OTS 05: How OTs and Teachers Collaborate with BCBAs: An Interview with Steven Troyer, Med, BCBA, LBA

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Welcome to the show notes for Episode 5 of the OT Schoolhouse Podcast.

In this episode, host Abby Parana has a discussion with Board Certified Behavioral Analyst (BCBA), Steven Troyer. Steven and Abby have previously worked together and collaborated to help many of the same students meet their IEP goals. Listen in to hear Abby and Steven discuss behavior from both OT and BCBA perspectives.

Links to Show References:

Connect with Steven - This is a link to Steven's linked-in profile page in case you would like to contact him.

Rising Star Autism Center - RSAC is where Steven currently works as a program director. It is a center-based early intervention program designed specifically to address the needs of young children with Autism. The center is located in Bellevue, Washington

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Be sure to subscribe to the OT Schoolhouse email list & get access to our free downloads of Gray-Space paper and the Occupational Profile for school-based OTs.

Have any questions or comments about the podcast? Email Jayson at Jayson@otschoolhouse.com

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Episode Transcript

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Amazing Narrator   

Hello and welcome to the otschoolhouse podcast. Your source for the latest school based occupational therapy tips, interviews and research now to get the conversation started, here are your hosts, Jayson and Abby. Class is officially in session. 

Abby Parana   

Welcome to the OTschoolhouse Podcast. I'm Abby, and today on the podcast, we're having a conversation with Steven Troyer. He's a board certified behavior analyst and director at rising star Autism Center in Seattle, Washington. I personally know Stephen because I've had the pleasure of working with Steven at a school district in Southern California. He and I collaborated in order to address the needs of students in our setting, and he provided me with valuable tools and insight at that time, so I invited him on the podcast today in order to provide us with strategies for all of us to help us with our student behavior. Well, let's get into the conversation. Hey, Steven. 

Steven Troyer   

Hi Abby. How are you? 

Abby Parana   

Good! I know Steven from working with him in a school district here in California, so I've had a personal experience of working with him as a behavior analyst in the school setting, and so that's why I invited him on the show. Today, we're going to discuss just his background and your practice areas of expertise and what you like doing, or why you got into being a behavior analyst. So why don't you tell us a little bit about your background? 

Steven Troyer   

Well, I start I've been in the field for about 15 years now. I started out in an undergrad program in applied behavior analysis, where they kind of told us, in five years, you'll work with kids with autism. And being, you know, in my early 20s, I didn't honestly, really know what that meant, and I believe that the statistics were about one in 180 kids that were born at that time, according to the CDC, were affected by autism. And now we know that those numbers have drastically changed. It's like one in 60 or even the higher now, so the need for behavior analysts working with children with autism has greatly increased. So where I kind of started out, I worked for the Johns Hopkins Medical Institute doing research on language development for older learners with autism. So we had kids that were in their teenage years, so they did an alternative school placement, and that's what they went to school in our programs, as opposed to going to public schools. So that's kind of where I started out. I was there for about two years, and then I realized, since it was such a small program, I'm like, I want to work in schools, and I want to be able to work with other practitioners, and I want to be able to, you know, help more kids than what I was really doing in that program, although research, obviously, is very important, and it was really great to work for Johns Hopkins. So I moved to California. I worked in the Bay Area. I received my master's degree in special education from San Francisco State University, and so I got the teaching element of, you know, the education piece of it, and really knowing what classrooms look like, and putting in the family component into that as well. So there I was doing more consultation for middle school and elementary school aged children. I did that for about three years, and then I moved down to Los Angeles, and I was there, working for an agency, working primarily, again, in homes and in schools. I developed a school consultation division, where I had about 15 staff underneath me, working in school districts such as Inglewood, Lawndale, Redondo Beach, just various schools in the LA area. And I did that for about five years, and then when I met you, I got a job at the Ontario Montclair School District where I had worked with the special education director previously, when he was the director of Inglewood unified. So when I went out there, I was a BCBA program specialist. So I oversaw about 16 to 18, I don't quite remember, but classrooms of children with were considered to be moderate to severe and those were developmental disabilities across the board, medically fragile individuals. I was exposed to a lot more developmental disabilities than just autism. Autism, actually, there weren't that many kids with autism in our programs, which is a little bit different for a school program, especially for behavior analysts. So it really required working with PTS, otschoolhouse, com, and then also administrators, because, you know, as you know in that, in that arena, a lot of administrators aren't quite sure how to manage a lot of these problem behaviors and a lot of these. Students. And as you know idea, you can't just suspend students with disabilities because their behaviors are really disruptive. And in a mod super program, you have a lot of kiddos that can have some pretty disruptive behaviors. So that's where I you know, that's where I was at. And now I'm in Seattle. I have a private practice. I also had started my private practice in the LA area as well just providing consultation to different ABA based programs, or programs that wanted to be more behavior analytic in nature. So I carried a caseload of kids in home, you know, in the San Bernardino County areas, as well as different programs throughout school districts and things like that. And here now in Seattle, I am the director of an Autism Center, and so we provide intensive ABA, full and half day programs for children with autism. And I also have a private practice up here. So I do see clients in home in different school districts and that sort of thing. So that's kind of my background.  

Abby Parana   

Yeah. Oh, not a short background at all. That's just super extensive. It sounds like you've had a ton of experience working with kids on their behavior management skills.  

Steven Troyer   

Yes, I would say so. 

Abby Parana   

Yes, I would say so as well. And I personally had the opportunity to work with you, so I know you've done incredible things with schools and within the districts. Thank you. So when you're looking at behavior, you had mentioned just that you've had experience working particularly in the school setting as well as in the home setting. But when you're looking to assess behavior somebody, does that referral come from somebody having a specific need, or does a teacher just approach you and say, Oh, we're having trouble with this student in the class? How do you then go about getting more information or kind of what is your process for that? 

Steven Troyer   

Well, in the school district and in the home, it's a little bit different. So let's start in the home. So mostly now, with insurance kicking in, it is a medically necessary service, so you have a referral coming in from a doctor that this child has autism spectrum disorder and needs the support of a board certified behavior analyst or a registered behavior technician to work with the family. So that's kind of how that referral process works in the school, it would usually be a recommendation for an assessment plan. So an assessment plan comes through an IEP is held, and that's how ot services and speech services are all kind of determined, right? It comes from that referral process. So when I was working in the school district, you know, a lot of those referrals were triggered more from there was some type of legal binding situation happening, and so I would do the functional behavior assessment, where I would go into the classroom and observe behavior, do file reviews, that sort of thing, and make recommendations from that standpoint, but it was more, you know, the referral comes through the IEP process versus through a medically necessary service, like if you needed to go to the doctor and you needed a referral for some type of treatment, you get that through the same referral process. ABA is no different now. 

Abby Parana   

Right, So then, did you ever provide strategies like in the classroom for with the teachers, or just where you could go in, and maybe it's not a specific student, but maybe just general classroom management strategies for them, or coaching. 

Steven Troyer   

Yeah, I mean, that's mostly what it is. So my philosophy is kind of building capacity within the team. So oftentimes we think behavior is very isolated to the individual, which is mostly completely off. So if you're going to go in and just try to treat that student. When you walk into a classroom that is completely chaotic, well, that students, reactions or behaviors are often a product of what is happening within the environment. So when you have better systems in place, just with any neurotypical classroom, when it is organized, it is structured. There are clear expectations. People are trained. Then obviously behaviors are at a minimum, versus when you walk into a classroom where there aren't behavior management systems in place, it often gets very difficult. So I will always know kind of the level of capacity from that team if they are giving me all of these behaviors and reactively, reactively, how do we manage this? What do we do when this happens? What do we do when that happens? That lets me know that team is not in the right mindset. Because the first thing I will say is you need to spend more time being proactive. You need to plan. You need to set this environment up for success. So one. Behaviors are occurring at a lower rate, the team is actually able to teach, and more productive things are happening, so you have more positive behaviors to reinforce, versus, oh, this kid is doing that, and this kid is doing that, and this could, it's just like, you know, it's like, whack a mole, you know, like you're just trying to put all of these things out. And the team is frustrated and the kids are frustrated, and it's just this super reactive situation, which we see over and over and over. So you have to front load and put the time and invest the time in to prevent behaviors, because lots of times what we would call as like that classroom for that child becomes the signal for chaos. When I walk through those doors, I already know I'm gonna get tons of tension for this behavior, or if every time the teacher assigns me something, I just tip over my desk, and now I don't have to do it. So those patterns of behavior are reinforced. And so if we just continue to do the same old thing. The behaviors never get better, and so you have to proactively approach those behaviors from a different from a different standpoint for success. 

Abby Parana   

Oh, definitely. Oh my gosh, that is probably the key to successful, having the students be more successful in the classroom. I'm so glad you touched on that, because that's part of that whole when you gave I used to notice that you would give teachers and staff data collection for filling out forms or chart of ABC data. Would you mind touching on just what ABC data looks like? And that seems to kind of, that's a great segue into that, that whole description of, kind of analyzing what the behavior is, and maybe not analyzing, but looking at what the behavior is and what the staff is doing in the classroom, how important that collection is. 

Steven Troyer   

Yeah, well, the first thing that you want to know, even aside from ABC data, that's very important in trying to figure out the function or the motivation of the student and why they are doing that, you need to have baselines. So oftentimes, if you go into a frustrated staff, they're like, I'm like, they will use be we'll use tipping over the desk as a behavior. And you ask the team, oh, it happens all the time. Every second. It never stops. Well, we need to actually have information. So what I will do, as opposed to having staff collect data the whole time, the whole day, all of the time, I'll say in a 15 minute window, give me the frequency of times that it occurs, and take five different 15 minute samples, time interval samples, so then we can average it out, and five samples of behavior occurs on average four times in that 15 minute window. Okay, that's pretty frequent, but it's way more accurate than it just happens all the time, and I just never stops, and I'm super frustrated the ABC component. The ABC stands for antecedent behavior in consequence. So the antecedent is what happens right before, and this isn't, oh, well, Mom said he wasn't feeling well last night. So you know that that's why he's doing it. No, it's not, um, you need to what did you deliver a demand. Did was the kid playing, and the other student took something away from that individual, you know, was the individual looking for attention? Were they attention? And then you also have the sensory component. If the child's alone, no demands are placed, nothing but the behaviors happening. That could be a sensory component, but oftentimes we add all of this other information, and it's not truly what it is. An antecedent is typically, demand is placed. A child is denied access to something. They're seeking attention. They didn't get it. But I flipped the desk over, and now someone tells me to stop. Oh, I got the attention right? So you really want to look at what those key components are, and then the consequences. How did we react? Did we give them attention? Did we tell them? No, and this is a very powerful tool, because as a behavior analyst, I already know in a very brief observation of what's happening, but you also have to build capacity with that team for them to see what is happening. So I go, I'll often go in, I'll kind of know what the patterns of behavior are. And once the individuals from the team start collecting the data, and you start talking to them, I remember one classroom that you and I both worked in very extensively, and I had them collect the data, but I didn't really explain what, because I knew that that would then give drift to what they were actually trying to say. And so when we went in, it was like, Oh, we never give attention. And out of 30 intervals, 27 out of 2033 27 out of 30 someone were. Responded with an attention component. So that's a really strong reinforcer. So at that point, you can't now say you're not giving them attention, and that the behavior is not maintained by attention. So now our treatment is going to look very different than, you know, than what they have been doing. You've got, you've got to stop that attention component for it, or in denied access, meaning the student isn't given something that they want right at that moment, you might have to do some front loading. You might have to say, Hey, you're not going to be able to have this right now. But first we're going to work on this worksheet, and then right after, you can earn it, versus just saying, Nope, you can't have it. And then the desk gets flipped over. So the antecedent gives you, how do I plan differently? The consequence component is, how do I respond differently? And you know, based on function, the way you respond, it always that you know. The saying is, is behavior goes where reinforcement flows. So if you're going to reinforce that behavior, then you already know that that behavior is going to continue to occur. So it is a choice by practitioners, too. And sometimes, I always say, we don't make it about you. Don't make it about the staff. It's about the student. And if you really want to treat that behavior, and I've had spitting behavior, you know, where kids spit and the cheers like, I'm not going to condone that. I'm going to tell them to stop every time we're doing it for attention. So you need to think outside of the box and treat that behavior based on the function, not on your personal views of spitting, because if you three months down the road, we're still going to be having the same conversation. And that gets tougher with teachers that have been in the field for a long time, because oftentimes you get why I'm going to do it this way. Well, you can do it that way, but I'm coming from it. I'm approaching it from a scientific way. So scientifically, I'm going to tell you how to better manage that behavior. At that point, it becomes a choice on whether or not you want to handle it that way. But I will give you the scientific approach and what you should do. 

Abby Parana   

So sort of taking out that subjective like, kind of removing yourself emotionally when you're collecting that data, trying to remove, like, what you feel as the professional, you feel like, oh, they should be doing it this way. They shouldn't do that. And kind of removing yourself from that and just looking at it totally objectively and saying, No, this is what the data is showing. This is what they're doing it for continuously, and then trying to make sure that you understand that component. So that's you build capacity in that respect, saying, like, Oh, don't so much. Look at it from your feeling on the subject, but looking at it from, do you want the behavior to stop? Do you want to change the behavior? And then taking more that approach, and this is how you do it, versus Oh, that's not right, and I'm going to handle it this way. 

Steven Troyer   

Absolutely. I mean, as behavior analysts, we only make database decisions, which makes us a little bit different than some of the professions. Oh, definitely. You know, you have to remove yourself from that and the date. There's no arguing the data. And so if you see those patterns of behavior, then you I always say knowledge is power, and so you make a database decision, you make an informed decision, and you do what's right for that student, not what you feel, because you'll also see an ABC data like I will have already went in and made my observations, and people will write down in The consequence, what should they should have done?  

Abby Parana   

Mm, hmm. 

Steven Troyer   

Okay, know what you should have done, but that's not what's happening. So you have to record it from a very objective standpoint and what actually is happening, because that's true data that's going to make that's going to make better change, it's going to make stronger, more durable change. 

Abby Parana   

Right? Because I think the other thing I've seen a lot is they'll record the behavior like people record the behavior consistently, but not the antecedent or the consequence, and it seems like just this tracking of what the behavior is over time, but there's nothing to show what was done before or after, or what the consequence was, or what the antecedent to the behavior was. So getting all those A, B, C, seems really important.  

Steven Troyer   

It's very important, yeah, because otherwise, then you're just really taking a frequency and you know the behaviors happening, because we're all seeing it so great. You know what's happening. Yes, you need to know the frequency or the duration or the rate of the behavior. Those are all very important. But the antecedent and the consequence is going to give you, and I'm not going to get too technical, but that operant conditioning, or those variables that are going to make. Maintain the reinforcement history of that behavior. 

Abby Parana   

Right? And I mean, I've been guilty of it too, even when I've been in OT I will jot down like, oh, this student did this. But if I don't cue into my mind and think, Oh, what was I doing right before, or what did I do right after, that behavior occurred, and then I see it show up again during therapy sessions. Then I kind of know, Oh, I gotta check myself. What am I doing before and what's happening right after? 

Steven Troyer   

Absolutely, because behavior is an interaction with the environment, right and you are a part of that environment as the teacher or the practitioner, you are a direct, direct result of how that behavior is maintained through reinforcement. So you have to be very mindful, and you can't do the same thing with every student because of students behavior, even if it looks the same, the topography, topography is the same and it looks the same may have a different function. You may be doing, if you're the student, you may be doing it for attention, but I may be doing it to get out of work. So you can't approach it from the same standpoint. It's whatever the data reveals for that student. So it's very individualized, which, in special education, we're supposed to be providing individualized education and programs, right? So you can't cookie powder it, you can't blanket it. You really have to make sure that it's individualized.  

Abby Parana   

Oh, definitely. So what I'm thinking to myself, what are like I know some of my mistakes that I've made when I've come to behavior management with students that I've made, or that I've pulled from classes, or that I've worked with in occupational therapy, and, like I said, sometimes it comes into that self check where I have to take a step back and be like, Okay, I've seen this behavior a couple of times, and I self check myself and then look at it. Try to look at it objectively. What mistakes you see when we're managing classroom behavior, or when we're managing behavior when we're working with a student, what would you say? Like, maybe, like, one or two of the biggest areas that you see most commonly. 

Steven Troyer   

I think one of the biggest things is just not really having the information as to why. You know, as behavior analysts, everyone's like, Oh, it's like the F word data. You know what I mean? Like, just knowing what in any behavior analyst, any good behavior analyst, is going to say, you really have to show me the data like you really have to have the information. I think that's really the number one standpoint, because otherwise, you're looking through it from a subjective lens, and you're so close to it, right? If you're the teacher, you're dealing with it every time. By the time the behavior analyst gets there, you're like, oh my god, get this kid out of here. I've dealt with it long enough so you have to have that level of objective information to really approach it. And then I think the other second piece is, so many people approach everything from a reactive standpoint, how do I deal with it when the behavior happens? Versus what do I need to be doing to prevent the behavior from happening? Because when you are in that reactive state, the team is way more likely to error. You're more way more likely to deliver reinforcement when you shouldn't. You're way more likely to let a kid escape when you shouldn't, versus like, oh, well, the behavior has reduced. Now I'm able to teach. Now I'm able to get opportunities for reinforcement. Now I'm creating way more positive interactions for the student, between myself and them, and them and their other, their other, the other students. So from a social standpoint, you're also just creating a better environment, a more reinforcing environment, research and statistics will show over and over and over that environment to provide more positive reinforcement, have higher outcomes, have better outcomes. That's not even debatable, that's the research. So even if you go into a neurotypical classroom and you have a teacher that never gives any positive praise, you're more likely to have kids acting out, because, well, if I act out, you're going to give me attention, right? Versus if that teacher is just doling out reinforcement here and there, and it's contingent on appropriate responses, I mean you, reinforcement is increasing positive behaviors. When you provide reinforcement, those behaviors are going to increase or maintain, and that's what you should be doing if you're only using punishment procedures and you're trying to reduce behaviors that can be really problematic. 

Abby Parana   

Right? Oh, absolutely. Those are that's actually amazing tips. That's fantastic. Thank you for sharing that and so well, actually, that's a really great so what are some of the simple positive behavior? What's an example of some positive behavior supports, I guess, or if you have time for a couple examples, but just giving kind of what that. Scenario might look like.  

Steven Troyer   

Well, when you're looking at a proactive standpoint, you my biggest things is it's a lot environmental. So if you think about it for yourself, if you go into a work environment and things are chaotic and you don't know when you're supposed to be working, where you're supposed to be working, what you're supposed to be doing, when transitions are happening, you're probably not going to produce the behaviors that you're capable of doing, right? So one of the big things is it's just having a structured environment, you know, knowing, working with children with autism that visual supports are helpful. A lot of us are visual learners. You know, I've had people that said, Well, I'm not going to do a visual schedule for a kid, and I say, Well, let me take away your calendar then, which owe all of the your daily planner of all of the things are happening, it's no different. So really, having supports in place that promote appropriate behavior, and a big piece of it is as a behavior analyst, one of the key things that I always look at is what is the student's level and ability to communicate. So many of our kids do not have communication systems in place that are functional for them. Some of our kids are non talkers, and so if you can't communicate and you get frustrated, what happens a behavior access happens, meaning I flip a desk, I yell, I scream, I hit somebody. So communication systems are important, whether that be sign, whether that be spoken word, whether that be an augmentative, you know, an augmentative system for that child, you really need to that's one of the key things that you need to look at is, what is this student's ability to communicate with the world around them? And then, you know, I think it's really important too. And what I see a lot in school systems is we really overshoot the individual's ability to do something. So again, when we go back to baseline data, if you've never seen a kid do it, you have to teach them, yes, if it's 0% that child doesn't know how to do it, yeah. So, oh, I thought it was a classroom. I thought we were teachers. I thought we were teaching here. So you have to teach them and reinforce that behavior so that they're actually able to accomplish the things that you want to accomplish so many times they see frustrates, oh, I just can't do it. He won't do it. You know, I always say, if you if you've never seen a kid do it, it's a can't do they can't do it. If you've seen a student do it once or twice or a few times, it's a motivation issue. So you really need to look into the fact of that individual getting reinforcement for actually engaging in that behavior. If the kid does it and you don't reinforcement, it's not going to increase. I mean, that's science. 

Abby Parana   

Well, and we call, I mean in occupational therapy and probably in teaching too, I would think we look at like the just right challenge. So finding, you know, a task that's motivating for the student to perform, but also that's within their let their independent level, that's it's a challenge to them, where it's motive motivating, and they're gaining a skill, but also that they're able to accomplish it, because that's when I've seen a lot of behaviors come out, as well as when they're presented with something like, for instance, a child doesn't understand that a marker makes marks on paper, but they're forcing the kid to hold it and put a mark on the paper, and suddenly they're flipping a desk or throwing the marker and running out of the room. Well, they don't understand exactly what that utensils used for, and that's part of teaching. Is that kind of what I mean? Am I hitting that part? 

Steven Troyer   

 Yeah, yeah. And you want to think about the approach for that. So, like that, that example that you gave from a mark, you know, using a marker. So they're going to use this utensil, you probably don't want to start them using a utensil doing math problems. You might want to start from the approach of, it's something fun. I learned that this will make a mark on the page, and then slowly you shape that behavior in whatever that trajectory is. Okay. Now we're going to sit down and we're going to do this. I think of it a lot on very basic things, and I see this with really young children coming into my center that have no learning readiness skills. Never really been in a learning environment. They don't know. And we, just my staff, expect them just to sit down and start doing things, yeah, and it's like, okay, well, you know, we're gonna start a goal of just sitting, and that means sitting at a table with preferred items. And we reinforce and we reinforce. So we reinforce now, okay, well, first you can do some playing. Then we're going to move to something else that's maybe not as accurate or not as fun, and then we sandwich it with something else, and we make sure that clinically, those amounts of times change to the point where now we can have that individual sitting and working longer. So when. Think about remediating problem behaviors. You You don't start, you don't go run a marathon with never even getting on a treadmill or even ever running a few miles, right? So you've got to put that practice in before you're going to get your terminal result. And so many times, practitioners try to start in the terminal. I'm going to get to the finish line this week, and it's like, well, you've got a lot of legwork to do, and you really need to think about that developmentally. When you're working with really young children. You know, you don't have two and three year olds sitting for long periods of time at a table or marking with a marker, doing tracing and writing their name and things like that. So you really have to think developmentally, and then you need to individualize it for that kid, because that kid develop, you know, chronologically, maybe four, but developmentally might be one, you know. So then you have to scale back and really just gage it on a daily basis. That kid may come in, and some days he can do it, and some days he can't. But if you've seen him do it a few times, you know, then it's a motivation. It's not a skill deficit. He can do it. You just have to think strategically how you're going to get them to do that. And that's what makes people good teachers and makes them good clinicians. And so when you're able to do that, you're able to do it from more of a clinical standpoint versus just this is how it's done. This is how everybody does it. This is how you know you teach, and I think in classrooms, that's people get to the traditional standpoint, or how they how teachers feel kids should learn. Where we have kids are very different than they were 2030, years ago, you know, and have more intensive behavioral issues, and not to say that they didn't used to but you know, 2030, years ago, we didn't manage behavior like we do now, either. You know, very true. There's some pretty horrendous stories out there of how behaviors were managed and hopefully not still in that way. But in the past, people did a lot of really crazy things in managing behavior, where now, as clinicians, we know we're way better than that. We know that, you know, we shouldn't be using force. We shouldn't be using, you know, just really only punishment procedures and things like that. We want to use motivation, and we want to get the kid a part of the process. So it's a learning it's not a forced situation, right?  

Abby Parana   

Right, More self directed. 

Steven Troyer   

Absolutely. Yeah, because generality and generalization is a huge part of applied behavior analysis. So if it only happens when I'm there, it only happens when you're there, and you'll hear it a lot in classrooms, right? You'll have a paraprofessional, oh, well, he'll only do it with me. He'll only, you know I'm the only one, and when I hear that and like, if you were truly trained and you were clinician, that's a bad thing, because you have not taught that student to generalize those behaviors, and that is not a good thing, because guess what? Five years down the road, you are not going to most likely be with that kid. When that kid is 20, you're definitely not going to be with that kid. So that kid is not able to engage in those behaviors in the natural environment. You haven't done anything. You've done a disservice to that student. 

Abby Parana   

Behavior. It kind of fading. So like building capacity with the staff and then building have them starting to learn how to build capacity within the child themselves. 

Steven Troyer   

Absolutely, absolutely and the spirit of supporting that piece at home. So this is what we do in the classroom, because that child also needs to be reinforced for that behavior at home as well. So that's another setting that they're able to do it, and then when they're in the community, you know? So that way they're fully able to access their world, right? Because that's, that's what we're here for, and not just, oh well, when they sit in Miss Betty's class at this table with this book, he can sit and read for 20 minutes, but he can't do it anywhere else. Well, that's that's not good either. 

Right? And I've made that mistake as an OT having them be able to do something in occupational therapy, and they do great, and then in the classroom they're not doing it's not the carryover skill that I'd like to see. And then that tells me kind of the same thing, I have certain supports that I should be collaborating more with the teacher on or other staff on that I've been providing an OT that should be in the classroom and then should be reinforced throughout. 

Steven Troyer   

Absolutely and like from the behavior analytics standpoint, we call that stimulus control. So you have that stimulus control with clients. How you do stimulus control transfer is you pair reinforcement with other people, other objects, other settings, other materials. So when you're able to do that, then that child is getting reinforcement from all modalities in all, all different areas. So then that. Behavior is durable across settings, and that's when you're a good behavior analyst or you're a good practitioner, you realize that. 

Abby Parana   

Oh well, that makes sense, because now I have a term to go with, what? 

Steven Troyer   

Signals control. 

Abby Parana   

There's, there's always like, that terminology. I'm like, Oh well, when I'm doing something. 

Steven Troyer   

When we talked about, when we spoke about the classroom, that's always chaotic, and that's almost the trigger. That's also that that classroom has control over that client, that student's behavior, that I can do whatever I want in here, and it's wild and crazy. Where the teacher that when you walk in, I remember the teachers I grew up with, you knew when you walked through those doors, you stand up straight, you sit down, you quiet, because that teacher has stimulus control over that classroom, and there's patterns of reinforcement and punishment. It's not to say that we never use punishment, because the technical term of punishment is decreasing behavior. Do we decrease behavior? Absolutely, we do. Punishment isn't in just what we think, Oh, spanking or sending the kid to the office, punishment is really any procedure that reduces behavior. So that's part of it too. Is like really knowing the terminology everybody calls negative reinforcement, and they think that that's punishment. Well, I, as a behavior analyst, I always kind of laugh people like, Oh, they're using negative reinforcements. Like, no, that's, that's straight up punishment. They're, they're trying to reduce the behavior. It has nothing to do with reinforcements. Right? And I think what is negative reinforcements? When you take something away from the child? Increase the behavior? Yeah, So I would say negative reinforcement is your unsung hero, because everybody thinks, oh, well, ABA, that's giving stickers and high fives, and that's your positive reinforcement. But we know those kids that they don't want to do work, they they want to work for a break. I will remove the work to increase the amount of time that you will stay on task. So you do this for five minutes, you get a five minute I will remove this, and you get a five minute break. That is negative reinforcement. You're typically it's something that the individual views as aversive. Typically. Work for kids with disabilities is not fun, and that's why you get a lot of escape maintained behaviors like, well, if I flip the desk, then I'm not doing my work anymore, right, right? So negative reinforcement, I always say, is the unsung hero of reinforcement, and people like there's no reinforcers, this kid won't work for anything. Heck, yeah, you will. He'll work for a break, right? Right? All he's trying to do is break all day. You're letting him break all day, so your outwork for a break, reinforcing his behavior over and over and over. Just set it up in a contingency that's more effective. Even if the kid works for 15 seconds, you can reinforce that, oh, now you can go because 15 seconds can be 30, then a minute, then five minutes, then 10 minutes, then a half an hour, and before you know it, the kids right back on track, working for breaks, great. 

Abby Parana   

And sometimes I'll even work for a break.  

Steven Troyer   

Oh, yeah, we all work for breaks. 

Abby Parana   

Yeah. Well, Steven, I have kept you past the time I said I was going to, but I really appreciate it you've given I just feel like this has been super beneficial, not just for me, but for anybody that would want to listen to it. I think that this has, I don't know, it just it's great to talk to you about behavior, because it seems that a lot of the difficulties that we experience working with students who have behavior difficulties in the classroom or in school or during occupational therapy, speech, PT, whatever it is that you put it in such a way that it seems highly manageable, where we can, if we remove ourselves, and we can just take a step back and take a deep breath and look at the situation, it's easy to kind of see those little markers in the behaviors. 

Steven Troyer   

Yeah, I would say so. And I think, you know, from the school district standpoint, you know, like, at like, what I would see a lot with you guys is, OTs, a lot of behaviors are thrown at you guys because they're like, everyone's like, Oh, it's sensory where, yes, very few times, in my opinion, is it sensory oriented, and patterns of behavior get formed through how we react to the behavior, right? So it's that reinforcement. So even if it started out as a sensory behavior, but we started managing it in a certain way, it's no longer maintained through a sensory standpoint. Often it's how we've shaped that behavior up. And if we feel like every time the kid wants attention and we tell them to stop it, it's not a sensory issue, it's an attention issue, and we to make the change. Oftentimes, we'll, you know, I'll go into classrooms and it's all about the student changing their behavior when often, that's not where we need to start. We need to start on how stat we need to change staff behavior and attitudes to. Towards that behavior, and once you can make that change, and people realize that you're able to have way more success. 

Abby Parana   

Oh, for sure. And that's where I think, like OTS collaborating with behavior analysts and really looking at the behavior part, because I noticed sometimes I've made the mistake as an occupational therapist of coming at it from that, oh, I need to work on the self regulation. They need this in order to maintain their regulation for the classroom. But then I end up providing almost a reinforcement for the behavior that we don't want to perpetuate. And I think that that collaboration between the behavior or the behavior analyst and an OT could be really beneficial to the child, because the last thing I'd want to do is provide a support to the classroom that's ultimately not a support necessarily, but reinforcing behaviors in a child. 

Steven Troyer   

Yeah, and it's not to say that they may not necessarily need that, but it's the timing of it. So if I start flipping desks, and then contingently, I get to go play on a scooter board out in the hallway, then I am teaching that kid, all I have to do is flip a desk, and now I'm out in the classroom or outside in the hallway on a scooter board, having a great time, right? My understanding of sensory in sensory strategies is that the student should be somewhat able to if they're not seeking that out, if they're not requesting that, or they're not really asking for it as a support, then you might want to take a look at that, you know, so it may be okay. First off, it doesn't mean you can't go get that sensory input, but first you need to complete that, contingent on completing that, even if it's a very short period of time, then you can go access that support. But if you just start flipping desks, and then you go out and you get to get on your scooter board. Is that is the flipping desk going to continue to happen? Sure it is, of course it is. 

Abby Parana   

Right, because we're taking and sometimes it's like, oh, the scooter board is a great fun activity. I mean, a lot of what we do is play, so I think definitely getting sensory breaks in, but not making them, you know, contingent on, oh, we saw this behavior happen, but it's built in throughout their school day, whether it's after they do work or after they've completed an assignment. Then they get to take that break, and if they want to seek sensory input during that break, that's fine. 

Steven Troyer   

Yeah, and it, you know, if they request it. And, you know, I've worked with a lot of kids that would be consider, you know, that were non talkers or not, what people would say, oh, you know, a lower functioning on the autism spectrum where they absolutely, they have those sensory needs. It's not to deny that at all, but it's contingent on, hey, on this amount of work and slowly increasing it to where teachers are, like, oh my gosh, this kid will sit and work for 45 minutes, and then he actually earns his break. And he can engage. He can grab whatever sensory tools that he needs, and he can use those for 10 minutes, you know? And now that behavior no longer impedes His instruction, right? It's just a planned break that he's well aware of. You need to make sure that he is or she is able to access it. So it's not to say that those things aren't needed, but it needs to be done in a planful way so that it's not like, well, I flipped desk to get scooter board. 

Abby Parana   

Right. And I think that almost teaches self regulation in a way where they have to maintain their attention. And they are taught that, like, there's a time frame that they have to maintain their intention, and then, oh, I get to get out, you know, my wiggles, or my, you know, the the bottled up kind of self regulation difficulty, and they can have an outlet for that, where they get to get that input or or in those cases, just release that excess energy and then come back to work, and it's almost teaching them to keep that kind of in check on a schedule. 

Steven Troyer   

Yeah. And the thing about it is, is when you have that more in check, especially when you're dealing with kids that are a little bit older, is that socially stigmatizing piece of it a lot of things, you know, if you have a ninth grader out on the scooter board going down the hallway, what does that look like to his peers, his neurotypical peers, you know, but if it's planful and it's like, oh, at 1pm you go to the multi purpose room and you do that, and they know that then that also is a time for them to be able to engage in that without any judgment, without any other kids looking at them and that sort of thing. And we really need to, we need to recognize that, because even though this may be a freshman with a developmental disability, when you think of it from an inclusion standpoint. You also want to make sure that you're being mindful, that you're not, you know, providing supports that could be viewed as socially stigmatizing and off. I mean, when you get into that level of talk with classrooms, it's like when, you know, we would go into sixth grade classrooms and everything is like Blues Clues. And it's like, well, our six go into the gen ed sixth grade classroom are, is there Blues Clues all over the billboards? Right? Not at all. No. And so that's where we have to make sure that our supports also come from a standpoint where we're not having that individual stick out like a sore thumb, especially when they have behaviors and things that already kind of put them on that level. As practitioners, again, we need to be better than that. 

Abby Parana   

Right? And that like, and I would say even when we're looking at because sometimes OTS will recommend, you know, an oral chew, where they can chew on something, and kind of being mindful of that, that that might be difficult. So recommending other things, like sports bottles or chewing gum or something like that, to get the same input without being or making sure that we're age appropriate. So Exactly, yeah, but I really, I think that it's important to for OTS to collaborate with behavior analysts 100% definitely, because just working with you had given me so much insight into behavior and how it played into my practice as an OT working in schools, and I've become much more aware of trying to figure out what is the cause of the behavior, versus just assuming it's always a sensory difficulty, or it's always something related to sensory and making sure that I talk to all players on the team, including if we're so blessed to have one a behavior analyst, or somebody who's looking at the behavior, or even just taking a time out to collect ABC data myself to make sure that I'm not reinforcing that behavior, if that's what it is. So I really appreciate you coming on the podcast, and you've given me a great insight, and hopefully we'll get to chat again soon, while we chat. 

Steven Troyer   

Anyways, yeah, I can talk about behavior all day, every day. So yeah, anytime, anytime you need anything, just let me know. 

Abby Parana   

Thank you so much, Steven. 

Steven Troyer   

You're very welcome. 

Abby Parana   

Thanks for listening to the otschoolhouse com podcast, and thanks to Steven for stopping by to discuss behavior with me. If you like what you're hearing and want to follow us on social media, go ahead and check out our Instagram and Facebook at otschoolhouse com, and be sure to hit subscribe if you're enjoying listening to the podcast. 

Amazing Narrator   

Thank you for listening to the otschoolhouse com for more ways to help you and your students succeed right now, head on over to otschoolhouse com Until next time class is dismissed. 

Abby Parana   

and I'm gonna let you go, because we are over by like, 20 minutes. I think I told you, I was like, Oh, it'll just be 30 minutes, but now it's going on three hour minutes. Yeah, almost an hour. 

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OTS 05_ How OTs and Teachers Collaborate with BCBAs_ An Interview with Steven Troyer, Med,.

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