Submitted by: Maria Whiteway, M.Ed., BCBA

In 2010 I became a special education teacher for children with autism. Given that my classroom was part of the Applied Behavior Analysis (ABA) program, I sincerely needed to learn a thing or two about ABA. Since I had several students who were non-verbal and others with limited verbal abilities, BCBAs trained me in Verbal Behavior. Simply put, Verbal Behavior applies ABA principles to language. While my intense training led me to become a BCBA, I still understand what it was like to hear unfamiliar terminology.

As parents, you are debriefed every session on your child’s progress. However, when a therapist uses terms like tact or intraverbal to describe your child’s accomplishments, you may walk away confused instead of delighted.

We know that knowledge is power, so here is a little cheat sheet on the ABCs of Verbal Behavior.

First and foremost, ABA is the science that implements behavioral procedures to improve socially significant (acceptable) behavior.

Again, Verbal Behavior is simply the application of these principles to language. Verbal Behavior can include talking, gestures, sign language, writing, using augmentative devices or utilizing picture systems. Verbal Behavior has been broken down into different verbal operants, so that we, as listeners, can respond appropriately to what a person is saying.

The main verbal operants will be explained using an ABC chart:

A= Antecedent (what happens before the child speaks)

B= Behavior (what the child said)

C= Consequence (what happens after the child speaks)

MAND

The first verbal operant is the Mand. Some common terms for this are request, ask, command, and/or demand. This operant is different from all others because when someone mands for something specific, they get it. Every other operant’s consequence is not specific to what was said.

TACT

The next operant is the Tact. Some common terms are labeling or naming. A tact has to do with the 5 senses. One can see, hear, smell, feel or taste something, so they will name what it is.

ECHOIC

Another operant is the Echoic. This is repeating what someone else says.

INTRAVERBAL

The next operant is the Intraverbal. Common terms for this are fill-in-the blank phrases (a pig says oink), word associations (socks and shoes), typical conversations and answering questions.

LISTENER RESPONDING

Another operant is Listener Responding. This generally involves people following directions. Think of it as the person is responding to what they are listening to or responding as a listener. 

MOTOR IMITATION

Motor imitation involves copying someone else’s movements.

Now that you know the ABCs of the main Verbal Operants, have some fun with them. When you are out and about, see if you can identify different operants that your family and friends produce. I know what it can be like to hear ABA jargon and wish you knew more. Hopefully this cheat sheet will help you, but if you still have questions, do not hesitate to ask your child’s therapist. You and your child are the most valuable members of the team at Reaching Milestones and we are always here to help!

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Submitted by: Chelsea Silva, QASP

We are so thankful to have the opportunity to work hand-in-hand with our incredible parents as part of our client’s treatment team. We only see your children for a portion of time each week so it is vital that we work together to create a plan that is deeply rooted in the science of Applied Behavior Analysis and fits naturally into our family’s everyday lives. In order to see change across the board we greatly appreciate active participation from our families!

But what does active participation mean? Active participation includes working together side by side with your child’s therapist during parent training sessions or when meeting to discuss the treatment plan, completing assignments such as recording behavior, obtaining information from your physician, making changes in home and routine as needed, and effectively communicating successes and challenges. In order to help our families feel comfortable and confidant in their participation we put an emphasis on systematic parent training. We strive to give our parents the tools to not only implement individualized protocols utilized to increase or decrease behaviors, but also to help generalize those increases and decreases to different places, different people, or during changes to routine (such as vacations).  During training we use what is called behavioral skills training to provide clear instructions, guided demonstration, opportunities for practice, and immediate feedback. We strive to break down each skill in such a way that it is easily understood followed by demonstrating the protocols or teaching procedures so that our parents have ample opportunities to ask questions throughout the demonstration. After initial instructions and demonstrations we provide opportunities to practice with us during role play activities to ensure you are comfortable and confidant before trying to do things independently with your child. Throughout the process we will be giving you immediate feedback with both spoken feedback and at times collecting data on progress so you can visually see how you’re doing!

Through this systematic teaching process we hope to help our parents to feel ready to tackle problem behavior independently, ready to teach using new strategies, and ready to implement across environments! We always strive to set our clients up for success, and we want our parents to feel the same level of support so they may be successful as well! We thank you again for your continued support and active participation, we love to work together with you and be on your team!

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Submitted by: Stacey Francesconi, BCBA

There are big things happening for Reaching Milestones in 2017! Already an established agency in the Southern Region (Florida, Georgia, and South Carolina), Reaching Milestones strives to bring high quality ABA services to families in need. In the new year we are broadening our services to cover a new region: New York! New York state is a mandated insurance coverage state but with a lack of providers in the Upstate Region quality services are hard to come by. The following is the process that lead to the Capital Region getting its very own Reaching Milestones clinic!

My name is Stacey and I joined the Reaching Milestones team in 2012. I am a certified Special Education teacher who needed a change of pace. Once joining the team as a behavior technician I was hooked on ABA. I worked my way up to lead behavior technician, BCaBA, BCBA, and supervising BCBA in my 3 years at the Richmond Hill Georgia clinic. This was the best time of my life but I wanted to move back to my home state of New York to be with family. Once arriving home I realized the immense shortage of clinics who were like Reaching Milestones. Who am I kidding I was shocked at the lack of ABA in this area all around! I showed a need, met with lots of influential people, and proposed an offer to the leaders at Reaching Milestones. I was unsure if they’d be willing to expand that far or to give me a chance. After reviewing my hard work and the NEED in this area they decided it was time for Reaching Milestones to give these families in need the high-quality services they both needed and deserved. Now it was my time to make it happen!

We have had a lot of help along the way from doctors, families, other practitioners, and others in the field. Dr. Bentley from Developmental Pediatrics in Latham has been instrumental in getting our mission statement out to parents and believing in our contiguity of services. Janine Kruiswijk and the Autism Society of the Greater Capital Region have let us host parent trainings on toilet training and food acceptance. They have welcomed us to many of their events where we could spread the word on ABA. The amazing ladies at ABC Nursery School in Clifton Park have been the most welcoming and open hosts as we await our own building. They have let us use space to see a small amount of kids while we develop a client base and determine the perfect building space for our own clinic. There have been many others on the journey, too many to name, and we thank them all!

At this point we are credentialed with multiple insurance agencies, have a small group of clients, and have been hosting workshops and events. The future holds our own building with what I know will be an amazing staff. The process has been tough, and the hardest parts might not be over for me but in the end I know it will be worth it to help the families that need it right here in my hometown. I am so thankful for all who have helped and cannot wait for the next leg of this journey! Stay tuned on the Reaching Milestones Facebook page to see what NY is doing and feel free to contact me if you’re in the area and would like to be a part of this amazing journey.

Let’s do this NY!

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Submitted by: Beth Vaughan

Our very own Jamie Redding (Senior Vice President) and Missy Rolison (Vice President of Operations) for Reaching Milestones recently took a trip to Washington, DC last week to meet with members of the United States Congress. The mission of the trip was an extremely important one for all of us involved in both the Autism and Military communities.

Recently, it has become difficult for many military families to find in-network specialists for their children who have been diagnosed with Autism. According to a group of US Senators, this is in part, due to the way federal officials have changed health insurance plan reimbursements earlier this year. A group of six lawmaking senators (including North Carolina’s Thom Tillis) are calling for Congress to reverse the reimbursement cuts via additional funding and sent a letter to federal funding decision makers last week, asking for this very serious issue to be addressed. The letter asks for leaders on the House and Senate appropriations committees to include $32 million in upcoming budget legislation. That money is expected to effectively reverse the reimbursement rate cuts and address the shortage of ABA therapy providers.

According to the Senators, the reimbursement issue arose after Defense Health Agency officials changed the rate that TRICARE pays medical providers (such as Reaching Milestones) for Applied Behavior Analysis therapy. Through TRICARE, military beneficiaries diagnosed with ASD are eligible to receive ABA treatment. The Academy of Pediatrics fully supports and endorses ABA as an effective treatment for individuals with Autism. A Report of the Surgeon General states, “Thirty years of research demonstrated the efficacy of applied behavioral methods in reducing inappropriate behavior and in increasing communication, learning, and appropriate social behavior. The ABA treatment program is used by nearly half of the 26,000 children covered by TRICARE who have been diagnosed with Autism.

On April 1, 2016, the DHA imposed reimbursement rate cuts of as much as 15% for ABA services in most areas of the country. These cuts were imposed despite indications from military families from across the country that they were experiencing ABA provider shortages; and, in some locations, families had no access to providers at all. Just this week, 3 providers in San Diego were forced to shut their doors and a major ABA provider in the Georgia area had to close down all but one of their locations because they could not afford to stay open.

The House and Senate has already approved the National Defense Authorization Act for fiscal year 2017 to include reinstating ABA reimbursement rates. However, that bill does not appropriate federal funding for such costs and final approval of the budget is expected later this year (most likely December).

Missy and Jamie personally met with 10 members of the US Senate and were very enthused by the conversations that took place. They were able to lock in signatures from these representatives and came back to Jacksonville feeling very positive about the potential outcome.

This mission is far from over, and the efforts to reverse the rates don’t stop with the Jamie, Missy and the group of Senators. We need YOUR help! Sign the petition. Voice your opinions and concerns. Let TRICARE and Congress know how important ABA is for the future of your children. Progress is made every single day with ABA. Please contact your local congressman and senators to voice your opinion and let them know how important this is to all of us!

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