If you are a part of running an ABA organization, the notion of waitlists or interest lists is all too common. You may maintain a formal waitlist where the next client in line is matched with a clinician to receive services. With an interest list, you have more flexibility around matching the right client with the right clinician depending on skill-need and expertise. Either way, given the community's needs, nearly every ABA agency has a wait for families before they can provide direct care to the autistic learner or individual with IDD.
When we look at the research for the best models of care, we see that models incorporating parent engagement consistently produce better learner outcomes (MacKenzie & Eack, 2022; Sneed & Samelson, 2022). However, getting parents to attend parent training sessions, now formally referred to as family adaptive treatment guidance (ABA Coding Coalition, n.d), can be a struggle. Data suggest that getting parents engaged at the earliest possible point in the therapeutic process is critical (Chacko et al., 2016). As such, we turn back to our notion of waitlists as we create opportunities for early engagement with parents.
Your agency may not be ready to provide direct care to a learner quite yet – but research indicates that we need to get that family engaged with care at some level to help position that learner for optimal outcomes before they even start to receive services themselves. As such, enrolling their family in parent training and collaboration sessions during the interim may be the solution. To do so, we encourage your agency to follow these steps.
3. Authorization: You are likely working with funders where you must submit for authorization for services. However, you don’t want the clock to start running for direct services to the learner until you have staff available. As such, submit your report for only family adaptive treatment guidance hours. Use your full assessment report to justify your request. Make a note in your report that you will return to request other codes for this client as resources become available.
4. Accessible Resources: When you provide parent training and collaboration to families and caregivers waiting for their loved ones to receive direct care, you must be diligent in ensuring they receive valuable care. Given that they ideally want to receive direct care, but they are compromising with this type of service, they could easily slip through the cracks. This is also the same reason the family may fall off your radar! As such, equipping the family with a tool where they feel connected and engaged, which requires less work on the part of the clinician, is ideal. The CR Care Coordinator does just that. The family can listen to parent training lessons introducing them to ABA, advocacy (e.g., easing them into the world of disability, insurance, and acronyms), and parenting through connection and values. Each time they listen to a lesson, they feel connected to your organization. You can also have them listen to lessons specific to your organization to prepare them for direct care when the time comes. Then, during parent training sessions, the family feels like they have already been enrolled in the conversation about the topic at hand and are a better participant during your time together. They anticipate your meeting and come prepared with outputs from their homework lessons from the CR Elements Curriculum.
5. Track Progress: You still have to monitor progress during this time together. You may want to document how parent training is impacting the learner’s skills. Those would be some incredible data! However, your learner, at this point, is also the parent. The CR Care Coordinator using the CR Elements Parent Training & Collaboration curriculum comes with rubrics during the parent education experience. When the parent is learning about content, you can monitor their competency based on their homework output and their verbal behavior around the concept. This then populates a graph that you can submit to insurance companies. During the parent support experience, you collect fidelity data on the parent’s performance of different skills (e.g., mand training, using a gestural prompt). These, too, produce a similar graph indicating the percentage of independently, accurately completed steps of the procedure that can be submitted to funders.
Whether using the CR Care Coordinator app or providing parent guidance and support through other means, data suggest enrolling parents early in the therapeutic journey yields more significant gains for the learner. As such, this model can be an assistance to organizations who want to support their families while waiting for direct care services.
Dr. Kerri Milyko, BCBA-D, LBA(NV)
Dr. Kerri Milyko came upon behavior analysis as a student of Dr. Henry Pennypacker at the University of Florida. Upon his encouragement, she forged a path that led to the University of Nevada-Reno studying under Dr. Patrick Ghezzi and then, as an entrepreneur opening precision teaching clinics in Tampa and Reno. Dr. Kerri served at CentralReach as the Director of Clinical Programming in 2019. In this role, she and her team created a fully digital, integrated, evidence-based curriculum, CR Elements, to service the needs of neurodiverse learners. Before this role, she was Director of Research and Development of The Learning Consultants and Development and Outreach of Agile Learning Solutions (formerly Precision Teaching Learning Center). Dr. Kerri is also adjunct faculty at the University of West Florida where she created and taught their VCS, master's-level Instructional Design class. Her primary behavior analytic focus is on instructional design, humane and dignified practices, measurement, precision teaching, direct instruction, percentile schedules of reinforcement, behavioral education, and bettering products for clinicians.
Finally, Dr. Kerri is a prolific volunteer. In 2019, she was elected to serve 3 years on the Board of Directors for the Standard Celeration Society. In the same year, she was appointed by the governor of Nevada to serve on the first-ever Board of Applied Behavior Analysis to create ABA practice regulations for the licensure of state behavior analysts, where she served as Chair of the Board for 2019. Currently, she serves as a trustee for the Cambridge Center for Behavioral Studies, a member of the Professional Standards Committee for the California Association for Behavior Analysis, and serves as the Teaching Behavior Analysis Program Area Coordinator for the Association for Behavior Analysis, International. Kerri values quality time with her three children, her husband, and dear friends. She loves wine and butter, true crime podcasts, and a good sci-fi novel while tinkering in her backyard.