Griffin Thayer
Hello everyone, and welcome to the practice of Dr Dimitra Robokos. I'm Griffin Thayer. I'm a clinical assistant, and I'd like to welcome you to the first in what I hope will be many video discussions with our team of professionals about a variety of topics related to child psychology, mental health, family wellness, and many other topics. Today, we're privileged to have Katherine Kar, a valued and skilled member of our practice. Kate is a school psychologist and a Board Certified and Licensed Behavior Analyst who's been working with children, adults, and their families in the New York City area for the last 15 years. She's joining us today to talk about topics near and dear to her heart, which are early interventions and Applied Behavior Analysis, or ABA for short. I hope that we have the chance to explore these applications for children and families. But before we do that, could you perhaps take a moment to talk more about you, Kate? Could you tell us a bit more about yourself and your training?
Katherine Kar
Thank you. Thanks for having me. I am so glad that we're finally doing this. Thank you for the chance to introduce myself here. Aside from working as a School Psychologist and ABA therapist, I've worked as a content creator and provider of professional development series for Department of Education teachers and administrators. So, I've been a teacher of teachers as well. But what brought me here to this practice, specifically, was a mutual colleague of mine and Dr. Robokos. We all went to Teachers College, Columbia University. We quickly realized that we believe in a multidisciplinary approach to helping children/teens/young adults – a collaborative approach that really seeks to support students, families, communities, and other professionals.
Griffin Thayer
That is wonderful. I am sure that everyone here is very lucky to have you. So, perhaps we could start this conversation by asking you briefly to review what ABA is and where it comes from.
Katherine Kar
That is a great question, and I love talking about it. So, ABA, applied behavior analysis, is essentially the practice of observing and analyzing behavior, and we do this to understand why humans do the things that we do. Broadly speaking, there are four main 'Whys,' -four main functions of behavior and they are 1) people seeking attention or connection with other, people 2) seeking contact with something tangible, like a thing or an activity, 3) seeking to escape or avoid something unpleasant, or 4) seeking out or avoiding sensory input, things that feel either pleasant or unpleasant, so the pursuing or avoiding of those things. So those are the four main reasons why people do what they do. So, almost all behavior is a form of communicating one or more of those needs. But why somebody does something, why we do something, depends on what need, what function you're trying to meet at that time. As practitioners, we must understand how we help students and families meet their needs? How do we impact behaviors in ways that are meaningful to a person? In other words, we're looking to understand what's important to a person, a family, a community, and to work with them to teach the skills to make the connections that help them meet those goals and meet their needs.
Griffin Thayer
By understanding these whys, so to speak, you're really able to develop new ways, tools, and behaviors for the person to use to more effectively meet those needs.
Katherine Kar
Yes, and the process is evolving as the needs change. So, it's not static. It's a very, very interactive process.
Griffin Thayer
What drew you in particular to these kinds of early interventions?
Katherine Kar
A few things, I think. My mom was trained as a school psychologist, and she then went on to become a social worker. In her particular line of work with the state of New Jersey, she actually taught parents essentially how to parent. But it wasn't all just about their interactions with their children. She taught parents other life skills, too - how to set priorities, how to determine what's important, how to make a schedule, how to make and stick to a budget. Things like that. You can't parent well if your own needs aren't being met. And so, there's this whole system to consider here. It is not just about the child, it's not just about the parents. It's about understanding the needs of both. It's about exploring those needs. I think that Dr. Robokos definitely appreciates the children’s and parents’ connections to the broader world and making these skills that we teach children and parents impactful and practical.
Griffin Thayer
I was just thinking these are very pragmatic, everyday skills that almost anyone would need to use.
Katherine Kar
Exactly. And I think seeing from an early age my mom's experience is one of the things that drew me to these fields, educational psychology mental health. My dad, on the other hand, is an electrical engineer. Sorry, Dad, if you're watching, but I think what I did inherit is his enthusiasm, his proclivity for taking things apart, putting them back together, understanding how they work, understanding why they work, understanding why maybe they're currently not working right. And that's really what we do in our work as practitioners, and particularly what we do here in this practice, is we're seeking to understand what's happening and why. We're seeking to appreciate what's important to the client, to the individual, to the student, and to their family, to their community so that we can make those connections to supports, skills, resources, and anything that will help families and children reach the goals that are important to them.
Griffin Thayer
Absolutely and so with this being centered around working on meaningful goals for others, I'm wondering if you could maybe give me an example?
Katherine Kar
That's a really good question. I work a lot with younger students. I also work a lot with people on the autism spectrum. There's a lot of focus around communication - spoken communication, in particular, as we're conceptualizing needs and priorities. As therapists, we first gather the information and then understand it, so bringing this back to the communication example, if we assume that a person who doesn't speak to communicate isn't capable of communicating, that would definitely impact what we choose to teach, how much effort we put into teaching it. The interventions that we suggest aren't going to work. Assuming the best about somebody is so important because it helps us stay engaged in the process. To be hopeful about potential, to be more present, to be more curious, to remember that we are all in this work together, and for whatever priorities, whatever goals that you have, there are ways to move you closer to those goals.
Griffin Thayer
I really like the example of someone not speaking and really trying to understand what's going on—understanding this person in their context and trying to find their motivations.
Katherine Kar
And to broaden the focus, what are we doing to help a child communicate? And how? Let's work with the things that we have to improve and develop communication, meet the student and the family where they're at, and build from there. There is no one-size-fits-all endeavor in all of this, and keeping an open mind and curiosity helps us find where to start and where to go from there.
Griffin Thayer
So, you're building on what they are doing right and on what is working for them.
Katherine Kar
Exactly.
Griffin Thayer
Okay Thank you so much. And so, from your own perspective and from your own experiences, how do early and intensive behavioral interventions like these work? How does it create this lasting change?
Katherine Kar
It is one of my favorite things to talk about; I'm so glad you asked. Firstly, I'm really trying to consider what needs and challenges exist for the individuals from the family's perspective. We do this by observing behavior, asking questions, gathering information, and gathering that data. To analyze things and understand them better, we consider what's going on in the environment itself. The people who are there, places, things, even smells. We take that into consideration, and we want to consider whether it's possible to change or adapt things. We also want to consider what's going on with the person when it's possible. How are they physically feeling? Somebody who doesn't feel well isn't going to be capable of the same thing as somebody who's feeling at their best, right? To keep in mind what somebody is thinking, what their emotions are. We want to keep all these things in mind. We do our best to check in with the families, and then with all that information in mind, we then teach the skills and we create, or we change, an environment so that the individual has the opportunity to practice and make use of those skills. And this is why this is so important – so that the person experiences success using a skill they have learned. Because if using that skill results in success and it is something interesting or enjoyable, then you're more likely to use that same skill in the future. You've heard of the concept of reinforcement – this is what it is about. And so, what we're doing is shifting from these lesser effective skills, with better options, essentially, to meet those same wants and needs (whatever they are, whatever that person chooses, it's up to them, not to us). And the earlier a person can learn these skills, the better. This is because these early intensive interventions build neurological connections; the developing brain, when you're young, is the most flexible, and that's a neuropsychology lesson for another time. The important thing to keep in mind is that younger brains are more malleable and more adaptable, and building connections then is effective and also practical. It builds healthy habits that do tend to stick with you over the course of time.
Griffin Thayer
You've seen these interventions improve other people's lives. And although you're saying early childhood, that isn't to say there isn't benefit later on in life to do this too.
Katherine Kar
Absolutely, yes.
Griffin Thayer
Exactly yeah, and that, I think that's a really important part of this philosophy that you're talking about, that we assume competence. We assume that people can learn, people can grow, people can change, as long as we find out what's important and meaningful for them.
Katherine Kar
Yes, and find the opportunities for them to experience that growth, that change, right? So, it's both things, and it becomes this feedback loop. A child builds comfort using the skills, it builds relationships among people who are there, supporting each other. The benefits are broad.
Griffin Thayer
I'm hearing that there are so many benefits, it's helped so many people. And I'm curious, from your perspective, what are some populations or groups that these kinds of early interventions benefit?
Katherine Kar
Early or even just simply intensive or thoughtful interventions like these are beneficial to everybody. We teach our students how to self-monitor, for example, how to understand their own needs and how to understand how they fit into the larger context of their communities, right? This can help them be good friends with their peers. This can also help them resist peer pressure and bullying, increasing their awareness and social skills. Things along those lines are beneficial, and being thoughtful and intentional is really helpful. These kinds of things are also, of course, helpful for teachers and other practitioners in the education space, as we learn how to impact our students as individuals, but also how to impact our classrooms or our school buildings. Again, it comes back to that understanding of motivation, understanding what's interesting, what's important to our students, and to incorporate those things into the academic skills, and social activities. Incorporating what's important to students brings their attention and engagement. And the better their attention that you have, the more engaged they are, the more experiences they will have again, and the more practice they get. It comes back to that idea of curiosity and neutrality. In difficult conversations and difficult situations, it helps us give our students, our caregivers, and ourselves a bit of grace. It helps us define needs: ways to support those needs, ways to know whether that support is working. It can reduce our anxiety about why things are happening if we have a better understanding. So, it reduces that frustration.
Griffin Thayer
I'm hearing so many reasons why ABA benefits many people. And I'm also really struck by what you're talking about, with how it fosters relationships. I imagine you need to understand people's behaviors in their context. For anyone, whether you're a parent, a teacher, a caregiver, or anyone.
Katherine Kar
Absolutely.
Griffin Thayer
Well, that is all the time we have for today. Thank you so much, Kate, for joining us on our interview. It was a pleasure talking about ABA with you and getting to learn a bit more about the work myself. If people would like to learn more about you and your work. Where might people be able to reach out?
Katherine Kar
You can reach out to me by email. My email is
Griffin Thayer
Oh, thank you. And for any questions or interest in seeking services, you're welcome to reach out to our practice at www.childtherapysupport.com or visit our Facebook page at Dr. Dimitra Robokos Psychological Services. On the website there are regular blog posts as well as information about child and family mental health. Lastly, if you interested in our practice covering a particular topic and it's related to child and family mental health, please email us and let us know. We would love to hear back from you on what interests you so we can get valuable material out there. Thank you again, Kate, so much for being our guest today, and I hope to see you again in the future.
Katherine Kar
Thank you so much.
Griffin Thayer
I really enjoyed this. Well, that's all for now. Thank you. Bye.
Fri, Aug 16, 2024
SPEAKERS
Griffin Thayer, M.A., Katherine Kar, Ed.M., BCBA, LBA