There's an old saying that goes something like "be careful what you ask for - you might just get it."
We continuously get asked about teamwork and how to make ABA teams more collaborative, cohesive and successful. In my last post, Are we a team yet?, I broached this subject - fully aware that I hadn't even begun to provide enough of an answer. From the feedback I got, it's clear the community is well aware of the issue and is starving for answers.
So I thought back on my own experience with my son's ABA program. We started it when he was about 3, with a newly qualified BA (there were few to choose from back then - 2001 if I recall correctly). We scrounged some people together and shelled out for a full-day crash course in ABA and off we went. Over the years many people came and went - I'd estimate 15-20 different team members and at least 6 different BA's over the 14 years we ran some semblance of an ABA program. Sometimes the team worked well together, other times it didn't. I looked through notes (yes I still have a shelf full of binders) and correlated them against the times I remember him succeeding versus struggling, both at home and in school. Was there one critical factor that made the most difference?
I have good news. I found an answer. Before I tell you though, a warning: you might not like it very much. That's because we all secretly hope for that magical answer that is simple and easy and obvious once it's been pointed out to us. Those are rare (here's one exception: the 5 second rule for procrastination; it really works); and I'm sad to say this is not one of those. It may seem obvious at first glance - so obvious you will think to yourself "oh OK, we'll just do that". And you will start to do it, and it might help for a bit. But if you don't embrace it fully and deeply it will stop working.
So my precaution is this: if you really want to create a high functioning team that is inspired to achieve great results - whether this is your ABA team or some other team - consider this point and find every possible way to apply it, everywhere. Not just in the team but everywhere. One of my favourite personal slogans (please tell me if you know who said it first) is, "how you do anything is how you do everything." So if you really want to apply this principle, apply it to every aspect of your life with unending persistence; infinite patience.
Nevertheless, here it is:
That's it. Simple, right?
Only on the surface; only when things are going well. It's when things start to go sideways (which they will) that it gets harder. That's when you need to dig deep and really believe that this is the glue that will ultimately hold your team together and help them, individually and collectively, to be the best that they can be in pursuit of supporting your child. Never stop believing that (with rare exceptions) they are there because they truly want to make a positive and lasting difference in that child's (and your) life. Your job, whether you are a parent or BA or team lead (or anyone for that matter) is to bring out the best in everyone else.
This the part in my story where I pause to reflect on the natural irony that children with autism, who naturally struggle to relate to others, are the ones to teach us how.
It's not news that communication is key to teamwork. This is why coaches talk to their players between periods; why players talk to each other on the ice or bench (sorry for my hockey bias, happy 150 Canada!); or why being good at coding doesn't make you a good software engineer. We are all part of a team at one point or another. And yet, our communication is rarely as effective as it could be. For the most part this is OK; most of us get by perfectly fine with average communication skills.
Perhaps it's because we are working with an autistic child whose natural way of thinking and communicating is so foreign to us, that our own communication skills need to be better than average to be effective at all. It needs to be structured, disciplined, consistent, and - as I mentioned earlier - respectful.
Let's break down what each of those means in practice.
Back in 2001, most people didn't have a cell phone and email tended to be hit-or-miss. Today you can pop a team meeting into your favourite Calendar app and send it to everyone's phone, but back then we had to pre-plan everything more carefully. Still, even today, it's important that everyone knows in advance how, when, and how often communication is expected. Some examples:
- All BIs meet at Stacy's house every second Tuesday from 7pm-8pm.
- Make an entry in the communications binder (if you're still using them; not judging!) at the end of every session
- If you have a question about any of the protocols, call Amanda.
In other words, don't just wing it.
It's important to remember that ABA is a scientific method. As such, it relies on consistency. It does no good to observe that the frequency of prompted responses is decreasing if there isn't a precise and consistent definition of what a prompted response is, that is clearly understood by everyone. Is there a shared definition of what SDs are, or do you talk about STPs and LTPs? What's an NVP? Antecedent? How do we document chained behaviours? Is the order of trial results important? What details are important to mention when recording behaviours?
Having established a common language, now you can talk to each other with clarity. The other aspect of consistency is in the communication itself. It's one thing to say you're going to meet every week or that everyone needs to put something into the session notes, or that long conversations over email are counter-productive. Most teams will need ongoing leadership in establishing these habits. "Hey, could you please put that in the session notes?" "Just a reminder, could everyone please remember to add session notes - this is really important so everyone knows what's going on." "Remember to add session notes before you leave." Yes, you may need to be the squeaky wheel sometimes. Eventually they may start to remind each other to keep with the discipline, but you need to own it.
This is particularly apparent when new team members come on board because you are forced to spend extra time with them so they understand how the team communicates. I think at one point we went for a stretch of almost 2 years with zero turnover. That certainly made things easier, because the team was able to establish a routine. But we made the common mistake of allowing complacency to set in, and the pace of progress began to slowly erode. Then our senior BI got a new certification and increased her rates, so we made the tough decision to let her go (more on that in a bit). When we found her replacement, he came with some new constraints and new ideas. So we adjusted, and communications and results started to improve.
Respect is much more than simply saying please and thank you, or not blaming people when things go wrong. It's about practicing emotional intelligence. Remembering that most of your practitioners will tend to be younger (early 20's), they may need guidance here. Here are a few examples of respectful team communication:
- If people are getting frustrated because they don't understand how to implement a protocol, ask. "Hey Kim, we're a little confused by the third stage of Categories. Would you have some time to explain it to everyone, or maybe clarify the description?" Your BA is most likely not a sociopath (although we did admittedly have one of those) and actually wants the team to understand.
- If someone is struggling, actually help them. Don't shame them in front of the team (unless you are trying to destroy the team), but don't ignore the problem either. "Hey Marcus, <insert sandwich technique> ... we've noticed that you seem to be struggling with physical compliance. Is there anything I can do to help you with that? It's a critically important part of the protocols we have in place right now." If you do nothing, you aren't being kind and you aren't being patient; you are being disrespectful: to the struggling individual who wants to succeed but may not know how; to the other team members who have to pick up the slack or worse, undo the damage; and most importantly to your child who isn't getting the appropriate intervention they deserve.
- Back to the example from earlier, where we had to let our senior BI go because her rates increased. On the surface this might sound disrespectful. But we knew she had other teams who wanted her as a team lead, something we couldn't offer her. Keeping her on would mean we had to reduce overall contact hours to stay within our budget. I wrote her a glowing letter of reference. She deserved it.
- On one occasion we had someone who, after several attempts to help him, just wasn't able to get it done. He was great in some respects but in the one area that mattered to us at that time, he just wasn't strong and there was nothing anyone could do about it. I had to tell him exactly that and wish him well. If you've ever had to fire someone you know it's not easy. (Even if it looks that way on TV.)
If this all sounds like a lot of work, you're right. It's not going to be easy (I did warn you after all). But if you've got a child on the spectrum, you've probably learned not to expect easy. You will make mistakes and you will fail. That's OK; we all do. Learn from it, pick yourself back up and do better next time. It will be a constant battle - mostly against yourself, if you're really honest.
It's really worth it though, every bit. Isn't it?