Mia and Applied Behavioral Analysis

Mia and Applied Behavioral Analysis, Part 1 of 2

With Kari Porter, MS, BCBA

By Alford Kerry Hardy

Kari Porter is one of the Board Certified Behavioral Analyst, BCBA, who helped with Mia during the timespan of Hope Comes in Pieces.  Kari represents one those persons who held a piece of the puzzle.  She helped develop a better picture of what is required for Mia to recover from the regression she suffered.

She is from Illinois.  She earned her Master of Science in Behavior Analysis and Therapy from Southern Illinois University.  As it turned out, we have a common associate, Jonathan C. Baker, PhD., BCBA-D, Faculty Specialist, Autism Center of Excellence, Western Michigan University.  She worked with him on Project 12 Ways when was an associate professor at Southern Illinois University.  I met him while working on a latency-based assessment project.

BCBAs, like Kari, designed and modified Mia’s developmental programs.  She looked specifically at Mia’s data to determine if there was progress toward the written targets.  If Mia made satisfactory progress according to the expectation, Kari usually kept the program the same.   If Mia didn’t progress, Kari was responsible for recommending modifications to improve outcomes. 

She coordinated Mia’s care with the team of therapists from different disciplines that came into the Smith’s home.  The behavioral therapist was educated in a specific approach called Applied Behavioral Analysis, ABA.  Kari managed and designed Mia’s program.  The ABA therapist carried out what Kari assigned.  All of the activities were recorded on charts and worksheets.  Volumes of data were generated and reported quarterly.  She met with Craig and Terra to review Mia’s progress.  She made recommendations based on Mia’s trends, other comparative data, and the ABA therapist observations, all pointing to what worked and what did not.  This is known as evidence-based practices.  Decisions were made using the evidence-base for what worked for Mia and, most importantly, Craig’s and Terra’s overall plan for Mia’s recovery.  

Kari describes ABA as, “… looking at the behaviors in which people are engaged.  Some may be problematic.  Others may be a skill we want to increase such as communication.  The objective is to maximize opportunities for positive growth.”

Hope Comes in Pieces required going into these very detailed charts, graphs, and worksheets.  Terra gave me advanced warning when I asked her for them.  Even though she told me, it took the data coming over for me to grasp how much data one little girl generated.  And this was just behavioral data for a year.  The medical and genetic data was a whole other matter.   Then, I thought about it.  Someone collected data on Mia nearly every day.  If Mia went potty, someone recorded what she did and how she did it.  If Mia went into a tantrum, the event was recorded: what happened, when it happened, how long it lasted, and what triggered it.

After going through the files, Terra would tell me of the story behind all the numbers and descriptive language in the reports.  The sheer amount of data can be overwhelming.  Kari recommends, “Parents should research and understand the importance of ABA.”  Her hope is that by understanding how ABA fits into their child’s overall treatment, parents will understand how important it is to take the time to read and understand the reports.

She goes further to give a glimpse into one daily therapy with Mia to encourage a behavior.  Keep in mind that this is one of many targets occurring simultaneously. “Typically, a toddler will smile and recognize a parent entering into a room.  The child will understand familiar voices.  Mia was not doing any of these things at the age of the three. 

“We designed a program to help Mia recognize and respond to a voice.  She was interested in several things.  But, if she was engaged in something, a movie or some other media on her mobile tablet, even if one of her favorite people said her name,  she didn’t turn to look at them."  Simply taking the tablet was not an answer nor would it address the behavioral issue.  It may have made adopting a different behavior even harder.

"She would not respond as if, I hear Mom’s voice where is Mom.  We worked a lot on recognizing when people were talking to her. The task was to get her to respond when called from a distance, out of her sight.  We started out with the therapist voice then brought in Terra to help with the transition from responding to the therapist to responding to Terra.

“Terra worked away from home at the time. She came home for lunch to help with the transition.  In the evenings, prior to the end of therapy, she helped again.  Also, we needed to transfer that over to Craig and Mia’s grandpa, who lives with them.  Mia picks up some things quickly.  Adopting a behavior like this particular one though, took hundreds of trials over months. 

1. We started right in front of her then slowly moved away
2. Each time she turned and looked, we provided verbal and physical reinforcements.  Mia likes ice chips so we gave to her those as well
3. Overtime, we slowly built on small successful responses to her name being called until she adopted the behavior"

Read Part 2 of 2