We’re Almost There!

IMAG0064-1-1-1

It was October 7th, 2012…a Sunday. Why Stephanie decided to reinforce my ridiculous idea to run a full marathon with basically ZERO bits of running experience in life thus far, I do not know. What was even more surprising was that she did this after just finishing the same year-long process herself! Anyway, there we were…running the Chicago Marathon for Team World Vision…and we (literally) ran across the poster that summed up our feelings & thoughts exactly. It said, “Punch anyone who says you’re almost there.” As you can see, we connected so much to this poster that we decided to sacrifice our awesome positions in the race to take a quick photo. It was just too awesome to pass up!

Now, fast forward to 2014…Stephanie and I began training for a half marathon. As SOON as I made this decision, I thought to myself, “Why in the world are you doing this!?!?!?” Let me just clarify…I do not have a runner physique, I do not enjoy running very much, and I’m not all that good at it. So, why?? As I wrapped my head around this question, I began to realize that, for me, there is something very reinforcing about meeting big, long-term goals. There was honestly nothing like crossing that marathon finish line back in 2012. That second of my life was one of the best examples of delayed gratification that I may ever personally experience. But that can’t be it, right? The fact is, training for an entire year at something that you aren’t good at and don’t like to do is a LOT of response effort. So you’d think there must be other, more immediate reinforcers along the way, right? For me, one of those reinforcers was seeing my donation money rise each week & knowing it was going to an amazing cause. The one I want to talk about the most, though, is the invaluable bond that grows between two people who run the race together.

Don’t get me wrong, there were probably many days that one of us was oh so annoyed with the other. Whether it was because they wanted to run too fast, too far without stopping, or even at all…no joke. Regardless of our words or actions, there was something about the comradery of working towards a common cause/long-term goal that was constantly reinforcing my hard work. I truly believe that God places particular people in our lives that are a perfect match for each of us in this way.

The race that Stephanie and I ran 2 years ago is, in many respects, similar to the race that we have been running since 2011. I’ll call that race the “FOC” race. Never did I think the FOC race would be as long and tiring as it has been. Looking back, it definitely wasn’t a race that I could have run with just anyone. And even though we haven’t quite contacted the “BIG” reinforcer that we’ve been waiting on for so long, the ongoing reinforcement of comradery with a business partner that was hand-picked for me is more than enough to keep running. I can even say that, “We’re almost there!!!” without a single flinch. 🙂

Liz

Advertisements

“Play nice in the sandbox”

AS0000114FD07 Children, in park and adventure playgroundThese kids seem to be playing nicely together, right? And that’s what we expect of them, isn’t it? If they weren’t playing nicely together, the parents would be hovering to make sure everyone stayed happy and unharmed by flying sand or toys. We, as adults, are often told to figuratively “play nice in the sandbox,” typically when discussing heated topics or collaborating across disciplines. But I always feel the need to ask the question, “Do I really have to?” And, better yet, “Is it really helpful?”

Personally, I think the short answer to both of those questions is, “No.” In general, the notion of “playing nice in the sandbox” is flawed fundamentally. It is based on the premise that this “getting along” ideal is both necessary and helpful in all situations. But what we fail to recognize is the dangers in this type of thinking…this all or nothing thinking.

We live in a world where, if you disagree with someone, you are immediately labeled as (and shunned for being) “hateful” or “anti-_____” or “closed minded,” and the whole world learns of such “truths” about you as a person. There in lies the problem: disagreement is NOT, in any sense of the word, judgement. Our society’s need to be politically correct and accepting of every idea anyone ever had is, in my view, leading to the degradation of critical thinking and healthy debate leading to progress. Don’t get me wrong, people have value (as fellow human beings) independent of their agreement or disagreement with others and deserve to be treated as such. That, in no way, suggests that we must tread so carefully as to not ruffle any feathers. Being kind and loving towards other people does not preclude me from having strong opinions and sharing them (in respectful ways) and advocating for what I believe is best. It also means that others can (and should do the same) with people yielding their misplaced focus or trust when needed.

Let me give you an example from the life of a behavior analyst…I’ll even borrow from our previous posting on sensory diets:

Let’s pretend I’m a behavior analyst (well I suppose that isn’t a hypothetical) who is doing an assessment for a student who runs away from the classroom, and I learn it is happening to both escape work and access preferred sensory activities. I also notice that the frequency of running away increased dramatically after the first time an adult played with him in the sensory room. If someone were to suggest that this behavior was a result of a sensory need during difficult academic tasks and that he should be allowed to continue accessing the sensory room under these situations, I would be remiss if I failed to point out that that was directly observed to make the situation worse.

But, truth be told, the notion of “playing nice in the sandbox,” and the proponents of its universal value, would suggest that the best response would be to say, “Sure, we can definitely incorporate such a sensory diet in the midst of those tasks. I can definitely see how that is something he really needs.” Wait…hold on a second…didn’t I just say that this response already resulted in an increase in running away?! It seems to me, then, that that particular response is neither helpful nor necessary. It might help to make everyone feel included, but it certainly would be expected to help the student.

On the other hand, consider the following response: “I see how it might seem like he ‘needs’ these breaks because he is running off so frequently, but the data show that this pattern is actually leading to increases in running away. I would be more inclined to teach him a more appropriate way to request these breaks and to better tolerate longer periods of difficult work while removing access to the ‘fun stuff’ accessed by running away.” People would suggest (and I’ve experienced it personally) that I would not be “playing nice in the sandbox” because I simply “dismissed” another’s suggestion. But what I know about this 2nd response is that it was polite but clear regarding my position and offered an intervention that is more likely to result in a positive change for the student.

And, again, here is the problem: disagreement does not equal judgement, even though society tells us it does. I’m not judging that suggestion; I’m simply offering an explanation why, scientifically, we wouldn’t expect it to be effective and offering another option.

I work daily to build positive relationships with people that may or may not have the same beliefs and training and passions that I do, but I don’t believe that the only way to do that is to avoid ruffling feathers at all costs. It is only through being challenged on our beliefs and actions that we can learn to understand them, defend them, and change them (when necessary). Without being challenged, we go through life as lemmings, willing to follow each other off a cliff when there is a route to safety.

Personally, I would rather be shown why I am wrong and have the chance to be better than always be told I’m right while sacrificing my very being in the process. So the next time you feel pressured to “play nice in the sandbox,” resist the urge and exercise the practice of respectful honesty instead.

Stephanie

Sensory Diets: What Are We Even Talking About?

Use of the term “sensory diet” or “sensory needs” has grown tremendously among professionals providing services to individuals diagnosed with autism. These days, it would be more surprising for a parent not to contact this idea than to contact it, both within and outside of the school setting. Families and schools spend crazy amounts of time and resources to ensure their children contact this type of therapy. In my experience, “sensory diet” and related phrases are one of the top 5 phrases used in IEP meetings, hands down. So, what do these terms even mean? Let’s first take a look behind the curtain of this infamous phrase to see how it got here. Although many people may not be aware of this, what we are really talking about when we say “sensory diets” or “sensory needs” is what’s called “sensory integration therapy” (SIT). Here is one source’s definition of SIT:

“Sensory integration involves providing a ‘diet’ of sensory stimulation to a child, in an attempt to improve the way in which the child’s brain processes and organizes sensory information. This can include vestibular and tactile stimulation, purposeful movements, use of weighted vests, and brushing, among other techniques.”

Sounds familiar (and experimental), right? Although most professionals using these strategies do not typically refer to them as sensory integration, the techniques and underlying theories would likely be described similarly as in the definition above. Put more simply, all of these terms imply that children with autism need some amount of various sensory experiences in order to function more normally from day-to-day. Now, at first glance, this seems to make a lot of sense. After all, many people with autism certainly love sensory activities – so it would be easy to assume that these are things they need from a biological standpoint. But are the acts of loving and needing synonymous? What if they aren’t? What if these sensory experiences are truly just preferences that are out of control because of a lack of social skills that help all of us keep our weird sensory habits (mine would be forcefully moving my feet under the table) in check? If we play devil’s advocate, this would mean that we are spending a TON of time, money, and energy on something that has nothing to do with progress or a better quality of life!

Now, take a deep breath. This next paragraph will likely blow you away and possibly even offend you. I simply ask that you finish reading with an open mind. I can also promise that you will still walk away with a positive outlook on the “S”-word if you’re able to make it to the end!

The bottom line is that nothing (to date) has proven that love=need when it comes to sensory experiences. I know it is easy to think that the underlying evidence supporting these ideas has been growing as exponentially as has use of the techniques themselves; however, this is completely false. Let me now present you with some factual information. According to the 2009 National Standards Project (NSP), a comprehensive literature review of research on many commonly used treatments for autism, sensory integration neither falls in the “established treatments” or the “emerging treatments” categories; instead, it was categorized as an “unestablished treatment” meaning that, “little or no evidence was found to assume its effectiveness.” More specifically, unestablished treatments may not have any research supporting them or the studies that were conducted have very low scientific merit scores; in the case of sensory integration, only seven total studies were found. These findings are comparable to other older sources such as, “Controversial Therapies for Developmental Disabilities” (2005). Based on an extensive review of the existing research at that time, the book echoes the NSP by noting that, “available studies [on sensory integration] are sparse and tend to be methodologically flawed.”

Despite multiple reviews with the same findings, the use of sensory integration techniques is widespread and typically incorporated into IEPs, treatment plans, and daily/weekly routines at home & school without question. As was my reaction upon learning this information, the common question is, “Why? If this is true, why are so many clinicians doing it?” Well, let’s remember the lesson we are always trying to teach our kids…that just because everyone is doing something, doesn’t mean it is good or right. I think this is one major example of us adults failing to practice what we preach.

Now for the positive note! We can easily see that people with autism seek and avoid certain sensory experiences in many different ways. Just because providing them as part of a “sensory diet” isn’t supported in a therapeutic sense, doesn’t mean that (a) these experiences can’t be used in meaningful ways and (b) people who love them can’t be taught to scale back on them based on social situations, just as we do. If we know these experiences are things that they love, can’t we simply use them for motivational purposes and/or to pair ourselves with fun stuff in the process!? In other words, there are a number of beneficial roles for preferred sensory experiences outside the theory of sensory integration that, therefore, don’t result in the sacrifice of precious time and resources on unproven therapeutic techniques.

I think we would all agree, as passionate clinicians and loving family members, on the importance of using time and resources as wisely as possible to help people live life to the fullest. To continue using any type of therapy with a lack of evidence simply does a major disservice for helping them reach this goal and at no fault of their own. My hope is for this entry to challenge all service providers and families, including myself, to continue seeking information on scientifically validated treatments so that our language, resources, and therapeutic strategies are as passionately driven by evidence-based practices as we say they are.

Precious lives are at stake…let’s know what we’re talking about!

Resources:

National Standards Project (2009) http://www.nationalautismcenter.org/about/national.php

Jacobson, J.W., Foxx, R. M., & Mulick, J.A. (2005). Controversial Therapies for Developmental Disabilities (pp. 68-70; 218; 252-253).

Liz Van Dorn (and yes, you did notice a trend of Auburn football colorsWAR EAGLE!)

Not According to Plan

Ok, everyone; I was charged with writing an opening post for For Love of ABA & Football, to introduce you all to myself (Stephanie) and Liz and the idea behind our new blog. But, for those of you who don’t know me, I am a HUGE Denver Broncos fan and am feeling slightly less-than-chipper this morning. For the non-football fans out there…that’s because they lost a horribly painful game (in the Super Bowl, no less) last night. Let’s just say, their game did NOT go according to plan! And, thus, neither did my Sunday night.

But I digress…well, sort of…Liz and I did not decide to start a blog for Footsteps of Change simply so we could rant about disappointing football games; but we did envision a place for us to share our thoughts on ABA, the state of our field and the work being done, and our love for the families we serve, as well as our own personal passions (which, needless to say, include football!). We are both blessed beyond what we could have imagined to be able to run Footsteps in the way we know to be best and to be able to work with each other and the wonderful families and professionals we have already come to know in the life of our young company.

As entrepreneurs and behavior analysts, Liz and I have seen that things do not always go according to plan…and that’s OK. (Anyone who has known me for more than a few years knows how hard it is for me to say that deviation from “well laid plans” is ok, because I am/was a planner!) But I think there is something inherently optimistic and maybe a little naive to the reality of limitations in both of those titles that has led us to where we are and will carry us through to a greatness we might not even yet see. If we’re being honest, though, where we see our plans not quite playing out as originally envisioned, we are building something even greater and full of joy and passion than we would have had otherwise.

Now, don’t get me wrong…last night’s football game not going according to plan is NOT one of those things that I see working out for the best in the long run. That truly was a let down for me and probably a massive disappointment to the Denver players and coaches…that one simply needs to be chalked up to a failure to be learned from. In our real lives–you know, the ones where we are behavior analysts and friends and supporters to our clients and loved ones (as opposed to the fantasy lives of being personally involved in the success/failure of our respective favorite football teams)–we’re learning to love to see things go not according to plan and we’re thrilled for what the future brings for us (in work, life, and in football)!

Stephanie