The American Occupational Therapy Assn (AOTA) conference has just concluded in Indianapolis, Indiana and as is always the case, I feel such enthusiasm and camaraderie after interacting with a focused group of my colleagues.
Joining OT with ABA
This year, my research partner and I were featured as poster presenters, and I had a sizeable group of my occupational therapy (OT) colleagues stop by to inquire about our collaborative work. This is noteworthy, since it wasn’t solely my work as an OT that was presented–we focused on the team effort of joining an OT service with an Applied Behavior Analysis (ABA) service in a co-treatment model to improve treatment outcomes, and to measure the efficacy of an OT intervention.
ABA Team Tends to be More Isolated
This is not a revolutionary idea, but you wouldn’t necessarily know it. OTs have long been vital team members with other team therapies, teachers, parents, and several additional professionals. Yet for some reason, we noticed that no one is talking to the BCBA (Board Certified Behavior Analyst). ABA seems to occur at arm’s length from other therapies, amongst families that receive it, and the ABA team and the therapy team rarely co-mingle.
Some of this is environmental (ABA may occur primarily in the home, while OT and other therapies may occur at school, or in a clinic setting) but not entirely. We spoke with OTs who had ABA with them on the school team, or both in the same clinic, and they still weren’t talking across the aisle.
The largest barrier we discovered is communication. There were a number of misperceptions about the field of ABA amongst the OTs we spoke with. The primary fallacy is that ABA therapists are not “functional.” While OT does corner the market on Activities of Daily Living (ADL), a common area of need amongst “Special-ism” children, the ABA can certainly address functional targets. Moreover, collaboration between OT and ABA can enhance the successful outcomes of both therapies.
We began our collaboration between OT and BCBA by discussing the sensory profile of the child. The OT is the professional uniquely prepared to assess a child’s sensory needs and prescribe a sensory diet. It is an age-old question to wonder, “Is it sensory, or is it behavior?” However, most likely, the answer isn’t mutually exclusive. The OT is just wearing sensory goggles and the BCBA is wearing behavioral ones. Yet by defining terms and setting mutual functional goals, we discovered that in tandem, a sensory plus a behavioral approach worked best of all.
Pose a Question to Your Colleague
If we admit that we’re stumped on a particular child and situation, it opens the door to collaboration much wider than if we approach the same situation certain that we already know the right answer. Tell your BCBA that you are working targeting an ADL for example, and that you have discovered what sensory needs the child has in performing that ADL. However, perhaps you notice that what started out as a sensory avoidance has become a behavioral struggle. This is the perfect opportunity to join forces.
Capitalize on Your Strengths
While my strength is sensory interventions, my BCBA colleague has data collection as a strong suit. What a perfect marriage! The field of occupational therapy is passionate about quantifying the issues of sensory processing disorder to begin to make headway in recognition and coverage of this critical issue. By joining up with my BCBA colleague, who was already collecting data on her ABA targets, I was able to introduce an OT intervention as a “treatment phase” and then was able to visibly see the efficacy of my intervention on the data she collected post-treatment.
Meet The Family’s Needs
Any OT will tell you that a child’s goals are generated by the team, and primarily by the family. Families are becoming very savvy about evidence-based treatment as well, and have a right to know if any therapeutic technique or activity is effective.
By combining efforts with our data collecting ABA colleagues, you have a ready-made data stream that is already being collected. Put your heads together and use the power of teamwork!