The first day I set foot in each camp was November 16, 1996 (yes, I remember the day). That was the day I started working at the University of Nevada Reno Early Childhood Autism Program through the Behavior Analysis Department. A couple of months earlier, I had just begun Speech Pathology 101. Little did I know that would set the tone for the next two decades of my life and lead me here to write this today.
As a leader of an autism program, you may have questioned how Board Certified Behavior Analysts (BCBAs) and Speech-Language Pathologists (SLPs) should interact. Maybe you know their roles are crucial to the success of a child with autism learning to communicate, but are unsure as to how all the pieces fit together. You may also be a unicorn, both a BCBA and an SLP or have one on staff. Which is fantastic, but not truly the answer to this collaboration conundrum. After almost 23 years of thinking about this topic and working on this in the real world, the most important thing I have learned is this: If you don’t do it, no one will. I don’t have all the answers, but here are some things that you can do:
Plant the “collaboration seed” in the beginning: Ideally, a program for children with autism would be a multidisciplinary program from day 1. This could include other professionals besides BCBAs and SLPs. I’m focusing on this relationship because this is what I know and love. I also feel you get a lot of “bang for your buck” in autism treatment when these two people collaborate well. I realize this is easier said than done. More times than not, a multidisciplinary program ends up being a staff of SLPs and BCBAs who stay in their own corners most of the time. Maybe the SLP gives the BCBA advice on programming or vice versa, but that is not true collaboration in my mind. At least not the kind that will really make the most impact for a child and family. No matter what the situation may be, you are the person who needs to make the commitment to collaboration and plant that seed. Whether you do it in the beginning or TODAY!
Exclusively hire staff with a collaborative mindset: I am not talking about the “how well do you work on a team” question. I’m talking about asking interview questions to find out what an applicant’s view is on working closely with a BCBA or an SLP. To some of you this may sound like a no brainer. You would expect that an SLP applying for a job at an autism treatment organization that employs BCBAs would be keen on collaborating with one. Wrong. In the first company I started, Autism Matters, I had an SLP tell me casually that she didn’t really believe in ABA. Well, that is probably not a good sign. You don’t have time to be convincing applicants to believe in what you do! Another incident happened a couple of years ago when Ally Pediatric Therapy was in development, and I was looking for a Clinical Director. One person I was interviewing was a BCBA who knew I was an SLP, and I told her I previously owned and operated Autism Matters, a collaborative clinic, for 11 years. The interview went great. I really wanted to hire her. Then she said she wasn’t sure how an ABA program could work with an SLP as the Executive Director (me). Pay attention to these comments. Go for the person who says, “Wow! This is a dream come true! I have always wanted to work in collaboration with an SLP or BCBA! Sign me up!!!!!”
Develop a system for how the SLPs and BCBAs will regularly collaborate: You cannot merely put an SLP and a BCBA in the same building or company and POOF! Collaboration is born. It doesn’t work that way in the beginning. That is like not using any cake recipe and putting an egg and flour in the oven until it explodes! Okay, you got me. I don’t bake. You get the point. As the leader, YOU have to set up the structure. YOU create the recipe. You can include your top SLP and BCBA in the process of developing the structure, which I would recommend. However, you are the one to make sure all the right ingredients are there for that collaboration cake! There is no right or wrong way to set up a system for how the two will collaborate. It is really up to you and what works with your particular setup. At a minimum, have set timeframes for meetings, structure for meeting content, and mandatory collaboration before implementing new treatment plans.
Support and guide as the collaborative relationships take shape: Once you have accomplished the steps above, there are only two things you can count on, conflict and change. You are going to have SLPs with a lot or minimal experience working with BCBAs and BCBAs who think they should write a treatment plan with a million speech goals or no speech goals without consulting the SLP. You will have some professionals fresh out of school with minimal experience working on any type of team or a full-time job for that matter. You will also likely not be paid for this extra time or effort associated with managing this effectively. You name it. It will happen. And that is okay. Your role is to support the process of professionals working together towards the common goal of helping a child. If things get a little hairy at times, everyone can go back to that starting point and work out the rest with your help. It is different every day, and that is why being a leader is so fun, right?
Reinforce and celebrate collaboration efforts: Throughout his journey, you will need to reinforce collaboration efforts between the two disciplines. For example, “Hey, I saw you and Mariah meeting today about Evan’s speech program. Thank you. I love seeing that.” At some point, something magical will happen, and you will see the lightbulbs go on. That is the best part and makes all of this worthwhile. It is essential to highlight the wins at regular team meetings and celebrate what you have all accomplished by committing to collaboration.