Building Bridges | Episode 3: Inside ABA & OT Teamwork

How Multiple Disciplines Work Hand-in-Hand to Support Therapy Outcomes

In this episode, we dive into the collaboration between Hopebridge clinicians and how multiple disciplines work hand-in-hand to support meaningful growth for children receiving autism therapy. Join BCBA Taylor Thomas and OT Haley Hatfield as they discuss how interdisciplinary care has evolved, the misconceptions that once created barriers, and how shared clinical insight leads to stronger patient outcomes.

Haley shares a historical view of pediatric therapy collaboration, highlighting how OTs, BCBAs, and SLPs have transitioned from operating independently to functioning as integrated clinical teams. Taylor explores common misunderstandings between ABA and OT and how trust, communication, and cross-disciplinary respect have shaped more aligned treatment planning.

Together, they offer guidance for clinicians working across specialties. Chat with us about how to approach goal-setting, how to balance sensory and behavioral frameworks, and how to remain anchored in child-centered treatment. You’ll also hear about standout moments where collaboration directly influenced patient success, and the meaningful lessons learned from those experiences.

Whether you’re an OT, BCBA, RBT, SLP, psychologist or clinical leader, this episode offers practical insight into what true interdisciplinary care looks like inside a modern pediatric therapy model at Hopebridge and why it benefits both clinicians and the children they serve.

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Taylor (00:01)
Welcome to Building Bridges. I’m Taylor Thomas, and today I’m joined by Haley Hatfield to discuss collaboration between ABA and occupational therapy. Enjoy the episode.

I’m Taylor Thomas and I am the functional assessment director and I’m here with Haley. Go ahead Haley.

Haley (00:19)
I’m Haley Hatfield and I am the professional development advisor here at Hopebridge and will be discussing the collaboration between ABA and ⁓ OT.

All right, Taylor, let’s get started with some of the questions that we have today. So in your experience, how has interdisciplinary collaboration evolved in the pediatric therapy industry?

Taylor (00:38)
Yeah, that’s a great question. It’s hard for me to say how it’s evolved because I started in one of our centers where we had OTPT and speech. So like from my experience, the entire time I’ve been in this field, I’ve got to experience what that full collaboration looked like. Right. So I came in as like an ADA therapist and was automatically working with our SLPs and our PTs and our OTs in the center. ⁓ I would say, though, that it has expanded into

I’m hearing more people be able to do that. A lot of other centers like pediatric providers don’t necessarily have that on-site collaboration. so them learning how to collaborate has been a process. And as they come to Hopebridge, I am asking questions when I meet with clinicians like, have you checked at the OT about that? And they’re like, no, I didn’t think about that. so starting to work with clinicians on thinking of them as like a resource that’s in center and available or reaching out to them for

you know, the SLPs as far as like a modality of speech and how how we can work together to establish that. I’ve just seen clinicians grow a little bit in their start to collaborate without a prompt, essentially, and even looking towards following those people on social media. Right. So like, yeah, I follow this SLP. I’ll hear people talk about that. I follow this SLP on social media or.

I saw this video on TikTok of an OT and so I think social media has kind of helped that as well. It like gives us insight into what those other therapy sessions can look like because we don’t always get to go to those, right? Like I’m in a consult with my kiddo or that kid’s an OT and so I’m thinking, I can’t go see them right now. So having ⁓ access to kind of see into those sessions that pop up on social media, I think has really helped with that evolve, know, evolution of collaboration as well.

Haley (02:23)
Yeah.

Yeah, absolutely. I agree. think we, you You and I both share that experience, that unique experience that we came along early on, and that we’ve always had that team of an OT and a PT in speech and an ABA therapist. But I do think the dynamics of the team have really changed from those early days. And I think a lot of it has to just do with the growth of the profession too. You know you think back to when we started in ABA,

⁓ it was early on and the profession was still very new at that time. I mean, it maybe was like, 10 years old? So there weren’t very many providers. And so I think back to my early days as an OT, the BCBA wasn’t on site with us every day, all day. And so we didn’t really have a lot of those opportunities. They were always available via phone call or email.

But just to have those daily interactions, I think, ⁓ you know, we’ve come a really long way now having centers that we have multiple BCBAs and the team is all there and present. ⁓ And so I think that that has also really changed the dynamic. think too, when you came along, I don’t think our BT wasn’t a thing yet, then either was at the credential. So when, when the BCBA was in the center, I mean, all of their time was spent around.

really working and training with the ABA therapists because that was their only way to get training at the time. And so there just wasn’t, you know, always the time to check in with the other disciplines and kind of do all that. Unfortunately. And, you know, you mentioned social media and I think that for sure, but also along the lines of technology in general, ⁓ you know, we, go back to the ancient days where we had the note cards and the recipe boxes of where you were running ABA programs. And so it just took a lot of manpower for the BCBA, think, to manage those programs early on and

there wasn’t any way for the OT, I we would have to physically go in and pull the actual paper program to look at it, whereas now we can do that electronically and we can see the goals that they’re working on ⁓ for collaboration. But I think that it just kind of fell to the bottom of the list because ⁓ there was just so much more, it took so much more manpower because there were just so few BCBAs at the time.

Taylor (04:28)
Yeah, and I had actually forgotten about the fact that we didn’t have BCBAs on site every day. So you’re right, it was like the ABA therapist just working directly with those OTs or, you know, species that were on site. So I had completely forgotten about that. It’s been such a long time. ⁓ But yeah, that’s a good call out. And I think too, One of the other things that I’ve seen kind of evolve over time is that in the past, we were so new to working together that

Haley (04:33)
Yeah.

it.

Taylor (04:55)
⁓ some of our language differences really caused a barrier between the disciplines. And I think we’ve done a really good job of merging. Like you say this and I say this, but what we’re actually talking about is the same thing. Or I used to hear a lot of, well, that’s an OT thing. I’m not allowed to do that. And it’s like, actually it’s functional play skills or it’s, you know, we can incorporate that. And so now I’m seeing a lot more collaboration too with like just the language kind of merging so that we’re able to kind of talk the same language and communicate better together.

Haley (05:25)
Yeah, for sure. think that has definitely helped. ⁓ Which kind of leads us into, think, our next question.

Taylor (05:32)
Yeah, so

this one is what are some misconceptions held between BCBAs and OTs and how have they evolved over time?

Haley (05:35)
Yeah.

Yeah, so you, you you mentioned the language as being one of them and the terminology and that I think has been a big misconception and that we just didn’t always understand that we were sometimes talking about the same things. We just called them differently. ⁓

I think for me as an OT looking at ABA sessions, there are times when early on, especially it looked like we were just watching a lot of discrete trial training and it looked like they were just running a bunch of trials and we weren’t really understanding what they were doing. ⁓

in understanding the framework that the ABA is based upon. And for BCBAs, think then they were kind of looking at OT like, what goals are you really working on? You look like you’re kind of just playing and you’re letting the kids just pick what they want to do. ⁓ And so really just understanding, I think, each other’s ⁓ frame of reference and our framework and understanding how we are both usually working on the same things. just our treatment sessions look very different. ⁓

from each other, but once we kind of understand that, then we can see where overall OT and ABA is very complimentary of each other. Even though they look very different, they still compliment each other, which is, you know, just as only going to help the child and increase those outcomes.

Taylor (06:51)
Yeah, I would not agree more. And I think to Partnering with your OTs on like, even asking what goals they’re working on, I know that seems like so simple, but just asking like, hey, what are you working right now on in that session? And to come to find out like we’ve been working on the same thing or maybe they’re working on something that I was like, oh, I hadn’t even thought about addressing that skill with them. And then we can kind of hit it from two different places is so helpful. And I feel like, you know,

Kind of goes back to the last question, but that has kind of evolved over time too. Like I want to know what you’re working on. Like what are your goals? I think the other thing too, and now we’re talking about misconceptions, but ⁓ there’s this like this big word of like behavior, right? And it’s like ABA, we have to focus on behavior. And then with OT, speech and PT, maladaptive behaviors can be a significant barrier to those sessions. And so,

Haley (07:35)
Yes.

Absolutely.

Taylor (07:45)
learning how we can support those OTs and those SLPs and PTs to reduce challenging behavior because maybe you can kind of explain that to us a bit, but if that becomes too big of a barrier, what happens to those kiddos that are getting those services? Because it’s different from what we would experience in ABA usually. So can you walk me through that? Because I think that might be helpful for some of our VCDAs too.

Haley (08:08)
Yeah, of course. And that’s where like, you we love our VCBAs and their areas of expertise and helping with that. That was actually what kind of sparked my interest in even going back once I became an OT to go back and to become a VCBA as well, just for that knowledge of like, wow, like they’re really able to work through that. And I was really having some hard challenges with like, I, know, as OTs, we come up with all these great ideas and we love to be creative and all these interventions. ⁓ but when, the child comes in and they don’t want to do that. ⁓ you know, you sometimes, and especially as an early clinician, you get stuck like, okay, now.

I’m trying to pull out all these things and they’re having a maladaptive behavior. And so I got to figure out how to address that because we’re never going to get to our goals if we don’t address that root cause first. And so really using the BCBAs to see what is the function of their behavior. And you guys have always done a great job of being able to figure that out and explain. And then we can really dig down to, if this is the function of behavior, then how can we help meet those needs? ⁓ Because if we can’t get through that, then we’re never going to be able to work on increasing self-care skills or fine motor skills.

So, you know, it’s just so crucial, I think, to have that someone come in with the behavior lens to help us get through those barriers. ⁓ Because if not, then, you know, we’re not able to really even make any impact in our treatment sessions.

Taylor (09:21)
Yeah, so it’s not that like OTs don’t want to deal with challenging behaviors. It’s like if you are spending so much time dealing with those things that you can’t get to your goals, then you could lose that authorization, right? Or like you won’t be able to bill for that. And so I think that kind of falls into those misconceptions sometimes is that OTs don’t want to work with challenging behaviors. It’s not that at all, right? It’s just like you guys have really specific outcome data to report on for what you did during that session. And if behaviors or maladaptive behaviors are

Haley (09:31)
Yeah.

Taylor (09:50)
causing a barrier to that, then you guys are at risk for losing authorization for that kiddo.

Haley (09:55)
Yeah, absolutely.

you know, as BCBAs, you guys are so good at analyzing, you know, the behavior where we’re like, we’ll try this and we’ll try that and we’ll try this and we try all these things and then when they don’t work, it’s like, don’t, you know, now what? ⁓ And so really having that lens of you guys coming in and going through a full functional analysis and determining that function of behavior just really will help us go so much further in our treatment sessions.

Taylor (10:07)
Yeah.

Yeah.

Haley (10:19)
So Taylor, what advice would you give a parent just starting their journey with OT and ABA?

Taylor (10:23)
⁓ that’s a good one. I think I would say like eat up every bit of time that they’re going to give you. So ⁓ I’m a pretty nosy parent. And I would say that I would probably advise any parent with a kiddo in treatment to be a nosy parent too ask like, what are the goals that they’re working on this week? What things can I work on in the home? What information do you need from me? ⁓ Are you having any barriers? And start asking some of those questions because

You know, it could very much be that like kiddos not eating their lunch and then they’re tired the rest of the day. And I have to say, you have to warm it up just like this. Or they actually will only drink it if you fill it up 20 percent juice and 80 percent water, you know, like little things like that. ⁓ Or same thing with like, let’s say that they, you know, the the OT created some goals for them. And I say, ⁓ well, at home, they can actually already do that. So I wonder if, you know, kiddo didn’t, you know, just wasn’t compliant during that time or whatever. So.

I would say just like communicate as much as you possibly can with your BCBA and with your OT and find a system of communication that works for you. That way you can you know what’s going on and how to implement those things. Because that’s as clinician like that’s our goal. Right. Is that everything that that kid learns at our center. We don’t just want them to be successful here. We want them to take that home into school and a grandparents house. And so we really need parent buy in to implement those things because that’s the whole point.

Right, like we need them to be able to do those things at home. So that would be my biggest thing is like, get nosy, get involved, find out, communicate with your BCBA and OT about what’s going on and what their barriers are so that we can all work together. What would you say for that one?

Haley (11:49)
Yeah.

Yeah. ⁓

Absolutely, I think right of line with that. you you are the as a parent, you are the expert in your child. And so don’t forget that. And it’s OK to ask a lot of questions. You know, we try really hard not to use our our professional terminology when we’re speaking to parents, but it is kind of like our second language. And so it does sometimes slip out. And sometimes I forget like, I haven’t even really explained that to a parent yet. So please like reach out and say, you know, what did you mean when you said that you provided proprioceptive input to my child and how did that help regulate them? You know, ask those questions.

Taylor (12:08)
Yeah.

Haley (12:31)
you know, just as you were saying, so that you can understand and that we can get that carryover into home. And there’s a lot of times where we’ll see very different behaviors in the center versus in the home. And sometimes it’s better and sometimes they’re not. ⁓ And so I think understanding that, you know, sometimes we bring in the family and because they’ll say, they’ll never do that at home. And then we bring them in and they’re like, wow, I didn’t know they could do all those things, you know. And that’s our whole goal is that we want them to be able, like you said, to do those ⁓ in their natural environments. I think Another big thing for parents is to really think about

when you’re talking about setting goals for your child, ⁓ what is really meaningful and going to make the most impact on you and your family? I think sometimes we can get caught up in like, well, they can do this skill and they can do that skill. So then this would be the next skill that we would work on. But is that really going to make an impact for you or for your child? You know, take

let’s say shoe tying, example, if your child is fine with the shoes that they’re wearing and they don’t want a different kind of shoe that does tie or there’s a lot of adaptive shoelaces now that are kind of like the zigzaggy ones that you don’t have to tie, know, then maybe you don’t want to spend your time and your effort working on shoe tying right now. Like maybe it would be more meaningful for you to work on sequencing tasks. like it would, it would be much more impactful for the child to, if the mom can lay out clothes and just say, like get dressed in the morning and the child’s able to sequence those steps and get dressed independently, that would be

increasing their independence, it would give mom time to maybe pack lunches or whatever you know she needs to do in the morning too and so that may be more beneficial than you know teaching them to tie their shoes right in the moment. So I think just always thinking about like what are your barriers in the home and what would make the biggest impact when you look at setting your goals.

Taylor (14:08)
Yeah, I love that. And it goes right along with ⁓ my thought process. And I say this all the time, but like I grew up in an autism home. So I didn’t know any different. My older brother is autistic. And so I didn’t realize until I moved out all of the mollifications that we had kind of set up in our home, just as an autism home, right? And so sometimes when I’m talking to parents and I’m asking them questions on an assessment, their answer will be like, no, actually that’s not a problem at our house. And then I give examples of

For example, let’s say, do you have to take the exact same route to therapy every single day and what would happen if you took a different route to therapy? And they’re like, that would not be good. Like, okay, then that is, if you can’t stop and grab a Starbucks on the way, or if you can’t stop at the drug store and pick up something that you need on the way to therapy, and you have to drop the kiddo off first because you can’t alter your route, then that would be what a term, we talked about terminology too, but it’s like a mollification, right? ⁓

Haley (14:45)
you

Taylor (15:05)
I think too, being honest with your clinicians, like you said, about the things that are really impactful to your family. And maybe you’re more than happy to make those changes for your kiddo. And I think that’s wonderful. But I also think about like sometimes that road is just gonna be closed. And so you’re gonna have to take a different route and what happens when life happens, you know? So I think like exactly what you were talking about, be honest about like, I need this kiddo to be able to do this.

Haley (15:06)
Thank

Thank

Thank you.

Taylor (15:32)
We need to be able to eat at other times of the night instead of just 6 o’clock or 6 o’3 exactly because life happens and so we need to know those things as well in both disciplines so we can help prepare your child for for when real life things happen, right?

Haley (15:47)
Yeah, absolutely.

Taylor (15:50)
Okay, here’s our next one. Tell me about a moment that proved the impact of interdisciplinary care.

Haley (15:56)
Well, I do really love that question because that’s really at the heart of what we do as clinicians and why we do what we do is because we love to see that impact and we love to see that progress and the increase in dependence for the child and the family. I think if you

take every day as a treating therapist, you can see those little moments in every single day. You know, if that’s what you’re really looking for, when you have a really good, strong, cohesive team that’s working together, you see how that is impacting the outcomes of the child in their everyday ⁓ therapy sessions. But for those big moments that really kind of stand out to me ⁓ are always really around the feeding. think that, you know, I think about a kid that I’ve worked with that’s had very, very severe food aversions, and I wasn’t going to be able to make a lot of progress in

alone doing that, for an hour session, one or two times a week. ⁓ But because I was able to work with the BCBA and because I was able to work with a speech therapist, we were able to come up with a comprehensive plan that could be carried out five days a week. You know, and so we could use that time when they were there five days a week in ABA to work on decent, some of those desensitization strategies and, you know, increasing textures and not just with foods, but just with all kinds of different items at first backing it way down where they were exposed to multiple things throughout their day and building up

to where then they were playing in foods, you know, because this poor little kid, he was gagging anytime he would even just look at a food. And so, ⁓ you know, we had that exposure every day when they were in ABA, they were able to build that into their program to where then ⁓ that really made a huge impact when it came time to then presenting different foods and textures. And they were able to present those foods and textures during his lunchtime every day in when they were coming in for ABA. then speech came in and said, OK, we also have some oral motor weakness. And so how are we going to address that? And here’s some exercises and, you ABA.

was able to add some of those into the program as imitation, ⁓ you know, just to work through strengthening those oral motor skills that will also help play into feeding. so, you know, and I think about then him being able to add additional foods into his diet and just really increase the nutrition that he, ⁓ you know, was receiving was a huge impact on the family and that kiddo, but that I would not have been able to ever even come close to getting that as an OT by myself.

Taylor (18:11)
that’s a good like call out for like what’s a barrier that OT would have and it’s like time with the kiddo but then we have ABA services who we could have 35 hours a week opportunity and so without that like cross collaboration you would have only gotten like an hour a week of feeding therapy so you’re right like that’s a great way to look at like a barrier from from your perspective but then like a strength in another discipline love it when we’re able to make that work. I was when I was looking over these questions I have like a one really specific

awesome memory with this kiddo. And it was one of my like kiddos that engaged in really severe challenging behavior. And I was working with SLP on ⁓ language options, know, modality options. And I was working with, you know, pecs and we were making very minimal progress. ⁓ One or two vocal mans without, you know, kind of without proms. So we were able to try all the lamp device with this kiddo. And

I still remember it vividly and I have a really bad memory. So this is how impactful this moment was. I remember exactly where we were in the center. And I presented this lamp device and I modeled a couple of trials for him. And his face just lit up and he just started going to town. And so I opened it up for like full board. was like, he just wants to explore. And he spent 10 to 15 minutes just looking at all the buttons. And he’d like, look at me like, oh my gosh, I know that word. That’s great.

And a couple of he had it for like an hour a day for a couple of days. And then he came in one morning and it had been snowing and it wasn’t snowing that day. And he came in and he was trying to talk to us about something and tell us. And we just didn’t understand. He kept pointing at our center manager and he finally got his device and he found the person and then he found shovel and he walked up to them and he put a whole sentence together of where’s your shovel? And he was just like every day that week that

Haley (19:55)
Thanks.

Taylor (20:00)
person had been out there shoveling. And so he got there at therapy and he’s like, where’s your shovel today, dude? And I was just like so proud of him. The fact that we just needed to find the right tool and without working with our SLP, without being able to like trial this kiddo with an AAC device, he would never have been able to tell us that. And it just like the way that it impacted his, his overall like affect throughout the day, he was so excited to get that device because he could finally communicate with us. And so I think like,

Haley (20:16)
and ⁓

Taylor (20:29)
You’re right, feeding is impactful. think so many times about like AAC devices and those kinds of things that we can only get from working with our SLPs and just how life-changing they are for our kiddos and the families and everybody working with these kids.

Haley (20:41)
⁓ dear.

Yeah, I agree. You know, the when you unlock that communication piece for a child, ⁓ you know, that is just it is, you know, it’s amazing to witness and just to feel that you are, ⁓ you know, making that impact for that child that they have that all inside of them and they just didn’t have a way to get that out and to give them that tool to be able to do that. ⁓ You know, you couldn’t be more happier for the family and for the child when they’re able to do that. Sometimes, you know, we we we’ll have a child that will start to learn how to say like not now.

or I don’t want to or whatever and we celebrate those really, you ⁓ that’s so great because they’re able to communicate to us right now that they don’t like something and they don’t want it and they’re able to, you know, whether that’s verbally or through a device. And so we do love to celebrate all of those moments. You know, we think, I think about the first time that a mom has come in and said, you know, my child said, love you, you know, in just those simple words that they haven’t ever got to hear before. ⁓ But that just, you know.

Taylor (21:17)
Good for you.

Haley (21:41)
there’s nothing really quite like those experiences when the child can start communicating and telling you things that they’ve always had inside and wanted to tell and just haven’t been able to do that.

Taylor (21:50)
Yeah,

that’s right.

Haley (21:52)
So Taylor, tell me what is one thing you wish every OT understood about your role and practice?

Taylor (21:59)
the fact that we have to figure out like motivation and we have to figure out what is causing this behavior to continue to happen, right? So we have motivation for something, we engage in a behavior, whether it be what we would deem as like good or negative behavior or challenging behavior.

it’s been serving a function for this kiddo, right? And so we have to replace that challenging behavior. And so we can set up anesthetic strategies and oftentimes we need to, but our goal is not to get this kiddo to a point where they just rely on anesthetic strategies, right? We have to be able to replace those challenging behaviors. Usually, or always with some kind of skill, whether the skill is like functional communication,

or the skill is ⁓ some kind of contextually appropriate behavior, which is essentially like instead of engaging and throwing the toy at your head, I will play with the toy functionally because now I understand how to play with it or I’ll tolerate giving it back to you and that’s the contextually appropriate behavior like when you ask it to. So, and I haven’t experienced, ⁓ you know, OTs that don’t understand that process, but I think it’s, it takes a little bit of time to.

assess those challenging behaviors and then figure out what’s motivating the child and what’s reinforcing those behaviors and the fact that it takes a lot of time. mean, sometimes these kiddos have been reinforced with these challenging behaviors for six or seven years because they haven’t had another way to do it, you know. So it takes a bit of time for us to kind of plug in. We need to implement this functional communication. Not we can’t, you know, just rely on token boards or visual schedules to kind of solve

⁓ the problems for our kiddos. And like I said, every OT that I’ve worked with has been really great about that. But it just takes us some time to figure out what tools are going to work with that kiddo. So that’s probably the biggest thing I would say is that sometimes we forget the process of like, we have to assess first and then we have to start with functional communication treatment and then we have to build in contextually appropriate behavior. And really before it can generalize, we have to master it within like a certain set of people first.

before that kiddo will start to show that into other spaces. So I think sometimes we can incorporate other things into OT and other times we’re like, hang on, just like another week, we can push it out into OT. Language is always like, yes, please use their method of communication, which our OTs are always more than happy to do. But some of the other pieces we’ll like hold on to a little bit because we wanna make sure that it’s really strong and that the protocol has been implemented really well before we try to

Haley (24:22)
Okay.

Taylor (24:42)
you know, push that out to other providers. So that’s the only thing I can think of is just like how systematize our processes and, you know, communicating where we are in that process. What are your thoughts on that?

Haley (24:48)
Thank

Yeah, and

I think, you know, OTs, that’s where we get, you know, because you guys are so good at being systematic in your approach and we are like, you know, OTs are doers and we’re like, let’s do this. we see that it works and we want to keep doing it. And so sometimes patience is not our strong suit because we’re like, well, it’s working in ABA. Like, let’s do it. You know, why are we doing it in OT too? And so, but I think once I understand

frame of reference that, you we really want to make sure we have solid program in place so that we aren’t doing it too soon and that we know exactly anything that could come up and how we are responding to those situations. And, you know, before we try to generalize it into a different discipline and across a different person, because as we know, you know, as soon as it switches sometimes to a different person, it goes kind of back to square one. And so that’s, you know, you got to have a strong foundation before you get ready to do that. And so just making sure that ⁓ OTs understand that that’s, you

why they have to be patient and wait a little bit before it gets generalized across other disciplines. ⁓

Taylor (25:52)
I

guess the only other thing that comes to mind here is like, want to implement a lot of the ⁓ OT recommendations for like, in your words, it would be some kind of like sensory input, right? But if we put the words like sensory input on some of our notes, it’s going to be like, heck no, that is not an ABA term. That’s not something you can bill for. And so we have to get really strategic about like, hear you and I definitely want to implement this in the session. have to figure out.

Haley (26:05)
Mm-hmm.

Taylor (26:18)
how I can provide this for this kiddo and it align with our POC goals the same way that like OT and speech would have that same dilemma, right? And so I think sometimes too, it’s not that I don’t want to implement this or sometimes it’s like the OT says, you used this word earlier, you should provide proprioceptive input at this many minutes every hour. And our RBTs are like, that sounds great. I have no idea what that means because they haven’t been in this field for a long time.

we’ll have to really break that down. Tell me exactly what that looks like and what do you mean? What are the activities I could implement? And I can get those added to rethink in that program. But it really has to go clinician to clinician so that we can break it down and put it in our data collection systems and our program so that it can be implemented and be considered an approved ABA activity. How can we implement this with man trials? How can we implement this with

Haley (27:10)
Sure.

Taylor (27:13)
some other things, so I think that would be the only other thing that comes to mind is like again, we have to align with language and we have to align with what OTs are allowed to do and what ABAs are allowed to do and how can we mix that and kind of work together and make sure that the kiddo is getting everything that they need but that both disciplines are kind of staying within their scope and making sure that it aligns with the hours that we requested for that kiddo, for that discipline.

Haley (27:23)
and

Yeah, for sure. And that also kind of just got me thinking, ⁓ how do you explain an FBA to an OT or speech therapist? Because I know a lot of times we, ⁓ know, OT and speech are like, well, you’re trying to make them have a behavior. Like, why would you do that? We, you know, we already think we know why they have that behavior. Like they do that when they get hungry or they do that when, you know, they get overstimulated. ⁓ And so how do you kind of explain that process to OTs and speech therapists?

Taylor (28:05)
Yeah, so an FBA or a functional behavior assessment is what we do or should do before we implement a behavior intervention, right? So in an FBA, we are trying to determine what turns this behavior on and also what turns this behavior off. And sometimes we have to wait until we get really strong answers. There are some things that we can do regardless of whether we have a really strong answer for that. But ultimately, it is part of our ethics code that we must be able to determine what is the root cause or

the root reinforcer for these challenging behaviors before I ever try to change the behavior. So I have to understand it before I change it or try to change it. Now, obviously that can get really tricky if I’m also trying to keep everybody safe, right? And I’m trying to provide, you know, dignified services as always, right? We want any person to kind of walk in and say like, I’m proud of what I’m seeing, right? We want them to feel good about what they’re seeing.

But we will oftentimes, and we’ve changed this over time, and Haley, this could be hour long conversation with me about how we’ve changed in our practices because 10 years ago I would have told you I definitely don’t wanna do a functional assessment on a kiddo because of all the barriers associated to that. Today I will tell you, yes, let’s do a functional assessment, let’s do an ISCA. ⁓ And that’s a big long acronym that basically says

Haley (29:09)
Thank

Taylor (29:28)
I can turn on really quick precursor behaviors and it could be as subtle as like a kiddo putting their hand up to tell me to stop or them turning their body away. And I can reinforce that behavior at the precursor so that kiddo is never getting really upset. So we can we have better tools now. I can implement that assessment. We can be done in like seven or eight minutes and I can continue writing that plan and finish it up. And then I’m ready to implement an intervention. Right. So I think like

Haley (29:57)
and

Taylor (29:58)
in explaining a functional behavior assessment, I have to be able to turn the behavior on, I have to be able to turn it off, and I need to be able to keep everybody safe and maintain a really good relationship with a child throughout that time. And once we’ve been able to do that, then I write a plan based on those results, right? So it does take some time especially to do it well and to do it safely, which are our top priorities that and maintaining dignity, and then obviously like maintaining that relationship with that child, but.

Haley (30:00)
Thank

Taylor (30:25)
it does take time for us to be able to do that. And sometimes it’s like multiple BCBAs getting together to design that specific assessment for that kiddo. But if we just jump right in and we start treating that challenging behavior without having done that assessment, for one, it’s unethical, but for two, we’re kind of just throwing the book at it, right? It would be like you going into a doctor’s appointment and saying like, hey, my back hurts. And the doctor’s like, okay, well, how about you do yoga?

and then I want you to take two aspirin two times a day, and then I want you, and he gives you like 10 different things to do, and then you come back and you’re like, hey, it’s not any better, or it is better, and he’s like, okay, great, just continue all 10 of those things now for the rest of your life, because your back no longer hurts, right? Like it, you don’t know like what it was. Was it just the Advil? Was it the yoga? Like what was it that fixed my back pain? And because we like threw the book at it and didn’t really figure out what it was,

Haley (30:55)
Thank

Thank you.

Taylor (31:24)
Now you don’t know what to keep doing. Does that make sense?

Haley (31:27)
Yes, that was very helpful. Thank you.

Taylor (31:30)
Yeah.

Okay, what is one thing you wish every BCBA understood about your role in practice?

Haley (31:37)
so this is another tough one. think, you know, BCBAs are really good at, like we talked about, relying on those objective measures and those systematic processes And OTs really kind of tend to emphasize more on outcomes in natural environments and natural settings. so ⁓ BCBAs have always been rooted in that evidence-based practice.

and OTs are getting there, right? Like that’s not where we really started. And that I know just because of the way that BCBAs are trained and the way that they think that’s usually their first go-to, right? Is what does the evidence say around this? And so especially when we talk about sensory processing, we don’t have a ton of those peer review journals to go back on compared to the literature that you can find when you’re working in BCBAs. And so I think sometimes that.

can cause just a like, well, you don’t have the evidence-based practice, you know, to support this intervention. And so not really open to some of those conversations and communication around like, well, this is why I’m trying to understand and seeing what the literature that we do have says and why it’s really not always cohesive and, you know, including all the information that that may be found when you do ⁓ research in an ABA setting.

We want to work together as a team. We want to understand your area of expertise and your framework and how you look through your lens when treating the child. And then we also would want you to do the same ⁓ for us to understand how we look through the lens, because I think at the end of the day, ⁓

you know, all we want to see is this is the child gain independence and make these impactful income outcomes for the family and the child. And so we’re all working towards the same goal. We’re just doing about it very differently. And there are things that we can, you know, mesh a little bit. And then there are also things that we have to kind of stay on our own lanes and say, this is under a VCEI code of ethics and this is under our OT code of ethics.

you know, but we’re still working together for that same outcome. And so I think just communication is just such a big piece of this that when you don’t understand what they’re doing to just ask like, hey, why are you doing this? Or what are you working on with this skill or what goal is being addressed so that we can just continue to understand each other’s professions.

Taylor (33:51)
Yeah, I think that sometimes when like OTs and ABAs talk, that’s where we get stuck. And then we can’t move past it. It’s like this conversation around ⁓ evidence-based practices. So I love that you talked about it and said like, we’re getting there, we’re moving in that direction. I think other things that we can do is like, we can collect good data, right? Like we can add really strict ⁓ recommendations and protocols in place and we can check.

Haley (33:58)
Mm-hmm.

and

Taylor (34:17)
to make sure that the protocols were done correctly and then we can take good data on those things. And then we can make more informed decisions on like, the OT recommended this, ⁓ we’ve implemented this on the data and we’ve done this for lots of grand rounds. Kiddo, the data indicate that it didn’t make a difference on the child’s behavior or on their attention. And so then we can kind of come back to the drawing board together and collaborate a little bit more. So.

I think it’s good that we kind of address that, like the elephant in the room, but also say like, we still have data. Like there are still ways that we can collect meaningful data. And I was reading an article, been reading a bunch of articles lately about cross collaboration. And that was one of the main things they were talking about, is like, write really strict protocols, check treatment integrity, and then look at the outcome data. Make sure your data are accurate, obviously.

Haley (34:45)
it

Thank

Taylor (35:06)
and then review them and then have a conversation about like it was impactful and it was meaningful and considered successful or it wasn’t. all everybody needs to agree on what a success look like for that child, know, which, you know, like you said, we all just want this child to succeed. So we need to have the same idea in mind too about what does that look like?

Haley (35:14)
Mm-hmm.

Yeah, that’s a really great ⁓ point, Taylor. BCBs are such good, you guys are so good at collecting data. And we, as OTs, think can rely on that data to see, ⁓ so that we can analyze that and make informed decisions.

Well, Taylor, thank you for this. think we’ve had a really great conversation today about OT and BCBA collaboration. I like that we, like I said, shared that experience of starting out together early on and thinking about how things were.

how many years ago that was and how far we have come from both professions to grow individually and then together as a team and really leaning on each other. I think back then we would have been a little shocked to think that there would be a day when BCBAs would come to OTs and say, hey, I need some sensory strategies for this. And the same, the OTs would come to BCBAs and say, hey, we’re having these maladaptive behaviors and I can’t get through my sessions. Can you help me? And so we are really respecting each other’s disciplines and relying on each other’s.

expertise and I think you know it just makes me more excited for the future to see where this this goes with collaboration between multiple disciplines.

Taylor (36:37)
Yeah, same thing. I I’ve really enjoyed our time today. And honestly, when they asked, you know, for us to talk, I was like, this is great. Haley and I have worked together for literally over a decade, not to age both of us. But and it’s just been wonderful to work alongside you. So really glad we were able to spend this time today as we wrap up. I think like for me, some high points of our conversation today. Number one, I loved like the I’m a BCDA at heart. So data like data driven decisions, data driven collaboration.

And really, I think one of the other themes for today was communication. If they kept track of how many times we said that today, it was probably a ton. We need to increase communication and we need to attempt to understand each other and ⁓ what your goals are, specifically your POC goals. What are the goals for each of your session? What does success look like? And then communicate those things. And then we also need to just problem solve together. These are the barriers that I’m having.

Have you been experiencing that? How are you overcoming that? ⁓ And then just take good data, right? Be kind and take good data, as one of my previous mentors always shared. So thank you so much. I’m glad we got to spend this time together. It was great.

Haley (37:47)
Yes, me too. Thanks, Taylor.

 

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