some of the medical harms that are increased after trauma include an increased likelihood of disease in adulthood (particularly obstructive pulmonary disease; ischemic heart disease; and autoimmune disease); greater number of infections; dental problems; asthma; sleep disturbances; and pain and gynocological disorders (Koita et al. 2018; Anda et al., 2008; Dong et al., 2004; Dube et al., 2009; Wyman et al., 2007; Lanier et al. 2010; Bright et al. 2015; Paras et al., 2009; Reissing et al., 2003).  

A small solution that goes a long way

Specific buffers (see Purewal et al., 2016) can actually protect against the harmful impacts of ACES on medical health. The particular buffers found to reduce harm include getting enough sleep, eating nutritious food, having access to mental health care, experiencing a safe relationship with someone, exercising regularly, and practicing stress relief techniques that allow someone to experience calming down (such as a simple mindfulness technique). Adding buffers may be a set of seemingly small actions, but they contribute to preventing problems from becoming larger, and may help solve challenges related to why a behavior plan is just not working. (Solving basic problems in the behavioral environment regarding access to needs can be an area consistent with the ethical imperative behavior analysts have to address conditions interfering with service delivery; see BACB, 2020, 2.19).

Image shows 6 buffer areas with an icon for each, including a lungs icon for mindfulness, an apple icon for nutrition, a bed icon for getting enough sleep, a heart for mental health care, two adults for having a safe relationship, and a picture of a person exercising. The text says "Be a buffer. Solve a barrier".
buffers-and-barriers-part-1-graphic-2Download

Install buffers, solve barriers

Although the buffers make a big difference in preventing from harms and protecting against future ones related to ACES, many individuals and families face major barriers related to access, information, resources, or behavioral needs. These barriers can reflect resource inequalities, individual differences, and cultural challenges that prevent many from experiencing the benefits.  How could we leverage “buffers and barriers” policies to protect against harms (and truly embody the preventative arm of behavior analysis)?

buffers-and-barriers-part-2-graphic-1Download

One of the difficulties with beginning to implement buffers for individual clients is that behavior analysts may be hesitant to devote precious resources to this new and potential preventive area. To assist teams in understanding further how policies might affect our clients, their caregivers, and our staff, Cusp Emergence is engaged in developing resources and collecting feedback about their use. Some of the resources provide examples for conversations we could have with others, while others are visuals to help others easily understand the buffers and barriers (such as the “Be a buffer. Solve a barrier” downloadable pdfs in this article). We also have lists of policy ideas for interested agencies, risk benefit assessments to aid in their implementation, and examples of how we define buffers for individual clients, families and staff. Use our contact us form below to let us know which resources are your favorites or what else would help you more actively approach this area. Oh, and stay tuned for more on this incredible topic. Soon we’ll be be exploring buffers in more detail, including sharing some ways we integrate it for our clients, how it can be meaningful for caregivers and staff, and some of the research on each one.

conversation-about-buffers-and-barriers-1Download

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:

  1. 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.
  2. 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.
  3. 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:

  1. 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;
  2. 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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podcast

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

Upcoming: Brief webinar series on TIBA in partnership with Connections-Behavior.com

28 Thursday May 2020

Posted by kolubcbad in adults, Autism, BACB CEU, Behavior Analysis, CEU, Community, continuing education, Education, Education and Trauma-Informed Behavior Analysis, supervision, teaching behavior analysis, teaching ethics, TIBA, trauma, trauma-informed behavior analysis, Uncategorized

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CEU, ceu bacb, TIBA, trauma, trauma-informed behavior analysis

Now that the annual conference for ABAInternational is past (whew!), Cusp Emergence is excited about upcoming webinars and online conferences (New Hampshire and FABA, I’m looking at you!). First up is a partnership with Connections-Behavior.com: We will look at trauma-informed behavior analysis in two parts, on June 1 and 15. Register here for this CEU opportunity!

Homebound and Vulnerable: What will you do to prevent abuse and neglect?

24 Tuesday Mar 2020

Posted by kolubcbad in adults, Autism, Behavior Analysis, boundaries of competence, children, Community, coronavirus, Covid-19, Early Intervention, Education, Education and Trauma-Informed Behavior Analysis, ethics, mental health, Uncategorized

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behavior analysis, camille parsons, coronavirus, Covid-19, ethics, mane, pandemic, reporting child abuse, telehealth

This is the 19th article in a series on Trauma-Informed Behavior Analysis by Dr. Camille Kolu, BCBA-D. Start by becoming informed; then please read to the end if you’re interested in taking steps with your organization to support therapists and teachers to continue to fulfill their roles as mandatory reporters.

Child abuse, elder abuse, domestic violence, and abuse of people with intellectual disabilities is going on all around you. It may have just become simultaneously more prevalent, invisible, and insidious.

For example, in some areas, there has been a marked decrease in calls to the hotlines that typically lead to welfare checks for vulnerable people in their homes to insure that families have resources they need, children are not being abused or neglected, and appropriate actions can be taken if they are. (See this story from Colorado reporting a drop in calls the 9th and 10th of March as schools began to close).

Across the nation, different states are reporting similar decreases in calls but also a spike in the number of serious child abuse hospitalizations and even deaths.

Reasons for this disturbing increase are numerous. Little annoyances become big ones when there is no possibility of a break and both mental health (e.g., patience) and physical (e.g., food and sleep) resources are running thin. Even a normal battle on whether your kid will eat the peanut butter sandwich becomes a crisis when you’re trying to feed several people a balanced diet with whatever dwindling foodstuff you still have in the cabinet, while money (and outside trips) become scarce.

For many families, the struggle is not only real but getting uglier by the day, by each hour the kids are home from school.

There is conflicting advice, some of it really unhelpful, yet most of it well-intentioned. (I read a recent article about how we should just give in and let kids watch endless videos during this unprecedented time; but for many children, a huge increase in access to media may be accompanied by major behavior challenges (and even injurious and aggressive behavior) when parents try to have them turn it off for meals or bed. Research shows increased screen time can cause impulsivity, hyperactivity, and inattentiveness,

all of which are even more difficult to deal with when you’re cooped up. Of course, you need solutions, and the quick fix is even more appealing right now.

And there are major barriers to resources. Some have said this crisis is leveling the playing field, but really, it’s revealing discrepancies.  

Being quarantined at home doesn’t hurt that much when there’s plenty of food, you already know how to navigate technology to work from a home office, and there is room and time to get away from housemates or family members for a little while.

Being at home with other people who normally require 7 to 9 hours of behavior support and school-provided structure, let alone meals, while you work to make ends meet—that is another story altogether.

So there are the struggles to which we can all relate, and then there is the reality of jumping into these struggles with no help, no end in sight: There is the reality of suddenly not being able to be by oneself for even a minute, and not knowing when it will end; there are children whining or crying (or hurting themselves while other things need their caregiver’s attention; there is behavior, so much behavior, that a parent doesn’t know how to handle and is made worse by a lack of structure, suddenly upended routines, and for some, the complete loss of safety figures.  At the same time, there are abusive people who are now alone with their victims for the next few weeks.

Maintaining a safe environment for a child depends on several behavioral and environmental factors. Right now, those factors are not all present. Instead, we have

-Caregiver behaviors that are really important to keep people safe, but may not be FLUENT (such as giving effective instructions to a child, creating a schedule for several people, or responding to unsafe behavior that you usually don’t have to respond to)

-Caregivers that may physically present, but not AVAILABLE (e.g., an adult who can provide continuous, adequate supervision to every single member of the household who needs it)

-The presence of new circumstances creating unsafe environments (such as having 3 children with special needs home at the same time, for hours and days on end, and without the things (therapies, bus drivers, respite workers, social outings and educational time) that typically provide structure and relief)

-The additional presence of huge stressors (the unending flow of news about the virus; the dwindling of food and resources; the loss of jobs)

-Competing, sometimes incompatible, needs (like people home from work who need quiet to make money but who also have to provide constant caregiving and supervision; or people who have intellectual and other disabilities and are without their scheduled programs, events, therapies, social opportunities)  

-Therapists and teachers who are working from home or not at all, but who normally document and relay evidence that a child or adult may be being abused, mistreated or neglected

These factors and more combine to produce

-The occasion for more abuse or neglect to occur

-Decreased opportunities for abuse to be reported

-Emotional and physical needs that may make the outcomes of a child being quiet or following directions suddenly much more important or reinforcing, whatever the cost

So, my therapist, day program provider, and educational staff friends- how will you add and document safety checks for all your clients on a reliable schedule to take the place of “having eyes on” the client in your clinic, their home, or your school or program?

There are no hard and fast answers. For instance, some behavior analysts are out of work; could they be repurposed to providing online support of families with children at home? Having eyes on the family is good, but it’s also introducing a risk that we will give advice that we don’t have an assessment to back up, or that is not fully safe to implement. And while I’d like to share ideas for behavior analysts to incorporate safety checks of your clients virtually, it’s most important for me to encourage you to reach out, right now, to your organization—and ask for your TEAM’S plan to do that. This is because different states and areas have different guidelines and requirements for you to follow depending on your local recommendations for HOW you monitor and report unsafe situations. You need to do it, but you should follow your local guidelines and state laws.

  1. Recommit to your role as a mandatory reporter for individuals with disabilities, the elderly, or children, if you are a therapist, teacher, etc.
  2. ACT as an employee: If you work for an organization, act by asking your company what their contingency plan is for all employees to fulfill this role given our emergency situation, and how you can help.
  3. ACT as an employer: If you own or lead an organization, stop right now and generate a brief plan for how you’ll support your team to fulfill their roles as mandatory reporters. Here are some ideas:
    • Write up a plan and email it out. Bonus points if you schedule an online meeting right away to disseminate it and give examples and encouragement.
    • Assign everyone a recommended frequency to make check-ins that specifically deal with the client’s physical well-being and mental health.
    • Give the team an example for what questions they can ask, and what they should avoid (if needed) to maintain everyone’s safety in the home they are looking at.
    • Tell employees to document the outcome of their checks (e.g., if they notice things that typically would indicate possible abuse or neglect; or if they notice something might be wrong that warrants another check-in from a supervisor on your team; if calls are made to CPS or APS)
    • Reinforce and encourage the behavior of employees who follow the plan, including having social support carved out for them so they don’t have to go it alone.

Telehealth provision is already a new skillset for some employees, including teachers, and if they are suddenly without any social support when they used to be able to walk down the hall to the counselor, administrator or psychologist on site, they may freeze and wait when action is important. It’s your job to make the unfamiliar but correct action as easy and supported as possible.

And here’s a notice: Social services haven’t closed down. In Colorado, not only are they still making visits, they are hiring. Hotlines are available and staffed with trained professionals to take your call.

Resources: Read guidance from the Behavior Analysis Certification Board on ethics, safety and more related to Covid-19.

Here’s more on how a few states are monitoring this issue.

Colorado:

Call 1-844-CO-4-KIDS if you suspect abuse or neglect

https://www.coloradocac.org/

For birth to 3 receiving services: http://coloradoofficeofearlychildhood.force.com/eicolorado/EI_QuickLinks?p=Home&s=EI-CO-Response-to-COVID-19&lang=en

Ohio: https://www.cleveland.com/court-justice/2020/03/staying-at-home-amid-the-global-coronavirus-pandemic-creates-new-dangers-for-victims-of-domestic-violence-and-abuse-experts-say.html

And in Texas, use this info:

https://www.allianceforchildren.org/

If you suspect a child is being abused or neglected, please contact the Texas Department of Family and Protective Services toll free at 1-800-252-5400, 24 hours a day, 7 days a week.

You may also file a report using the secure TDFPS website. Reports made through this website take up to 24 hours to process.

The Texas Abuse Hotline is 1-800-252-5400.

Connecting Behavior Analysis, Aging, Trauma, and Supervision

18 Monday Nov 2019

Posted by kolubcbad in adults, BACB CEU, Behavior Analysis, boundaries of competence, CEU, collaboration, Community, continuing education, Cusp Emergence University, dementia, ethics, mental health, supervision, teaching behavior analysis, TIBA, trauma, trauma-informed behavior analysis

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aging, gerontology, janet ellis, trauma, trauma-informed behavior analysis

Behavior Analysis, Aging, Trauma, and Supervision (or BATS, in honor of Dr. Janet Ellis).

This is the 18th article in a series on Trauma-Informed Behavior Analysis by Dr. Camille Kolu, BCBA-D. It includes something new that we have been asked about: Companion notes for students and supervisees working through this information with the support of their supervisor.

I heard Jon Baker give a great talk on advances in behavioral treatment of gerontology the other day at COABA. It made me think of my students at the University of Colorado Denver and our supervisees. (There was also a fantastic talk on supervision and feedback by the incomparable Ellie Kazemi, whose book on supervision is out now). When they ask about clients other than autism who have benefited from applied behavior analysis, my supervisees are usually excited to read stories in which ABA changed the lives of people with dementia, brain injury, medical needs, and more. For example, an article from Baker (2006) Continue reading →

Seeing Snakes and Spiders

27 Friday Sep 2019

Posted by kolubcbad in BACB CEU, Behavior Analysis, boundaries of competence, CEU, children, collaboration, Community, continuing education, Cusp Emergence University, CuspEmergenceUniversity, edtiba, EDTIBA10, Education, Education and Trauma-Informed Behavior Analysis, ethics, mental health, resources, sale, teaching behavior analysis, teaching ethics, TIBA, trauma, trauma-informed behavior analysis, Uncategorized

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ABA, continuing education, CuspEmergenceUniversity, edtiba, ethics, events, mental health, resources, trauma-informed behavior analysis

This is the 17th article in a series on Trauma-Informed Behavior Analysis by Dr. Teresa Camille Kolu, Ph.D., BCBA-D.

spider

What did you do when you saw this picture? Chances are you experienced some additional events beyond just “seeing it”. Did you jump? Experience an increase in your breathing rate? Use some choice verbal behavior? Avert your eyes? (And are you prepared to read on? Fair warning… there’s a snake coming up).

Seeing with fresh eyes

I noticed a couple of things about our culture, and fear responses, this past week.

My young daughter’s love for flap books—the kind where you pull back a piece of paper to reveal something—knows no bounds. So she was instantly drawn to a tattered old library copy (apparently she shares this love with lots of peers) of “Buzz Buzz, Baby”- with poorly rendered babies exploring “bugs”. Around the third page the baby pulls back a web flap to unveil, in the book’s words, “EEK! The itsy bitsy spider!”

Whenever I read the book to her I leave out the “Eek!”.

I think she can come up with that on her own, if she happens to, although chances are she’ll get it from me in a non-mindful moment. (In the 1980’s Cook and Mineka did a classic study in which infant monkeys “acquired” a persistent fear of snakes by watching their scared mothers encounter a snake).

Now that we’ve moved out to the country, we encounter our own “Itsy” (and many for whom that name is woefully inadequate) all the time. (I do recommend this thing called the BugZooka… it does work really well, if you like catch-and-release). Itsy and I go way back, and not necessarily in a good way, although I always appreciate her beauty. But I still want to be warned before you text me her picture, dad.

This summer, one tenacious spider (pictured, top) built a web, over and over, in a windy area outside the kitchen, where we see it numerous times daily. The first few (ok, few hundred) times I nearly jumped out of my skin. When I remembered in time, I was very careful to breathe and compose myself before walking to the sink with my daughter, where I’d point out the spider cheerfully and sing (with all the hand movements) the requisite song. Before long she was signing the song herself. Next I noticed myself no longer jumping when I saw the spider.

THEN… one windy morning Itsy was gone. Gone!

I didn’t breathe a sigh of relief.

I was surprised and curious to feel a strange emotion… like MISSING. I missed her! Was she alright? Would she come back? (She was. She did).

With painful awareness that this is temporary, I often marvel that my daughter’s eyes are not only young… they are unconditioned. They don’t have a lot of pairings with events like scary movies about this deep primate fear, being bitten, or seeing spiders while a parent jumps and screams. They are fresh, curious, hopeful eyes.

Yesterday we chanced upon something rather larger than even the biggest spider. It was this old girl… fat and long, with ring upon ring adorning her useful brown rattle. Depending on my readers, maybe you’ll be happy that instead of grabbing a hoe, I called a guy I read about in my new community’s online forum… apparently this guy LOVES snakes. “ANY snake’s worth my time”, he told me as he jumped in his truck. 35 minutes later he had driven up to our homestead, hooked it and taken it. Now it’s in a quite different rattlesnake heaven than the kind I had sort of planned to send it… blissing out in a protected wilderness area up near Fort Collins, I’m told.

rattler

As he removed our snake into a large vented box and curiously counted the rings (while remarking on how huge it was), the guy’s face was composed; he exuded a strange calm excitement. Normally, the fear response to snakes and spiders is part of our biology. Evolutionary biology has several theories why it’s present even in infancy, and why it might have behooved our ancestral mothers to experience more arousal and get out of there to protect their young in the presence of these critters. I can’t help but wonder what this guy’s history is like. Why does he love something that most of us are scared of?

Kids with traumatic histories

If you’re an educator going back to school, many of your kids are coming in with an avoidance response, or a “get out of there!” escape response, ready to go. Some of them will use these responses in the most annoying ways, dropping all their work on the floor or crawling under desks when you announce the quiz. But some of them have a special background you can’t see. For some, they will use these “fear responses” when they encounter “triggers” that you and I do not think of as scary.

Why is that?

Well, the things that were there when they experienced really bad situations are now “paired”, living together in their past, the same way I smelled an old lady yesterday wearing my own granny’s soap and got emotional thinking about my dear departed loved ones. Or the same way you hear a certain song from your high school dance and think about that year, or that person, or that kiss.

And that’s not all. Psychology explains in anxiety journals why, if you’re a person with an intense “fear” or phobia of spiders, not only do you spot them more quickly and tend to see them where your peers might see other things, like mushrooms or flowers faster in the SAME PICTURE—but to you, they also appear BIGGER.

What can we do about it?

How can we help students show up for their education and get all the learning opportunities they can… even when the school, teachers, and peers accidentally give them “fear related” stimuli all day long? (While psychology explains partly WHY these pairings happen, behavior analysis does too, especially if you read some relational frame theory, learn about respondent conditioning, and take a long-term functional analytic approach. Behavior analysis also goes a long way in helping the helpers undo some of the damage, teaching kids to approach adults and “unpair” adult attention from it’s previously bad parts: if I’m a student who has been through neglect abuse, my teacher coming over to me to praise my “good behavior” might not be a welcome stimulus at first… and my teacher’s praise, as well-intentioned as it may be, might not work).

Cusp Emergence University has been hard at work getting the new online training course ready for educators, and behavior analysts who work in education. We hope to help you to start answering these questions for yourself and your students and teams. On Monday, September 30, our course “Education and Trauma-Informed Behavior Analysis” opens to a 7 day sale (use the code EDTIBA10 for 10 percent off this CEU opportunity). We’re providing BCBA’s and BCBA-D’s with 3.5 continuing education credits, and 3 of those are in ethics.

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Sign up now!

Start your fall to-do list: Register now for Paradigm play webinar this Monday (and more)!

06 Friday Sep 2019

Posted by kolubcbad in BACB CEU, Behavior Analysis, CASA, CEU, children, Community, continuing education, Court Appointed Special Advocate, Early Intervention, Education, learning, play, resources, Uncategorized

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This summer has been a busy one for Cusp Emergence. Dr. Kolu taught Ethics to University of Colorado Denver students, jumped back into work doing consultation to support businesses and BCBA’s to reach their behavior analytic goals, trained CASA volunteers and more. Next month we will be training Friends of Broomfield and (finally!) putting the finishing touches on the Education and Trauma Informed Behavior Analysis course by Cusp Emergence University.

In the meantime, we just learned about a great low-cost resource for parents! Paradigm Behavior has all kinds of great parent-oriented supports that also help behavior analysts and caregivers. This Monday they are having a sale on an informative webinar!  REGISTER HERE:

https://paradigmbehavior.com/play-registration

You know who would also benefit from this? Foster and adoptive parents, preschool teachers, and church nursery staff would find this super helpful. Our trauma informed teams also love learning how to enrich “time in” with kids who are just learning to have fun with adults in carefree ways after a difficult early life.

And coming up, this fall we’ll register for the APBA (Association for Professional Behavior Analysts) convention coming to Denver 2020, attend COABA (Colorado Association for Behavior Analysts) on November 2,  sign up for 4CABA (Four Corners Association for Behavior Analysis) that meets in Colorado Springs April 2020, and submit proposals for the May 2020 workshops at ABAI (Association for Behavior Analysis International) in DC. We’ll be back shortly to tell you all about the new courses we’re offering this fall. Contact us today if you’d like Cusp Emergence to tailor an online workshop or training for your team. Hope to see you soon at a local event or meet you at one of our webinars (CEU’s offered at all of our events)!

 

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