Building Bridges | Episode 1: The Family Experience at Hopebridge

Hopebridge Experts Connect over Varying Perspectives of Family Guidance in ABA

In this episode, you’ll learn about the pivotal role that caregivers play in autism care. Join Meg Moore, BCBA & Clinical Training Director, and Ruth Bernstein, Director of Psychological Services, as they share insights on the family experience at Hopebridge, from diagnosis to therapy.

Meg and Ruth share their advice for families just getting started in their autism journey, debunk common misconceptions about ABA therapy & autism, and celebrate what makes working with families special. Discover how Hopebridge empowers caregivers to collaboratively work with their child’s care team by guiding therapy goals to fit their family’s lifestyle and bridging the gap between therapy and everyday life for their child.

In addition to Applied Behavior Analysis (ABA) therapy for children, Hopebridge offers parent support and training every step of the way. Tune in to learn why families are the cornerstone of successful, individualized autism treatment.

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Dive into the Full Transcript

Meg Moore (00:21)

Hi, I’m Meg Moore. I’m a BCBA and our clinical training director here at Hopebridge.

 

Ruth Bernstein (00:26)

Hi, I’m Ruth Bernstein. I’m a licensed psychologist and the director of psychological services here at Hopebridge. And we are here to talk about the family experience at Hopebridge.

 

Meg Moore (00:36)

Okay, so I have an icebreaker for us. We are going to try and describe our roles in 10 seconds flat. So we’re gonna time each other. I’ll go first. So if you wanna time me, get your timer going, 10 seconds, I will try and describe my role. So you tell me when to go.

Okay, so I’m the clinical training director. I create trainings and provide resources to our BCBA and our RBT staff to further develop their clinical skills. Okay, perfect. Let me get my timer ready for you.

 

Ruth Bernstein (01:10)

That’s so hard.

 

Meg Moore (01:12)

It is so hard. Okay, ready, set, go.

 

Ruth Bernstein (01:16)

Okay, I’m the director of psychological services. I essentially try to create our system to be able to diagnose as many children as humanly possible as quickly as possible.

 

Meg Moore (01:29)

That was good, though! So I work on training.

 

Ruth Bernstein (01:32)

I like I started speaking so fast.

 

Meg Moore (01:32)

Yeah, you kind of do our diagnostics and really set our families up for success. And I think that leads us really nicely into the bulk of our conversation, which is about the family experience here at Hopebridge.

 

Ruth Bernstein (01:47)

Absolutely.

 

Meg Moore (01:48)

All right, I’m going to kick us off, Ruth, with our first question. This one’s for you. So what should caregivers expect when it comes to getting a diagnosis?

 

Ruth Bernstein (01:57)

Unfortunately, families often spend a long time waiting for an evaluation. Here, it’s actually part of our mission to make that waiting time as short as possible. If a kiddo needs intervention, it’s really important to get that started as quickly as possible and not have them sitting on a wait list. So we’re pretty driven to get that wait time as short as possible.

So things to know, the evaluation can happen in person or through telehealth. I think a lot of families expect in person. That’s kind of what they’re used to hearing about. I will say that telehealth can actually be so much more comfortable, especially for the kiddo because they’re in their own home. You know, it’s an environment they’re used to and they’re comfortable in.

But for the evaluation, parents are going to be asked a lot of questions. Probably more questions than they thought possible. But I think the assessments with the kiddo tend to be the part that can be a little more nerve wracking and parents don’t really know what to expect. But we actually try really hard to make the process as fun as possible for the kiddos. We know we’ve done our job well if they actually have no idea they’re being tested. So they’re all play based, there’s no prep involved if there are any materials that we need, we’ll let you know ahead of time. But you don’t have to do anything in advance. If you are doing telehealth, you don’t have to clean your house. We understand what a home with children looks like. And we’re just grateful that you’re allowing us to do this.  If they’re in person, we play with the kiddos and we may ask the caregivers to engage as well, but we may not.

I personally think as a caregiver, watching the assessment and not intervening is one of the hardest parts, which again makes telehealth a little bit easier in that we just kind of guide the caregiver through activities with their kiddo, which admittedly can also feel awkward. I’m sure you probably don’t often have an adult telling you how to play with your child. It’s strange, I know.  But I think one thing that’s just really helpful for parents to know ahead of time is that we do understand children

are young, they can fatigue quickly and as much as we want this to be a good experience, it’s not the most fun thing for every kid. So we try to get a really good picture and a good representation of the child. But if we take too long, that’s not going to happen. So our tests are actually a lot faster than people think. And I think that can throw people off. They think that this process is going to take a long time. But telehealth, especially is actually really fast. The kiddos in their own home, they’re interacting with you, someone they know, someone they’re comfortable with. So it’s actually much quicker to get a really good picture of what we need to see. And in-person can actually take longer and be a little more uncomfortable, although, hey, we introduced a whole bunch of new fun toys. That can be great. But in general, as an industry, we’ve gotten faster. Tests have gotten shorter. And I think that can be really disorienting when caregivers are expecting something different.

Meg Moore (05:05)

And it sounds like at Hopebridge, we have quite a few options as well. You we have the option that’s going to suit the family best and in both avenues. The priority is that the family’s comfortable and that the child is comfortable and that they don’t know that they’re being tested.

 

Ruth Bernstein (05:06)

Absolutely. That’s why we love the play-based assessments so much. mean, really, imagine, you you bring your kiddo in and they get a whole bunch of new toys that they’re introduced to and somebody just wants to play with them. It’s great. And they should feel like it’s a really fun time and not feel like it’s a test. That’s not, that’s not at all what we want. And we want to see them as they truly are, as they naturally are. And if they know they’re being tested, that’s not what we’re going to get.

 

Meg Moore (05:52)

Definitely.

 

Ruth Bernstein (05:53)

So after that’s done, think that’s the other part parents can get a little nervous about. They’re not really sure what that looks like. Here, we let parents know as soon as the evaluation is done, whether or not their child meets criteria for autism. So they will leave the evaluation knowing the results. That can just be, you know, waiting for results is so stressful. And, you know, we don’t want to put anyone through any unnecessary stress. So

 

Meg Moore (06:11)

Yeah, yeah.

 

Ruth Bernstein (06:20)

We go ahead and give them the results. We let them know recommendations for next steps, you know, for so many families. They’re just, they’re just wanting help for their kiddo and they want to know what that is. And we want to be able to get them started with that as quickly as possible. So we let them know that right away,  which can include various types of therapy, but we also try to give families some, you know, tips and tricks and techniques that they can go ahead and start doing at home with their kiddo right away.

 

Meg Moore (06:50)

So they leave the appointment with your team with an answer and a plan, essentially.

 

Ruth Bernstein (06:57)

Exactly. Yeah.

 

Meg Moore (06:58)

That must be so comforting to them.

 

Ruth Bernstein (07:01)

I hope so. That’s certainly what we’re shooting for. So I do hope that that’s the experience that they have. Yeah, we want them to have, you know, an idea of where they go from here. You know, I never want a family to leave an evaluation thinking, now what? You know, that’s that’s the worst thing I can imagine for them.

 

Meg Moore (07:05)

Definitely.

 

Ruth Bernstein (07:20)

Okay, so thinking about those next steps, what should families expect when getting started with therapy?

 

Meg Moore (07:29)

So very similarly to your experience, our priority is that the family and the child feel comfortable. So they have had a lot of information, they’ve had a lot of conversations, and so rather than throwing more at them, what we want to do is just get to know them, get to know them, get to know the child, get to know what matters to them. And then we also help them understand what ABA therapy is. We walk them through the conversations of identifying where they want to see their family and child grow and succeed. Our families are talked at quite a bit before they get to us. They’re told what’s important. They’re told where their child should be. So we flip that script here at Hopebridge and we really allow them to drive that conversation and tell us what matters, tell us where they want to see their child. And then from the information we gain from them, we collaboratively create a plan there.

 

Ruth Bernstein (08:27)

And I love that. I feel like that’s, you know, one of those things that I hear from families, even during the diagnostic process of, know, they have, they have a lot of pieces that they have to kind of orient themselves to. There’s so much going on and they do have a lot of people kind of telling them, this is what you should be doing, you know, and even us, I mean, we tell them, hey, this is your, these are your next steps. And we definitely want that to be helpful, but I love hearing that they come into therapy and now.

This is their opportunity to really direct and really say, hey, this is what’s important for our family. This is what we see as important for our kiddo. I can’t imagine how good that feels for them having gone through this whole process and now they get to be in charge.

 

Meg Moore (09:15)

Definitely. And we want to take a little bit of the wind out of the sails of the situation as well. You know, they have been on a very oftentimes quick escalated stressful path to our care. And so rather than them going into another treatment room, having another conversation about, you know, as I mentioned earlier, where they should go where they should be just sitting down and bringing the human into the room and just saying like, I’m a human, you’re a human. Let’s talk about what matters to you. Let’s level set. Let’s get on the same page and get a game plan going. It’s very much so the beginning of a team, building a team rather than walking into the room and saying, okay, I’m the next clinician you’re going to talk to. I’m going to tell you what you’re going to do next. It’s very much so, hey, I’m your new team member. Let’s sit down and talk about how we’re gonna work together. You help me understand where you want to go and I help you get there. So again, setting that expectation of I’m not just here to tell you what to do, I’m here to help you help you. I’m here to be the person on your team that guides you to do the things that you and your family want to do and what to achieve.

 

Ruth Bernstein (10:34)

I’m sure that’s also so comforting for the child who I, excuse me, I understand, you know, the the parent is really kind of the one in charge and going through this whole process. But for the kiddo, it’s not like they’re not experiencing any of this as well. And I can imagine coming into therapy and having things slow down a little bit has got to also be so comforting for them where they feel like someone’s really trying to get to know them and, you know, spending-

 

Meg Moore (10:55)

Yeah.

 

Ruth Bernstein (11:04)

spending real time with them.

 

Meg Moore (11:06)

Definitely. And when you you consider what that getting to know each other conversation looks like, yes, it’s the family helping the clinician identify where they do want to go. But it’s also helping the clinician identify what do they like? What what kinds of activities, what kinds of things bring them joy? You know, the first step is identifying what brings that child joy so that we can replicate that in session. So when we even get past sort of those initial family conversations and into the kind of potatoes of the therapy, we’re still just trying to figure out how to make that child happy first and foremost. And then once we have developed a relationship with that child, and we know that they consider coming to our center, a good thing, a really exciting thing, then from there, we can start to talk about learning from there, we can start to think about shaping skills and behaviors, but that’s never our first step. Our first step is to get to know the child and family, and it’s to make sure that child feels safe and happy and supported in our care.

 

Ruth Bernstein (12:13)

I really love that. think sometimes we’re so, you know, as humans, we get really focused on making sure, you know, our kids are going to be successful and can do all of these things. it’s almost sometimes it’s easy to forget their kids and they also need to just have fun and just enjoy.

 

Meg Moore (12:31)

Yeah. Play, be kids. Yeah.

 

Ruth Bernstein (12:32)

Exactly. Yeah, that’s just, it’s so, it’s so important. And I just, you know, I think sometimes it’s easy to lose sight of because there’s a lot of fear when your kiddo is not progressing the way you expect them to, they’re not developing the way you expect them to, and that’s so scary. And so it’s easy to just kind of forget that play and fun is actually incredibly important for your kiddo’s overall health, for their mental health, for their development, everything.

 

Meg Moore (13:10)

I could not agree more. So that was very long winded, Ruth. I think I answered your question and maybe many more. So we’ll pop to our next one. This one’s for you. What advice would you give to those just starting the autism journey?

 

Ruth Bernstein (13:28)

Man. Yeah. My number one piece of advice is give yourself some grace. You know, working with families so early in the process, I tend to be there during what I think for a lot of families is a really emotional time. And I hear a lot of fear and a lot of blame. And the specifics range but like a common theme is, you know, I should have known I should have done something sooner, you know, things like that.

 

Meg Moore (13:34)

Sure.

 

Ruth Bernstein (13:55)

And you know, the whole like hindsight is 2020 is so true here. It’s like now we know this piece of information and we look back and think, well, I saw this and I saw that and I should have put it together sooner. And that’s just really not fair. You know, I mean, you did see it, you know, you did do something about it and recognizing that something’s going on with your kiddo isn’t typically a light bulb moment.

It’s a lot of little moments that add up over time. So, you know, have to go through this process of figuring out what to do next, how to respond. I mean, it takes time and you want what’s best for your kiddo and you are doing everything you can. So give yourself some grace.

 

Meg Moore (14:44)

I love that. I think you know, everyone in the world could give themselves more grace and especially the families that we work with. I love how you mentioned that, you know, there’s 1000 what ifs that don’t matter because what matters now is that you recognized you are taking action and your family is now on a really positive path to success. And that’s, that’s really the only thing that matters now.

I would agree with that advice and I would add on to that, you know, our goal is never perfection. I think that our families also put a lot of pressure on themselves to meet certain milestones or to be like other families they’ve seen or even compared to, you know, friends or cousins or things like that. And so I would say to, you know, stop comparing and stop trying to shoot for perfection because no one is perfect. And we certainly are not aiming for perfection in our therapy. We’re just aiming for better, happier, easier lives, you know, so  even just getting out of bed in the morning, putting one foot in front of the other, that’s a win. And we’re going to celebrate those small wins. So I think to like, giving yourself the grace to just be where you are as well as the opportunity to celebrate small wins and not put the pressure on yourself to just like meet these giant perfect milestones.

 

Ruth Bernstein (16:14)

Absolutely, I couldn’t agree more. It’s funny, still, you I’ll hear parents who are like, well, I feel like I, you know, should be doing X should be doing Y, you know, all of these things. And they’ll kind of ask, you know, well, like you mentioned, right, my kids not doing this, my kids doing that, and I see these other kids. And I think it’s fantastic to ask questions. I mean, ask all of your questions, right? You want to know, ask the questions.

But that doesn’t mean that what your kid is doing isn’t wonderful and it doesn’t take away from that celebration of their progress. I think for a lot of people, they think that they’re sort of a destination in mind when it comes to this journey. And I think that can be a robber of joy.

 

Meg Moore (17:07)

Yeah.

 

Ruth Bernstein (17:10)

And the truth is that applies to all children, not just children with autism, it’s all children. We want our kiddos to be successful. We want them to be happy. The definition of that is individualized. And when we have this sort of idea in our head of this is where we’re trying to go, I think holding too tightly to that can really take away a lot of the joys along the way.

 

Meg Moore (17:23)

Mm-hmm.

 

Ruth Bernstein (17:38)

So I’m personally, I’m a big fan of asking questions. I am a big fan of getting more information. Ask all the questions, get the information, seek out what you want to know, seek out what you feel like your kiddo needs and balance that with recognizing the wins and kind of just staying in that moment and enjoying them and understanding that even if your kiddo is a kiddo with autism, they are a child and they are a human and they’re gonna have all their own fun, unique, individual quirks and things that make them them. And that’s wonderful. And we don’t wanna lose those.

 

Meg Moore (18:16)

Absolutely. Agreed.

 

Ruth Bernstein (18:21)

Okay, so, this flowed perfectly into the next question. Why is family involvement important to a child’s progress?

 

Meg Moore (18:24)

I love this question and the data show us that family involvement results in much better outcomes for the child. And so why is that? The family, the caregivers, they are the experts in their child. They are the ones that tell us what matters, what supports match best for that child. The clinician, we bring the science. So we bring the science that drives those changes. But the family, they’re the informers. They tell us what they want to see. And then we just bring our science and our tools and help them achieve that. So they really bridge that gap because oftentimes our services are provided in centers as well. And so while that very contrived setting can be so fabulous for so many reasons, it’s not resemblant of where they’re going, where they’re going to be using those skills.

So the caregivers really bridge that gap from, you’re learning these skills here, you’re practicing these things, and now as your caregiver, I’m going to help you take these skills into our home, into our community, into the places that our family lives, that we are and interact with every single day. They’re really the drivers. We try to empower the caregivers to be the driver of change in their own child, their own family. It’s called generalization. We want them to be able to take the skills that they’re learning in this very small one setting and be able to generalize them to the world. And that will allow these children, these families to access reinforcement, to be successful.

I would say if there’s a loop of learning and growth, the caregivers are at the beginning of that loop, they’re at the middle and they close that loop for us. At the beginning, they tell us what our path is going to look like. In the middle, they’re practicing the skills that we as the clinicians are giving them. And then at the end, they’re bridging that gap and helping the child take those skills to all of those other environments. So they’re so pivotal to the work that we do. I mean, if we don’t have that partner at the beginning, middle and end, that’s driving the entire treatment. You know, we’re missing a huge piece of the individuality that you mentioned, Ruth, you know, of the holistic care that we can provide. Caregivers are the unlock. They really, really are.

 

Ruth Bernstein (21:05)

That is, it’s such a good point. almost think of it the same way we think about like parents and pediatricians, parents and teachers, right? It’s so powerful when it’s a true team approach, when it’s a collaboration. I think, you know, for parents home with their kids, there’s all these wonderful experts who are incredible and know all these things and do so much and it’s so important to be able to trust and rely on the experts in your child’s life. But really the experts can only go so far without the parents, right? Like you have to have both. It truly is a team. And with that team approach, your child can really thrive. It’s incredible what you can do together.

 

Meg Moore (21:52)

And acknowledging that for the families is extremely powerful as well. You know, I may be the expert in ABA, you may be the expert in psychology, the caregiver, the parent, they are the expert in their child. And very rarely throughout this process, have they been told that like you said, they’ve been in a lot of conversations with experts telling them what they should know and what their child should do. But to sit down and say, Okay, you’re the expert, you help me understand what you want to see for your child because you know them best. And in every treatment planning conversation, every modification that we make to a procedure, the caregivers, the child, they’re informing those procedures because they’re the stakeholders here. so putting the power in their hands, I think, is rare. It’s not something that they’ve encountered before. And I think it’s really, I mentioned, is the unlock to success in that treatment.

 

Ruth Bernstein (22:55)

Yeah, absolutely. You know, I’m kind of thinking back to the question about advice and I feel like the same really applies, right? You know, I don’t know, an important piece of advice. Hey, you are such an important part of this team. You know, even before you get a diagnosis, right? Partner with your child’s pediatrician. Yes, they’re the expert, but so are you.

 

Meg Moore (23:04)

Mm-hmm.

 

Ruth Bernstein (23:24)

And if you’re not sure about something, if you think your child needs something, keep pushing, partner with them. I just think, man, I’m thinking now I’m just going across the lifespan. just, I think it’s a good  understanding, a good mindset to have, right? Don’t forget that you’re the expert too.

 

Meg Moore (23:37)

Yeah. Exactly.

Okay, this one’s for you Ruth. Tell me about a moment with a family that made you think this is why I do what I do.

 

Ruth Bernstein (23:54)

My gosh, just one moment.

 

Meg Moore (23:55)

I know, it’s so hard.

 

Ruth Bernstein (24:00)

You know, for me it happens with pretty much every family. It’s being able to give a family an answer. I mean, I love puzzles. And I love helping people. so for me, diagnostics is like the perfect combination of both of those things. You know, with every family I work with, I get to solve a puzzle and it’s a super meaningful puzzle. It’s a puzzle that helps the child. It’s a puzzle that helps the family.  I will say here, you know, at Hopebridge, I’m in a special position where, just more often than at other places I’ve worked, I get to see the kiddos that I diagnose actually progress through therapy.  Just a few weeks ago, I was actually at one of our centers and a kiddo who I diagnosed probably a little over a year ago,  came up to me and started interacting with me in a way that she definitely didn’t when I diagnosed her.  You know, when I diagnosed her, she seemed totally uninterested in me, but really, she just didn’t have the skills to interact socially the way that she wanted to. And when I saw her a few weeks ago, she was so much more socially engaged, so much more communicative, both with me and I watched her interacting with some of the other kiddos. I mean, those, it’s been, it’s so nice, right? Those skills have just really blossomed and I got to actually see that, which is just so special for me.

 

Meg Moore (25:27)

Incredible. That’s, I mean.

 

Ruth Bernstein (25:40)

I,, actually this week I’m getting to update an evaluation for a kiddo that I diagnosed probably a year and a half ago. And that kiddo has made so much progress and is getting ready to transition to preschool. So I’m super, I know, I know I’m so excited to get to spend some time with him and see how much he’s grown and get everything updated for him to have him ready to move to preschool.

 

Meg Moore (25:56)

No! That’s so special and I think it’s important you mentioned too that not all psychologists have that opportunity. You get to diagnose and then you get to see your patients move through therapy, make those successes and graduate. So that’s so special to hear from you and to experience that with your patients.

 

Ruth Bernstein (26:27)

Yeah, I honestly I just I feel really lucky with that.  I think I just you know, a lot of times, I don’t necessarily know a ton about what happens to kiddos after they leave me and even here I think I’ve also had more families here who will come back after the eval and just give me a little update, you know, tell me something like a you know, a new fun thing that their kiddo is doing and that’s just-

 

Meg Moore (26:31)

Yeah.

 

Ruth Bernstein (26:56)

That’s always really fun and really exciting for me. It just sort of reminds me of the long-term impact, how impactful this work can be. also just, I don’t know, I really love hearing all the sassy things that kids are doing.

 

Meg Moore (27:15)

Yes. And like now that we have taught them how to use their words, they are using them and we love it. Amazing.

 

Ruth Bernstein (27:23)

Oh my  gosh, I know. I’m just hearing some of them. I’m like, okay, I might have to just like adopt that. You know, some of the ways that they are just using their words are so cute, so fun. Like, okay, you are… Right? Yes, exactly. I know.

 

Meg Moore (27:32)

Uh-huh. Right? Noted. I’m storing that for later. I’m going to use that phrase later. No, I think that’s so special. You know, you mentioning that you get to see the families as they progress through therapy, it lines up as well with some of my special moments, which you were like, just one. That’s exactly what I thought when I read this question, too.

I would align as well though and just say it’s the moments that you see that families never thought they were going to see. know, like when families finally see the moment they’re asking for something and they’re using words that they never thought they were going to be able to or the moment that they’re able to go into the grocery store and not tantrum, you know, because we wanted X, Y, Z thing or whatever it may be, you know, little or small, they’re big to the family. Those moments are big to the family and the child. And those are, that’s why we do what we do.  Same with our clinicians. So I am fortunate to work with our BCBAs as well. And so I see similar kind of light bulb moments with our clinicians as well. And some of the most rewarding experiences I’ve ever had are talking through a clinician, with a difficult case, helping them brainstorm through things that they may not have thought of and watching that light bulb go off and see them think like, I know what to do now. I have a new plan. I’m going to go in. I’m going to try something new for this child and this family. And I think that is so important about Hopebridge. We’ve talked about the team approach and to be able to have you as a psychologist our speech or OT or 360 outpatient team members, as well as ABA, all of us being able to put our heads together and have those light bulb moments for our families. It’s not just one person making the decisions, you know, we know the caregivers are driving what we’re doing. And then we have a whole team of clinicians who are relying on each other to make the best decisions for these families. And I just, I think that’s a special approach that not everyone has the opportunity to experience. So there’s lots of moments, but I think for me, just being involved in that kind of opportunity has been so special.

 

Ruth Bernstein (30:03)

Okay, so this one’s thrown to you Meg. What is your favorite part of connecting with families at Hopebridge?

 

Meg Moore (30:05)

All right. Such a great question. I would just reiterate a lot of points I have already made to the point just previously though about what are those moments that are so special that are, You know, the reason we do what we do, it is the moment where the family realizes that they are empowered to continue the success. You know, when they realize, you know, our goal is to work ourselves out of a job. You know, from the second our families get in our care,

 

We want them to be able to get back into those less restrictive settings with all the skills that they need to do the things themselves. You we don’t want them to have to rely on a third party to support their family, to care for their child and to be able to do so without stress and with confidence. And so when we have gotten to a place in our therapy where they no longer have to outsource their support. And they feel like, you know, know what I do, I have this, I can do this. When we see that confidence in our families, that says to me, okay, they’re ready. You we know they’re gonna succeed. We have done our job, not just teaching the child skills, but teaching the family and the caregiver skills as well, so that when they leave our care, they’re going to continue to succeed.

It’s all about, you know, teaching our families how to fish rather than give them the fish. You know, we could easily say, do this now, do this then, do X, Y, Z. But if we say, here’s a skill, I’m going to tell you when and why and how to use it, that just opens the doors for so many other things. And so, yeah, to summarize, that was a long-winded answer.

But when our families realize that they have the tools in their own tool belt to support their family, I say that is my favorite part about connecting with them. That must look different though on the diagnostic side because you’re often that first contact that they have.

 

Ruth Bernstein (32:09)

Yeah, which, you know, my hope is that we’re setting them up to be able to have that experience once they go to the therapy side. You know, I think everyone is a little bit different in how they do diagnostics, but I kind of try to set that stage from the beginning of, you know, explaining to them what I’m doing, why I’m doing it, when their child responds, you know, what that means. You know, I think for for lot of parents, it’s just, it’s weird and confusing when, you know, we’re drawing conclusions from playing with your child.  So I really enjoy getting to kind of explain all that and kind of explain to parents sort of the, the why behind what even what their child is doing, right? As humans, you know, there’s, there’s reasons for everything that we’re doing. And, you know, when you understand that, I think that actually

 

Meg Moore (32:52)

Really? Yeah!

 

Ruth Bernstein (33:15)

hopefully sets them up even better for the therapy piece. But I mean, I will say, know you said, you know, it’s a long-winded answer. I think this is a hard question to answer quickly.

 

Meg Moore (33:27)

Should we start our 10 second timers again?

 

Ruth Bernstein (33:43)

I think that’s just, that’s… I definitely could not answer this in 10 seconds. There’s no way. I mean, it’s just, I feel like, you know, there’s so much that we get out of this as well. Right? mean, as human beings, I mean, think about the the basics of human behavior, we’re not going to keep doing it if we don’t enjoy it. And this is really meaningful and really, honestly, enjoyable work. I absolutely adore seeing all the incredible, fun, silly things that our kiddos do. I mean-

 

Meg Moore (33:52)

Sure.

 

Ruth Bernstein (34:12)

Children are the best. just, they’ll keep you on your toes, but they’ll keep you laughing.

 

Meg Moore (34:15)

They are. Agreed. All right, one more for you, Ruth. What is the most common misconception or concern that you hear from families?

 

Ruth Bernstein (34:30)

I think permanence is probably the most common misconception, meaning, you know, I think because autism is a lifelong condition, I think families think that a diagnosis of autism means that their kids automatically have all these things that they can never do. You know, especially if a kiddo needs a lot of support when they’re first diagnosed.  you know, I’ve, personally the experience of parents calling me after the evaluation because they went online and their child at the time of the diagnosis needed significant support. And the internet told them that that meant that their 18 month old child would never speak, would never be able to take care of themselves, would never be able to maybe even feed themselves, would never be able to have friends, would never be able to have a job, all these things. And that’s just so misleading.

 

Meg Moore (35:27)

That’s so scary.

 

Ruth Bernstein (35:28)

It’s so scary. And it’s so misleading as this statement of just like fact about their child’s future. You know, in an autism diagnosis, we assign something called levels. And that really corresponds to how much support the kiddo needs. So I guess what I’m trying to say, I think the most common misconception I hear is that essentially the levels are permanent. They’re not. They’re definitely not, you know, while a kiddo with autism will always have autism, they will not necessarily always need the same level of support, especially if you’re thinking about it as how significantly their symptoms are impacting their daily functioning. I mean, kiddos are developing, their brains are changing and developing at such a rapid rate. So it actually means that children have this-

 

Meg Moore (36:02)

Mm-hmm. Absolutely.

 

Ruth Bernstein (36:22)

incredible, unbelievable ability to respond in such significant ways to intervention. I mean, thinking about what we were talking about at the beginning, what we’ve been talking about kind of this entire time, right? We don’t want kiddos to sit on a waitlist during that critical window of development. We know how impactful treatment can be. We know how successful our kiddos can be with the right treatment that is driven by their families, that their families have engaged with, know, everyone’s collaborating, engaging in this team effort together that can do so much for the kiddos. We want them to be able to engage successfully with the world. We want them to be able to be who they are and enjoy who they are, which I will say is another thing. Sorry, now I’m the one being long-winded.

 

Meg Moore (37:13)

No, it’s all, I’m like so enthralled. This is such a beautiful answer.

 

Ruth Bernstein (37:18)

I think parents can be really concerned that therapy is gonna sort of take away who their kiddo is, know, like take away their personality and that…

 

Meg Moore (37:29)

Yes, that’s exactly what I was thinking as well on the ABA side.

 

Ruth Bernstein (37:33)

Yeah, and that, I mean, correct me if I’m wrong, but that should never be the goal.

 

Meg Moore (37:40)

No, no, as soon as I read this question, that’s the first thing that popped into my mind, I would say, for ABA, you know, we do hear a lot of, you know, are you going to make my child a robot? Are you going to try and take away the individualities that make them them? And first and foremost, I would say everybody’s experience and opinion is valid. There are definitely times within our field where those constructs hold more true. I’m so grateful, you know, where our field is today, and especially where we are at Hopebridge, you know, every single goal that we write for a child is individualized, it’s informed by, you know, what matters to them, where are they going, and what specific supports do they need. And on the other side, we love a good stem, we love a good we were just talking about we love the sass we love when we start hearing those, you know, unique phrases and words.

Those are all things that make a child who they are. And those are never things that we would ever work to decrease or get rid of.  You know, those are things that make them who they are as a person. And we want to celebrate all of their nuances and personality traits and use them almost as springboards to acquire other skills. So rather than saying, you know, no, that’s not what society thinks you should be like, what we are approaching the conversation with is who do you want to be and how can we help you get there? So I would say that, you know, that kind of concept of ABA again holds true a long time ago. And we have come so far in our field as all sciences do. And we are at a place where we can confidently say that, you know, the programming we create for our patients, the therapy we provide, is individualized, it’s specific to who that person is now, and also who they and their families have told us that they want to be. And so that’s really what we use to drive our treatment.

 

Ruth Bernstein (39:46)

Yeah, that’s so important and so good, I think good for families to hear. I think, you know, not just within the field of ABA, but also as a society, think,  you know, one perk of one good thing that’s come out of the internet, you know, people are definitely more aware, not just of autism as a whole, but also of how different everyone with autism is. I think really it wasn’t that long ago that it was easy for people to kind of have this image in their mind of what someone with autism looks like. And I think our society as a whole has gotten a better understanding of, no, autism is in no way one size fits all. People with autism look really different. They’re individuals and, you know, autism has a pretty big range. You know, so I think that’s that’s gone a long way in helping the world, you know, sort of understand and be a little more inclusive. think we still have a ways to go. But, you know, progress over perfection.

 

Meg Moore (41:05)

Exactly.

 

Ruth Bernstein (41:08)

But, you know, I think, I think it’s easy for people to kind of be afraid that we’re trying to like cure autism. We’re not, we’re not here to cure autism. That isn’t a thing. That doesn’t need to be a thing. You know, we, I just, I don’t know. I loved how you said like it’s, you know, we want kiddos to be successful in the world as themselves, as exactly who they are.

 

Meg Moore (41:31)

Exactly. Exactly. And back to, you know, family involvement, who can better help us understand who that individual is, but them, especially if the child is not yet able to tell us, know, hey, these are the things I like, this is who I want to be. I like this quirky part of me, you know, like those are all of the things that we want to know so we can include those in what we do.

And the family is the one who can really tell us those things. And so as we kind of circle back to importance of connecting with families, importance of involvement in therapy,  I mean, they’re everything. The family is everything. They’re the reason we can be so individualized in what we do.

 

Ruth Bernstein (42:22)

Yeah, I love that. That’s, it’s such a good point, right? I mean, it’s the families are, I don’t know, maybe the families can be the answer to every one of these questions. They’re our favorite part. They’re why we do what we do. They’re so important.

 

Ruth Bernstein (42:42)

So that was our discussion. I wanted to take just a few minutes to chat a little bit about how that went, what we learned.  I gotta say Meg, feel like this is one of those we’re more similar than we are different.

 

Meg Moore (43:00)

Agreed, agreed. And I feel like that shines through in a lot of multidisciplinary conversations that we’ve had recently.

 

Ruth Bernstein (43:10)

I agree. I agree, which is nice. I mean, it’s, you- we have very different roles. We see families at very different points in the process. And yet, think that kind of speaks to hopefully some continuity that parents get to experience that, you know, we really are. We’re coming from very similar places. We have similar experiences. think sometimes, you know, I get a little jealous of y’all’s.

 

Meg Moore (43:42)

Well, I love hearing that, you know, you’re able to go into centers and see the patients that you diagnosed, see their progress, see what they’re working on. I will say, you know, hearing from you, the conversations you’re having with families on the front end about what that diagnosis even means is something that, you know, I hadn’t considered beforehand. I hadn’t considered them having that conversation with you. And having to kind of sit with that in the interim between diagnostic to ABA. You know, we of course consider parents coming in, caregivers coming in with that diagnosis and wanting to know a lot about ABA therapy, but wanting to know just about autism in general and having you be the face of what that conversation looks like. I can only imagine how stressful it is for them and how…you know, you are so careful in approaching that with them to give them comfort and let them know that, you know, stay off the internet. We’re here to help you. We are a team and we are going to just put one foot in front of the other and make progress. And that is what we can promise them.

 

Ruth Bernstein (44:53)

Yeah, absolutely. I think that kind of makes me think about though that it can be almost disorienting for them to then come to you guys. And it’s almost like they’re sort of totally flipped and given this like, hey, talk to us about what’s important to you, talk to us about what you want. And I think that’s a good thing.  But I also am sitting here going, I feel like I can better prepare them for that. I can do a better job, but kind of, you know, now that I understand a little bit better about what they’re sort of walking into and how different that is from their previous experiences, just kind of giving them that heads up of like, hey, you know, you’re going to be asked what’s important to you. So think about it, you know, this is going to be a little bit of a difference in how things have been going before. So I appreciate hearing, you know, more about what their experience is like because it really does help me do a better job, you know, making sure that they have a a smooth transition, you know, from diagnostics to treatment.

 

Meg Moore (46:03)

Yeah, and on the ABA side of things, you know, it’s very helpful for me to understand that interim period because when our families do get to our care, we are able to take a step back and say, you know, I know you have a lot of information about this diagnosis. Please understand that, you know, when you’ve met one child with autism, you have only met one child with autism. They are all different as every single human in the world is, diagnosis or not. And so you cannot take anything you’ve read on the internet and try to apply it to your child because it’s just not applicable. It’s just not the same. And so to have that conversation of, I know you probably read a lot of scary things.

But we are going to identify some goals and we are going to meet those goals. And for the BCBA to be able to break things down in such small steps so that we’re actually accessing reinforcement, we’re actually meeting goals, you know, it’s really important that our BCBAs are writing feasible goals. You we’re not biting off too much more than we can chew because if we’re working towards really big goals and we’re not making progress or able to show that progress in the interim, that can be discouraging. And so it’s even more important, especially as we’re getting started in therapy, that we’re meeting more smaller goals rather than trying to kind of work towards really, really long term and also making sure our families understand how these short term goals inform and work towards our long term goals.

 

Ruth Bernstein (47:42)

Yeah, I love that. think, you know, this kind of goes back to that idea of sometimes it’s easy to forget that our kids are kids, right? But even just thinking about our kids as humans, right? I mean, think about, you know, if you go to work and you’re given this massive task and you really don’t get to feel like you’re making progress for a really long time, you’re an adult, you’re not a kid. That’s still…

 

Meg Moore (47:48)

Mm-hmm.

 

Ruth Bernstein (48:11)

really disheartening and really hard to feel motivated to keep going, right? Well, we’re all human. got to, we have to feel that reinforcement in order to feel like we want to keep going. So yeah, I write our takeaways. Let kids be kids.

 

Meg Moore (48:30)

Yeah, let kids be kids, give yourself grace. We’re not going for perfection, just progress. I think we have some slogans to put on some stickers, Ruth.

 

Ruth Bernstein (48:41)

I like that, our accidental outcome of this.

 

Meg Moore (48:45)

Yes. Well, I had so much fun talking with you today. I love the conversations of how our disciplines unite and work together and how really our primary goal is to just uplift our caregivers, our families, and our children. And we’re all working to do that as one team.

 

Ruth Bernstein (49:04)

Me too. This has been so great, Meg. I’m really excited to hear the future conversations too. I think this is a really nice thing to bring conversation and perspective that maybe we don’t always get. So I really appreciate it. I think this has been absolutely amazing and I’m super excited for the next one already.

 

Meg Moore (49:12)

Yeah, me too. Yeah, I’ll talk to you later,

 

Ruth Bernstein (49:29)

Sounds good. Bye Meg.

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*Informed consent was obtained from the participants in this article. This information should not be captured and reused without express permission from Hopebridge, LLC. Testimonials are solicited as part of an open casting call process for testimonials from former client caregivers. Hopebridge does not permit clinical employees to solicit or use testimonials about therapeutic services received from current clients (Ethics Code for Behavior Analysts 5.07-5.08; BACB, 2020). Hopebridge does not provide any incentives, compensation, or renumeration for testimonials provided by a former client or client caregiver.