Centering Consumers in ABA and Why Graduations Send the Wrong Message

Graduations are a time of celebration and happiness. Often, a season of accomplishment is felt by all. Graduations imply that the graduate will move forward and not return back. Graduations imply that what needed to be learned has been satisfied and social outcomes of independence are the new level of expectations.

I have seen the children of close friends graduate from ABA. There is a celebration and, sometimes, an unstated confusion about why their child is graduating. Some of these friends decided that their children needed to be in school. Some friends have been told all of the boxes on the XX assessment tool had been successfully marked. And all of these people have found themselves clapping with dreams not yet completed, unfulfilled, and parent goals unattained.

As a clinical person with a deep resistance to the use of the word graduation in our world of therapy, graduating from therapy can be one of those areas that miss the mark in centering the client and family. Think about it, during intake, a vulnerable process ensues where parents divulge history, challenges, and things they’d like to see. We may or may not wholly focus on these items during parent coaching…because that’s as good as the BCBA in front of them. And then, #voila, Graduation.

For some, the accomplishment of discharge achieved is true. This looks like a transition plan written AND implemented with successive markers and with communicated success. This is intended to support the success of the person and family as direct services are reduced. It is generalization and maintenance. This is data-driven and happens over a period of time. Here it is not named graduation, but it is the accomplishment or win of everyone. The child and family are centered.

I remember an old client Landon who had accomplished all of his short and long-term goals. We started to successfully integrate him into the classroom and Afterschool sports. His real life took over from a time perspective the hours we would see him in treatment. The data showed success. We dismissed him from therapy and informed the parent(s) that we may hit some social snags in the 2nd/3rd grade. Check-ins and coming in for tune-ups of support would be a necessary welcome.

And they did. Mom checked in occasionally. He came in for about a 3-month stint to work on social language. And we sent him back out into the real world.

We are not here for graduations. It sends the wrong message that social significance has been accomplished. It miseducates families because the messaging of graduation has a different meaning in the real world.

Service identity matters. Our clients do not graduate, they are discharged. Educational therapy or medically based therapy service administratively commands that our language is different to describe this process.

Because therapy is not the dream, no one would care to graduate as much as we (therapists) care to say the word. When parents clap at therapy graduations, our industry should feel that the miseducation has occurred again. This time we celebrated it and let it walk out of the door with social outcomes and significance for that child and family unaccomplished. It’s damaging and no matter the clinical outcome discussions. The fact is, in that moment, we have allowed parents, clinicians, interns,etc. to be miseducated for a moment of egocentrism called graduation from ABA.

The discussions about #redflagsinABA #greenflagsinABA are equally damaging because for whom is this messaging? Consumer education and consumer marketing would implore us to check our language, egos, and how we translate information to inform.?

Parents depend on us. They give us their children in hopes that we will see them and elevate them. Using the language of discharge and planning is an ethical line of obligation based upon behavioral principles and our theoretical constructions.

We cannot uphold these principles, graduate consumers, and know that families will continue to struggle after the cap and gown are removed.

In the example of Landon, we planned for his exit at the time of intake. Not only in words, but in deed. We planned for his exit at the onset of our relationship. Each organization and team has unpublished and consumer-protected details related to exiting. But, graduation pictures from parents on social media and the tales of our family friends fuel the words in this blog.

Parents need to know what we know. Sure, they may consume this information differently. But, in centering families…where are they when we consider clinical quality and shifts the industry has made in office closures and the like.

Whether televised or untelevised, these revolutions and revelations have not centered families. It is possible for the duality to balance the voices of the clinician and consumer. It is also important to educate both beyond the webinar and workshop. Activating and extending professional learning groups allows parents and clinicians to be informed.

Education can almost develop one’s autonomy and communication advocacy.

At the Huddle, we sincerely believe in clinical quality by extending professional learning. Our Huddle for Parents will open soon.

Shifting an industry begins with shifting ourselves through actionable work grounded in professional and consumer education.

Everyone needs a Huddle. Parents need one too….because clapping at ABA Graduations is so #déclassé

Sign up here (parents only and invited clinicians)?https://www.thehuddleforparents.net/

Live Well. Live Whole.

~Landria Seals Green,MA., CCC-SLP,BCBA

• Baer, D. M., Wolf, M. M., & Risley, T. R. (1968). Some current dimensions of applied behavior analysis1.?Journal of Applied Behavior Analysis,?1(1), 91–97.?https://doi.org/10.1901/jaba.1968.1-91
• Brodhead, M.T., Quigley, S.P. & Wilczynski, S.M. A Call for Discussion About Scope of Competence in Behavior Analysis.?Behav Analysis Practice?11, 424–435 (2018).?https://doi.org/10.1007/s40617-018-00303-8
• Lord, C., Charman, T., Havdahl, A., Carbone, P., Anagnostou, E., Boyd, B., Carr, T., de Vries, P. J., Dissanayake, C., Divan, G., Freitag, C. M., Gotelli, M. M., Kasari, C., Knapp, M., Mundy, P., Plank, A., Scahill, L., Servili, C., Shattuck, P., … McCauley, J. B. (2022). The Lancet Commission on the future of care and clinical research in autism.?The Lancet,?399(10321), 271–334.?https://doi.org/10.1016/S0140-6736(21)01541-5