TILE

When working with children with autism, often a major constraint is the amount of time we have available to work with the learner. There are so many possible behaviors where our procedures may help, but we only have x number of hours to work with them. Everyone also has limited attention; even if you could work with the student more, there’s only so long they can work without needing a break. Using your limited time with a student wisely requires making careful decisions. If you don’t plan well, you are sure to waste it. 

 

Something that I have found useful is the concept of the TILE (Time in Learning Environment). Probably, the main goal for any behavior analysis program serving children with autism should be something like making sure the TILE is optimized. How can we make sure that we are maximizing the use of the TILE and not wasting it?

 

When people learn about the TILE, often their first idea is to make sure that we have “extra” things to work on so that if we end up with extra TILE on a particular day, we can always keep the learner busy and not waste the TILE. Of course, our goal isn’t to keep the learner busy, but to make a socially significant difference in the life of the learner. It is easy to get distracted by measuring whether the learners are on-task, acquiring new skills, or reducing problem behaviors. Sure, those things may be important. But maybe not as much as you think if you are focused on the long-term view of what matters. 

 

I think the key is to not to try to make sure every minute of the TILE is focused on some learning activity. That’s almost guaranteed to add unproductive and distracting tasks that won’t make a long-term, significant difference. The key is to think, “If we mastered this behavior change, would it make a significant difference in the life of the learner?” Then, optimize your time on those behavior changes. In most cases, the time available will be shorter than what we’d like. But focusing on the most important things in the TILE will make a big difference. 

 

Sometimes, even just asking the question is helpful. Is this the best use of the TILE? How can I prevent wasting the TILE? What’s the best use of the TILE–a social skills group, time in the general education classroom, or 1-1 therapy? Well, let’s think, what are the behavior changes, if made, that will make a major difference in his life outside of therapy? 

Behavior analytic services should only be delivered in the context of a professional relationship. Nothing written in this blog should be considered advice for any specific individual. The purpose of the blog is to share my experience, not to provide treatment. Please get advice from a professional before making changes to behavior analytic services being delivered. Nothing in this blog including comments or correspondence should be considered an agreement for Dr. Barry D. Morgenstern to provide services or establish a professional relationship outside of a formal agreement to do so. I attempt to write this blog in “plain English” and avoid technical jargon whenever possible. But all statements are meant to be consistent with behavior analytic literature, practice, and the professional code of ethics. If, for whatever reason, you think I’ve failed in the endeavor, let me know and I’ll consider your comments and make revisions, if appropriate. Feedback is always appreciated as I’m always trying to Poogi.

Humble Arrogance

People who do well as a BCBA (Board Certified Behavior Analyst) or an RBT (Registered Behavior Technician) are people who truly enjoy seeing children learn, grow, and make progress.  These people did not go into the field to become rich, and it is impossible to do well in the long run if this is just a job you are doing for money alone. Of course, we all need to make money, but there must be other reinforcers to sustain high levels of performance over time.

That sounds good, but there is a downside to this characteristic of effective professionals. When things are going great, the job is fun–we can hardly wait to get to work to see what’s next. On the other hand, no matter how good you are, there will be times when things don’t go well.

I’ve argued before that this is a time when professionals are at a high risk for burnout, and ideally, you can call a plumber to help fix the problem. But, unfortunately, that is not always the case. Sometimes, you have to show up for work without assistance, and many of the most potent reinforcers you expect from work are likely not going to be present.  That can lead to depression and stress. Even worse, people are often angry in this situation, and emotions can be high, leading to seemingly endless conflicts. I know what this is like.

I survived all those long lonely days When it seemed I did not have a friend.

 The one thing that I think has helped me personally is the attitude of “Humble Arrogance.”

Usually, when I work with a child, I am not the first professional to have seen the child. In all likelihood the parents or school team have seen quite a few professionals before they have reached someone like me. So, I try to remind myself there is ample reason to be humble. In all likelihood, the problem will not be easy to solve. Many smart people have already tried to help this child and not succeeded. This is likely to be a significant challenge. Too often, we think that all the other people that worked with the child before just didn’t have the proper training or experience, and this will be an easy fix. Often, that isn’t the case. It is easy to become overconfident when you have had a lot of success (as most BCBAs do). I try not to expect that everything will go smoothly. If I expect bumps in the road, then I am prepared for the times when things go wrong.

On the other hand, being in this situation requires some arrogance too. Despite the fact that all these other smart people have attempted to help this child and were not succeeded, I’ll be able to do it. Try to think like a scientist with humble arrogance.  If something doesn’t work, our response is not frustration or depression, but to think “that’s interesting.” Why didn’t it work? Figure that out, and be on a Poogi. Be humble that the first thing you try may not be successful, but arrogant enough that despite the fact that other smart people haven’t been able to do it, you will be successful.

Behavior analytic services should only be delivered in the context of a professional relationship. Nothing written in this blog should be considered advice for any specific individual. The purpose of the blog is to share my experience, not to provide treatment. Please get advice from a professional before making changes to behavior analytic services being delivered. Nothing in this blog including comments or correspondence should be considered an agreement for Dr. Barry D. Morgenstern to provide services or establish a professional relationship outside of a formal agreement to do so. I attempt to write this blog in “plain English” and avoid technical jargon whenever possible. But all statements are meant to be consistent with behavior analytic literature, practice, and the professional code of ethics. If, for whatever reason, you think I’ve failed in the endeavor, let me know and I’ll consider your comments and make revisions, if appropriate. Feedback is always appreciated as I’m always trying to POOGI.

Teach More, Better, Faster, Now as Well as in the Future

I believe that a major component of effective organizations is to have a mission that is meaningful, motivational, and measurable. After some work on this issue, I crafted the mission: “Teach more, better, faster; now as well as in the future.”

This mission generally had great social validity among staff, parents, and other BCBA’s where I tried it out. We could easily measure how many new skills children were acquiring and increase that over time. We could use the best available research data to design treatment checklists and measure whether our instruction was getting better and better. We could look at rates of acquisition to determine if those were improving. Finally, we could look at whether our procedures were continuing to be used over time. We were on a Poogi!

I was pretty happy with this for quite a while. But one day, I realized that I was focusing on the wrong things. There are a lot of ways that we might be performing well on those measure and still not doing what is in the long-term best interest of the child. It is great that he is learning new words faster, but would he have learned them naturally through play if he wasn’t in therapy? It is wonderful that he is reducing problem behaviors and increasing appropriate social skills, but does he use them outside of therapy?

It doesn’t really matter how well a child is doing while they are still in your care. In most situations, that care is not going to last forever. What matters is what happens after the person leaves your care. Did the person go on to have a better life without your assistance?

Measuring things like how many skills are acquired, how fast those skills are acquired, and if the staff are implementing procedures accurately are all relatively easy to measure. They seem like the common-sense things that, of course, we should be doing. Maybe that’s true. My argument is not that these things are bad, just that they can be a distraction from what’s really important, which is making a socially significant difference in the lives of the children we serve. That could involve teaching, more, better, faster. But maybe not.  For some children, it may be that more is not better. It may be that teaching just a few things really well is what they need. The ultimate goal is not success during therapy, but success when the child is no longer in therapy.

Behavior analytic services should only be delivered in the context of a professional relationship. Nothing written in this blog should be considered advice for any specific individual. The purpose of the blog is to share my experience, not to provide treatment. Please get advice from a professional before making changes to behavior analytic services being delivered. Nothing in this blog including comments or correspondence should be considered an agreement for Dr. Barry D. Morgenstern to provide services or establish a professional relationship outside of a formal agreement to do so. I attempt to write this blog in “plain English” and avoid technical jargon whenever possible. But all statements are meant to be consistent with behavior analytic literature, practice, and the professional code of ethics. If, for whatever reason, you think I’ve failed in the endeavor, let me know and I’ll consider your comments and make revisions, if appropriate. Feedback is always appreciated as I’m always trying to POOGI.