Autism Acceptance and ABA

In observation of Autism Acceptance and Awareness Month, Mike and Dan examine a very poignant and sharp criticism of ABA intervention strategies (link is below). Reviewed exactly as published on the website 'autisticscienceperson.com,' the current brew integrates several points of disapproval, as written by an author that identifies as autistic. While ABA on Tap welcomes a deep analysis of ABA itself and has entertained several detractors before, this particular point of contention presents a bit differently. Mike and Dan are able to diligently identify validity in the author's concern, and more importantly delineate and establish the notion of misuse of ABA, rather than accept the premise of ABA as an inherently abusive, philosophy of the science of both human, and non-human, animal behavior.

So, grab a nice, tall, chilled glass and pour slowly. This one begins with some bitter notes up front but, as usual, Mike and Dan are able to guarantee a smooth finish. Enjoy and always analyze responsibly.

https://autisticscienceperson.com/2023/03/31/autism-acceptance-week-and-applied-behavior-analysis/

Transcript

SPEAKER_00: 0:00

Welcome to ABA on Tap, where our goal is to find the best recipe to brew the smoothest, coldest, and best tasting ABA around. I'm Dan Lowry with Mike Rubio, and join us on our journey as we look back into the ingredients to form the best concoction of ABA on tap. In this podcast, we will talk about the history of the ABA brew, how much to consume to achieve the optimum buzz while not getting too drunk, and the recommended pairings to bring to the table. So without further ado, sit back, relax, and always analyze responsibly.

SPEAKER_02: 0:53

All right, all right. Mr. Dan, we are back to another edition of ABA on Tap. It's been a little bit of a pause. Weddings, illnesses, kids, family stuff, you know, all those things that cause a good pause for the ABA on tap.

SPEAKER_00: 1:11

What do you call it, the COVID-23? I

SPEAKER_02: 1:15

didn't know if you were going to go there, Dan. So, Dan, I've officially deemed Dan as the first COVID-23 patient. He's been sick for a couple weeks, and not to make light of that, I'm glad you're feeling better, you sound better. I know you might be taking a little side face pauses Sure. Try not to

SPEAKER_00: 1:36

blot anybody's eardrums.

SPEAKER_02: 1:37

I took all the COVID-19 tests. See what I mean? It's important for us to be very precise and scientific here. You were trying to detect COVID-19 when in fact, sir, you've got COVID-19. COVID-23.

SPEAKER_00: 2:03

But nonetheless, we're back. Very excited. This was an episode that we've been planning for a while and hoped to do in April due to the Autism Awareness Month. Got pushed back a little bit to May. Better late than never. Let me pass it to you for a little bit of introduction, maybe a little preface, and then let's jump right into it because super excited about this one. This is kind of our, I feel like our comfort zone in the tap over the multiple years that we've been going about this now of looking at criticisms of ABA trying to look at the validity while respecting the individual because that's certainly their experience. Look at the parts that we can bring back to the field and say, hey, as a field, we need to improve this. And maybe looking at the parts that may be misrepresented into the field or misrepresentative of the field as well.

SPEAKER_02: 2:49

Yeah, so this comes, we have to thank the algorithm, right? The ever-powerful algorithm. I'm not sure which algorithm, the algorithm, though. The one that puts autism news across my news feed And this one might be a little bit politically charged, right? So the algorithm knows to put criticisms of ABA across my news feed. And this one came across. It's from Autistic Science Person, which is a website, I guess sort of a blog with a lot of posts. And this one for April was deemed specifically Autism Acceptance Week and Applied Behavior Analysis. And we'll link this in the description, correct? Absolutely. The link will be in the description. We want to make sure that... We cite our sources specifically. And we've entertained a lot of criticism on ABA on tap. I think we've gotten... You're absolutely right. It's become our strength. We've become better at... Truly analyzing and dissecting, not refuting. And I think that's an important distinction here. And the reason this particular article caught my eye is that at least the author identifies as an autistic person. Very, very well-written, very impressive writing, very, very well-described writing. Responses and emotions, and then more importantly for me, is that the author has taken citations from an actual treatment plan that is as recent as this year in February, I believe, if I'm citing correctly. Sure. And these are things in a treatment plan that immediately I identified as traditional approaches, things that I know work, things that maybe you... me, I've moved away from a little bit in our more recent practice as I've explored early intervention and the mix with early childhood education best practices and sort of trying to, for lack of better phrasing, normalize our treatment and the way we treat our clients. So maybe not things that I would necessarily do anymore, but things that at least still sound very reasonable that this author is able to refute and dissect and criticize pretty harshly. So we have another harsh criticism here. It's not easy to get through those. Again, we've gotten a lot better at refuting. It's not our role to refute here as much as to try to inform and advise otherwise. We Do not have any doubt that this author here had a very poor experience with ABA treatment. That is clear. And we can't take that away from this individual.

SPEAKER_00: 5:24

Absolutely.

SPEAKER_02: 5:36

Your ABA is a little bit different from my ABA.

SPEAKER_00: 6:06

of looking at that and seeing how relevant it was and more of the general critiques of ABA. Then we looked at Alfie Cohen and looked at that critique of ABA, which was another harsh criticism of ABA. We looked at Chloe Everett, who was our first kind of experience of somebody on the spectrum, maybe speaking not so, reflecting not so admirably about her experiences with ABA. And this will be our fourth kind of looking at that situation, as well as our second discussing or reviewing somebody with autism's experience of ABA. I will say there are a couple of things that I just want to highlight, and then I want to get into some specifics. But one of the things that they say is ABA rebuttals, the field has changed. And you mentioned that your ABA is different than my ABA is different than anyone else's ABA. So I do think there is validity in saying that the field has changed or that an individual got one experience of ABA. So that's like saying I went to McDonald's and that's going to be the same as Burger King or Chick-fil-A or something like that, just because they're fast food restaurants. There's some similarities and things like that, but everything's going to be a little bit different, both within each McDonald's and then comparing McDonald's to Chick-fil-A to Burger King, et cetera. So because there's not, there is the BACB and there's a board that governs everything, but they don't go out and oversee each individual practice. They are only there for egregious ethical violations for the most part. Everyone's ABA is going to be different. So yes, the field has changed, and also everyone's ABA is going to be a little bit different. While we do represent the field of ABA, and we should all do that with that level of significance, because everyone's is different, this one person's experience is not necessarily representative of everyone's. Everyone's experience is representative of their own experience. And

SPEAKER_02: 8:11

these analogies can get a little tricky. We're not trying to admit the importance of the science or the customer's experience or what have you. And I completely understand where you're coming from. So you made me think about that there and the idea that we're talking about fast food restaurants in your example. We're talking about things that are all sandwiches, for example. Some are burgers. Some are chicken sandwiches. And then it's It's like a massage therapy, right? Somebody's going to appreciate and benefit more from deep tissue, and then others are not. So one thing that's very prevalent here that I like to talk about, that I like to stay away from, the idea of withholding reinforcement or withholding potential external or extrinsic motivation.

SPEAKER_00: 8:53

And that was a huge theme of this article that we'll get into.

SPEAKER_02: 8:55

Yeah, yeah. It's one thing to say you're withholding indefinitely, which I know traditionally has been something available to us that can be problematic. And there's the idea that you're creating a motivating operation online. only in as long as the learner is within a specific stress zone, right? So once you've withheld so long that you tip over into distress and now maybe we're erroneously going into our extinction mode, yikes, that's a lot to unpack there, maybe we'll come back to that, but that's not unforeseen, then yeah, yeah, I'm gonna agree with the author. We've probably lost a huge opportunity there, right? And not to say that that in and of itself is gonna be traumatic or abusive, to the learner, but perhaps an abuse of ABA, something I want to talk about in terms of a misuse. So he's talking about abuse toward the learner with a circumstance like that. And I think what you and I are going to talk about today is the potential abuse of aba techniques yes by doing things like that not reading your audience not dynamically gauging your learners distress or stress levels toward optimal learning knowing that we come in with an idea in aba that the exact behavior that we need to occur if the child doesn't make the sign for more then that trial is lost where the other side of what we've been exploring on aba on tap and professionally speaking developmentally um uh looking at the idea of modeling or the idea of presenting the information toward the incidental occurrence of that envisioned behavior such that we can pounce and differentially reinforce a variety of communicative behaviors toward that word for whatever item we're withholding. So again, I've unpacked a lot there because there's a lot to unpack. Really enjoyed this article and I'm glad we've got it. We'll need to find more about this individual who's putting up this website and see if we can. We've put a lot of invitations out there to talk to to critics, Dan. We've yet to have somebody take us up on one. So maybe this will be our first.

SPEAKER_00: 11:00

Yes. And I think, again, I want to stress that within these four episodes that we've done kind of reevaluating the field, we have taken, I can say, personally, we've taken a lot of these strategies, brought them to our company, And our company is different, and the way that we implement ABA is different as a result of these articles. So there's some positive things that they have done to the field, or at least our representation of the field. On the flip side, we also are trying to defend the field in some areas as well. So we're... critiquing the field. And of those things that we have said, yeah, these things are valid. We need to fix. We actively go and try to fix them and have case manager meetings and discussions about how we're going to fix them, specifically citing these articles. On the flip side, some of the critiques that we don't find is valid. Again, I would really encourage any of you that feel strongly about them. We really want to debate them. We really want to discuss them with you. Unfortunately, we have had people come and express these feelings on Facebook comments and things like that, but don't want to take the time to discuss them so without further ado please reach out to us and we'd love to have that discussion if nothing else so that we can be more informed and deliver a better practice Going back to what you said, you covered two grounds before I get there. Did you want to add? You were talking about withholding, which I think is going to be a general theme of today's discussion and review because that's a general theme of the article. The second thing you talked about was the dangers of a structured practice. And Jennifer, who, if you haven't checked out that episode, please check out that episode with Jennifer Stevens. It's one of our most popular episodes. Talked about the BCBA that she was training that wanted the standard practice. So give me the sheet of what I do when I'm with a client, that's one of the things that we run in danger of in the field is autism is such a diverse diagnosis and everyone's going to be different. So having a standardized practice is going to potentially get us into a lot of trouble because now we're trying to use procedures that aren't necessarily going to be individualized for each individual and we can run into trouble with that. So when we talk about withholding, which is going to be one of the procedures that is constantly referenced in this article, I think there's some maybe hyperbole a little bit in this article. So I want to differentiate between the hyperbole and the things that maybe are systemic in ABA. So I'll read a quote here. It says, if a neurotypical parent withheld water from their five-year-old kid until they answered a calculus problem, would society in general consider that abuse? I have to think that's a little bit of hyperbole. I don't think anybody in ABA would recommend withholding water or something that's going to be important for an individual's livelihood contingent on something that trivial like a calculus problem. So I do want to highlight some of these things. Now, I do think there's a point that they're trying to make within there that's relevant. But I think sometimes when we take it to this level of hyperbole or exaggeration, it then creates a picture of ABA or creates a narrative Which people then read that And almost take it at face value And then create a perception of something that's not accurate

SPEAKER_02: 14:19

I'm having a hard time not being facetious here, only because I was going to say, hey, I'm really impressed that a five-year-old knows calculus. But I don't want to, to your point, you're absolutely right. It's these exaggerations.

SPEAKER_00: 14:33

Maybe with Chad GPT they might know calculus.

SPEAKER_02: 14:36

Oh, we're going to have to have a whole episode on Chad GPT and people's behavior around that. But I wanted to make a slight... A very nuanced point here that I think is important. So when we're talking about withholding, if a neurotypical parent or the parent of a neurotypical child, I think is what the author is also trying to communicate here, withheld water from their thirsty child. Right. So it doesn't say thirsty child. If it's one thing, if you're putting a child in a hot room, you know, made them run around. Now sit down and I'm not going to give you water until you get this calculus answer correctly. OK, I exaggerated there a little bit to make it seem a little worse. Right. Yeah, that sounds terrible. Now, let me reframe that for you. I'm going to sit with my child, my five-year-old, my amazing five-year-old, to do these calculus problems. And every time they get some aspect of the problem or the whole calculation correct, I'm going to offer them water. Is that a completely different situation, or have I described exactly the same situation in many ways and just shifted the focus a little bit in terms of the withholding? And I think that that's something super important that it's difficult. I'm going to credit... our experience in the field, our time grinding and deep dives and rigorously looking through things and trying to improve our practice, and I think that's something that younger professionals in ABA need to understand. It's not about you in an authoritarian way having this instructional control, you can't do anything until I tell you. It's about looking for the opportunities to deliver said reinforcement when it does occur, whether your SD is to And that's tough. That's not easy to figure out.

SPEAKER_00: 16:37

Yeah, I agree. And I really like that delineation. I guess the only thing I'll slightly push back on is I think that term water creates like a little bit of cringing. If we were to say like chocolate milk or if we were to say money, because a lot of people are incented, once water comes in, then it's like, oh, is this? If this person never does the calculus problem, are we therefore withholding water forever to a point where it's going to be detrimental? So I think that when this person maybe specifically chose water, I think they did it to create maybe a significant reaction. No, for sure.

SPEAKER_02: 17:10

For sure. No, I agree. And I think that, again, that's why it lends itself so nicely for me to that shift in saying that it's as easy as saying that, yes, we are creating a motivating operation, assuming that the water has anything to do with them being interested in calculus in that point in time. which is, again, I can dissect this all day, right? I don't want to get overly philosophical about this point, but I do think that the author allows us as behavior analysts in this point, in this moment, to get a little philosophical, a little bit silly almost in how how far we dissect this example to realize some of the problems, some of the true problems with this hyperbole. I think you're right. It's hyperbole, but if it's not far-fetched, these things do happen, right? People do find the idea of a motivating operation with something that is functionally completely unrelated to the actual behavior.

SPEAKER_00: 18:01

So let me take that same argument and just reframe entity A. We can even keep entity A, you know, the first then. So first calculus, We'll keep the calculus. Then you get paid. How many... neurotypical, ASD, whatever, offer money for good grades. Why? Because the prefrontal lobe's not developed to age 5, 10, 12, that maybe an individual doesn't really care about getting good grades. So what? They get incented by money. I don't see there being a huge backlash about paying your child for good grades and that being an ethical thing. So let's take out the water, replace it with money. The same premise is there, one different motivator, and I think it'll have people look at it in a totally different light.

SPEAKER_02: 18:42

Yeah, no, no, that's exactly, again, I I think that's the important part of this particular example is being able to turn it over on its head. And the main point for me here being is you want to create a flow, right? What this author is describing here with the water is going toward a power struggle. The idea that I know as a learner you're struggling to vocally communicate. So I'm going to withhold this toy or this balloon because you said bah recently. And now I'm holding the balloon over my head and saying, say balloon, balloon, balloon in the child. Looking and reaching and looking around and looking at the balloon and pointing to the balloon. Getting increasingly frustrated. Right. And then all of a sudden the child melts down or loses interest. But we think we've done the best ABA possible as opposed to waiting two to three opportunities for that vocalization. And then after that, waiting for that part. that child to do that slightly emphatic reach toward the balloon where their finger points out and you go, yep, here's the balloon. Why? Because you pointed at me. Because you shifted your gaze toward me. It wasn't the only singular target that was going to give you access to the balloon to sort of refute the author here because he talks about the eye contact, right? Eye contact, gaze shift, I think there's an important difference there. We've covered it, I think, pretty well here. I won't get into it now. But the idea that we're always looking for that microcosm. There is somebody behavior you're doing here that I can differentially reinforce, even though I may be targeting something more specific. You know, for me in my particular practice, I've even stayed away from Yes. Sure. Sure. Thank you. you're ever going to match a developmental trajectory. Sure.

SPEAKER_00: 21:07

Your bubble example resonates a lot because I show a video in my new hire training in my company of actually Laura Schreiman, who I think universally would be considered probably one of the more ethical people in the field. She's devoted her life to pivotal response training and how can we motivate these kids a little bit more. She was in an episode of Super Nanny and they were trying to get this kid to use their words and the kid wanted tickles and the I think it was Shryman at the time, was basically having the parent withhold giving the kid tickles until the kid said tickles. And the kid specifically did say tickles in the episode. But it does highlight, and this is, I don't know, 10 or 15 years ago, that we're going to withhold the reinforcement until the behavior is omitted. And I think you're talking about even in those 10 or 15 years, we're maybe looking at a way of differentially reinforcing other behaviors or a gradation of behaviors that let's try to find a way to reinforce this before we lose the motivation, get into frustration, and now we've lost everything. I'm not sure if you want to expand on that or if we want to get into maybe specifically, it might be a good time to read what the recommendation was that this person is referencing with their critique.

UNKNOWN: 22:26

Yeah.

SPEAKER_02: 22:27

Go ahead and let's quote the recommendation there. Oh, go ahead. I'm going to try to develop a closing point towards something you said in sort of striking the balance between withholding and finding opportunities to reinforce differentially. I think that's the dance we're talking about here. Because, yes, there's a great deal of importance, value, if you will, in being able to offer reinforcement to the occurrence of a behavior as envisioned through the lens of social significance. As we also know that from an antecedent perspective, there's a lot of value to modeling said behavior repetitively ad nauseum. So what is the balance between those two things, knowing that If the behavior occurs as envisioned or somewhere close to an approximation, yes, that's our jam, right? That's where we're like, yeah, we reinforce that behavior. But then learning to realize that there's a whole bunch of other behaviors that we can emote, that we can model. toward the emission of that more idealized behavior. You might be catching a little bit of special effects here in the background here at the Reptile Studio in my teenage son's bedroom. Next door would be my two-year-old daughter, and she is not wanting to nap. I think she understands that there is an episode of ABA on tap being recorded. She wants to be in the mix. So if you hear a two-year-old crying in the background, just know that it's all being very, very kindly taken care of by my lovely wife.

SPEAKER_00: 24:06

Are you sure your wife's

SPEAKER_02: 24:06

not withholding water? I'm positive. I'm positive. I'm positive. That child has blankets, water. She had a snack. You saw it when

SPEAKER_00: 24:15

you came in. Mike, you You have the article up there. Would you mind maybe reading kind of the protocol or the structure?

SPEAKER_02: 24:22

The bubbles or

SPEAKER_00: 24:23

the milk? Either one. They're both pretty short, so let's read both situations really briefly, and then we can kind of talk about them in their entirety.

SPEAKER_02: 24:30

So the first situation is the adult has blown some bubbles and has then waited to give the child the chance to respond. The means, this is defined as the means. The child usually communicates by reaching for the object he wants, but with encouragement, he can also give brief eye contact and vocalize. Okay. It's nicely described. Again, one of the reasons I like this article. The reason is the child wants more bubbles, the opportunities to be created. The child reaches for the bubbles, but the adult holds them out of reach and waits a little longer for eye contact. As soon as the child attempts to communicate by giving eye contact and vocalizing, the adult responds All right. So, again, even for me, the anti-traditionalist in ABA with an uphill battle the majority of my career trying to blend these developmental pieces, this doesn't sound... bad to me but this author takes issue with it and we understand why the author takes issue with it so go for it what what are your thoughts

SPEAKER_00: 25:36

um my thoughts are i really love the differentiation that you have uh brought about at our company and program about eye contact engagement okay and i think that the joint attention piece so if we're forcing eye contact probably then we start to get into ethical issues. We start to get into the communicative issues that I think we should talk about a little bit later about how people may just communicate a little bit differently. And because we associate eye contact doesn't necessarily mean everyone needs to do it the exact way that we do. So I like your delineation between gay shift and eye contact. Um, and yeah, I think that's, that's pretty much, uh, it for this, this particular point. Um, I've got a lot more on the second situation.

SPEAKER_02: 26:21

Well, so let me jump in for a second here again, because I really find this a nicely described scenario, right? That could be very effective. Now, let's talk about what... might be missing. And I'm not being critical when I say what might be missing. But I'm talking about all the permutations, the dynamics of life that are going to make this little scenario, this little script that was written, it's going to make it go impromptu. It's not going to run exactly like this. So that is to say that one of the things that is being implied here, I think, is the child can reach for an object, can point to an object, can look at an object, and or vocalize that object's name. in order to man and receive the object. Okay. Okay. We could. differentially reinforce any of those how by the amount of time we blow bubbles in response by the number of bubbles in response that we blow now do you want a child of any kind or a human being who is learning to communicate effectively to never look at or physically reference the object they're manding for or is there value even if you vocalize to be looking at the object that you're vocalizing the name of yeah there is right

SPEAKER_00: 27:32

yeah both of those conditions looking at the person too right because as they get older if they're communicating into the abyss how is anyone going to know how when we talk about the speaker or listener how is anybody going to know that they should be the listener in that situation

SPEAKER_02: 27:45

so in that sense any of those things could be right it could be that you as the listener know that I'm trying to grab something else as I'm saying give me the bubbles show me more bubbles or I could be looking away as I point toward the bubbles behind me and telling you bubbles or I could just be saying bubbles any of those situations has a social significance now ideally for a child we're going to want them to look at point two and say the word that is the big prize right that is the sweepstakes that doesn't mean it's going to happen that way every time yep so we have to be ready as the listeners as the adults in the situation the technicians or what have you to differentially reinforce that somehow now as i'm describing that what does that do that insurance that ensures a continuity in the flow of play which means naturally you've eliminated withholding you've kept things going.

SPEAKER_00: 28:36

Yes, which is going to be a huge, huge theme. Yeah, I'm going to talk more about the withholding on the second one. Let me pass it back to you. Let me read the scenario, so

SPEAKER_02: 28:45

thank you for letting me talk about that. Of course. Okay, the situation here is the adult has placed the milk... On the table, but purposefully not given the child a straw, which kind of implies that the child is really partial to a straw in this situation. Yep. Okay. We call that a motivating operation, is that? Yep. The child can communicate nonverbally by pointing and is starting to use a few single words. The reason, the child is thirsty and she has got her milk, but not a straw. So again... implying the child will not drink this milk without the straw. The adult waits for the child to initiate interaction. The child points at her milk, and the adult then gives the child a choice. Do you want a straw or a plate? Showing the objects. The child points to the straw, and the adult gives her the straw, modeling the next step by emphasizing the single word straw. You need a straw. The child is not expected to repeat the word at this stage. Again. Even me as a pretty harsh self-critic of ABA, this does not sound unreasonable to me. So talk to me.

SPEAKER_00: 29:49

Yes. So I'm going to read part of the criticism and then let's address it. So it says, let's focus on the second situation first. So that milk situation that you just read, as this may seem to be the most obviously cruel. This guide tells the parent to put the milk in front of the autistic child while they're thirsty but without giving them the straw to drink it. Then the parent is supposed to wait. Yes, wait. Not prompt the child. Not ask the child to do something. Not communicate with the child. Just wait. The goal is to force the child to initiate interaction as if there's no other possible way for the person to initiate interaction with their parent. Then the child initiates interaction because you know the child is thirsty and the parent is supposed to force the child to do a task, whatever it is. The child is required to point to either the straw or plate. The child must point, not explaining why this is important, to the object, which is the straw. Of course, it doesn't say what to do if the child points to the wrong object. And then it gets into a little bit more things. So I want to talk about kind of the micro and the macro of their retort here. So on the micro, I think there's a couple things that are relevant. I do think waiting... isn't necessarily the worst thing in the world. Because if we're prompting the child, now that man becomes an intraverbal. Now that child is responding to our SD, not the milk is the SD. So now we almost kind of become the motivating operation, them pleasing us or them responding to us more the SD than the milk is. And I think it is important that the milk remains the SD and the MO. Because when we're not there to say, what do you want? We want the child to be able to communicate. So I do think the the retort here is a little bit misguided when the person's actually trying to communicate something i have to disagree a little bit um with the fact that the the initial prompt isn't there now a prompt is certainly going to be important if the child doesn't have any any way of communicating it or doesn't know the appropriate response that gets into language mapping like you've been so eloquent and describing throughout the the time here that maybe we don't withhold for for that item maybe we prompt oh you want the straw and we give we give them the straw a whole bunch of times with that language model or i'm drinking with the straw we present that over and over and over again with the reinforcement without that expectation so i do think that's um that's an important discrimination first on that that first paragraph of making sure that the milk becomes the mo and not uh and the sd and not us Before we get into the second one, let me pass it to you, Mike.

SPEAKER_02: 32:31

One thing that makes me... As often when we face these situations, we get the criticism, but we don't get the answer. So I don't know what resolved... This author had a bad situation with ABA, clearly, and I can respect that. I wish they had included what it was that resolved... or ultimately got them to whatever zenith they're at now to be able to write so eloquently because they must have engaged in a different therapy. I don't hear them discussing that here.

SPEAKER_00: 33:01

Sure, sure,

SPEAKER_02: 33:02

of course. And then, yes, fair criticism on that scenario that we described. Yeah. That seems pretty natural to me, and I don't understand why the contrivance is such a problem for this particular author, other than they must have had a similar circumstance that left him without milk for an extended period of time or whatever the case may be. So again, even in what you described in sort of keeping more of a workflow or a play flow, the idea that You might have created a routine now at a certain time after a certain activity in which you go with your child and you open the refrigerator with them and you grab the milk and you pour the cup of milk and then you grab the straw. And then one day you inadvertently forget, I love the way you put it, that now becomes the intraverbal. We've been doing something in such a routine fashion, in such a systematic fashion over time, that at some point when you, mom or dad, forgot, or therapist, forgot this one step in this chain, Yeah. Sure, sure. Yeah. It doesn't have to be done this way. But again, I really do think that this was a bit of an unfair criticism.

SPEAKER_00: 34:57

Yeah. I think so going from the micro to the macro, just to make sure that we don't miss the forest from the trees in this example, I wonder if the author is not necessarily focusing so much on the milk straw example, but saying that he didn't like, or she, I think it's he, didn't like the way that his entire environment was made contingent on his behavior. Yeah. So what you're saying, the milk straw example might be completely natural, right? Maybe you're fixing your kid a meal and you forget the utensil or something like that. Each example in its individuality makes sense. I think potentially maybe what this author is saying is, okay, that's the exception to the rule where you forget it, but maybe with individuals with ASD, now that becomes the rule and now you're intentionally forgetting everything and now they have to communicate to get everything and their entire environment It's made contingent.

SPEAKER_02: 35:49

So I think that's one of the important points that is made by this author in not setting up overly obvious contrivances. So the idea that what we can learn from this criticism is that we keep the flow, we create routines, something we've talked about early on here on ABA on Tap, such that the natural variations may occur for the child to then man for or pitch the introverbal for to move on. Unfortunately, we get a little impatient. We already have a situation where there's a quote-unquote developmental delay. So the idea that we have to contrive and incite or elicit these behaviors becomes a real detriment at times for our better motivating operation as interventionists. So again, I'm really trying to... So, again, while we... Yes, pretty harsh and unfair criticism to start. I agree with you 100%. We have to analyze a little further, dissect a little further, and really understand what I think the author is saying here, which is very important.

SPEAKER_00: 37:10

Yeah, yeah, and that's where we run the risk of being overly structured as a field of saying, because something may be good in one situation, withholding for communication doesn't mean we need to do it all the time, every time. Another thing that... I don't know. When I read this sentence, I almost felt like the author contradicted himself within the same sentence. He said, I almost feel like that's contradictory within the same sentence. Is the goal for them... I feel like what he's trying to say is the goal... that the parent's trying to set up for the child is for them to initiate interaction in the way that the parent wants them to initiate interaction, judging by the next paragraph where he says, he talks about the child is required to point for the straw, the child must point as if there's not other ways to communicate. So I think what the child, or what the author is saying, instead of the goal is for the child to initiate interaction, it's for the child to initiate interaction the way that the parent wants to initiate interaction, which I do think there is some, if you were to word it that way, I think there's a lot of credence into what he's saying, which we'll get back. So going from the micro of this specific example of the milk, going back into the macro of communication. And my buddy, who's a therapist, brought this to my attention, as did a parent who comes to our parent groups, talked about the movement of looking at autism and and ASD as not necessarily like a mental disorder or DSM diagnosis, but as just a different way of looking at the world, which kind of gets into communication. So talking about, you know, this person initiating interaction, well, maybe not pointing, but maybe they're crying. That's initiating interaction. Maybe they're looking to grab, but we're only looking for, we're only counting interaction as, you know, pointing or vocalizing or something like that. Whereas there's a plethora of different ways to initiate interaction based on, you know, if, um, well, what would the word, uh, straw be in Spanish? I don't speak Spanish. Okay. So that would be a way of initiating interaction or I could say straw, right? So there's multiple ways, or I could say it in Chinese. There's all sorts of different ways of initiating that interaction. The question is going to be because communication is Skinner defined is from a speaker and a listener.

UNKNOWN: 39:37

Um,

SPEAKER_00: 39:37

How am I going to be able to initiate an interaction in a way that a listener will understand? I do think that part is important.

SPEAKER_02: 39:46

I like that. So you're going in, see, this is the kind of balance I've been trying to strike, and I'm continuing trying to strike, is I've made a clear decision to shift from... adult directed to more child directed pieces. And this reminds me a little bit of the idea of reciprocal imitation, right? So the notion that I've set up, I've contrived a situation, a learning scenario. And I'm looking for a certain level of communication. Or let's take joint attention as another example. Gay shift, pointing to, reaching for, bringing the object to. These are things that I'm prepared to entertain as reinforceable, if that's a word, actions. Right? But I have to be ready to see anything else that occurs in the environment from that learner that might also fit that description based on the environment's response, right? And I think that's part of the trouble. That's that dance that I've been trying to discover is, yes, we have to come in with some level of structure and direction, and then we have to come in really observant of everything the child is doing towards seeing any sort of natural occurrences of communication that could be reinforced as they exist already and then shaped by the environment. Absolutely. Absolutely. Unfortunately, we might get stuck there traditionally in ABAs. Whatever targets we define, whatever things we're looking for as those things that are on the developmental charts and the milestones, this is the way communication is supposed to look. And if it doesn't look this way, then it's not worth reinforcing. That might be where we get stuck sometimes as opposed to saying, well, the child points, the child reaches, the child brings objects. If the child coos, oh, you know what they tend to do? They tend to blink their eyes sometimes, mom said, when they want something. Let's give that a shot. Let's we shape it somehow towards something that is going to be more easily reinforced by a more standard and less specific environment, if you will, less individually catering environment. The author talks a lot about this notion of getting ready for the real world. Yes, that's maybe an overly general statement. I may have walked right into your plan here. I love it. I love that serendipity, baby. So that's the idea. I understand the author's frustration with that phrasing. At the same time, I understand the validity and the value of that phrasing.

SPEAKER_00: 42:26

Yeah, they do say one of the ABA rebels preparing autistic children for the real world is one of his segments in this article. And like you say, I do think that ABA practitioners and the forefathers of ABA did do this from the premise of how can I allow this individual or how can I help this individual be most successful in the most environments in the real world. And maybe we did get lost in the weeds a little bit of, okay, well, in the Euro-Western culture, the way that we communicate is we stand directly in front of each other with eye contact. And let's say in America, we speak English. So those are the targets that we have to teach. We have to teach appropriate posture. We have to teach direct eye contact. We have to teach vocalization. And I do think that came from a place of, if an individual is able to do that, they will be probably most successful in the majority of environments that they'll be in. But on the flip side, what makes that right or wrong? It's kind of like, you know, somebody from China comes and starts speaking Mandarin. Is that right or wrong to do here? Well, it's not right or wrong, but the premise is how is this message going to be communicated? And maybe we... On both sides, I think that the detractors maybe need to take a step back and say, okay, maybe the intentions were good. Maybe we got a little lost in the weeds. And us as practitioners, maybe we could look at it and say, Can we differentially reinforce other things? Can we be a little bit more flexible in the communication? What if the individual isn't looking at me the entire time? Do I know that they're speaking to me? Maybe if they're using an ASL or maybe if they're using a speech device. Maybe if they're pointing. Are these all ways that can effectively communicate that I can reinforce rather than, as this person said, ABA becoming a breeding ground for meltdowns?

SPEAKER_02: 44:16

I like that quote, actually.

SPEAKER_00: 44:17

So I think again, it's not this or that it's this and that it's probably not bad that we really focus on these things because on, I think we're kind of trying to fight two battles at once. We're trying to fight the micro battle and the macro battle. So on the macro level, should the, should all of us become more aware of individuals with autism and not necessarily force them to be in our box? Absolutely. I think that's the case. In the meantime, that individual, that specific individual is going to have to learn some way to communicate for those people while they're learning that. Like, again, if I'm speaking with somebody and they only speak Mandarin Chinese, do they need to learn English? Do I need to learn Chinese? Well, somebody has to learn something for us to communicate. And the thing is, we have to come to a common ground of being able to communicate first before all of society learns to help, you know, learns to accommodate more. And I think that's an important thing to keep in mind that, yes, society absolutely should do that. And we should keep that in mind and not necessarily force these people with autism diagnoses that may communicate differently to fit into our box. But in the interim, for that individual person to live the most successful life and have the most effective communication, we have to find some way that we can interchange thoughts appropriately.

SPEAKER_02: 45:40

Let me take a step back. Absolutely. Let me take a step back here to this quote about the breeding ground for meltdowns because I know that's something that I've sort of alluded to in the past in the sense that our techniques are sometimes the antecedents for these meltdowns and then very conveniently we're able to point back to the diagnostics as the reason that sustain these meltdowns and this overflow so this idea that we're withholding we're not reading our crowd now the child starts crying uncontrollably because they're frustrated but the reason that they're tantruming is now the autism and it's like well

SPEAKER_00: 46:12

no it's the fact fact that we are in our labs with our petri dishes breeding, literally breeding meltdowns, right? I thought that's what you were going to. The literal breeding ground where we have them in our highly controlled labs where we're figuring out how we can breed these meltdowns most effectively.

SPEAKER_02: 46:27

That's just it, yeah. If we're not careful, this is the way this author is perceiving that, right? The idea, so yes, and I understand the argument with intent, whether you intend it to or not, this is this author's perception of it, but you're absolutely right. We have to be careful that we're not inadvertently Constructing or construing ourselves as the people that create those as learning opportunities, right? Standard disciplinary approaches would say that well, they have to learn they have to feel let them cry it out, you know Okay, there's a time and a place for that for sure but traditionally we've maybe perpetuated that a little bit too long and then now we're looking at this data for tantrum or protest and it's you know, Trending in the wrong direction because it's increasing. We're blaming that on the diagnostics when, to the author's point, there's probably things we can do on the front end to not get there. Now, is that stress? Again, we're going to have to do an episode on this at some point. But there is a lot of evidence from neural networks in learning. Thank you very much. such that stress is alleviated, and now they learn that by taking this action or making this sound, they can access something that they desire. Sure. It's a really fine... Cause-effect relationship. Super fine line, right, to try and figure out. And I do think that... I can look back at my career and think of many situations where I was on the wrong side of that line, where I misconstrued the notion of motivation and probably pushed a little too far, probably withheld a little too long. And again, how do we not withhold? How do we create motivating operations but not get to the point where somebody like the current author is going to be construing that as withholding?

SPEAKER_00: 48:30

And the last thing I'll say, because I do want to get into the withholding part because that's the second part, so Last thing I'll say on this communication piece is back when the author was talking about the straw and instead of waiting, prompting the individual to communicate for the straw. I think that's actually a slippery slope because I can even find myself being victim of prompting kids to communicate. And maybe they're not even motivated by that. That's us making a big assumption that we know what that individual is motivated for. And now if we're prompting an individual to communicate for something they're not motivated for, I'd say that's actually a much larger ethical issue than waiting them out. But I do want to talk a lot about the withholding aspect because I know that's a big part of this article and a big part of kind of our specific therapies. But before I do that, anything you wanted to wrap up on communication? Go

SPEAKER_02: 49:21

right in. And we are just a little time check here. We're about 10. minutes out from our usual end here so no need no need to rush or no need for urgency we'll just stay mindful

SPEAKER_00: 49:31

so go yes so it says ABA rebuttals we don't use punishments anymore and then at the end it says can I stop you there for please

SPEAKER_02: 49:39

again misnomer there Of course we use punishment. We don't use things that are traditionally regarded as punishment. But if we ever implement anything that leads to the reduction of the emission of that behavior, we've used punishment. So I just want to clarify that because, again, I do think that even this author, who's rather eloquent, makes some comparisons between rewards and reinforcement and now this idea of punishment that is not fully accurate. Go right ahead.

SPEAKER_00: 50:08

So the quote in the end of that section is, if a neurotypical parent stopped in the middle of an activity and withheld the fun activity until a neurotypical five-year-old kid put their hand on a hot stove, would our society consider that child abuse? Well, number one, yes. I... I don't know how much the BACB does in terms of individual oversight of companies, but if we're making individuals burn themselves contingent on something, yeah, I'm pretty sure that's child abuse. So again, I think that's one of those hyperbole examples.

SPEAKER_02: 50:41

Very much so. That's why I chuckled. That's a little extreme, but I get the point.

SPEAKER_00: 50:46

That I do want to highlight, again, going from the micro to the macro, this being in the micro context, When people use these extreme examples, it paints a picture. And I think I need to call out this individual because I agree with a lot of what this individual is saying. But when they take these extremes, they kind of lose me. So yeah, I think everybody would call that child abuse. And if somebody is doing that in ABA, that's not the ABA that I would like to be associated with. And that person could be reported to the board. Okay. That being stated, I think the larger issue here is the withholding of an activity. And you had a really good, when we were talking right before we recorded, about kind of the difference of withholding an object. Maybe an individual wants something and you're holding out a few seconds to give it to them versus maybe coming and taking something and then making that contingent on it. Sure. So I'd like maybe if you could bring that up. And the last thing I'll say, maybe you can also talk about this. I do remember one of the clients that you started working with recently, you actually had a discussion with them about withholding. And they said something along the lines of, you're not going to come just take all my toys from the kid and make them work for him or something along those lines. So I think those two things you could shed some really good light on.

SPEAKER_02: 52:01

Yeah, let me make sure I'm remembering everything correctly. So These are actually related circumstances, right? So the idea that traditionally you might see You come in, you see that, say, an autistic child has taken a strong liking to an object, which is not unforeseen for any young child who has a blanket. Sometimes our clients take to other objects. So you can assign some level of preference or desire for that object, and then suddenly you're seeing that as your motivator, right? You're going to take that item away because if they want that item, there's reason for them to demand or communicate for it. And The difference that you might see that item lying by itself and are able to obtain it, the idea that you might be able to trade for it. different item and then have that child ask for that item back or the idea that you plain overpower the young child and take the item from their hands which is what I think this author would be highly critical of and something that you and I work very very hard in training our younger professionals and saying there's no need to do this in order to contrive your next trial there's at least the other two ways I mentioned first to do this and yeah recently one of the clients that came to us from another provider for various reasons. You know, in discussing sort of our approach, and I like to tell, prepare people for our approach, look, what we do is going to look different. If you've had a different provider, this is going to look different. I'm going to ask for your patience now. We're a little more child-directed for these reasons, so on and so forth. And as I was explaining this to this parent, she said, so you mean you're not just going to come in and take something that he's enjoying away from him so you can do something else? I said, no, we'll never do that.

SPEAKER_00: 53:47

That's not ABA, though, Mike. Well, again,

SPEAKER_02: 53:50

this is such a nuanced misconstrual, right? The idea that as a young professional, you're going to come in and see, oh, they like that. Let me try to get that in my possession such that I can motivate them to do something. When I describe it like that, it doesn't seem that bad. But when that's been going on for 45 minutes and the child is kicking, screaming, and reaching for the object, and one of us is sitting there withholding it above our heads, behind our shoulder... the optics there are pretty bad. So, you know, there's a lot to learn from there. It's not that withholding something dangerous, for example, of course, that's for safety reasons. But if you're withholding desired items that are otherwise acceptable for the reason of perpetuating more trials... please think again. Please go back to your supervisor. Go back to somebody. If that's their answer, please tell them to report themselves to the board and get a little more creativity going. Please, please. This is something that, by and large, I'm going to, again, the author lends some pretty strong and unfair hyperbole here toward it, but I think the essence of it is not lost. If that's what you're doing to motivate more trials, go back to your drawing board and think again, please.

SPEAKER_00: 55:01

I think so much of that, too, comes from the more antiquated trial-based or DTT method of ABA of work and break. And what we're going to do is we're going to do some work and then you get a break and that's away from me.

SPEAKER_02: 55:11

That's

SPEAKER_00: 55:12

with an item that you want. And then in order to get back to work, I need to stop your break and take what you want.

SPEAKER_02: 55:17

So there's no way that you could be enjoying reinforcement along with me. It's got to be solitary, which means that the actual work we're doing can't in and of itself be reinforcing. Only the time away from me and away from the demand. I know that's not the message we're trying to send that's a really i love the way you describe that

SPEAKER_00: 55:36

yeah no that's that's pretty simple that's all that is is that that withholding makes sense and that more antiquated i'm gonna take something that you want and make it contingent on something i want but i can't i'll speak for at least our company i can't speak for the field which is going to be the last thing i'm going to talk about in a minute is i think as we do more naturalistic therapy the work is the play And we don't need to withhold anything because we're, if, if the child's not motivated by what we want, um, them to what we want to engage in, we're going to find a way to make them motivated in it by not taking what they want or by not taking what they're doing, but by making what we're doing more exciting. So like you said, if, if our RBTs are doing ABA the way that we're prescribing, then we're not withholding anything. So all of this is kind of out the window. Um, because we're not withholding. It's just making... uh taking what they're engaging in and making it functional or trying to make what we want more engaging than what they're already engaging engaged in now that being stated obviously things like the ipad and stuff like that can be um a little bit challenging but we're not often even withholding that we can engage in that and there's a lot of nuance with that that i think we can talk about a little bit later because that goes down a whole nother avenue but i'll pass it back to you because i know you've kind of led the charge and i i really I really am excited about how little we do withhold. And you've kind of been the conduit of that with our company specifically. So I will give you the final words on withholding because you are the resident expert on that.

SPEAKER_02: 57:11

Well, what I'll say here, because, again, we're coming close to the end here, and we run the place. We've got the right to go over here. We can allow ourselves. I think your daughter would disagree with that. Maybe. I think she's settled in. I'll try to speak a little more quietly here as we wrap up. The idea, there's a couple things that the author does here. I have a lot I want to say here in the last few minutes, so I'll try to make it succinct. I'm going to say that, number one, I want to thank the author of this article for speaking out and making their opinion known. While I may disagree with the overall notion of the evils of ABA that are portrayed here, I have no doubt that this author had their own experience and is really citing about the things that we need to be mindful of in terms of changing as Science practitioners. So I'm going to say,

SPEAKER_00: 58:00

go ahead. And just piggybacking on that, this is the author's experience and in no way am I making myself saying that's not valid. I do not feel good that a field that I am a part of left somebody with something that they call PTSD from that service. So whether that's representative of everything, whether that's accurate, whether this individual... even necessarily understands what the alternative would have been, it doesn't matter. This is that individual's experience, and that is unfortunate and something that doesn't make me proud to hear about in the field that I currently am employed in.

SPEAKER_02: 58:33

Thank you for saying that. I'd like to think, and I'm quite certain, 99.9% certain, that none of my former clients are out there with PTSD. I hope that is true, and I agree with you 100%. It's awful to learn about this representation. Now, something we've been going back and forth on in this episode is, you know, and to the authors, to quote the author here, ABA practitioners saying the field has changed. I'm going to say something. Please. You know what? The field hasn't changed, nor should it. What does have to change are the practitioners that are promoting that field. Because we don't want the science. The science works. And the science should only lead to more philosophic doubt to lead to new science that either proves or disproves what we're doing. And we've proven that what we're doing works. Now, to the author's point, whether it works or not isn't what's at stake here. It is how it works and how it's done. So you and I are saying we're confident that, yes, The author has a lot of valid points. And guess what? It doesn't have to be done that way. Baby in the bathwater, right? We're not going to throw the baby out with the bathwater. I agree. I think some new bathwater would be really nice here. Yes. And that's one of the things that we like to talk about. Here on EBA on Tap, the other thing that I know that...

SPEAKER_00: 59:52

That's a great point with the baby in the bath water. You could take a bath in ice-cold water or nice, warm, comfortable water. Either way, your baby's going to get cleaned, but the process of going through that might be really more comfortable for both you and the baby.

SPEAKER_02: 1:00:04

And what's available. What's available? Do you have warm water? I mean, again, I don't want to overanalyze this, but that's a wonderful point, the idea that the value of the experience and how you endure it as opposed to contrive it to be uncomfortable toward learning is what we're talking about here. There is a certain level of discomfort that's required, stress, if you will. Even eustress, the idea that I had a frustration or a problem and I solved it. A lot of intrinsic motivation in that situation, despite it starting in a way that didn't look so good. But the idea that we're actively promoting or a part of enduring, if not applying distress toward motivation, I think is what the author should get a lot of credit for describing here. The last thing I'll say is that Currently, and I appreciate all the accolades that you give me in promoting these ideas of more child-directed, more play-based therapies, especially given my role in early development. But I have to say that there's still an active question for me. One of the things that's really worked, for example, this past week is I hired a new client. And just with our rapport-building techniques that I've talked about here on the podcast in terms of contingent imitation toward reciprocal imitation, linguistic mapping, and joint attention, we got the child to start referencing over the course of two days. So the idea that now they're shifting their gaze over toward the staff in an effort to kind of say, hey. Unprompted. Unprompted. Hey, I just got up and I'm walking away from where you are. Are you coming or not? Which is exactly what the child was waiting for because they would stop and look back, right? So the idea that we've now not prompted, that we've used these very basic techniques that are much more a part of early childhood education, I hope would be a concept that might interest this author here with these very harsh and not entirely unfair criticisms, but I still need to answer the question is once I've got that joint attention built and once I've got that sustained attention, then there are things that are going to be adult directed and target specific that are important. toward the development of a human child. So the colors, the numbers, the letters. One question that I'm still trying to answer for myself is, how do I bring that back in without falling into some of these traps that the author's talking about, where you're not patient enough to wait for the development of the skill, and you're actively just trying to contrive based on extrinsic motivation? So I don't think we've got it wrong in ABA. I think that we put all our eggs in a couple of baskets that are now being highly criticized. It's not to say that we've got to throw everything out. I think it's just we're actively trying to find new and improved and innovative ways to apply these technologies, this science that, again, to start with my original point, We don't want it to change. We want these calculations to be what they are. We want positive reinforcement to stay what it is. It's how we apply and administer the techniques toward that procedure that are going to be the important frontier.

SPEAKER_00: 1:03:06

That's a good point. I never thought about it like that. Astronomy hasn't changed, but our understanding of it sure has. Or biology, right?

SPEAKER_02: 1:03:12

We've made some adjustments and we've made some corrections, but we don't want those to go away. We want to know what those are. Or

SPEAKER_00: 1:03:18

same with medicine. If somebody... have, you know, invented the polio vaccine a hundred years ago or hundreds of years ago, like they wouldn't have polio anymore. But our understanding, the science was always there. Our understanding of it wasn't. I think that's a really important point.

SPEAKER_02: 1:03:33

That's a great example, right? So we've had the polio vaccine. It did its job. We don't want it to change. We're just going to have to readminister it now because there's going to be a resurgence otherwise, or we're going to have to make sure and continue to administer it in a certain way or adapt the administration of it to make sure that polio stays at bay.

SPEAKER_00: 1:03:50

And as... as something is around longer, the understanding of it increases. So, um, that's another thing this person should look at is if they're saying ABA is the worst and we're going to start with something else. Well, whatever that is, is going to be fresh. And now you're going to have all the growing pains of a whole new field that we've had to, you know, that's probably going to be much worse, at least in the growing pains before it even gets to where we're at now. So I do want to highlight this last piece where he says, you know, ABA rebuttals, the field has changed. You will hear this argument a lot from ABA therapists and other therapists who use ABA. The field has drastically changed. We don't do that anymore. And to that I say, this paper was given to a in February 2023. You can't get much more recent than that. I have to push back a little bit on that because I am in the field and I can say in the last three years, the way that we deliver ABA in our company has changed so much to the fact people have left our company because they're like, this isn't the ABA that I'm used to. We've gotten in a lot of discussions and debates, both contentious and happy about the way that it's gone. So our company has changed specifically in the last three years, much less the last seven years we've been there. So to poo-poo that and say the field or the delivery hasn't changed, that is 100% incorrect. Now... That might be correct for that person's experience. So I really just push back when people try to say, oh, the field of ABA is this. No, the field of ABA is a lot of different people's experiences. Some might be great. Some might not be great. This is one person's experience. And absolutely, this is this person's experience, and it's relevant and should be considered. But this is one person's experience. And maybe this person will push back and say, well, I have hundreds or thousands of people that agree with me. Well, there are, what, 10 million? As of when I made my training, like eight years ago, there were over 10 million people in the world that have ASD. Have we consulted all of their experiences as well? So while this is one person's experience, and while maybe one company within ABA didn't change, maybe 10 companies within ABA, maybe 100 companies within ABA haven't changed, that doesn't mean that other companies haven't changed and that other companies aren't doing it significantly different than one company. So I think when this person is presenting it, where I push back on is when they say, the field of ABA is X. No, I don't know what the whole field of ABA is because I don't, experience every single person's administration of ABA. That's what I have to push back on. So if this person were to say, my experience was this and look out for these within the context of ABA. Totally good and reasonable with that. We don't necessarily have to throw the field out because this person doesn't know if their experience is representative of the entirety of the field or if their experience is representative of their experience. And that's what gets me a little bit upset is when they try to generalize their experience as representative of everyone's experience.

SPEAKER_02: 1:06:55

Well, we've covered a lot of ground, sir. That was a great way to wrap it up. Let me see if I can conceptualize it very, very simply. I had a toothache. I had to get a root canal, and the first dentist I went to botched it. I went to the next dentist, and they fixed it. So what you're saying is because of the first dentist, I shouldn't write off the entire field of dentistry. Exactly. And always analyze responsibly. Cheers. Cheers, brother. ABA on Tap is recorded live and unfiltered. We're done for today. You don't have to go home, but you can't stay here. See you next time.