An Interview with Katie Bauer, Board Certified Behavior Analyst
Behavioral therapy is one of the most successful approaches for helping children with Autism Spectrum Disorder (ASD). An effective Behavior Intervention Plan, developed and implemented by a qualified behavior therapist, can significantly reduce, or even eliminate, negative and maladaptive behaviors in many children on the spectrum.
But what exactly is a Behavior Intervention Plan? What goes into creating one that’s effective, and how can it be used to have the strongest positive impact on the child?
To answer these questions, we spoke with Katie Bauer, a Board Certified Behavior Analyst with her Master’s in Applied Behavior Analysis and nearly 10 years of experience working with children with autism. Over the years, Katie has worked in a variety of settings and with a wide range of care professionals and parents to develop and implement effective Behavior Intervention Plans.
During our conversation, Katie emphasizes the importance of creating a behavior plan that is practical, approachable, flexible, and above all, unique to each child. She says, “If you meet a child with autism, you’ve only met ONE child with autism.”
Q: Katie, what exactly is a Behavior Intervention Plan?
A: A behavior plan is simply a tool that outlines practical ways of dealing with difficult behaviors in children with autism. It’s based on understanding the function of specific behaviors and generally involves several different approaches, all of which have already been tested with each individual child. The most important thing to understand about creating an effective intervention plan is that it must be customized to the needs of each child.
Over the years, I’ve created a lot of Behavior Intervention Plans, some simple and some quite extensive than others. Each and every one is unique, because each child is unique. If you meet a child with autism, you’ve only met ONE child with autism. Every child has their own unique strengths, weaknesses, challenges, and needs. So, it’s important to think outside the box and approach each situation with a fresh perspective.
One of the things I am most passionate about in my work with Cornerstones is facilitating a collaborative approach to the treatment of each child I work with. In most situations, a variety of people are involved in a child’s care – parents, speech therapists, occupational therapists, teachers, psychologists, feeding therapists, and so on. If I’m working with a child on increasing self-help skills, verbal skills, or social behavior modifications, that work must continue beyond the time I spend with the child if it’s to be effective. A clear, concise Behavior Intervention Plan can help keep everyone on the same page and create continuity in everyone’s interactions with the child.
Q: What’s your approach to creating a Behavior Intervention Plan that’s truly effective in treating maladaptive behaviors in children with autism?
A: I try to keep them as simple and straightforward as possible. The more practical and accessible the plan, the better. If it’s complicated, lengthy or confusing, it’s just not going to get used. Parenting a child with autism is already an overwhelming task. The behavior plan should help that situation, not make it worse.
I’ve found that plans containing concise, proactive measures are the most effective. “Proactive” is really the key word there. The more proactive we can be about a behavior, the better.
Dealing with difficult behavior in children on the spectrum is, well, difficult. Parents get overwhelmed and don’t know what to do. As a result, they will tiptoe around the behavior, doing all they can to avoid it. Some parents avoid taking their child out into the community altogether because of the fear of yet another meltdown in public.
My goal is to face the behavior head on. Rather than avoid it, I want to see what situations provoke it so that I can start to understand the behavior’s function – the reason the child is acting out. If I understand the reason behind the behavior, I can create an effective strategy for working through it and creating real change. Generally, my goal is to work on the behavior inside the home and then move the child out into other environments so that they can conquer those situations as well.
Q: Could you give me an example?
A: Of course. One that comes to mind is a child I worked with for nearly two years. He was super aggressive and had a lot of other behavior issues, so much so that the mom did not want to take him anywhere outside the home. For months, we worked on a variety of strategies within the home. Then, we started using the same strategies in situations outside the home, starting small at first. Eventually, the child’s mother was able to take him out into the community by herself, something that was simply impossible before we started working together. That was huge for her.
I feel that if we’re not exposing kids to different situations, their overall behavior is not going to get better, and that situation is a good example. Most children will only fully adapt to behavior strategies when we push them outside their box – stretch them beyond their current boundaries and teach them how to behave in different environments.
In a behavior plan, it’s important to emphasize very specific proactive measures that will help us accomplish this. It’s about creating strategies that set them up for success. This systematic approach is not only useful for all the people involved in the child’s care, it also creates structure for the child. It’s important for children with autism to know what to expect, to know that their behavior will elicit a consistent response.
The other thing that’s really important is to test every strategy before putting it in the behavior plan. As I said earlier, every child is different. One child might respond well to the setting of a timer that allows them to know exactly how long we will be in one location before moving to the next. For another, the timer might only increase the maladaptive behavior and make the situation worse. What works with one child, doesn’t necessarily work with another. I’m not going to write up a behavior plan that includes strategies I haven’t already tried and believe to be effective.
Q: It sounds like you spend quite a bit of time with each child before writing their Behavior Intervention Plan. What does that process typically look like?
A: Every situation is new, but there is a process, and implementing a behavior plan right off the bat isn’t always useful. Usually, I need to get to know the child and the family first. It’s important to understand the family dynamic, and to also understand what the family wants and needs from my work with their child.
I’ve also found that it’s vital to create a relationship with the family. If I want to tell a parent how to manage their child’s negative behavior but haven’t yet built rapport with them, they might not be as receptive.
The same goes for the child. It’s important that I build trust with them. Before I can really help them, they need to decide that they like me. Then I can slowly begin to work on their behavioral challenges.
Since the main point of a behavior plan is to keep everyone on the same page about what’s best for the child and create consistency for dealing with problem behavior, I also do all I can to understand how other care professionals are working with the child. A lot of times, schools will already have behavior intervention plans in place for that child. When that’s the case, I try to incorporate the strategies they are using as well.
I really believe that a cooperative approach is important when several people are involved in a child’s care, and that it’s my responsibility to forge those relationships at the start. My goal is to build on their successes and take their words of caution seriously.
The other thing that’s vital to an effective behavior plan is to understand the function of a behavior – why the behavior is happening and what the child really wants. This requires my spending quite a bit of time with them before I hand over a behavior plan.
Q: Do you have another story you can share that demonstrates this cooperative approach?
A: Sure. I’ve recently been working with a child that has a difficult time requesting the things they wanted. Understandably, this would make him upset. Typically, the mom would cuddle the child to calm them down. This was fine, but it wasn’t doing anything to address the root cause of the behavior – that the child couldn’t communicate his needs. To address this issue, I implemented a picture strategy. I would hold up a picture of milk, for example, point to it and say “milk”, until he began repeating the word along with me. The mom and his teachers at school began doing the same thing and we saw his tantrums begin to decrease, both at home and at school.
Skill acquisition generally has the effect of decreasing negative behavior. This is an important part of ABA therapy – a lot of negative behavior is the result of a child not having the skills they need to cope with their world. When we – myself, the parents, their teachers and other therapists – are able to teach them these skills in a variety of environments, it automatically reduces negative behavior.
At Cornerstones we are very focused on getting the parents as involved as possible. When I’m in the home, working with a child, it’s much more effective to pull a parent in and show them how I’m using a strategy, rather than just telling them about it later.
Q: How can parents use a Behavior intervention plan to both support their child and make their lives easier?
A: From a parent’s perspective, if the behavior plan is clear and specific, it can break down the overwhelming task of parenting a child on the spectrum into something more manageable.
I always urge parents to watch what’s happening during sessions with their child, participate and ask questions. The worst thing parents can do is tiptoe around behavior and try to avoid it. It’s much better to face maladaptive behavior head on, work to understand it, and then work through it, not around it.
It’s also really important to understand that often, negative behavior gets worse before it gets better. We call this an extinction burst and you just have to work through it.
If you have a child with autism and are curious about how Cornerstones can support you and your child, we would love to talk with you. Contact us today so we can discuss your unique situation and the needs of your child.
Are you looking for ABA services for your child in the comfort of your home? Are you looking for less stress in your life? Cornerstones Autism Services can help.