So really, even between all the community partnerships that I have in the sites that I oversee, there are some going from early intervention, we were thinking at a younger age, all the way up through adulthood and adolescence. So that looks very different, and so it's interesting to navigate that. What's short-term and long-term, even within this young age range versus adolescence, and where you're thinking like that's closer to a lot more transitions and life stages. And so it just really depends. But some of those short-term goals, really, when you're younger, can be more immediate, and really, when you're older as well. But I'm thinking like it's gonna look very different obviously for those early intervention sites, where maybe you're prioritizing what's important right now to get them to a space where they can be in a school setting around typically developing peers. Thinking long-term, hopefully that they're back in school more full-time, and what does that look like? What is it going to look like when they start to approach young adulthood? Adolescents? Wersus those adolescents and adults that we're serving. Maybe short-term is like, oh my gosh, we're in the here and now. And it is like, I mean, we're going through a bunch of insurance mandates right now. We have to act now. And so the short-term is what do we do right now to get them even, maybe just safe, or what was that transition look like that we're in the midst of?

And long-term is again thinking more functionally, where they're going to live and what things are going to be helpful for them to be independent, and maybe have access to community sites and settings. And what does that look like? So it's very unique to not only the age group, but the family dynamics and their functioning level, what kind of supports that they need. So it also just takes a team of people to help with those goals.

It sounds like you're naturally, I mean, you and the people that you are typically collaborating with are somewhat naturally drawn to those long-term goals. And then that makes me wonder sometimes when we get so familiar with those long-term outcomes that maybe sometimes we can just sort of assume that what we're doing in the meantime is just naturally getting us there.

So I'm curious if you have any- and I was just like, how do you process through, okay, this is that long-term goal that we're headed to that we know because it's like these are our people and this is how we do what we do. But how do we not sort of lose sight of the short-term to make sure that we are actually getting to where we think we are getting, or are we just sort of like, yep, just going through the motions? Because we know that in theory, it lands there, or we've seen it traditionally land there. But just to make sure that like, are we actually? Does that make sense?

Yes, I think it's going to be important to have data and to continue to reevaluate. And maybe even at the beginning. So having those initial conversations with parents or service providers, other people on the team. Again, ultimately, in the next five to ten years, what is our goal? Where do we want to see this learner, and then kind of almost working backwards. So what are the smaller short-term goals that can help us work up to that, and then along the way, continue to reevaluate that. Are we hitting our short-term goals? Do we still feel like this is going to get us to that long-term goal? Are these steps that are necessary, and are we hitting these? And then sometimes those will change, and sometimes they won't, and maybe like, oh, we thought that this was a necessary step, but actually, you know what, maybe we need to push that back, or maybe this has become a lot more immediate, and we need to move that one forward. Or maybe there are some that we really just don't find important at all. And we're going to need to take those out. But continuing to reevaluate those regularly and consistently helps you know whether or not you're on track.

And again, asking parents, even if you feel like, hey, I feel like we're in a good space, or you know what, I don't think that this is maybe as important as you. Again, asking where do you feel like we're at? Has anything changed based on the progress or lack of progress? Do you feel like this is still a really good goal to shoot for, or have things changed? I recently had a meeting with parents where they felt like some of the more functional daily living skills and skills to promote more independence with hygiene were less important or less of a priority if they secured funds to ensure that she always had someone there to care for her and do some of the things that they felt like maybe- we were really wanting to promote maybe some of more of that independence and maybe parents didn't feel like that was as much of a priority. And maybe this could be culturally relevant too; they really wanted us to focus on more of the academics, and that can be a whole other talk. And that gets tricky. But all to say is that, you know, we've even realized over time too that the priorities were different, and we needed to adjust our short-term and long-term goals. And that's going to look very different from then also, the adolescents that we have and the adults, where all of a sudden, insurance right now we're having to deal with, we thought that maybe we would have authorization for a longer period of time. And now we've had to adjust knowing that we're not going to have authorization for much longer.

And so maybe we really also again need to pivot both our short-term and long-term goals to know that we don't have much time and we're really going to have to focus on how do we work on fading ourselves out and generalizing those skills across other people, other settings. And so that's a constant thing that we're talking about. And I'm encouraging the BCBAs that I oversee to revisit in each, I mean, at least monthly in those parent meetings, if not, even more regularly. But that's something that I think we need to continue to reevaluate as we go.

Oh, for sure. And I'm curious because you are at tables with lots of different service providers. But I also know that you are at tables with school providers. And I know from the school side, sometimes we can get so narrowed in that it's almost like short-term only, with sort of the assumption that we'll get to the long-term. But it's like I am seeing week to week, month to month, because I am looking grade level to grade level and not even like developmental level to developmental level over the lifespan.

So I'm curious for you, if you've worked with folks that are so stuck in the here and now, like the right now treatment plan, the right now academic goals, like the right now, how do you help them kind of pick their head up and see, oh gosh, but there is such a bigger picture or, where are we actually headed long-term and does this really fit into that? You were kind of hinting at some things, but I'm just curious if you can sort of have that conversation from the other side?

To kind of go back to that parent meeting that I had. I think that we were looking at treatment plan goals and recent assessments, and we looked at some skill deficits and even things that we were observing in the day-to-day, whether it be in our setting in the ABA clinic or in the classroom that we saw, oh, I think this would be helpful. And you know, we brought the ideas to the table, and the parents like, you know what actually- in their mind, thinking okay, knowing what the setup is we want our daughter to have, we don't think that that's a priority. And so we had to say, okay, as much as we thought that that's what we wanted for her, the parents have thought otherwise. And so long-term thinking like this short-term goal that we have in our minds isn't really going to matter as much. Not to say that it won't matter at all, but maybe in terms of priorities, that's not the top of their priority list. So we even had to take all the goals that we were thinking of, and we sent them to parents and asked them to help us prioritize them and rank them. And so that was just helpful for us, and maybe add other ideas.

So now that's kind of really prompted me even more so lately to again re-evaluate and revisit those conversations with other service providers or families to say again, ultimately, what are we thinking like five years down the road, ten years down the road? Are we on track for that? Is our trajectory looking like the things that we have in place right now are supporting us getting there, or is there anything going on right now that maybe we think, oh shoot, that's actually really not important, or we're not doing something that's really important that we need to add to the list?

So I've heard you talk a lot about prioritizing. I'm really curious, where do these goals even come from? And I know, I think you shared like ‘I gave them a list’ and ‘I asked them to prioritize them,’ but where did that list come from? So either from you or from your other colleagues. How are we identifying what both short and long-term goals could even be?

So, each BCBA, I would say we try to extend the freedom for them to gather a variety of resources that they feel meet the needs of those clients and that family and that system, so that we don't have necessarily certain, set, exact assessments or that they have to use. It's really like they have a few, obviously, that are mandated by insurance that they have to use for treatment plans. But then we also encourage them to explore additional assessments that they feel would be helpful.

So I would say a combination of just a variety of different assessments that they may be using, obviously, like direct observation. Things that they are observing. I strongly encourage them to ask parents, hey, what's going on at home? What's going on in the community? What do you feel like is important for you? What's socially meaningful for you guys, and what do you want to see for your son or daughter? And I feel a combination of some things that these assessments are telling us, things that we're directly seeing with our own eyes, things that we're asking, maybe our RBTs or our staff that maybe we're not seeing but they're seeing and that they're seeing as, oh, this is something that really impacts or impedes on their daily life. Those are things that I note down to discuss with parents. Maybe this is something that we're noticing that maybe we need to talk about further. And then again, obviously, parents and siblings and other caretakers' perspectives, what are you finding that this is what's impacting their daily life the most and preventing them or hindering them from accessing typically developing peers or access to other community activities. And how can we prioritize those things that the people who know them the best say are really impeding on their lives? And that's what I feel weighs heavily in our list and should be prioritized.

I appreciate how you are driving into that social validity piece that it's not just here's what I know from my expertise or here's what my tool told me or here's what fill-in-the-blank team member wants. It's what's actually meaningful for this student. And I know for me it's a bit of a soapbox topic because that was a lot of my early research is in social validity and how that shows up or doesn't show up and how it interacts or undermines treatment outcomes.

So, it is so refreshing and so needed to hear the, ‘well, what's actually meaningful for this student?’ Because a lot of times, I know in education, we will define goals that are either especially behaviorally helpful for adults. It makes my life easier. So therefore, the kid's behavior needs to change. So therefore, that becomes the kid's behavior goal, which is not necessarily what the kid needs.

But I'm really curious, how do you interact with so many different people with different perspectives? They're either doing the right now treatment intervention, or they're doing that long-term, making sure that the individual is going to be set up to access or get whatever they need long-term and still keep that individual at the center of it all. Especially, I'm thinking, like individuals with really complex needs that sometimes can't even advocate for their own needs in those moments. How do you still keep them at the heart of all of this?

I really like to prioritize my approach, especially when going into conversations that I know are going to be tough, that I know I'm disagreeing with. It could potentially elicit some conflict. But I say, hey, we all want so and so to live their best life. And I think that I can see, and I may say, hear me if I'm wrong. I may just try to reiterate what I feel like I'm hearing from them. This is how you feel and what you want to prioritize it. Am I right? And here's what I'm thinking too. And we may be on different ends, but how do we make both happen, or do we decide that, okay, what I had in mind maybe wasn't a priority for you? Are you okay with that? Is this something that maybe we need to talk about further? Again, I think it comes back to like, really validating.Even if you disagree strongly with someone, validating that you know where they're coming from or that you can at least try to see something that they're bringing to the table and understanding, okay, I see where you're coming from. And while I may not agree with all of it, I know why you made that decision or why you feel that way.

And so I feel like if you lead with that, then people are just more receptive to hear what you have to say. And again, even if there's not a whole lot that you can compromise on, or a whole lot that you feel like you can agree with, but if you're like, you know what, you can lead with just validating people, then they're more willing to be like, okay, you heard what I had to say. So let me hear what you have to say, too. And maybe there is a compromise, and maybe there's not. And maybe we land on you know what, we're going to agree to disagree. But, like, did we hear each other out? Because if you lead with, listen, I don't think that we should be doing this, or I think that you're wrong, or I really think that my professional opinion should supersede what you think. You've already lost them. And so sometimes too, I may feel strongly that I think that we really do need to focus on this goal or this task. And then parents strongly disagree. But ultimately, parents are going to win. And so I'm going to have to say, you know what, maybe for now, we'll table that, and we'll focus on maybe what you want to focus on, and we'll revisit it.

Yeah. Can I challenge you to really bring in that student perspective into what you're sharing? Because I'm thinking like person-centered planning. Student-centered planning. So, yes, there are all these people around the table making these decisions, but how do we still keep that kid in the middle of it? It's not just how we're thinking or how we're interacting. It's how are we focusing them in those interactions that we're having, really about them with or without them.

As much as possible, ask them ‘what is important to you?’ And ‘what do you find is most applicable?’ And sometimes, there's an easy way to ask and go about that, and sometimes it's not. But I think as much as you can, trying to know what the client themselves find important, and asking them if you can, and asking as many questions as you can, and using as much information as you can to do what you think the client feels like is most important.

Yeah, I mean, especially in the populations that I work with, that is make or break. But I know typically in your world, a lot of times the professionals are the ones who are sort of sitting around having those conversations on behalf of. And so I know for me in my, in my population, I can just say, hey, student, you're joining. You're going to be an active participant in this conversation, which has its own challenges that come with it as well. But it's also a challenge if that individual cannot represent themselves or is not able to engage in ways that certain professionals would maybe find useful in what they're trying to accomplish. So I was just curious to hear from you. How do you, when that individual is not able to be present, how do we collectively, professionally hold ourselves accountable to centering them still in the middle of all those big professional decisions that are being made?

I think that kind of touches into this, which could be a whole other conversation in and of itself, but a topic of assent. And how some clients can say, hey, I don't like that. I don't want to do that. And some aren't going to vocally, verbally be able to tell you that. So you have to just know that learner and learn the signs of when they are telling you in their own way that I'm uncomfortable with this. This is not something that I am okay with. And so I think that for those that can't outwardly and explicitly state that, we have to be able to know them well enough and be in tune to try and know what their behavior is showing us that they are okay with and not okay with, and what they like and what they don't like. And that's our best- is for those that maybe we can't identify that, can we at least do our best to try and understand what they would want?

Thank you so much for bringing just again, the complexity to this conversation. I appreciate that you are coming from that long-term is almost a given perspective because I think a lot of our listeners are more in education, where short-term is the given, and long-term is assumed. And so I just love the complexity that you're bringing forward to this, and knowing that, really at the end of the day, if the student can or cannot be present in that conversation, it doesn't really matter. It's just a matter of whether that student can hold us accountable to having that validity, that social validity within those long-term and short-term goal planning, or if collectively, professionally, we need to hold ourselves accountable to making sure that that is still accurate as we're planning for this population that this entire season is talking about. So thank you so much for bringing that perspective. I think it's really fresh compared to what we're used to in schools.

Thank you.