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Category Archives: job aids

Dr. Kolu of Cusp Emergence interviewed by Awake Labs

19 Friday Oct 2018

Posted by kolubcbad in adults, Behavior Analysis, children, Community, data, Education, job aids, resources, trauma, trauma-informed behavior analysis, Uncategorized

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Tags

collaboration, community, partners, self-advocates, trauma, trauma-informed behavior analysis, visual tools

This post is part of the series on Trauma-Informed Behavior Analysis by Dr. Camille Kolu, Ph.D., BCBA-D.

TIBA quote

Sometimes you meet someone who does work that you can really get behind. Over the past month, I have enjoyed learning about Awake Labs, a Canadian company providing easy and elegant solutions to self-advocates, families and teams who need to track information, data, and progress in the context of clients’ stories and strengths. Their Reveal Stories are an interesting way to do this. Awake Labs partners with community educators, providers, and medical professionals, offering ways to collect data and graph progress. During our conversations this month, Paul Fijal of Awake Labs also interviewed me about my work with trauma and behavior analysis, posting our interview on their blog. Check it out!  

https://awakelabs.com/

 

Ethical Friday presents: The power of a Worst Case Scenario

04 Friday Aug 2017

Posted by kolubcbad in adults, Behavior Analysis, Community, ethics, job aids, risk assessment, safety skills, supervision, teaching behavior analysis, teaching ethics, Uncategorized

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Picture the worst that could happen.

Can you even imagine it?

And if you’re a seasoned therapist or behavior analyst, how do you communicate about this with your students and supervisees, who almost certainly can’t really go there?

If you’re like many of us, you don’t know what you don’t know. Suppose a client wants to gift your staff a gourmet coffee gift card, or a mother wants to step out quickly to get her dry cleaning. “It’s a five minute drive, I’ll just be a second”, she calls, as you work with her child in an upstairs therapy room. “No problem”, you start to call… but your ethics bone starts to tingle. Surely you’re over-reacting. What, if  anything, could go wrong?

When the worst case scenario relates to our vulnerable clients affected by trauma, the consequences may be even more dire– and yet, those who haven’t faced the possibilities may not recognize the dangers.

Should I accept this client in foster care with severe challenging behavior and a history of abuse although I have never treated similar cases? Should my agency supervise our new BCBA to take on a new trauma case (we have funding, after all) when we haven’t experienced this situation?Danger sign

For those of us tasked with supervising and teaching others, or working with families, we can help students, supervisors or parents picture the worst case scenarios so they can better prepare for, predict, and prevent dangerous outcomes. The Compliance code helps give guidance and rules that we follow, but for those of us who have NOT encountered situations that make us keenly aware of the reasons for these, some of the code items may seem “nit-picky” or unreasonable, and may be disregarded in a dangerous way.

To support our own cases and our supervisees where it counts, we must have a wealth of experience, stellar training that exposed us to a variety of worst case outcomes and possibilities and some solutions, or a great imagination- and a few good teaching and documentation tools.

I get a new wake up call every semester I teach ethics students about the origins of Behavior Analysis’ Ethics Code, which was spurred in part by atrocious, life changing and widespread abuses by those doing “behavior modification” in recent decades.

When I ask “what do you think? Could those things ever happen here?”, Continue reading →

Resource Wednesday: How do you document risks?

02 Wednesday Aug 2017

Posted by kolubcbad in adults, Behavior Analysis, Community, Education, ethics, job aids, risk assessment, supervision, teaching behavior analysis, teaching ethics, Uncategorized

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Many behavior analysis supervisees, students, and even young Board Certified Behavior Analysts (BCBA’s) have not yet obtained proficiency communicating with their clients and agencies about risk assessments, and may even lack the experience or training to use or document them in their own practice. Yet, a risk assessment is required by our Compliance Code (for example, see related items 2.09 c and d, or items 4.06-4.07), and the need for this skill is evident in the Task List (see C-01, C-02, and C-03).

As a consultant and an instructor for a university’s course sequence toward certification in Behavior Analysis, I use the Bailey and Burch text on ethics as a resource both for my students and for my practice. Several editions of this text mention and describe a Risk Assessment Tool which is not only necessary and required, but can also be a powerful decision making tool for teams, supervisors, agencies, and even families. When services are discontinued after barriers to service have been repeatedly encountered, supervisors and the court systems value evidence that the behavior analyst documented and discussed the risks and barriers with a family or team. Also, lives might be saved by considering the short and long-term risks before moving forward with an intervention that is at best, inappropriate, and at worst, dangerous. Risk assessments can facilitate otherwise difficult conversations about risks (or benefits) to a client, family, team, agency, system, or even a consultant’s reputation and credentials.

So what tools do YOU use, and what are those used by your team? Kolu and Winn (2017) presented tools for our work, based on something developed in our consulting practices. First a Risk versus benefit flowchart helps walk a supervisor, team, agency or family through a sequence of questions. Then the Risk Assessment Tool helps keep track of the answers, and can be used to facilitate a discussion with families and teams. When making a tough decision, it helps to ask about the short- and long-term risks of doing “the current option” or doing “something else”, and weigh these against the potential benefits. Should my family pull our child out of a school where he is not really benefiting from education but has immense social interaction opportunities? Should I stay with this employer billing in a confusing and possibly unethical way, or start my own practice? What should I consider when approached by a long-distance supervision client whose client caseload doesn’t really match my skillset?

And as the Compliance Code makes clear, we should be continuously asking, what is the best treatment recommendation, given the possible options, the current environment, resources, and the risks and benefits?

With these questions and more, a risk versus benefit assessment can be extremely informative, helpful, and may even be required. Know the requirements, and then assess, document and communicate about the risks. It might just save your credibility one day when you are called to testify. (We all think it won’t happen to us, until it happens to us.)

Need a tool to document your risk versus benefit results? Download this Risk Assessment Tool and let us know your suggestions or what kinds of decisions you use it for.

Email us if you’d like a word version of the form that you can use to fill in with your team or agency. And if you’d like to share, let us know what YOU use to document risks.

Job Aids: On Compassion, Visual Aids, and Individualizing support

06 Wednesday Mar 2013

Posted by kolubcbad in Community, job aids, play, Social Interaction

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Tags

individualized support, job aids, neurotypical, visual support

A family member leaves a job aid easily followed to use technology while the "savvy" person is away

A family member leaves a job aid easily followed to use technology while the “tech-savvy” person is away

A separate job aid for turning off the system

A separate job aid for turning off the system

To begin, it is helpful to understand that although behavioral support can often be widely useful, some strategies are perceived as “for autism”, “for children”, or even “for parents only”.

At Cusp Emergence, it’s about relationships– whether with our peers, employees, employers, family members or significant others (or even ourselves).

While today’s idea (the “job aid”) is often linked with the workplace environment, this article is  about compassion and individualized support. Perhaps you’d like to experience this article as a challenge you to find yourself in one of the stories even if this week’s idea doesn’t seem immediately related to your life’s work.

Bonnie and technology: Bonnie used to avoid technology while her housemate was away. She described herself as resentful that she was often bored, never played a game by herself, or turned on the complicated computer-controlled television while alone, and claimed she never had the opportunity to learn how. Her roommate dominated the remotes when they played together and she always felt it was useless to figure out herself. It sounded strange to her friends, she knew, that she couldn’t work it. But she never had the opportunity or need or desire to do it anyway.

Joey and laundry: Joey never did laundry. Why should he; his partner (or even their son, who enjoyed that particular chore) usually did it. Sometimes he resented his slowly shrinking jeans, and often his wife tried not to resent the fact that Joey never helped. But it was honestly quite complicated, and past attempts had not gone well, producing pink underwear for everyone in the family, or shrunken, discolored sweaters.

Benny and the restroom: Benny was 15 years old and growing, and unlike most of his family and friends, he had never mastered the final steps in his toilet routine. He attended the special education program at his local school, and his paraprofessional often needed to stand at the door asking if he needed help. He usually came out with his pants down around his ankles and was instructed and guided back to the bathroom, where he was instructed to pull up his pants and turn off the light before once again entering the classroom. Often he yelled “Go away!” and slammed the door when his paraprofessional entered to assist him.

How are these stories related?

  • First, they represent situations in the client has no physical limitations preventing him or her from accomplishing the task. In addition,

  • The stories all involve communication partners, life partners, or an activity partner completing some or all of the task involved, instead of the client completing it himself or herself.
  • In each of these situations, there was a “learning history” in which the partner had TRIED to communicate how, why, and when to do these tasks. But the communication had not been effective! Parents and partners often try repeating instructions, yelling, or standing beside their partner naming every next step.
  • Finally, these situations all hold hidden potential payoffs if clients learned to do these things themselves.

Consider:

  • If Bonnie used technology by herself, she could have a greater variety of enjoyable things to do while her partner was away. She might be able to develop individual interests. She might have time to practice alone and therefore enjoy the activity even more when they did it together later. She could feel good about being an active participant in the household.
  • If Joey did the laundry by himself, he could enjoy wearing what he wanted or needed to wear without someone else needing to do it, having to stop something they needed to do in order to fulfill his request. If he did it himself, he could have access to clean clothing that he had picked out. He could feel good about contributing to the household.
  • If Joshua finished his routine in the bathroom and came out to rejoin the group, he could enjoy doing it by himself. He could feel good about doing it himself and joining the social expectations of his group. He could immediately transition to a new activity with his friends, instead of feeling embarrassment as others laughed or pointed to his pants around his ankles.

In every case above, job aids provided compassionate, individualized assistance to bridge the gap between the need to complete a task, and the actual execution of that task.

Toward solutions

Bonnie’s partner whipped up a set of easy-to-follow job aids that helped her navigate quickly through technology that previously had seemed mystifying. When her partner was out of town, Bonnie now used it herself and enjoyed the freedom.

Joey’s partner posted easy job aids (post-it notes) above the laundry machines. When his partner was out of town it was easy to see what to wash together or separate, which buttons to push, and how hot or cold the water needed to be.

Joshua’s paraprofessional and teacher posted reminders near the bathroom door that visually reminded him to check his pants and zipper and turn out the light.

Here are some of the potential benefits Bonnie, Joey, and Joshua may begin to enjoy:

  • Ability to meet a need or want alone
  • Gain more control over their life
  • The chance to gain mastery over something they will likely need to do in the future
  • The ability to rely on themselves instead on someone else
  • Increased range of options at any one time
  • Decreased dependence on others
  • Dignity, autonomy, confidence, etc

A final note: After we begin to do more for ourselves, it is compassionate for our life partners, parenting partners, communication partners, peers, or providers to consider the importance of whether, how, when, and why they will fade out their assistance. More to come on this topic in a future post!

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