Applied Behavior Analysis (ABA): As Easy as ABC

Hosts Julianna Scott and Kelley Jensen dive into Applied Behavior Analysis (ABA), exploring its evolution from Ivar Lovaas's pioneering work to modern practices. They address common myths and criticisms while sharing personal experiences of how ABA transformed their families. From potty training to turn-taking and communication skills, the hosts explain why ABA remains a cornerstone therapy for autistic children, how it's covered by insurance, and practical strategies for finding quality providers despite challenges from private equity investment.

Key Takeaways

• ABA has evolved significantly and no longer uses aversive techniques—modern ABA focuses entirely on positive reinforcement
• The antecedent-behavior-consequence framework helps parents understand what drives their child's behaviors
• ABA is covered by most state-regulated insurance plans, including child-only plans purchased through state exchanges
• Finding a local ABA clinic with an on-site BCBA (Board Certified Behavior Analyst) is preferable to large corporate chains
• ABA isn't bribing—it uses temporary external motivators until natural consequences become rewarding
• Turn-taking, communication skills, and other social abilities that develop naturally in some children may require years of ABA intervention for autistic children
• Parents should practice skills learned in ABA sessions at home to reinforce progress
• The criticism that ABA makes children "less autistic" is fundamentally impossible—ABA helps children reach their full potential
• Quality ABA looks like play but involves methodical skill-building based on your child's unique interests and currency
• Social media movements opposing ABA often suggest alternatives that are actually ABA techniques with different terminology

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Creators and Guests

Guest

Julianna Scott

Guest

Kelley Jensen

What is Refrigerator Moms?

Born from 20 years of friendship, during which they navigated the trenches of autism parenting and advocacy, the Refrigerator Moms is Kelley Jensen and Julianna Scott’s way of reaching out to parents waging the same battles they were.  Their purpose with this podcast is to clear the fog, silence the noise, and find a path through neurodivergence for parents that are stuck between bad choices. They tackle parenting topics such as mom guilt, tantrums, pathological demand avoidance, siblings, medication, comorbidities, social media, and much more. 

[Julianna] (0:09 - 0:15)
Applied Behavior Analysis, ABA, was a lifesaver in our house. Did you guys do ABA?

[Kelley] (0:15 - 0:38)
Of course, it was the first thing we did. Even before we really knew what it was, the first thing we did with our son was speech therapy. So I didn't know what it was, but that's what the speech therapist was using.

You know, it's like, you know, he would say something, she would give him a stamp, you know. So, you know, it all started there and extremely effective for us.

[Julianna] (0:38 - 0:44)
Us as well, to this day, some of the skills we learned we use. But did you know that parents are turning away from it?

[Kelley] (0:44 - 0:48)
I heard that. I am confused as to why.

[Julianna] (0:48 - 0:50)
I am too, but we're going to talk about it.

[Kelley] (0:50 - 1:47)
Okay, so let's talk about it. Welcome to The Refrigerator Moms. This episode is ABA as easy as ABC.

This episode of Refrigerator Moms is brought to you by Brain Performance Technologies. Brain Performance Technologies is a specialty mental health clinic that offers magnetic e-resonance therapy or MERT for autistic people age three or older. MERT is a transcranial magnetic stimulation protocol that utilizes an EEG diagnostic to deliver personalized magnetic pulses to stimulate the brain and build neural pathways effective in managing autistic symptoms.

The origin of ABA therapy goes back to Ivar Lavas. He pioneered the use of ABA in autism based on the work of his forefathers and some contemporaries, one of which was Bruno Bettelheim, a name we know. And if you don't know it, go back to our first episode called Blame Shame and the Guilt Game.

[Julianna] (1:47 - 1:50)
And our origin story of the name of Refrigerator Moms.

[Kelley] (1:50 - 1:50)
Yes.

[Julianna] (1:50 - 1:51)
Find out.

[Kelley] (1:51 - 2:12)
Yes. And you can also go to our paper. There's a little summary of Bruno's work.

So our refrigerator paper, you can find on our website, refrigeratormoms.com. But he introduced this ABA in early intervention, but what was controversial about it is he used aversives. So ABA has definitely moved away from aversives and not used.

[Julianna] (2:12 - 2:15)
It has moved away from aversives decades ago.

[Kelley] (2:15 - 2:25)
It's for some reason a lingering idea that ABA uses aversives, but it's all positive reinforcement.

[Julianna] (2:25 - 2:50)
Well, and it's interesting to me because social media is such a strange echo chamber where some things are latched on to this idea that ABA is aversives. But the idea of early intervention, which is probably the cornerstone of all learning, the smartest thing you can do for any child is to get in there early and teach them the process they need to work on. That falls by the wayside.

And we would not have even the term early intervention without ABA.

[Kelley] (2:51 - 3:08)
So no. I mean, but to give you an overview of the general principle of ABA, you ask your child to do something and you are rewarded for it. But I mean, let's give an example of how ABA works.

[Julianna] (3:08 - 4:04)
So the whole concept of ABA is antecedent behavior consequence, which when you think about it, antecedent, what is driving the behavior? What's causing the behavior? What is the behavior that you want?

Right. The behavior itself and then the consequence, which this is, I think, the term consequence people conjure, a spanking, it conjures punishment. But the consequence is just what happens naturally because of the behavior.

So probably the most useful thing for ABA, a lot of parents tell us, is potty training. So the concept that, you know, the antecedent being that you need to go to the bathroom and then you go to, this is where you have bathroom, on the toilet. And then if you go to the bathroom on the toilet, the consequence is that you get a sticker, you get a piece of candy, you get whatever the motivator is.

The reinforcement is that going to the bathroom on the toilet is the...

[Kelley] (4:05 - 4:15)
Yeah. So basically, you know, in lieu of a natural consequence that is like self-motivating. Right.

You have an external motivation for it. A hundred percent.

[Julianna] (4:15 - 4:32)
And then the other idea is you take away that self-motivation, the motivation, the sticker, the piece of candy for going to the bathroom on the toilet. Eventually, the reward is being a functional person that, you know, can take care of toileting for themselves.

[Kelley] (4:33 - 5:00)
Right. I mean, another example I know, like, especially like in social groups, there's definitely ABA, there's... We say ABA and there is a strict, you know, it goes back to like discrete trial training.

There's a strict, you know, you say this, you get an M&M. Right. But ABA comes in all sorts of modified formats now.

And very few, I think, ABA practitioners go back to like the old school, like discrete trial training.

[Julianna] (5:00 - 5:01)
Yes.

[Kelley] (5:01 - 5:17)
So we're using ABA as sort of this modified ABA. And, you know, I know like for my son, there was no like positive internal motivation to do things, even like in speech therapy or something like conversation skills.

[Julianna] (5:17 - 5:18)
Yeah.

[Kelley] (5:18 - 5:47)
So even that you can use ABA because, you know, at the time, you know, turn-taking, conversation, that was not something that he enjoyed doing. Right. And really kind of didn't see the purpose of.

Right. But, you know, turn-taking, you know, if you learn turn-taking, you get to play more games. You know, you get to play those games that you want to play.

And then eventually that will evolve into, you know, collaborative work.

[Julianna] (5:48 - 7:59)
So the concept of turn-taking, that's a perfect example. So the goal of turn-taking is to advance that skill to playing an organized game or, you know, eventually as an adult working in a group of people. So but it starts very, very simply with a child that doesn't have a concept of why they should take turns or what turn-taking is.

It's something that doesn't come naturally. Turn-taking is something that develops naturally in some children. Yes.

Who learn to speak in the most, you know, textbook way, right? Right. So they learn to communicate in the most textbook way.

The concept of turn-taking might be something that an ABA therapist works on with a child for years. I mean, it might take two or three years of, I'm going to give you a red M&M. I'm going to give you a red sticker.

I'm going to give you a red, you know, whatever. Right. And eventually you're going to give me a red one back.

Maybe I'll give you a red one. You give me a blue one. And it's really quite fascinating how they engage a child to, oh, you gave me red.

I'm going to give you one too. Right. It's fascinating.

It also can be a lot of fun. You know, if you're a parent and you're having a hard time connecting with your toddler or your young autistic person because they seem to be in their own world or they're so easily distracted, getting them to focus a minute on, I'm giving you this. You give me that.

It gives you a lot of confidence in dealing with your child. The other thing I'm going to say about ABA and the antecedent behavior is we hear this all the time. No matter what theory of parenting you subscribe to, and there are, they abound on social media.

And we are, we talk about some of them that are directly opposed to ABA in the later papers, but antecedent behavior. So that's the cornerstone of every parenting guide that you will find will tell you what is causing this behavior? Why, what is, what's going on with your child?

What is the antecedent? And easier said than done. You're a parent.

You don't always know. You're not, you know, you think, oh, I know my child, but maybe you don't. And having someone that works with your child to help you collaborate on antecedents is, one of the best things I did for my son.

[Kelley] (7:59 - 7:59)
Yeah.

[Julianna] (7:59 - 8:03)
They told me things about him that I needed to know that I wasn't getting.

[Kelley] (8:03 - 8:07)
Yeah. You definitely need to be a detective. Yeah.

And think about that a little bit.

[Julianna] (8:07 - 8:09)
So how is ABA not the same as bribing?

[Kelley] (8:09 - 9:05)
We hear this from some of the critiques of ABA that you're just bribing your kid to comply. Right. Right.

Well, you know, bribing is bribing. Usually it results in kind of escalated demands. So, you know, we start out with one M&M and all of a sudden there's a negotiation.

For two M&Ms. For two or whatever. And that, you know, will get out of control and that's something different. I mean, part of it is you kind of set up those parameters, but also, yeah, bribing, it is definitely not.

And you wean your child away from those kind of external, those, you know, M&Ms or any of those kinds of rewards. And the result of that behavior becomes the reward. So, you know, if you can learn to play nicely and take turns, you know, in a game, then you're going to have more people who want to play that game with you.

[Julianna] (9:05 - 9:53)
Well, I remember my son was doing it. They were trying to get him to take turns and also trying to work in his speech at the same time. And he fell in love with a microphone.

They had this toy microphone. And the program was they would say a set. First, they start with a sound, boo.

Yeah. And then they put the microphone to him and try to get him to say boo. And that took a while, but then he said boo.

And then they would say a word. And he loved it so much that by the time they were done with that exercise in the microphone, he could sing a whole song together with. First with a therapist and then eventually with me.

And it was really quite amazing. And obviously got a lot of language out of it. But the notion of finding something that he found fun and then using it to build on a skill set was incredibly eye-opening.

[Kelley] (9:54 - 10:14)
Right. And the bribing, I mean, you can determine what it is that you are rewarding them with. Right.

So don't use something that it's going to cause them to. Don't start giving them a Pokemon card or something like that. Don't start doing something that's going to lend itself to that.

[Julianna] (10:14 - 10:34)
And so in that example, at first, it was the shininess of the microphone. But then eventually, it was way more fun to sing a song together than the microphone wasn't the reward, quote unquote. So for probably about six months, breaking out that microphone was the reward for sitting in the circle or wherever they needed him to sit.

[Kelley] (10:34 - 11:18)
But that said, you do need to understand your child's currency. Because they won't work for nothing. Right.

So we learned that too. And it was ever evolving. So just like you need to be a detective about the antecedent, you also need to know what will your kid work for too.

And I remember it was, again, ever evolving. The therapists were always like, OK, that doesn't work. Yeah, totally.

And that's where sometimes special interests come in. Lawnmowers. Yeah, like you get a little extra time doing this, maybe a little extra time.

Again, not to the bribing point, but just something that will interest them enough to participate.

[Julianna] (11:18 - 11:30)
Well, and that's where another thing to have a behaviorist in your house to help you determine what those high reward treats are, those high reward activities, what they really are.

[Kelley] (11:30 - 11:41)
And sometimes therapists will come in with novel things that you don't have in your house. So it's like that was only something they got to do with the therapist. And that was always really great.

100%. Yeah.

[Julianna] (11:42 - 12:25)
OK, so we talked about how ABA has evolved over time. And it's now actually included in many of the school curriculums, which was definitely not something we had access to. ABA was something that we had to kind of fight for through our insurance carriers.

But it's now covered by insurance on state-regulated plans, right? And there's a lot of information about insurance coverage and ABA in one of our papers, the paper about ABA. It's kind of an interesting story.

Many, many years ago, I worked in health insurance. And I was sort of at the cusp of the ACA, which sort of ushered in access to ABA. But now it's sort of standard and built into many, many plans.

There's a few plans that it's not built into.

[Kelley] (12:25 - 12:32)
Again, go to the paper for details. It's one of the few. Correct me if I'm wrong.

It's one of the few things for autism that is covered.

[Julianna] (12:32 - 12:59)
Yeah. And a lot of times, even today in health insurance plans, they'll cap speech therapy at so many sessions. They'll cap occupational therapy or even physical therapy at so many sessions.

But ABA is based on hours, right? So you automatically have more wiggle room when the speech therapy runs out. So it's something to really look out for your family and take advantage of.

And we're going to get into what to look for and all of that later in the paper, right?

[Kelley] (13:00 - 13:09)
So we were talking about how people are kind of resisting ABA. Yes. So why are they doing that?

What are some of the myths, criticisms of ABA?

[Julianna] (13:10 - 13:38)
So the first is that, again, the use of adversive and discrete trials, which if you interview an ABA company and they tell you that they use discrete trials, that's not the one you would want to recommend, right? That they're overly intense. This is an interesting critique.

And I think sometimes there is some merit to that, that a lot of times a doctor will prescribe 40 hours a week and that's just too much for your child.

[Kelley] (13:38 - 13:58)
I don't know anybody who was doing 40 hours a week. I remember hearing, there were some people I know that you fought really hard for those hours. So they would feel like they needed to use every single hour.

But they were like waking their kid up from naps to do it. Again, not the best mind space anyway to be doing that. You let your kid sleep.

[Julianna] (13:58 - 13:59)
Well, and one thing...

[Kelley] (14:00 - 14:01)
That is intense.

[Julianna] (14:01 - 14:25)
It is intense, but keep in mind that those 40 hours might not be 40 hours of work with your child. Because you might have a child that is severely autistic that is going to have a very, very, very hard time learning to potty train. And it might take some intense oversight and collaboration with behaviorists.

And so they might be doing a lot of... They might be working five hours to the one hour that they spend with your child.

[Kelley] (14:25 - 14:27)
And they're also doing note-taking. They're doing planning.

[Julianna] (14:28 - 14:28)
Yes.

[Kelley] (14:28 - 14:35)
You're doing the meetings with your therapist. So it's not all sitting there across the table doing work.

[Julianna] (14:36 - 14:50)
Yes. So I would not assume that if you've been granted 40 hours a week, that they're going to be with your child 40 hours a week. They're going to be probably...

There's going to be some fraction of that. And you have some leverage and say as a parent as to how many percent is in front of the kid.

[Kelley] (14:50 - 14:58)
How much time your kid can handle doing that. And they're going to give you that feedback too. You're going to get diminishing returns.

[Julianna] (14:59 - 15:56)
So another criticism is the state-by-state regulation of coverage. And it varies from state to state. It varies also because of the availability of services in certain states.

And that's a legitimate critique. Again, there's more in the paper about some ways to combat that depending on what area of the country you are. Probably in my opinion, the most legitimate critique and fault since the Affordable Care Act has passed has been private equities investment in ABA.

They have, as they tend to do, ruined it with gobbling it up, loading it with debt and spreading behaviorists too thin. So again, a very detailed discussion of that in the paper and shame on private equity for doing that. But we have suggestions for how to find quality care and a quality provider.

[Kelley] (15:56 - 16:12)
And I know another criticism. This isn't of ABA specifically, but the access. I know that access, depending on where you live, whether it's even available or if you're on a wait list.

So that is a valid criticism.

[Julianna] (16:12 - 16:15)
100%. But that is not a fault of the therapy itself.

[Kelley] (16:15 - 16:31)
It's a fault of many things, right? No, but there is one criticism that I will say I don't think is valid. And that is that ABA can make someone less autistic.

I mean, I think you and I both know. That is purely impossible.

[Julianna] (16:31 - 16:32)
It is impossible.

[Kelley] (16:32 - 17:17)
You can't make someone less autistic. You can't, you know, obviously that is, we're not trying to make our children less autistic. We're trying to help them reach their full potential.

And function, you know, the best for their own goals. And, you know, and it is not us trying to take away their autism. Trust me, if it was that easy to, you know, change someone fundamentally, I mean, we wouldn't need a therapist for anything.

No therapy is going to change who you are at your core. And at their core, you know, people with autism have autism. And might need help learning on a turntable.

[Julianna] (17:17 - 17:55)
They have the rights to learn to play a game. Yeah. I mean, the joy that my son got out of being able to sing a song or play Uno with his sister.

That's probably, I would say that Uno was one of my favorite ABA successes because it has brought him games with his family that he was not getting, right? He did not, I would, I could not have taught him to play Uno and the joy of it and the right he had to be able to do that simple activity. I mean, without addressing autism as standing in his way, we would have never had that.

So I don't understand this criticism that autism doesn't need to be cured. Well, good, because you can't cure it.

[Kelley] (17:55 - 18:43)
So, okay. But also like the idea that you can somehow minimize their interest in their special interests. Like, first of all, no, no one's trying to do that.

Maybe there's ways to integrate their special interests into ABA. Like, we definitely did that. And in fact, nobody I know, that was the currency.

No therapist I know was trying to say like, well, let's try to diminish their talking about Pokemon. Yes, in certain situations, sure. But that's really just in their best interest.

And I would do it all the time. I would just say like, okay, you know, now it's my turn to talk about something I'm interested in. A hundred percent.

Or that you fell in meltdown starting.

[Julianna] (18:44 - 19:50)
Hey, let's talk about Pokemon. I mean, the effect it would have was almost instantaneous, right? Right, right.

I will say though that, and I certainly, an ABA therapist would never do this, but sometimes in the school system, and I don't think the behaviorists at the school would do it. There is this concept of age appropriate, right? Where they sometimes wouldn't want them to listen to a certain song or a certain cartoon because it wasn't age appropriate.

And when you get this with the older kids, your kid is still listening to Barney or still loves Barney videos. And they're not allowed in their downtime at school or to have it as an activity or special interest in school because it's not age appropriate when they're in middle school. But those people are really uneducated as to what a special interest is and why you should have at all your special interests without regard to age appropriateness.

And that's definitely not a concept that was driven out of ABA. That's something that's more educational. And I support every parent's ability and advocacy to tell the teacher, I don't care if it's age appropriate, but I guarantee you're not gonna get that from an ABA therapist.

[Kelley] (19:51 - 20:21)
No, no. And to push back on that notion a little more, it's just like that criticism of ABA implies that your autistic child should be less functional. Somehow.

And that to me is more dehumanizing than anything else to say that an autistic person is somehow doomed to be less functionally developed than what we know is possible through ABA. Yeah. Okay.

Yeah.

[Julianna] (20:22 - 20:42)
The fundamental premise of ABA is really just breaking down fundamental parenting into digestible chunks and connecting with the child in a way that leads to the goal of whatever the program that they build for your child is. So sticker charts and potty training sort of go hand in hand.

[Kelley] (20:42 - 20:49)
Which people do for their neurotypical kids. So this is not a foreign concept. Right.

Yeah.

[Julianna] (20:49 - 20:51)
It's just one that is maybe formalized, right?

[Kelley] (20:52 - 20:52)
Right.

[Julianna] (20:52 - 21:01)
And certainly a lot of data that goes into those stickers don't work or stickers didn't work at all, but what is the currency that, you know, that is kind of the value of that.

[Kelley] (21:01 - 21:10)
And the things that, you know, neurotypical kids tend to learn naturally. This is something that, you know, kids on the spectrum need a little more help with.

[Julianna] (21:10 - 21:44)
Yes. And one of the criticisms comes from the PDA community. We have a paper about PDA.

We're going to be talking about it, but that these things, stickers and even the notion of potty training your child at all, creates a demand in that your child will never be able to do it. You have to find a way to collaborate with your child and not do it until the child wants to be potty trained. Right.

Again, we're going to talk more about that when we get into PDA, but... And that's pathological demand avoidance. I'm sorry, pathological demand avoidance, but...

[Kelley] (21:44 - 21:48)
Not a public display of affection, which we're all for.

[Julianna] (21:48 - 22:49)
Right, yes. But, you know, that just seems like in the instance of potty training, kicking the can down the road, right? I mean, do you want a 12-year-old, if you're waiting for your child to tell you, I don't want to, you know, go to the bathroom in a diaper anymore, then you might be waiting a long time, and then you might have a bigger problem that has snowballed, and maybe you should have just thought of a different sticker to begin with when they were three or four, and it was kind of built into the development, right? Brain Performance Technologies is a specialty mental health clinic that offers neuromodulation treatments, including their latest protocol, SAINT. SAINT, or Stanford Accelerated Intelligent Neuromodulation Therapy, was developed at the Stanford Brain Stimulation Lab to provide rapid and lasting relief for patients struggling with treatment-resistant depression and major depressive disorder.

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[Kelley] (22:49 - 23:06)
So in every paper we write and in every podcast we record, we talk about what would we do in certain situations. Yes. So we ask ourselves and we answer our own questions.

So what would we do if our insurance does not cover ABA?

[Julianna] (23:07 - 24:00)
Ah, so this is not as much of an issue as it used to be, although for very technical reasons there are some group health insurance plans that do not cover ABA. If you find yourself in that situation as a parent, you have the option of a child-only plan. You can buy your child a plan of their own and those plans are state-regulated.

You buy them through the exchange in your state and then your child, they mandate ABA be made available to them on those plans. That's one answer. In the interim, if you find yourself outside of open enrollment, which is the only time you can buy a child-only plan, you can ask assistance maybe through your county program or your school.

Okay. And what would you do, Juliana, if you were interested in ABA for your child, but you had heard the criticisms through friends of friends and you had someone, maybe even a spouse, that was adamantly opposed to it?

[Kelley] (24:00 - 24:23)
I think what we would do is just really not listen to them. I mean, that's the short answer. And this is really, I know our philosophy is just like, it's your family, your child.

And those opinions and those people, well-meaning, probably.

[Julianna] (24:23 - 24:25)
Or maybe not. Maybe it's a social media echo chamber.

[Kelley] (24:25 - 25:13)
Or maybe it's some political movement, social media, something on social media that they've read, that they just feel like they need to tell you before you do something. Well, before you do that, I heard this. And it's just like, well, do your own research.

That's what we always tell people. Do your own research and look for those solutions that work just for you. And just ignore the rest.

And if the criticism is something specific, like to ABA in your area, a particular clinic you're using, well, yeah, listen to that. Again, explore that. Like if you told me, okay, I go to this one and no good.

[Julianna] (25:14 - 25:14)
Don't try that clinic.

[Kelley] (25:14 - 25:52)
Yeah, like they got some therapists that aren't very well-trained or something like that. Yes, of course. Use that information.

And also it's like, I wouldn't just stop there. I would want to know why, are they telling me to just not try to modify my child's behavior in any way? And if that's true, or are they just saying don't use ABA?

Well, what are you suggesting otherwise? Don't tell me no, if you don't have a better idea. Right, like just, yeah.

Okay, so what do you suggest instead? Right. I mean, my kid won't use the potty.

Right. And he's, you know. Just leave it.

[Julianna] (25:52 - 25:54)
Yeah, he'll let you know when he's ready.

[Kelley] (25:55 - 26:08)
Yeah, like unless you have an alternate solution, you know, don't tell me to stop doing what I'm doing. That's fair. So, you know, that is our advice.

All right. So, yeah.

[Julianna] (26:08 - 26:27)
And we are at the to-do list now. So we love a list. Love a list.

And so a lot of this, the what would we do's and the to-dos are born out of years of coffee talks and conversations that we would ask each other, what should I do? What would you do? Let me ask someone.

So let me get on the paper.

[Kelley] (26:28 - 26:37)
And that's something, Kelly, I love about you. I, you know, you never not, don't have a solution. Yeah.

I always, I love a good idea. You love an idea.

[Julianna] (26:38 - 26:49)
I love an idea. And I love a list. Yeah.

Together we were formed. We have a list of ideas. That's right.

We, and a to-do list and things to chase down. And so here we go.

[Kelley] (26:49 - 26:57)
Okay. So right away, what would, what would, well, not what would you do? What, well, yes.

What's to do? What do I do right away?

[Julianna] (26:57 - 27:11)
ABA is not something that you do once. It's not done. It is a long game.

It is evolving. It happens slowly and gradually. So in the immediate, develop long-term strategies for ABA.

[Kelley] (27:12 - 27:22)
Yeah. Yeah. And be patient because again, like any of these things, you got to give it a chance.

It's not going to happen. You know, overnight. Yes.

So give it a chance.

[Julianna] (27:22 - 27:56)
And in the short term, to the extent possible, practice some of the skills they're working on. Again, they start very slow. So turn-taking doesn't just start with learning how to play sorry, you know, or some board game.

It's when taking starts with a very, very simple thing. Sometimes with some kids, it might just be getting them to say what you say. And to the extent you can kind of pick up what they drop, you know, in the session.

One, it gives you something to do with your child. That is more fun than you think it's going to be. And two, it kind of reinforces concepts that they're working on and it makes progress go a little faster.

[Kelley] (27:56 - 28:21)
Oh, definitely. I mean, I often felt like that was just almost the starting point. Yeah.

And then we were trained. Yeah, totally. You know, and then you kind of realize how you can kind of naturally take on some of that too.

A hundred percent. And you're always looking for the antecedent, the behavior, the consequence. And again, you know, take on the program, but also keep doing the detective work.

Keep, you know, tracking.

[Julianna] (28:22 - 28:23)
Oh, yeah. Oh, yes.

[Kelley] (28:23 - 28:31)
Also, one thing in the short term, take advantage of the, you know, the little glorified babysitting.

[Julianna] (28:31 - 28:32)
Yes.

[Kelley] (28:32 - 28:57)
You know, a lot of ABA is done, especially in the early years in your home. Yes. And I loved it.

Like, it was a chance where I got to, you know, either play with my younger son. Sometimes he would even join in. Yeah.

And then they got to do a little stuff together in a nice, you know, mediated environment. And then I could, you know, have a cup of coffee and just, you know, you know.

[Julianna] (28:57 - 28:58)
Do a little laundry.

[Kelley] (28:58 - 29:01)
Do a little laundry. Just take a little 20 minute nap.

[Julianna] (29:01 - 29:01)
Yeah.

[Kelley] (29:01 - 29:12)
Anything. It was just nice to have, to have my child or children taken care of for a little bit. So enjoy that part.

That's the silver lining. Well, sometimes I hear from parents.

[Julianna] (29:13 - 29:40)
Well, it just feels like they're babysitting. They're not doing anything. They're doing, it's, it's not about what they're doing.

You know, your child is playing, you know, they're looking at the development of your child. And, you know, it wouldn't be appropriate for your kid to be sitting there doing spreadsheets. Right.

So it does look like play. It does look a lot of times like they're not doing anything. They're trying to get your kid to say boo and do it.

Right. You know, that does look like play, but there is a method to it and relax and try and join the fun.

[Kelley] (29:40 - 29:42)
I really did love all the therapists that came over.

[Julianna] (29:42 - 29:43)
Oh, I know.

[Kelley] (29:43 - 30:10)
And, you know, you are in such kind of a time of crisis and having these people come in to me, it like, it kind of relaxed me a little bit. It's like, oh, OK, here's, here's somebody who knows what they're doing. They're not going to judge my child.

You know, that I really felt like they can come into my home and I can, you know, usually that was such a fraught experience. I think if a person was coming into our, into his space. Yeah.

And with them, I'm like, oh, you know, come on in.

[Julianna] (30:10 - 30:11)
Come on in. Yeah.

[Kelley] (30:11 - 30:16)
Let me get you a cup of coffee. But OK, what about in the long term?

[Julianna] (30:16 - 30:46)
So, and again, I touched on the criticisms of ABA, including private equities, investment in it, and that leaving some of the clinics in not good shape. So look at the corporate structure of the clinics that you have access to. Is there an ABA in the clinic?

Are there, I'm sorry, a BCBA in the clinic? That is the licensed behaviorist that they have on staff. Or are they across the country?

Because it's a big conglomerate that they have, you know, that they're spreading these folks too thin.

[Kelley] (30:46 - 31:44)
Try to find a local shop with its own BCBA. Yeah. And my long term strategy or to do would be that, you know, change can be hard.

But if for some reason your therapist leaves your clinic or if, you know, your head therapist who's programming, you know, consults with somebody else, don't get upset about that. Just, you know, even if you loved your therapist or, you know, like it's really nice to mix it up a little bit. Yes.

Like keep their phone number. Yeah, definitely. Always keep that network.

But, you know, it's great for your child to, you know, connect with somebody else that's different. So don't resist that change because it will happen. Therapists will come and go.

It's sort of a nature of the beast. And, you know, kind of embrace that a little bit. Don't freak out.

Yes. All right. So some things that are blocked.

[Julianna] (31:45 - 31:47)
Yeah. That means don't do it.

[Kelley] (31:47 - 32:08)
Don't do it. Don't be afraid to ask for modification in a program that doesn't seem to be working. You know, you're working with professionals, but you still are the expert on your own child.

And, you know, I mean, you know, if something's working or something's not quite working or what the effect is. So, you know, be an active participant in that process. You have meetings with your therapist.

You know, speak up. Read the notes.

[Julianna] (32:08 - 32:37)
Read the notes. Take copious notes and read them and see if you jive with what you're seeing in your home. Yeah.

So don't become a social media movement at your own child's expense. You're raising a child. You're not starting a movement.

So if it is working for you to try ABA, if it's in your budget, if it is what your family has access to, then do it without regard to what a social media movement is saying. Yeah.

[Kelley] (32:37 - 32:45)
And sometimes those people in, you know, who are talking about it are doing things that, you know, you might call ABA.

[Julianna] (32:45 - 33:02)
One of the most fun things to do is to go into these social media echo chambers and read the comments of what they suggest you do instead of ABA. And when you read them, you're like, but that sounds like ABA. But that is ABA.

Like, yeah, like the doughnuts behind the doughnut holes. That's that is.

[Kelley] (33:04 - 33:13)
Reward behavior, right? So the doughnut holes, give that is something that we will talk about when we are talking about pathological demand avoidance.

[Julianna] (33:14 - 33:52)
And but a lot of it is the point I'm making is a lot of it is regurgitated, tried and true behavior concepts that have a new vernacular. Yeah. Be wary of them.

Yeah. Yeah. So Kelly, why is this conversation important?

The concept of ABA has been around for a long time. It is the primary therapy that families have access to for their child. And it matters if you don't try it because of something you've heard.

So you should know all about it. You should do your research. You should probably try it and make an informed decision for your family.

Yeah. Good advice. Thank you.

[Kelley] (33:53 - 35:05)
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