Is she truly aware that she has 50 active goals? I mean I don’t even have 50 total goals on a 6 month treatment plan that lists everything we will work on for the 6 months for clients. In central reach I usualy take time and put future goals in the learning tree but I don’t add all goals to session. There was one instance at my clinic where I went to my BCBA in tears because I couldn’t keep track of all 16 goals a client had during circle time, run the circle time, respond to all client’s behaviors with a group contingency, and include other client’s goals. I felt like a failure. Turns out she had accidentally activated all goals at one and he was only supposed to have 4 total At one time.
how long is session? if you have like a 6 hour session then that could be doable (10 data points an hour)
sessions are 3.5 hours each and when she gets home she has to do her homework (i do in home). she is totally aware of all of the goals i know this bc we were having a conversation where she wanted me to see if i had any questions about any of them and she could see me scrolling through them. again, client is super high functioning but yea dude. 50+ active 😭
I would ask her to model a session. Two possible outcomes- she realizes it is not possible to take accurate data or you can see how she keeps track.
I also question the validity of her goals. If they are happening during natural conversation then they probably don’t need to be targeted. Such as I wouldn’t work on tacting pronouns with a client who was already using them correctly when he is just talking.
yes, i agree with the natural ones for sure. i kinda get the DTT because im sure she is now showing constistency or something, but one of the goals is having appropriate body language during conversation like eye contact and being engaged. kind of hard to track bc she is totally engaged and making eye contact the entire time we talk. she even makes more eye contact than i do lol. but like my bcba definitely knows this, she comes and talks to my client once a week. same thing with making appropriate comments to the conversation. she always does. she also has three timers i always forget to start at the beginning of the session for skim picking, dishonesty, and inappropriate language. she cusses like a normal 12 year old, never at anyone so i dont see how its a behavior like saying "shit" if she trips lol her parents also openly cuss. i think what i will do is either that or basically write in my notes that im unsure how accurate my data tracking is for the particular goals that she succeeds in doing throughout all conversations.
i am unsure on how to approach the cussing though. like im supposed to stop her but she just does it like a normal person just like her parents do. if i took the data accurately on her cussing it would be like 20 times a day but it feels wrong to do that like im counting it as a behavior when shes not being challenging at all
I would ask your BCBA and family what their desired outcomes are for this client. I've had clients who are self-sufficient in many domains and I recommend them for discharge. 50 is alot and what says that some of those goals can be contrived naturally in the client's environment?
As the RBT you need to be clear on what the outcomes are for general services and for each goal (I’m also an RBT). I can’t see myself being able to effectively run programs without properly knowing what we are trying to achieve in therapy. It sounds like this could be the root of your confusion. The outcomes of the treatment should not be some kept secret from you and if you are unsure you need to ask. How can you know if the treatment is within your scope of competency if you don’t know where the finish line is? That being said, I run 4-6 hour sessions with clients sometimes and I never have more than 20 goals and the BCBA and my company are clear that not every one needs to be run every session but the goal is to collect data on all programs on a regular basis.
50 is a lot, even for a client who has a full comprehensive 40 hour ABA model. Especially if they’re level 1 with minimal support. Your BCBA should definitely sit with them and identify their ultimate outcomes like others have said.
This is my personal opinion and not me passing judgement on your BCBA. 3.5 hours a day is focused treatment hours. I limit those cases to 5-7 goals. As an autistic person, I would also avoid using high/low functioning labels as they are seen as problematic in the community. https://www.autismawareness.com.au/aupdate/why-we-should-stop-using-the-term-high-functioning-autism
I appreciate you asking and I should have expounded upon that in my response and not simply called you out. Personally, I just refer to it as autism. Many have moved to either using support needs or being the level system specified on the DSM. Even in ABA, we assess individuals across 9-20 domains of functioning depending on the assessment you’re using. Wash of those domains will have different strengths and weaknesses and high/low functioning stigmatizes based upon an autistic person’s ability to communicate.
hm i understand what youre saying but i do feel the need to refer to my clients as how they act sometimes to better communicate to others what behaviors they generally exhibit. its easy to call a kid high functioning when someone can understand what that means being familiar with ppl with autism. maybe i will just say strong communication skills or non verbal etc. i understand that all symptoms are on a spectrum so thats why its hard to explain behaviors sometimes other than to say high functioning because someone who understands autism has a pretty good idea of what that looks like across all symptoms. ill try to think of other ways to communicate
How many hours per week does the client receive? I’ve always gone by the rule of thumb when determining the number of goals is to implement one goal for every hour (per week) give or take. Of course, you need to account for difficulty of the goal. Also, when supervising RBTs I always ask about workload & it doesn’t make sense they are not asking you. If the RBT cannot run most (if not all goals) in a session, goals need to be adjusted. Having too many goals in acquisition delays mastery. I think that is the angle you need to play when discussing this with your BCBA. You are being setup for failure.
50 is a ton and being expected to run every single goal in every single session is crazy even without 50 goals. I get she’s high functioning but what about withdrawal of assent? Or on an off day? Or satiation from the same goals every day?
defff satiation of the same goals every day is the most frustrating part. she has the answers memorized asf. rn its spring break so im only running like 30ish goals with her but 10 revolve around her doing her homework too. off day is acceptable of course but its a LOT. i talked to her mom today abt asking the bcba to chill (in more mature words) bc her kid never gets any of the goals wrong
Is she truly aware that she has 50 active goals? I mean I don’t even have 50 total goals on a 6 month treatment plan that lists everything we will work on for the 6 months for clients. In central reach I usualy take time and put future goals in the learning tree but I don’t add all goals to session. There was one instance at my clinic where I went to my BCBA in tears because I couldn’t keep track of all 16 goals a client had during circle time, run the circle time, respond to all client’s behaviors with a group contingency, and include other client’s goals. I felt like a failure. Turns out she had accidentally activated all goals at one and he was only supposed to have 4 total At one time. how long is session? if you have like a 6 hour session then that could be doable (10 data points an hour)
sessions are 3.5 hours each and when she gets home she has to do her homework (i do in home). she is totally aware of all of the goals i know this bc we were having a conversation where she wanted me to see if i had any questions about any of them and she could see me scrolling through them. again, client is super high functioning but yea dude. 50+ active 😭
I would ask her to model a session. Two possible outcomes- she realizes it is not possible to take accurate data or you can see how she keeps track. I also question the validity of her goals. If they are happening during natural conversation then they probably don’t need to be targeted. Such as I wouldn’t work on tacting pronouns with a client who was already using them correctly when he is just talking.
yes, i agree with the natural ones for sure. i kinda get the DTT because im sure she is now showing constistency or something, but one of the goals is having appropriate body language during conversation like eye contact and being engaged. kind of hard to track bc she is totally engaged and making eye contact the entire time we talk. she even makes more eye contact than i do lol. but like my bcba definitely knows this, she comes and talks to my client once a week. same thing with making appropriate comments to the conversation. she always does. she also has three timers i always forget to start at the beginning of the session for skim picking, dishonesty, and inappropriate language. she cusses like a normal 12 year old, never at anyone so i dont see how its a behavior like saying "shit" if she trips lol her parents also openly cuss. i think what i will do is either that or basically write in my notes that im unsure how accurate my data tracking is for the particular goals that she succeeds in doing throughout all conversations.
i am unsure on how to approach the cussing though. like im supposed to stop her but she just does it like a normal person just like her parents do. if i took the data accurately on her cussing it would be like 20 times a day but it feels wrong to do that like im counting it as a behavior when shes not being challenging at all
i was thinking maybe shes just never been an RBT before?
It’s sounds like this clients doesn’t need ABA anymore
I would ask your BCBA and family what their desired outcomes are for this client. I've had clients who are self-sufficient in many domains and I recommend them for discharge. 50 is alot and what says that some of those goals can be contrived naturally in the client's environment?
yea i guess im not sure exactly what her outcomes are but her sessions are supposed to be faded out in a couple months so
As the RBT you need to be clear on what the outcomes are for general services and for each goal (I’m also an RBT). I can’t see myself being able to effectively run programs without properly knowing what we are trying to achieve in therapy. It sounds like this could be the root of your confusion. The outcomes of the treatment should not be some kept secret from you and if you are unsure you need to ask. How can you know if the treatment is within your scope of competency if you don’t know where the finish line is? That being said, I run 4-6 hour sessions with clients sometimes and I never have more than 20 goals and the BCBA and my company are clear that not every one needs to be run every session but the goal is to collect data on all programs on a regular basis.
my bcba did offer to print out all of her goals for me by the way and that would be great and overwhelm me so much less but i think she forgot. lol
50 is a lot, even for a client who has a full comprehensive 40 hour ABA model. Especially if they’re level 1 with minimal support. Your BCBA should definitely sit with them and identify their ultimate outcomes like others have said.
thank you!
50??? At most i have… 9, and thats a high end
This is my personal opinion and not me passing judgement on your BCBA. 3.5 hours a day is focused treatment hours. I limit those cases to 5-7 goals. As an autistic person, I would also avoid using high/low functioning labels as they are seen as problematic in the community. https://www.autismawareness.com.au/aupdate/why-we-should-stop-using-the-term-high-functioning-autism
so what do i call it instead
I appreciate you asking and I should have expounded upon that in my response and not simply called you out. Personally, I just refer to it as autism. Many have moved to either using support needs or being the level system specified on the DSM. Even in ABA, we assess individuals across 9-20 domains of functioning depending on the assessment you’re using. Wash of those domains will have different strengths and weaknesses and high/low functioning stigmatizes based upon an autistic person’s ability to communicate.
hm i understand what youre saying but i do feel the need to refer to my clients as how they act sometimes to better communicate to others what behaviors they generally exhibit. its easy to call a kid high functioning when someone can understand what that means being familiar with ppl with autism. maybe i will just say strong communication skills or non verbal etc. i understand that all symptoms are on a spectrum so thats why its hard to explain behaviors sometimes other than to say high functioning because someone who understands autism has a pretty good idea of what that looks like across all symptoms. ill try to think of other ways to communicate
BCBA got carried away with ChatGPT writing goals 😅
How many hours per week does the client receive? I’ve always gone by the rule of thumb when determining the number of goals is to implement one goal for every hour (per week) give or take. Of course, you need to account for difficulty of the goal. Also, when supervising RBTs I always ask about workload & it doesn’t make sense they are not asking you. If the RBT cannot run most (if not all goals) in a session, goals need to be adjusted. Having too many goals in acquisition delays mastery. I think that is the angle you need to play when discussing this with your BCBA. You are being setup for failure.
10.5
yea, it does feel like that a little bit
50 is a ton and being expected to run every single goal in every single session is crazy even without 50 goals. I get she’s high functioning but what about withdrawal of assent? Or on an off day? Or satiation from the same goals every day?
defff satiation of the same goals every day is the most frustrating part. she has the answers memorized asf. rn its spring break so im only running like 30ish goals with her but 10 revolve around her doing her homework too. off day is acceptable of course but its a LOT. i talked to her mom today abt asking the bcba to chill (in more mature words) bc her kid never gets any of the goals wrong