What If “Hardwired” Is Just History: Breaking the Rules and Finding Reinforcement with Mark Malady (Part II)

ABA on Tap is proud to present Mark Malady (Part 2 of 2):

If you have ever felt pressured to list “behaviors for reduction” even when you know the real need is skill building, this conversation will hit home. ABA on Tap continues our sit down with Mark Malady, to talk about constructional ABA, where the aim is not to stop behavior for everyone else’s comfort but to build the repertoires that let a learner get their needs met with more freedom, safety, and dignity.

We get into why procedure-heavy programming can create rigid learning that looks great on paper but does not generalize in real life. From joint attention and enriched environments to response classes and functional outcomes, we explore how to stop obsessing over response form and start focusing on what the behavior does. That includes a candid take on eye contact goals, developmental milestone traps, and why “critical periods” matter less than building the component skills that support informed choice.

We also unpack process-based practice and measurement. Mark shares how process can still be measurable and accountable, why clinicians may need to make many small adjustments in a single session, and how low-dose models can outperform massive hour prescriptions when targets are chosen well. You will also hear about the 'GenArete' skill-based assessment, milestone benchmarking, and a powerful example of “dignity of risk” where opportunity, not skill deficit, is the real barrier.

If this episode sharpens your thinking, subscribe for more conversations that challenge default ABA habits, share it with a colleague, and leave a review so more clinicians and families can find the show. What would you stop targeting tomorrow if you shifted fully to function and quality of life?

Tune In, Drink Up, and ALWAYS ANALYZE RESPONSIBLY.

Transcript

Copy

Welcome Back And Setup

SPEAKER_02 0:01

Welcome to ABA on tap. I'm Mike Ribio with Dan Lowry. So without further ado, sit back, relax, and always analyze responsibly. All right, all right. Welcome back to another installment of ABA on tap. I am your ever-grateful co-host, Mike Rubio. And this is part two of What If Hardwired is just history, breaking the rules and finding reinforcement with Mark Malady. Enjoy.

Replacing Behavior Reduction With Skills

SPEAKER_03 0:50

So when you're talking about D sell targets, I'm assuming you're talking about like behaviors for reduction. Is that kind of what you're referring to there? It is interesting. I think in general, I think that's something. Maggie Harabuda, are you familiar with her? Yeah. She's another autistic BCBA from Philadelphia. What's her company called? Unfurling Littles. Unfurling Littles. She's awesome. She's been on our podcast and very insightful, just like yourself. But she's really talked about the strengths-based model, which sounds kind of like what you're referring to versus the deficit model, right? Of the deselling and of working on these behaviors for reduction, which is still funny because sometimes with insurances, they'll want they'll want like, well, what are the behaviors for reduction? You have to have behaviors for reduction. But I bring that up in your context because a lot of times behavior reduction, I feel like, is done from like the environment side or the benefits for the environment, not necessarily the benefit of the individual, right? It's like a DR DRI versus DRA. It's like, well, if I can get them to stop hitting, that'll make my life easier. But a lot of times it loses like, why are they hitting? That gets lost in the we just need to get them to stop hitting.

SPEAKER_00 1:58

Absolutely. And you know, the the strength-based approach I like a lot. I think sometimes that can go a little RI too. I prefer to think about it from the constructional lens from Gold Diamond, where basically skill construction is how you allow people to alter their life, right? So if if D cell targets are fulfilling some purpose, then really it's because there's a missing repertoire, and that missing repertoire, if constructed, will make it to where the D cell target doesn't really need to come through anymore. So in generate in our assessment, in our first versions, we had this really cool barrier section that was about like what do you do with D cell targets? We actually took it out from our main assessment area and we only put it in our motivational interview component to benchmark, mainly because we found that we very infrequently, unless it's severe and there's immediate risk to sell for others, um, actually have to do any direct implementation on it. So it's really that idea of if you construct the base, then the learner will be able to engage to get their needs met and to explore the life that they want to live. And you don't really have to spend too much time on that.

SPEAKER_03 3:09

Go ahead.

SPEAKER_02 3:10

I see your brain brain spinning. I've I've got a I've got a ton of of I've got too much going. I know so many questions. So you're kind of alluding, I guess. Well, I'll share this. What I was thinking about earlier when you mentioned it is we outright took I mean, with rare exception, unless they really bug us, right? I don't know. I can't think the last time I approached it from a behavior reduction, even on a treatment plan for insurance, it it was hard at first, but I made the the argument of, well, yes, these are concerns, but this is what we're teaching to remedy those, as opposed and and it's not to say that I'm not giving we're not giving our staff responses to those problem behaviors. That's active, that's just a no-brainer. But the idea that I have to make them spend time, additional time counting, uh, you know, doing data, I think uh, at least from the in-home perspective, I would say a lot of that's qualitative. You ask mom and dad, hey, how's this going? Oh, it feels better. Cool. And they're accessing other behaviors that you think are you know are good to be reinforced. Great, then we're good from that perspective. But I I really appreciate the way you you pitch that because I do think that again, from that authoritarian, you know, that that really that strong authoritarianism, this idea that I'm coming here to help you, uh, even worse, I'm coming here to fix something for you. That, you know, you focus too much on those things that are uh to your point, Dan, sometimes not even that detrimental, they're just annoying, you know. So from a developmental perspective, I spent a lot of time telling parents, hey, yeah, does that annoy you? Yeah, that's actually right in line with what most three-year-olds would be doing right now. And yes, I as a parent myself, it's very annoying, right? But this but this is the value of it, and this is how I want you to respond to it. And and these are other well, not one way, but these are ways you can respond to it in terms of addressing function and so forth, you know, making sure that you're not inadvertently lending attention when you should be removing it, and there's a million other things they're doing that you could be lending undivided attention to right now, but because they're not annoying you, you leave well enough alone. And I find that that basic premise goes a long way with parents a lot of the time.

SPEAKER_00 5:14

So absolutely, and I have an autonomous three and a half year old who's going on 35 right now, too. He's got a five?

SPEAKER_02 5:22

I have a five-year-old.

SPEAKER_00 5:23

She's the same one. Just coming out of that phase.

SPEAKER_02 5:26

Yeah, no, for sure.

SPEAKER_00 5:27

Just just on the relief, just on the pressure release.

SPEAKER_02 5:30

Yep, yep.

Enrichment Over Rigid Trial Teaching

SPEAKER_02 5:31

No, it's great. I I love that age. I think it's there's just so much learning. I think you were talking about this earlier in terms of our methods and our our pacing, in terms of our outcomes, or I guess what our efficiency, the learning efficiency is if we dare measure them. That's one of the things that developmentally very early on from my background, when I came into say DTT for early intervention early in my career, I was looking at this programming and all these rigorous things we were doing that were very logical and and you know, obviously empirically valid, in order to confirm that a learner had hit a certain target. And I realized very early on that from the developmental perspective, we were creating pretty unenriched environments by being so target specific. And it was like, man, wait a minute. And so that's where that process versus product thing first hit me from a more play-based, you know, oriented child development approach, and saying they have to experience a whole bunch of things, and I have I can create those environments, and then in terms of how I reinforce certain things differentially, I think that's the name of the game here, right? Can I get you to jointly attend with me to something, or from a developmental perspective, now you're engaged in an activity with me, so now I've got some level of instructional control. And I love that the sororist play between fields because I think that oftentimes we're talking about the same exact thing, but you know, one side of us wants this term to be the prevalent term, and when we can lose a whole lot there. But yeah, what you're saying makes it really resonates with me because I think I've had a similar progression.

Critical Periods And Informed Choice

SPEAKER_02 7:00

I want to get into just I guess briefly the idea of critical learning periods, which uh you mentioned earlier. And I love that notion because I think that the value of it is time limited. I mean, and to your point, it from a behavioral perspective, we're able to disprove a lot of that stuff. So things that you're not supposed to be able to learn after a certain time, well, clearly we can disprove that easily. And then I've spent a good part of my, I still do, spent a good part of my career exploring what that really means. Like what was the value of that in saying? So one thing that I know from the the you know, the fourth dimension of time, okay, so I can understand that if you don't learn this here now, maybe this many years later, it might give you a different trajectory or a different challenge in learning something. But I'm with you. I don't think that this thing ever closes. I think it I think it's always open, and you know, depending on exposure and experience, yeah, you can learn a lot, but then yeah, time's always ticking, right? And getting you closer to the end, I suppose.

SPEAKER_00 8:00

Yeah, I think that there's kind of threshold skills, whether you want to call them whether you go with component composite or skills, whichever kind of differentiation helps you. But if you think about component composite relationships, there's definitely some generalized component skills that will allow you to meet that vision that my mom had for me that I talked about earlier of like you get to make an informed choice about what you want to do with your life. Making an informed choice is different than arbitrarily reaching your hand out and picking something and saying, Oh, look, he selected that.

SPEAKER_02 8:38

Yeah, yeah.

SPEAKER_00 8:40

And and getting learners to the point where they're going to actually be able to make informed choices about their time allocation is a fair dang goal. And every parent I've ever met really likes that general idea. And when you really do like a values clarification activity with them, it tends to come down to that parent, a lot very few parents really care about the specifics of where their kids are at or what they're doing, as long as they're not hurting people. And they really just want to know that their kids are trying to live a good, decent life and they're armed to be able to do so. And so that idea of like, hey, what are like the skills that we should just make sure every kid has? I think that's a fair question if you take a functional orientation rather than a topographical orientation.

Eye Contact And Functional Outcomes

SPEAKER_00 9:26

I think where we've gotten ourselves in trouble is we've got stuck on topographical orientations rather than functional orientation. So, you know, the eye contact example is a really good example in our history about this. Like we got hyper-focused on a topography of how we indicate that we're actively listening, that we're engaging with the ammunition of the environment, and that we're oriented to the same thing. Those are functional classes that are vital. Does eye contact matter? As a person who my whole life I've been told that my eye contact is super weird. And sometimes, like in my early career when I was working with moms, I started tacting, like, oh my god, they think I'm checking them out. Um, which because I scan in a really different way, like, yes, sometimes I scan around the chest region, but I swear that is not what's happening. Um and you know, as I started to disclose my my autism diagnoses to people, a lot of that, like that awkwardness that I would have with moms at first kind of started going away. And I didn't even like clock it for a couple years because I don't know how to check people out. This was actually a thing that happened in graduate school. I had to ask, like, hey, when people say they're checking somebody out, like, what does that mean? So I didn't understand how most people's sexuality works, and I just thought I had like a pretty typically presenting heterosexual sexuality, but apparently I don't. I'm what's called demisexual now, and that is like I have to have an intimate connection with the person before sexuality renders. So, like, flesh doesn't do it for me. Like, I don't like I've never looked at somebody and been like, oh, they're attractive. That like does not exist in my world, like it just doesn't register that way, and so it was hard for me to detect that because I was coming from this perspective that's very different than what most people are doing. But so my eye contact has gotten me some awkwardness in my life. Like, that's real and that's fair, that's okay. But I survived that awkwardness. Um, I learned from that awkwardness, and it didn't prevent me from being here today, it didn't prevent me from having partners, it didn't prevent me from raising kids, didn't prevent me from learning and living the life that I wanted to. So that over-emphasis on topography, I think, is what gets us in trouble. And if we actually stick to the core of our science, which is a functional orientation and it's heart, we'll avoid that. It's when we we skirt around that heart of our science of a functional orientation that we oftentimes find ourselves in trouble with that stuff, I think.

SPEAKER_02 11:59

I I would agree. I think maybe developmental milestones is something else that fits into what you're saying in terms of somebody putting together a really good treatment program from a deficit perspective and saying this milestone has to be achieved and expressed in this manner before we can move forward. My from an even from a developmental perspective, somebody who I studied milestones immediately I was like, this is a problem. We're already looking at a situation that's individualized enough to be on a different trajectory. Another way that we try to sort of shape the curve to one line, and it's this is clearly a different curve. This is a a different situation, is the way I like to see it. One way, and I would love to get your take on this, but one way that I've at least for our staff and and my purposes, I've taken eye contact to the idea of gaze uh of shifting gaze. The idea that our eyes do give us a certain amount of information, but in order to respond to my name, I don't have to turn my head to look at you. I can just say what.

SPEAKER_01 13:00

Yeah, yeah.

SPEAKER_02 13:02

Yeah, I could raise my hand and be like, Yep, go, I'm busy here. And then, yes, I I love the point you made. I've I've actually used a similar explanation and saying, Yes, we have this vision, this ideal that if I'm sitting with my hands crossed looking right at your face, that I might actually be listening to you all the whole time, but I can guarantee you that some of that time I'm still thinking about something else.

SPEAKER_00 13:24

You're yeah, you're in your land most of the time. Like when you put you on the nose, you're like, yeah, right, that person's not attending at all. Those are the people who teach their ass to raise their hand, you know? It's like they call on you because you're playing too good at the part.

SPEAKER_02 13:36

And and I I I've narrowed it down to that. I'm I'm not this is not the BLN doll. This is not my stopping point. Again, would love to get your take on it. But then sometimes parents, especially for younger children, will ask me, well, then why do we put that value on it? And I think, well, I can think of only one reason at this point. I think that being able to see what somebody's mouth looks like while you hear the sounds they're making just might be kind of a cool cross-modal piece of information that you can use and learning how to talk. And that seems to satisfy a lot of parents. Oh, you're right. So I'm like, yeah, so we want to have all of those aspects of joint attention where I'm looking at you, where I'm not looking at you, and then somewhere with all that put together, we might actually be listening to each other 75% of the time.

SPEAKER_00 14:17

Yeah. How we we had tackled that problem is Orients to a attention recruiting stimulus change. And so the idea being that the Orients to allows you the functional class to identify orientation responses that make sense for that learner. And that is kind of like what we're trying to really bring home across all of our pinpoints in our assessment, is that when we let go of the response form and we go back into response classes that have functional relations to the immediate environment, we we aren't dictating how a person does a certain thing. We are looking at the outcomes that come from those actions. And so the emphasis on interaction and that behavior is really the interaction of a person with their world, and it's not the action of the person, is part of what drove me most crazy about mainstream behavior analysis for like the

Why The ABC Model Falls Short

SPEAKER_00 15:13

first 10 years. Honestly, it still drives me really crazy, and I absolutely hate the ABCs.

SPEAKER_03 15:18

Um, why don't you speak to that? Why do you hate the ABCs? Yeah, talk to us.

SPEAKER_00 15:23

Yeah, because what is behavior? Oh, behavior is an antecedent behavior consequence. Wait, wait, wait. You're allowed to use the term that you're defining in the definition.

SPEAKER_02 15:33

Okay.

SPEAKER_00 15:34

That doesn't make sense. You can't do that. We've known that for years with logic. That's not how language works. So so from a very basic perspective, it can't be like you cannot say the definition of behavior is the ABCs because you're you're using the reference and the description. So when we say, okay, well, honestly, okay, I get that, I get that, but that's semantic stuff. It's really a stimulus response, stimulus. Okay, cool. So now we're talking about the middle term, but that middle term is response, right? Those are actions. So what is operant behavior? Well, operant behavior is the reliable interaction of a response class with a functional change in the environment. Ooh, response class. Now that's an interesting term, right? So if we get too stuck on individual responses, we're we're negating you know some of those things that we make extra problems for ourselves. So when we say like, hey, we're not getting response generalization, we're not getting stimulus generalization, that's because we misunderstood our basic unit of the operant when we designed the program, right? So we created an extra problem for ourselves by going back and using two mid-level of a term. So what I what I teach is I teach a couple. One, I teach the before, the action, the after. So I call myself the black sheep of behavior analysis. I'm gonna teach you the bob.

SPEAKER_02 16:56

Before the action, the after, the ba. I like that. The ba. I like that a lot.

SPEAKER_00 17:00

And then another that we'll we'll go with like more students who we're trying to break the ABC thing with like students' behavior analysis. We'll go with antecedent response consequence. I don't like consequence. It's not is the it was a bad mid-level term. I think we did a bad job with that one. It confuses the hell out of everybody.

SPEAKER_02 17:17

The connotation, the connotation is rough for sure. Uh positive-negative, another example of where just our our the semantics and the connotations get the best of us in terms of disseminating the information.

SPEAKER_00 17:27

And punishment, punishment was all punishment.

SPEAKER_03 17:30

Yeah, brutal. I remember reading the what was Jack Michaels' definition of response. He had the because you were talking about behavior and then relating it to response. I forget in his book. He had it was like something about like a gland, like in a muscle. Like it was, it was like it was a legit definition, but it was just so non-technological to anyone not in the field. But it it it makes sense, it was not circular, like like you're saying, that a lot of it's almost kind of funny, like how we are very judgmental in the field about circular reasoning, but in some ways I almost feel like reinforcement is like circular reasoning, right? How do we know it increases behavior? Because it's reinforcement. Why is it reinforcing? Because it's increasing behavior, like that almost deeper into that, yeah. That almost does sometimes become circular. But I had a I had a thought for

Process Versus Procedure In Real Care

SPEAKER_03 18:16

you. I wanted to run by you in the the process versus procedure piece. I mean, it's something that in theory we we would have we will probably have to deal with more than we have. I gotta give insurance companies, at least in our experience, they haven't been that bad with us. How are you still in the like applied field? Like, do you do a lot of like day-to-day direct services or are you more on the like consulting academia side?

SPEAKER_00 18:39

I do, I do. I we actually run a short-term low-dose learning center model that we created based off of our assessment. And it is a one-tier model. So I actually do the direct work. I don't work directly RVT. I do the direct session work with my learners, I maintain an active caseload through it. And essentially how the model works is we do our skill-based assessment, and then we go through with the family or learner, depending on the age or both, and then we pick a milestone comparison, some big thing that they want to accomplish in their life, like, hey, we want to get a job at Starbucks, or I want to go to college, or I want to have a girlfriend, or I want to go to a dance class, some really big thing. That's the comparison criteria, and then we select five skills that are going to be the most likely that makes movement towards that thing, and then we do that over only 24-50-minute sessions over a three-month or a six-month period. So two sessions per week or one session per week, depending on the targets that we're working on with the learner.

SPEAKER_03 19:34

I love it. And is that funded by the learner? Is that funded by insurance?

SPEAKER_00 19:38

So, right now we are not insurance funding, we are private pay, but honestly, we do a lot of grants. So we actually got a grant from our local foster system, and we worked with a lot of learners who were in the various stages of going from not in their family placement to either long-term foster or back integrated with their family placement. So we had a grant with them. We had a couple of local grants. So we actually only had four families pay private pay out of the 60 families that we've worked with so far. Um, so we've got most of them uncovered. So yeah, the model is designed though to kind of fix some of the core issues that we're seeing in in mainstream behavior analysis of the flip of the ratio of hours and all of those things that kind of happened where you don't have time to actually program or design things or kind of work through the process on the back end that you need to work through.

SPEAKER_03 20:31

Love that. We're very similar. We're very much on like the low dose. I think maybe one of our clients gets four hours a week. Like it's not like you know, we hear people saying that they come to us and they're like, Well, I called this ABA company, and they say I have to commit to 25 hours a week. Like, are y'all gonna make us do that? And we're like, we don't even know your kid. How are you gonna do that? And Mike's one of the owners, but also maintains a full caseload, and a lot of that is direct. But I bring that kind of going back to what you said about the process versus the procedure piece. And I wonder what because I feel like from the medical side of things, and that's because a lot of our insurances are funded by medical, or a lot of our services are funded by medical insurances, it seems like the medical base bot based model a lot of times is procedure-based. Like you get this diagnosis, you do this, whatever this regiment is, and then this is the prognosis within that. And it seems like I don't know if that, if it's the chicken or the egg, if that came first, or our field came first with the procedure-oriented, but from what I've seen, just because we had to break out of it at our our previous company, is things are so procedure heavy. Like, insurance company wants to know by what date you're gonna do this. Um, how are you gonna do it? I want to know your exact procedures. And I kind of get it because there can be a lot of ambiguity of people asking for 40 hours a week and not coming up with any results. Like, I I'm not saying insurance is the only bad people. There's a lot of bad actors in the ABA side of things too, just requesting hours and not doing anything. Totally. Get it. It seems like historically that's kind of what people looked for. It was more of the procedure so it could be easily replicatable if somebody were to come in and show your child the green card that that child would be able to identify it within a reasonable doubt, right? And then we broke it down into it, it was even like the presentation was broken down. We would write the SD, the R, and the SR, right? And the the instruction, the RBT or the behavior interventionist, they would present the same SD because you don't want to vary the SDs because you can't do that. And then get the same response and the same SR. And that that built a lot of rigidity and didn't really generalize well. So when you speak of process and you speak of that generalization, I just vibe with that so much because I remember specifically we were talking about I forget exactly how it came up, and please correct me if I'm wrong. We were talking about manding and like the SD not being like, what is this? The SD being like natural environments. And we would just write this stuff because we're like, we don't want your response to always be in response to the interventionist response. We want you to just live your life. We don't always have to present all the antecedents. That's what it was, right? Yeah. Us presenting the antecedents. And hopefully I'm not rambling here, but I think it comes down to kind of what you're saying that resulted in the lack of the stimulus and response generalization. It's because we became so procedure heavy as a field, yeah, like early on.

SPEAKER_02 23:27

That's where developmentally I felt like we were. I mean, it you know, enriched the idea of enriched environments has such good data from a developmental perspective. And the more I was promoting this DTT idea, the way we that company was running it early on for in our careers, it was like, man, this isn't an enriched environment at all. In fact, does this kid ever start wondering why I keep asking him the same damn question, even though he already got reinforced for it? Like, what the hell, right? So it's can he ask you for something without you having to preempt it?

SPEAKER_03 23:56

Right, exactly.

SPEAKER_02 23:58

That's a protest. So that's where, you know, again, more of that process play, or at least for the younger learners, that idea of play just kind of made sense development. It's like, what do we do to enrich your environment through play? And then let's fit all of these targets we've come up with into that interaction. Sure, we can plan. You can hey, he might enjoy this, they might enjoy that. Hey, I know you know, dad might like to play this with them, and then be ready to fail, be ready to present that stimulus and the kid to be like, Nope, I have no interest in that. And what are you gonna do about it? And then, yeah, what are you gonna do about it? You better be ready to pivot to something else, right? So then from that opened up the idea that hey, these kids have preferred eye, you know, these kiddos are showing prefer preference or such preference to items that they they hold them two items in their hand. Okay, well, that's a problem. Take it out of their hand. Well, what if it was a blanket? Would I be so worried about it? No, I wouldn't. Now, would it obstruct their grip from other items just the same? Yes, it would, but it's still a comfort item. So, how am I gonna be able to provide enough security, comfort, whatever you want to call it, so that they feel okay putting those items down and grabbing something else? And so it just opened up from stimulus response, you know, from a contingency analysis. All of a sudden, it was like, I'm the one that's being rigid. You know, here there's this diagnostic perspective about rigidity and inflexibility. Look at our treatment approach. That's like the most rigid thing you could come up with. You know, it was it was so enlightening to be like, well, we're doing this all wrong. I thought I had it right.

SPEAKER_03 25:24

It's interesting too, because like I think that the the the vagueness with process, and and we we love it, especially versus procedures. It's probably difficult for insurances, right? Because if we're like we want to get this person to talk, and they're like, Well, how are you gonna do that? We're like, well, we'll build rapport, we'll do some joint attention. How long is it gonna take? Well, I I don't know exactly. I can make a guess, but everybody's gonna be a little bit different, and that ambiguity can be pretty difficult, I feel like, versus procedures. Like, if I sit somebody down and I expose them 10 times a green card, like they can probably identify green after like a couple of weeks, like pretty consistently. Now, is that gonna generalize? Probably not. And I know like you you are really big on the joint attention, right? So, like, why do a lot of the kids that we work with need a million trials? Well, because they're probably not engaged in 999,000 of them. So just instead of working on all these specified targets, let's work on like the pivotal behavior of joint attention. But that can be tricky because you don't necessarily get the immediate measurable results that you would with the more tangible procedure-oriented targets. I said a whole lot.

SPEAKER_02 26:33

And if you're not running through, if you're not forcing the physical prompt, you're not gonna get any of the envisioned response to it.

SPEAKER_03 26:39

It made sense in my head. I don't know if it made sense out loud. What are your notes on what I just said, Mark?

SPEAKER_00 26:44

I've got like three threads to go off. Perfect. Welcome to my head.

SPEAKER_02 26:48

You're the man.

SPEAKER_00 26:48

Yeah, we're good. So the first one is kind of this idea about the medical model, and that the medical model is procedural driven. And I kind of want to dispel that a little bit because process-based medicine actually started getting kind of big again in the 90s and early 2000s. And the argument being from those literatures that actually process-based medicine was how medicine was originally practiced. And it was only in the development of cure-all ideology that procedure-based approaches became the big mainstream. But kind of just think a little bit about like a surgeon, right? Yes, a surgeon knows an outcome that they're trying to achieve, but what makes one surgeon good versus the other is how many things they can adapt to in the context that they actually get in there and start working. So the process is up to the surgeon to make the decision. And you can think about a psychiatrist, right? A psychiatrist working through medications with one of our kids. One psychiatrist might just say, Hey, do this pill, because it's the one that's the best right now. And next year it might be a different one, and I'll give a different one to those kids. But another one might actually say, Hey, I want you to monitor their sleep. I want you to bring some data on this, I want you to do this, and I'm going to see you again in two weeks. That's a process-based orientation. So there's nothing inside of the medical model that dictates a procedural-based orientation to practice.

SPEAKER_03 28:09

That's fair.

SPEAKER_00 28:10

Now, the measurement part, so kind of the second thread there is this idea that procedure is measurable and process may not be measurable.

Measuring Process With Accountability

SPEAKER_00 28:19

And it's not that process is not measurable, it is more complicated to measure. And complicated doesn't mean harder, but it means the systems that need to be designed and put in place are very different, and they're usually not a single linear thing. So it's really easy to make a plus or a minus when I do this, I'm gonna do a plus or a minus. That's really easy. What might be a little bit more complicated is you know, what number of signs of joy do we see throughout this session? What are the indicators of joy that this learner has? What does that look like? Right. But both of those are countable events. There's nothing uncountable about those, and you can set benchmarks on them. So we kind of what uh Stu and Sella, those are the two other co-creators of Generate, they like to say this saying in Spanish, and I'm really bad at Spanish, so I won't even try it. But it's essentially why not both? It's kind of a 1990s throwback. So they say that all the time. And I would say that right now for this question of why can't we have process-oriented and really good data? Um I love it. That I would argue that I so in our program model in those 24 hours, the reason why we say it's a three-month enrollment or a six-month enrollment is to make an accountability statement to our families. I'm going to get three of these skills mastered out of these five. That's that's my accountability statement. If if if we really rock and roll, we'll get all five. So we're gonna have some bonus capability, so we're not locked out. But at the very least, I'm gonna do my best to get three of these mastered throughout these 24 hours in this three-month period. So I am making an accountability statement. What exactly, what procedures exactly are we gonna use? What slices are we gonna work at in what moments? That needs to be flexible and it needs to change moment by moment with the learner. So I'll go through people will be online and they'll be like, you know, hey, when data is flat, how long are you gonna wait until you get your RBT to do a new procedure? And I'll be like, do we wait 10 data points? We seven data points. And I'm like, I'll make 13 changes in one session on one target. I'm like 13 phase change lines on a single thing is actually uh we went back and we kind of looked at this. That is my average when I'm stout. When my standard acceleration chart is a one, which is a flat line, or if it's a negative, a deselling trend, if it's a divide by 1.1, which is a 10% divide over a seven-day period. If I'm on that trajectory, I'm making on average 13 changes within that single session until I find the thing that moves it around. And again, I'm being held accountable to the outcome of on that three-month time. I'm gonna sit down and we're gonna say, what did we accomplish or not? And here's my commitment to the learners that's not a failure of the kid because their whole life they've been told that they can't learn things. Their family has this perspective of they don't learn like other people. Oh, maybe you can teach most kids three things in that time, but you're not gonna be able to teach mine, right? Sadly, that's the reality that a lot of our families come to the table with. So if I fail, it's not that I look bad, unfortunately. It's the families confirming their belief that their kid can't learn. Wow, that's and and that's really what's on the table when we when we fail. And I don't think a lot of people talk about it that way. Like when you do an enrollment for your insurer and you have to come back and you have to do a reassessment, you say, Well, we didn't master these ones, you know, like, but we'll try again, right? What the family's learning is my kid doesn't learn like they thought they learned, right? And so, like to me, that's that's that's the worst case scenario. Now, we've just finally had our first kid that only mastered two things. It's our first time that we failed. So we we we hit him with a second enrollment on cost with us. So we said, hey, we'll do a second enrollment to fix this. And we explained very clearly about why we failed and how it was an issue with us and not an issue with that learner, and we're able to recover that. But besides that, we hit three, four, and five every single time, except that one learner out of 60. And again, that was really a unique coming together of his splinter skills, and we really identified that hey, getting these three is gonna be really hard. We told them that, but because of where he was at in the transition stage of his life, we needed to reach that far if he was gonna actually meet his milestone and moving out of his parents' house. So we just had a unique situation. Um and those happen, you know, like that's okay. It does just from it.

SPEAKER_03 32:56

You made me even think though, of like, we need the word the way that we when even when we're reviewing like parent goals, instead of so-and-so didn't meet their target this reporting period, maybe like, hey, we failed to help this individual meet their target. Like, that's that's really interesting. Even the way the way that you brought that up. Thank you, Mark. Yeah, that's that's empowering.

SPEAKER_02 33:18

Yeah, you you've uh you you've uh certainly incited a change in my next uh set of goals and my treatment plan in terms of looking at time frame. Because I like your point there in terms of it's it's like for the insurance is these six month periods are gonna dictate a lot of what the parents' expectations continue to be. So if you set up a whole bunch of goals, which we're pretty infamous for in the past, right? Long laundry list of goals.

SPEAKER_03 33:43

As a field, not us. Yeah. Yeah, that's a good idea. Yeah, for sure.

SPEAKER_02 33:47

Although we used to do that. Yeah, no, but for sure. I mean, that's that's what I learned on that. I was like, wait, this I I can't manage this. This is way too many bowling pins to juggle, right?

SPEAKER_03 33:54

Can't run 25 goals. You can't do that.

SPEAKER_02 33:56

And and then even worse, right? So now you're not running everything every time, or you're as a younger professional, you're stressed to run everything, which reduces the quality and the continuity. But yeah, the point being that that that treatment period, that authorization period, could have a lot of influence on a parent saying, Oh, wait, all the goals transferred over versus hey, they mastered 75% of these in this time, and now they've got a whole bunch of new things. I I never really stopped to consider what that might do to a parent's understanding or perception of their child's learning efficiency. That's cool, man. Thank you for sharing that. That uh for whatever it's worth, that's that's gonna make a change in my next treatment plan for sure.

SPEAKER_00 34:37

Oh, I love to hear that, man.

SPEAKER_02 34:38

Yeah. I mean, it you know, I I I like to kind of think of it from uh maybe six-month to eighteen month piece, but that year, you know, of of of lag, if you will, where things, even with my better comments and explaining it, hey, we're you know, we're making progress along the way. Could I find a requisite skill or something else, a component, if you will, that might be achievable in uh in that time frame? And then what does that do to the parents' uh confidence of their child being able to move forward? I mean, that's it's it seems nuanced, but I think it's huge. Wow, that's that's super, super cool. Thanks so much for sharing that.

SPEAKER_03 35:14

I think I cut you off, Mark, so I'll pass it back to you. But yeah, thank you.

SPEAKER_00 35:18

Awesome. No, no, do you guys mind if I use the restroom quick ahead and drink part of this serious and I have three empty drinks? We're good. We're good. Rock and roll, I'll be right back.

SPEAKER_02 35:29

All right, we're back. Glad you didn't take that break. We've we've been at it. So we're we're we're nearing the end of our time, so to speak. We'd never would like to rush people off. I do have, unfortunately, a commitment after our segment today. So I think we could probably sit and talk for four hours. Not that we would monopolize that much of your time, but we already have all sorts of plans for you, sir, in terms of maybe getting you to come talk to our staff, or we certainly want to have you back on again because I'm sure there's many of the things we could explore. So you know, just just thank you once again for for sharing your time.

SPEAKER_03 36:03

Dan, do you have anything on your uh So I I I guess going back to the first thing that you said about the the medical model not necessarily being procedure oriented? I I think that's right. I think that a lot of the the reasons that things are procedure oriented are probably more so from the provider end of making it easily replicatable. I mean, uh I know we've been big on individualization, and it seems like the field in general a lot of times is more big on like templated programs. How can we just get it out there as quickly as possible? So yeah, I think think what you're saying is spot on, and maybe that's more honestly us as a field. To be fair to insurances, yeah. I think we've had one or two phone calls, everything else has gone through, and the phone calls are like, okay, yeah, that makes perfect sense. We really haven't had much pushback. So thank you for clarifying that. I think what you said was really enlightening and maybe more of a reflection of us as a field and our delivery rather than what we're being required to do.

SPEAKER_02 36:56

So you're you're saying the ABA chicken laid the procedural egg?

SPEAKER_03 36:59

Is that what you're you're you're admitting here? There you go. Yep, yep. Did you have more that you wanted to chat that you had in terms of the questions that we've asked?

SPEAKER_00 37:12

Yeah, please. I think I think on part of that though is that the idea of science that we kind of got stuck on early in our field. So when you go back to uh Skinner and you kind of look at like what was happening on what science was, he actually had kind of an outdated model of what science is and how it operates, even at the time period that he was writing. And field-based models were really coming on board with how modern scientists were thinking about the work of science and the interactional effects across things. And so part of that procedure element actually think comes into how we define science and what science is and what it means to be doing good science, is the idea of the procedure. And so we took that kind of into our applied work. And I think that that's part of where that kind of got lost. And that was that was a little bit of my general thinking through that as I kind of ponder the question of like, why does everybody get so obsessed with procedures? And then I think the other part is because we tend to work with staff who aren't oriented to our worldview, that procedures create an approximation of the things that we want. So, in uh differentiating our scope of practice between our RBTs and our BCBAs of who designs and makes decisions, we're actually limiting the perspective of the RBT should be making reasonable adjustments. So that kind of two-tiered model, I think, also messes with us a little bit. First is, you know, hey, in the precision teaching world, you it's not uncommon that you'll kind of design a program where, hey, if the first timing of the day produces this result, you're going to slice back here. If the first timing of the day produces this result, you're going to jump forward to this. So you have differential decision making that's happening. Rather than don't make a decision, we need to teach our frontline people, you need to be making lots of decisions, but it's the scope of those decisions and how those decisions work with and impact the overall approach that we're taking that is really important. So part of it is we need to actually design and think through how do we empower frontline workers to make meaningful decisions that are oriented with where a learner is trying to go.

SPEAKER_03 39:30

That's a really interesting application of first trial data. Yeah. Of like based on that first trial data, it would it could affect your divergence of your procedures andor processes for the that's really interesting.

SPEAKER_02 39:43

That's a great starting point.

SPEAKER_00 39:43

Well, it makes sense because we all like show up different every day, you know? Like right, right.

SPEAKER_03 39:47

Yeah, absolutely. I mean, there's certain things.

SPEAKER_02 39:49

What a great starting point to empower our RBTs to be able to make at least one, have one option, or have two options, as opposed to wait until next week when your BCBA comes to adjust this, and now I'm just gonna apply this ad nauseum despite the learner not showing any engagement or otherwise, right? Which is unfortunately, I think tends to be the model right now. They they don't want to make decisions, they don't feel empowered or capable of making decisions without an option like this. Yeah, that's that's powerful.

SPEAKER_00 40:16

One one of the things that we did in our assessment that I think differentiates us from other skill-based assessments on the market is that before you actually start the assessment timing in our early learner skill sets, we actually have a pre-teach component where it's your goal to see can I teach this person to do this one time correctly within three minutes? And you're allowed to use anything you want to teach them to do it within three minutes. So you're doing really fast shaping, prompt fading, altering reinforcers, anything that you want to do as the clinician. And the reason being that I hate it. So when I was in uh FIT, you know, in most behavior analysis programs still today will teach when you're doing an assessment, do not deliver reinforcement. Like you're doing it in an extinction type condition because you don't want to accidentally teach. My whole life is teaching, and there's no situation where I don't want to teach a learner who's in front of me. Why would I dishonor them and waste their time by having them do something that wouldn't allow them to grow into who they want to be? Like to me, that's a disrespectful thing to do. And I ain't trying to disrespect a learner the first time I meet them because you're usually doing a skill-based assessment in the beginning of your relationship. So the beginning of your relationship is asking somebody to do hard stuff with no meaningful change in their immediate experience. Like that that's not that's not conducive to building a connection with another person. So if you can teach and shape a skill in three minutes, basically, our argument is people may be missing skills because of deprivation, a history of a deprived environment that didn't evoke and select that skill, or they're missing the skill for a lot of other reasons, component skills are missing, yada yada, yada. If we accidentally select skills that we're going to then put in a six-month off that is because of deprivation, we're wasting everybody's time and we're wasting a crap ton of money. That's the reality. And we do that. Like I can point to if you show me people are using ables or VB maps or peaks or any of those, I can point to that where that's happened with the learner, and you can see it really clearly on their graph. And now they're just running maintenance for you know five months out of last six months off.

SPEAKER_02 42:28

And go ahead. Sorry.

SPEAKER_00 42:30

Yeah, that's okay. That is that is the tool misleading us. And so we wanted to break that kind of historical approach. And then what we do is we use rate-based measures to differentiate where the person's at from acquisition to maintenance and utilization of functional classes. So if you teach somebody something brand new that they've never done before, they're gonna be able to do it, but they're gonna be way slower. It's not gonna be as precise, it's gonna be clunky, right? So I can see when somebody scores a one, maybe when I'm debriefing, I say, Hey, Joe did this in our session together, and the parents are like, We've never seen him do that before. And I'm like, I didn't think you had. I think I taught him that in that first moment together. So now in the debrief, before we even select things, there's this narrative of, oh my god, my kid actually kind of learns.

SPEAKER_02 43:17

Yeah.

SPEAKER_00 43:19

Which which is a different story.

SPEAKER_02 43:21

Do you think that that's an element, the idea of no reinforcement during assessment? Is that just a pure element of experimental control that renders itself impractical? The way you're now describing it, it's like, do we really? I mean, what what's the point of that other than experimental control, which has nothing to do with your objective now in trying to take that from we like to we like the phrase from the lab to the living room, right? Yeah. You know, Dan's kind of said earlier, are we really trying to prove that reinforcement works anymore? I think we kind of know that already. Like, why do we have to prove it again to implement it? Or, you know, so I I really appreciate that we explained that, but I mean, is there any other reason why we? We do that other than this sheer experimental control and trying poor measurement.

SPEAKER_00 44:04

So if you're if you're using a if you're using a relatively restricted criteria to square the like right, like performance on three trials, and you teach them that poor measurement could tell the wrong story of like this kid's doing it, and then that's not going to line up with what the parents say. So if you can control for the measurement criteria, you could you can break that that issue. And that is a real issue if you're using limited measures. And so how we fix that was by using robust measures that really had the idea of fluency built into them so that we could identify when things are in an acquisition state. And being able to talk about them in an acquisition state means you're probably not seeing it this at home. They probably can't do it when they're stressed, they probably can't do it when they're in an active meltdown. Like that's okay. What this means is we have a base that we can work from, though, and we can get them to that spa, which is a different story.

SPEAKER_02 44:57

So it's not that they can't, they won't in certain circumstances, and that's a huge difference.

SPEAKER_00 45:02

They aren't yet, you know? Yeah.

SPEAKER_03 45:04

Can you speak specifically? Just I know you've talked a little bit about the assessment, but speak about where people can find it. Because I think Mike and I, when you were gone, we're like, we are super interested in this, so we want to know where we can find it. Yeah, please speak on the this assessment.

SPEAKER_00 45:18

Yeah, or anything else you'd like. Yeah, absolutely.

The Generate Assessment And Dignity Of Risk

SPEAKER_00 45:21

So we have a skill-based assessment called generate, G-E-N, and then A-R-E-T-E. It's a combination of two words, Genesis and Arete. Arete is a Greek word that means fulfillment of self-potential or to reach the peak of self. And so we kind of did a play on words. We pronounce it like generate, generator, but it's spelt with arete at the end. So it's kind of weird. But essentially what we did was we designed this tool because in our adult services for that nonprofit I talked about, we saw across all of our programs we didn't have a standard way to select targets for people. And it was really whoever was the loudest in the room got their vision for the learner. And it very infrequently was the learner, it was somebody in their support network, a guardian, somebody else. So we started designing it back in 2014 for that reason. And we spent a lot of time designing it. And originally we envisioned that we were making an assessment for adults with disabilities. But in making an assessment for adults with disabilities, if we really believe that adults with disabilities can do anything, then it means that we are building an assessment for any human who had ever lived. And we decided that we're gonna open it. It's not an assessment for people with disabilities, it's for all people ever. I call it my point of poking the neurotypicals. So if you want if you want to know what's different between the three of us, any of the standard assessments on the market can't tell you that. None of them. You can use your vinylin on all three of us, we're all gonna score the same. And if you scratch our names off and mix them up on a table, you know what? When we pick it up, we're gonna say, hey, whose is that?

unknown 47:00

Yeah.

SPEAKER_00 47:01

That our goal was that our assessment could never be that way. That the three of us are three different, unique human beings, and we should score different on a skill-based assessment. And so we have really high ceilings, we also have really low floors. When we started our learning center model, I had a lot of kids who were three, four years old, and they were being told that their kid didn't score on the assessment. And the mom told me, like, you can assess him, but he's not gonna score. Everybody that we've taken him to, he's too low for the assessment. Wow. Which is a heartbreaking story. So when we actually scored that kid on the assessment, mom cried. She like straight up cried because it's the first time that somebody acknowledged that her kid was doing things that humans do. And that idea of there is no there is no limit to how low how low a learner presents and how high a learner presents doesn't matter. If you're a human, we got you. So womb to tomb, that's the idea. We'll take you from the beginning and then we'll take you to the end, and we'll see where you go through the journey. Now, when we do that, what's cool is the goal shouldn't be that the three of our assessments look the same, right? But if you think about like traditional developmental milestones, and you and I have to link on this, I'll probably send you a paper I'm working on. Because we're actually working on the concept of developmental milestones and how behavior analysts adopted the wrong one. And so I'm actually really, really interested in your thoughts on it. I would love that. Probably in the next week or two, I'll send you a draft version and check out for me.

SPEAKER_02 48:31

I appreciate that. I would love it. I'll soak it right up and let you know what I think. Thank you.

SPEAKER_00 48:34

Yeah, and like be critical, like because we're still early, so we're still playing around with some stuff. But so the issue with that is that the goal is to get 100% on all of those assessments, right? And that's a weird thing to think about. Our goal is that everybody needs to get 100%. If you're not a hundred percent, then you're bad. We might not say that, but the reality is that is how any parent is ever going to look at those things. My kid's not good, my kid can't do this, my kid can't do that, and that's gonna be the story. So we wanted the assessment to not be able to get a hundred percent. And the idea is that it is impossible for anyone human to get 100% because if you allocate your time over here on these skills, you're taking time from being able to learn these skills. So when you get into really top-end skills, your skill distribution is really a reflection of who you wanted to be as a person, right? Like our skills are different in areas because we chose to allocate them in different ways. So you can't just look at a person's score in the outer layer of our assessment because you're not supposed to get 100% attacked. What that meant was we needed to make a visual way for people to compare where they are to something. That's something we call milestones. So that's I want to get a job at Starbucks, I want to go to college, I want to have a child, whatever those big things in life are. And then we benchmark what people who typically accomplish that, we benchmark how they perform on the assessment. And there's room for variation. We tell people like, hey, if you're within certain ranges, you're probably good. You don't always have to do skill building. Some accommodations can fill the gap, right? So maybe we're not going to recommend skill building. Maybe instead we're going to recommend some accommodations to get you there. What's crazy about this though is sometimes we see that the person's current skills are over their goal. So we had one lady who wanted to stay home alone and she was in a 24-hour care system and she actually was living in the community in a 24-hour home, but she didn't have line of sight supervision, which is a restriction in every state, by the way. If you have to have another adult watch you at all times, that is a huge restriction when you're an adult. So she didn't have that, but systems defaulted into line of sight supervision when they started meeting people. And so she was never left home to stay home alone because she'd never been home alone before in her life. But she's like, I'm tired of having to run out to the store because my roommate wants something. Like, can I just stay home when you guys go run errands? And so, for like three years, it was always a new reason why it wasn't safe. A new reason why it wasn't safe. Okay, let's work on this habilitation plan for a year, let's work on this one. Oh, yeah, you you do on that one. Let's work on this one now. Three years, this lady just got pulled around and round and around. So when we used generate with her, we saw that she was significantly over people who are staying home alone. And we said, Look, guys, this isn't a skill deficit issue, this is a dignity of risk issue, and is what risk is your service system comfortable with? And what do you need in place to roll the dice and see what happens? So we started with 15 minutes alone. She's now staying home alone for six hours a day. Like she can just be home, she's good, man. We didn't build a single skill, no skill was needed to build for her to be able to do that. It was the opportunity to practice it. That's all she needed.

unknown 51:54

Wow.

SPEAKER_00 51:55

Which fit with the Medicaid waiver model, like it was allowable inside of her Medicaid waiver system because Medicaid waiver actually allows for maintenance goals. So, like it was all good. We could write a goal that was a dignity of risk goal, and we could outline in a way that the provider felt covered and everybody felt comfortable and that the guardian felt comfortable, and we were able to navigate a really hard situation and not say, yeah, hypothetically, what if a person breaks in through the window? Would you know what to do with the burglar? And it's like, come on, like and none of us move.

SPEAKER_03 52:26

Yep. Well, you have a new assessment now for your new group home clients.

SPEAKER_02 52:29

Oh man, you have no idea. I'm going to be looking into what you're doing very, very closely. I I we recently got approached to provide consultation to uh adult residential facilities. Yes. And a lot of what you're talking about, and it's and I told them from the beginning, I said, hey, not you know, from an ethical perspective, I do not have I know how to deal with behavior, I do not have that particular experience. And they were like, nah, we've we've vetted you, we've seen your experience, we want you to help us. And I appreciate that, but at the same time, I've had to be very humble about saying, Oh, I need to go research this. I I don't know that I'm hitting the mark yet. And luckily, I don't know that anybody is outside of yourself, because it's it's all pretty new, at least here in California, for us to be involved with this level of facility. So it's still kind of wide open, but the things you're talking about are very exciting in terms of not just maintaining order in these homes, but moving things forward, giving people new access, letting them develop new skills, new friends, new ventures, whatever it is. It's I think we do, I mean, it's a really good place to be when you've stabilized somebody and their situation, whatever that means. But further moving that forward, I think, is much hard, much more exciting and much more challenging. Yeah.

SPEAKER_00 53:43

When I got conned into coming back into behavior analysis, and I always do say she conned me. It's not like she did. I got conned. It's okay, she's real good. So she conned me into coming back. But the first thing I did was I consulted for 24-hour homes that couldn't afford a behavior analyst. So I did case-based consultation because in our state, if you can't make it in a 24-hour home because your targets are too intense, we don't have a stepped care model where you can go to a place that serves you. So we actually sent people, we had an interstate contract with Texas where they had some residential facilities that could handle more complex stuff. So I was the last stop to Texas, and I just consulted with people that were like, if we couldn't figure out in three months, they would be sent away from everything and everyone they've ever known. Wow. And that's how she conned me into getting back into it. Nobody underneath my care went to Texas. Everybody we were able to get back into being able to stay in their known environment. So yeah, I would love, I would absolutely love to talk to you about that.

SPEAKER_02 54:42

Thank you. Thank you. We'll we'll be in touch. That's that's a badge of honor, man. Good for you. Shout out to you. We are. Yeah, we're so glad you got conned.

SPEAKER_03 54:48

Mike's from Texas, so we we don't want people going back to Texas. That's where he's from. And um, hey Mark, I I would love to chat longer. I know he's got a hard cutoff 230. I've got one last thing, but you go. Go ahead. No, no, I don't have another question.

SPEAKER_02 55:03

Oh, you don't? Okay, so I I won't explain too

ABA As A Lens For Parenting

SPEAKER_02 55:06

much. Um, I think that early on in our careers, we used to think that teaching parents to do discrete trial the way we were trained was the way the parent training went. And I won't get into the finer points or detriments of that, but I developed this mantra, which was ABA is no way to parent. Yes, we can provide parents a lot of knowledge, but the idea, at least back then, that ABA was this way to parent, I disagree. I know you're very passionate about your own parenting experiences. How does your ABA fit into your day-to-day experience with your kids? And how doesn't it fit?

SPEAKER_00 55:41

Yeah, so I basically everything I do, I look through uh a behavior analytic lens. Now, remember, my behavior analog lens is very, very wide.

SPEAKER_02 55:50

It's you've got a whole business game going, man.

SPEAKER_00 55:53

Yeah, very wide one. But what I will say, I don't do is I don't give my partner procedures. That is not what I do. Uh, never in a million years would I would do that. But I do utilize the science in our interactions with my kids all the time. And I try to teach them to leverage the science for themselves. So, like with my 11-year-old, it's really uh focused on like what is what are the goals that you're setting, how you're engaging with them, what are those values that those are fulfilling, how are you checking in with them? If you want to learn something new, what are the things that you know about yourself to design that environment and how are you doing that? So she comes up with her crazy goals about what she wants to learn and she pursues it. With my three-year-old, it's like, hey, there's levels of tantrums that are typical for three-year-olds. And like, I ain't trying to get her to zero, but I ain't trying to get her to screaming and yelling at her mom and pulling and biting and going wild because my kids are wild. I make wild children. You know, I'm a wild man, my children are wild. We have very strong opinions, and pre-language for us is really hard. Um, so so getting to the point where like we're learning to utilize language in different ways is definitely a thing that I do with my three-year-old. Um, I utilize it, I utilize it, but in our parent training, part of our model is while the kids getting assessed, two hours of parents are doing parent collaboration with us, and they have a little module that they go through on strategies, and I actually evoke them to tell me no. So I want them to say, like, that strategy does not work for my family, and that's the dumbest thing in the world. Why would anybody want to do that? I need them to tell me that. I don't want them to just nod their head and say, Yeah, I like I could see why that's good. I see why that's good, I see why that's good. So they do those on their own, and then we come together and we actually talk about which one of those are interesting, which one of those sounds like you're kind of doing a version of it already. And let's kind of tweak a little tiny micro thing you do. I'm not trying to get you to do brand new big things. I actually want to see what you're naturally doing, what feels good in your home for your family. And I want to see a micro change because I believe that behavioral processes work on the micro level, and switching something like a delay of three seconds to a delay of five seconds is a big deal. Um, yeah, yep. And you don't usually need a whole new thing. Like the parents already have a built relationship, and if you can help them tweak, you're gonna get that natural buy-in that everybody kind of complains about and feels like it's really hard to establish.

SPEAKER_02 58:13

And it goes back to a practical version of that experimental manipulation, just change that a little bit, see what happens. Oh, there you go. Check that out. Oh, wait, nope, that didn't work so well. Maybe don't do that. I love it, Mark. We could spend the rest of the day talking to you, man. You are a wealth of knowledge. I tremendously appreciate how you turn these paradigms on their head and back to their feet again. It's been a distinct pleasure. Oh, we went to school today, that's for sure. And we love sitting in the seat for that reason and a use or a PhD course for sure.

SPEAKER_03 58:44

We'll be reaching out to you to get back on the tap, but also outside the tap, I know you said you wanted to reach out to Mike to review your paper. I think we might want to reach out to you to maybe do some uh partnering or consulting just with our company, maybe some of the group home stuff. I think there's a lot here access. There's a lot that we could benefit from.

SPEAKER_00 59:00

So I love that, guys. I look forward to chatting more in the future. Have a great day, yo.

SPEAKER_02 59:04

Let's see, just give us just one second before you go. I'd like to end with some gems that we've collected throughout our discussion with you so we can put in our tagline. So I've got consider process as well as procedure, establish an accountable therapeutic relationship, let families be families, generate low dose approaches, and always analyze responsibly. Cheers, Mark. Thanks so much, man.

SPEAKER_00 59:27

Have a good one, y'all. Always analyze responsibly.

SPEAKER_02 59:31

ABA on tab 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.