When it comes to language development, speech therapists and behavior analysts tend to hit a wall. Perspectives differ, orientations may not coincide, and discussions can get heated. The goal of this blog is to provide perspectives on language development in children with autism, language disorders, and developmental disabilities from the perspectives of a speech and language pathologist (SLP) and certified behavior analyst (BCBA), in order to show how these two domains can happily work together and collaborate. This is a new endeavor, so please be patient as we work together to address topics in language development. Questions, comments and concerns are welcomed and encouraged!

Thursday, December 31, 2009

Speech and ABA collaboration on goals - by Angela Mouzakitis, BCBA

Consistent with the need to work together and be respectful of each discipline, now what? Working with children with autistic spectrum disorder requires careful assessment, program planning, program implementation, and program monitoring. All of this needs to be collaborated on with the entire team: not only speech and aba, but parents, occupational therapists, physical therapists, and anyone else involved in the child's development and progress. What this translates to is that goals cannot develop on speech, ABA, PT, OT, and parent bubbles.

Usually what happens is that each domain assesses, decides on the goals, decides how they will implement them, and reports on progress to the other domains. This is not sufficient across so many levels:

Assessment: Each domain has something to offer regarding assessing the child and identifying skill deficits. Additionally, priorities need to be identified. If a child is not communicating with any of the people in his environment, communication development needs to take precedence across ALL domains, and all the therapists need to target this area. Additionally, assessment in each area will be supplemented by adding results from all the domains. Speech assessment will benefit from cognitive and physical growth assessment as the speech skills will then be viewed and assessed within an appropriate context.

Program development: The domains need to get together here, and prioritize goals and needs for the child and family. There may be a limited number of goals and targets that can feasibly be addressed. Additionally, related service providers should understand why certain goals are chosen. This is done by collaborating on development of goals.

Implementation: This is another key area. While some goals may be specific to a domain and special training is required (ex. PROMPT certification) all goals should be addressed by all therapists. An occupational therapist working on a pincer grasp needs to also work on and implement the child's behavior support plan. It is un-ethical and irresponsible to assume this is the role of the behavior therapist. In a collaborative and comprehensive program, it is impossible to extricate the goals from each other. They shouldn't be taught in isolation, rather across domains, settings, and people.

Monitoring: This is an area that ABA therapist could support the related service providers, and I'm sure that Diana could speak more to this, but progress NEEDS TO BE MONITORED. Statements like "is responding well" and "appears to be making progress" and "is doing better" are NOT acceptable. How do you know he is doing better? Show me the data. Show me how he is doing today in comparison to yesterday. This is incredibly important.

How to monitor various programs is a challenge. And data collection should not impede program implementation. Not everything needs to be broken down into numbers. Anecdotal data is data as well, but a system of data collection, whether numerical or anecdotal needs to be implemented. If a goal is a particular speech sound, the team needs to ask, "How will we know when he has mastered this goal across people, settings, and times of day". A system to monitor it must be implemented.

My hope is that the next few posts will illustrate how to develop appropriate data collections system for goals in related domains without compromising the integrity of the goal or of the data.

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