Griffin Thayer
I'm Griffin Thayer, a clinical assistant, and I'd like to welcome you to the first in a series of discussions with our team of professionals about a variety of issues related to child psychology, mental health, family wellness, and many other topics. Today, we're privileged to have Katherine Schoenfeld 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 New York City for the past 15 years. She is joining us today to talk about a topic near and dear to her heart, which is Applied Behavior Analysis, or ABA. Throughout our conversation, I hope that we'll have the chance to explore the history and key principles of ABA, its applications for children and families, and the latest advancements shaping ABA's future. Kate, thank you so much for joining.
Katherine Kar
Thank you for having me. I'm really glad that we're doing this.
Griffin Thayer
Me too. So, before we go into ABA, I'd love to just get a moment to talk about you a bit more. Could you tell us about your training and what led you to join our practice?
Katherine Kar
Sure, again. Thanks. Thanks for the chance to introduce myself here. I'm really excited for this. So, my name is Kate. I am originally from South Jersey near Atlantic City down the shore. I studied psychology and business at St. Joseph's University in Philadelphia. One of my most formative experiences was as part of this class on child development and developmental differences. We had this assignment to interview a family about their experiences with assessment and a diagnostic process (and their experience with the eligibility process for school-based supports). So, for this project, a very dear friend was kind enough to connect me to his family and his family members. They graciously and also candidly shared their experiences with me for this assignment. I suppose I was surprised because it wasn't just related to the challenges of determining whether their child had a diagnosis of Autism but also how to access support services like ABA to help the child. This was sort of my first encounter with both school psychology and ABA. The rest is history. Through that class, I got my first job in the field of ABA as a one-on-one aid, shadowing a child at a summer camp. Then, during the school year, I provided after-school ABA sessions. After college graduation, I moved to New York City to pursue my Master’s in School Psychology at Teachers College, Columbia. And while there, I learned (and eventually also taught) many of those same assessments that I encountered in that college project when I interviewed the family about their child with suspected Autism.
I guess my career here in New York has been kind of unusual. Most school psychologists work in schools. I have had some school-based roles, but actually, most of my work has been outside of schools in what I like to call Department of Education (DOE)-adjacent agencies. So, these contracted vendors provide services to the Department of Education, such as teaching educators. Another thing I've been doing for a long time also is conducting and supervising evaluations with preschoolers. So, we're assessing what I like to think of as school readiness skills or pre-academic skills. You need these skills before learning or to learn academic skills. We evaluators go where the kids are, at school, daycare, or home, and evaluate them there. These evaluations aim to assess the children's needs and determine eligibility for educational and related services through the Department of Education.
Griffin Thayer
So, you're basically making sure the kids get the support they need to develop the skills needed to learn.
Katherine Kar
Yes. PRE-school, quite literally - do you have the prerequisite skills and supports in place to help you succeed later in your education and in your life?
Griffin Thayer
That sounds like a really interesting field, and I'd love to hear a little more about that. To get these skills in place in early development - that sounds really crucial. Also, how did you get involved with Dr. Robokos in the practice here?
Katherine Kar
Yeah, it's a great question. I was working in an ABA-focused school, specifically for students with autism, so I decided to take a deeper dive into the ABA field. And so, I went back to grad school again. And this time, I went to CUNY Hunter, where I got my Board-Certified Behavior Analyst training. I'm a Licensed Behavior Analyst in New York. But what brought me here to this practice? I think I met Dr. Robokos, probably around, I want to say, 2018 pre-pandemic, and it was through a mutual colleague. I think we immediately found that we had a lot in common, which is wonderful. We have not only attended Teachers College, but we also happen to have lived at a place called International House, which is not just a dorm; it's this unique community of graduate students and interns from all around the world. We also both taught graduate students at Teacher College, Columbia University. Dr. Robokos still teaches at the Albert Einstein College of Medicine, and I know that she really enjoys that. I think we both have a very deep appreciation for assessments and also a careful approach when assessing children, teens, and young adults. We both also worked as ABA therapists too in the past.
Griffin Thayer
So, speaking of that, perhaps you could just start the conversation by explaining what is applied behavior analysis and where does it come from?
Katherine Kar
Great question - ABA, Applied Behavior Analysis, is the practice of observing and analyzing behavior. It is a way to understand why we do what we do and why humans do the things that we do. There are several main functions of behavior. You're either seeking attention or connection from/with other people; seeking something tangible (access to something or time with something); escaping or avoiding something you don't want to be a part of (or sensory input). So, this is important to keep in mind, because almost all behaviors are forms of communication. Why you do something depends on what need and what function you're trying to meet, and so understanding those things leads us as practitioners to understand the person better. So, in other words, we're trying to help people reach their goals, to meet their needs, and we do this by understanding what it is that they're communicating to us through their behavior.
Griffin Thayer
And by understanding their communication and motives for it, you can help them find more adaptive, more flexible ways of getting what they want and need.
Katherine Kar
Absolutely.
Griffin Thayer
Okay, yeah, that's really interesting. And so, how did this field really develop? Where does it come from? Does it come out of a therapy tradition, or has it come out of a research tradition? How did this get developed?
Katherine Kar
Yeah, it's another great question. And before I say anything, I want to offer my full disclosure here. History is not my area of expertise, but I'm going to do my best to give us a sort of a basic timeline of some highlights. There were several dominant schools of psychology in the early 1900s, mostly focused on studying inward thoughts, feelings, and what they thought of as consciousness. Freud comes to mind here. He's, he's pretty famous one. There were other schools of psychology that took different approaches to understanding this, but all sought to understand what they called the psyche. Sometime in the 1920s, a practitioner named Watson developed another school of thought that is directly in reaction to this, called behaviorism. So, behaviorism, instead of focusing on what is internal, not observable, focuses on observable and measurable behaviors. I bet that you've heard of Pavlov and dogs, right? That's a very famous experiment - dog salivates for food. That's natural. We have that association. Dog does not salivate when he hears a bell. Bell currently is meaningless, right? But then the scientist rings this bell while also presenting the dog with food. So now that becomes a learning experience - the dog now salivates for the bell separately from the food. So, the bell now has meaning because of this experience of being paired with the food. Pavlov demonstrated that these involuntary behaviors/unconscious behaviors, like salivating, are not just related to our thoughts, but they're also related to learning experiences. So that's classical conditioning. Building upon this later, someone who may be equally famous, B.F. Skinner, takes this theory and continues with it. His theory is called operant conditioning. He focused on the idea of reinforcement. Dr. Ivar Lovas, another scientist, took this idea and developed what we think of as Applied Behavior Analysis today. Peer-reviewed research at that time found that there were significant impacts and improvements in almost all the children with Autism who received the ABA interventions compared to children who received no specific intervention. Follow-up studies years later show that those same children maintained those skills all the way into adolescence. It demonstrated that we've found this way to meaningfully impact behavior, but also that those impacts continue; they maintain over the course of time.
Griffin Thayer
Yes, evidence-based long-term results are powerful. And it sounds like ABA has a very long tradition, starting in the 1920s. And so, from your perspective what do you think about ABA?
Katherine Kar
That is also a very good question. It's a very important question. So, first, what we're trying to do as ABA practitioners is to consider what needs exist, what challenges exist. We do this by observing behavior. We also want to consider what's going on in the environment itself. In the environment, there are people, there are places, things - all of these things that are part of the environment and we have to consider, when it's possible, what's going on with the person themselves. How are they physically feeling? What are they thinking, what experiences are they coming into the current context with? From that point on, we teach the skills and behaviors. We use that information to understand what skills and behaviors must be taught. The families and the students are also very important in determining what those things are. So, what we're trying to do is also change or impact the environment so that the individual can make use of those skills. Behavior change happens when we consider these less effective or challenging behaviors with better options to meet the same needs.
Griffin Thayer
Okay, so it sounds like with ABA, you would meet with a child or a family, find out what motivates them, and use positive reinforcement, praise, and encouragement to help them develop these new skills that they will learn to rely more on.
Katherine Kar
Yes, absolutely. And there's a couple different ways to think about engaging. There’s some of the classic examples of ABA that you think of, maybe, like sticker charts and external motivators. Extrinsic motivation. But it is also about being intrinsically motivated, something that you enjoy. And so, we're engaging both sides of one’s interests and their attention. Because if a child is interested in what we're doing, if it's exciting, the longer we can hold a child’s attention. We can use that time effectively to teach and continue to practice in ways that bring joy and that are meaningful.
Griffin Thayer
Okay, and so it sounds like you are trying to cultivate the internal motivation, this intrinsic piece.
Katherine Kar
Yes - there's a feedback loop that I think is interesting to consider here because learning new things is difficult, of course, and when you're learning something new, you need a lot of support as you're learning that skill - as you practice it. As you get better at it, it becomes easier. It becomes something that you internalize. And so, the better you get at it, the more you do it, and the more you do it, the more you like it, and so on and so forth.
Griffin Thayer
A feedback loop
Katherine Kar
Yes.
Griffin Thayer
I'm curious if there are examples we can use to discuss how ABA might work with a child, how it might help them learn to read, or how it might help them with challenges in the classroom.
Katherine Kar
It comes back to first understanding the challenging behavior and why it's happening. One behavior can have more than one function at the same time. One behavior can have different functions at different times, so I'll use an example of how I work with toddlers. Big feelings are pretty common in young children, but crying, for example, is a specific, observable behavior. We can define it. We know it when we see it, and it can be a way to communicate (“I need help”). Sometimes, that can be a way to communicate “I don't like this” or “I want out of this.” And so, when we're thinking about what skills to teach, we must think about what functions we're addressing. Perhaps we have to triage or prioritize which functions to address first. But it comes back to understanding better ways to bring that student in contact with what they want or need. So instead of crying when they need help, how to raise a hand or approach a teacher and tap on the shoulder and say, 'I need something,' instead of crying. We can teach the student how to ask for help or to say to the child who took that toy away, “That's mine - I wasn't finished with that yet.” That makes ABA such a wonderful skill set and tool set. Your approach is specific to what the child needs.
Griffin Thayer
Okay, so it's all about this context, the situation, and being specific to the child.
Katherine Kar
Yes
Griffin Thayer
Okay, thank you. When we think of ABA nowadays, at least, I think of autism and neurodiversity. And I guess I'm curious, from your perspective, how does ABA really help individuals who are neurodiverse? And maybe we could even start off by asking what neurodiversity is. Because that is a word we hear a lot nowadays, too.
Katherine Kar
Yes. Neurodiversity is a word we're using to describe differences in how people's brains work. We're moving away from the deficit approach. These are just differences in the ways that people think. The idea is that there's no correct way for the brain to work. Instead, there's a variety of ways that different people perceive the world, respond to the things in the world. And again, these differences are not problems to be fixed. They should be embraced, they should be understood. And I think that ABA really aligns with this endeavor, because it helps us observe and quantify what those differences are and what those needs are, so that we can better understand, better embrace, encourage our students, give them the skills that they need to be the best versions of themselves. It's not about making them into somebody else or something else. It's about giving somebody the skills they need to access the experiences that they want to have.
Griffin Thayer
Yes - you're trying to give them tools.
Katherine Kar
Yes, exactly.
Griffin Thayer
Besides Autism, I'm curious if there may be other populations, other groups, that ABA might also be really helpful with.
Katherine Kar
Certainly, I like to think of ABA as being for everybody. There's been this long association between ABA and autism services, but ABA really is for everyone. It's for people of all ages, for general and special education students. We can use principles of ABA to help people engage in things like self-monitoring, resistance to peer pressure, bullying, understanding social dynamics, to help them build relationships, to build their own self esteem. I worked for an education tech startup for a while, where we provided training to teachers in the Department of Education on how ABA relates to classroom behavior management (motivating students to engage in the activities and making learning fun). This is super important and relevant for therapists, psychologists. There are ways to help people expand beyond that immediate behavior consequence to align their behaviors with their larger values and goals.
Of course, there are practitioners in other fields—behavioral economics, organizational behavior management. These fields are all trying to seek to understand the human condition, if you will, and how we engage with each other meaningfully—how we engage with our work, how we engage with our world.
It helps us understand how things work, why they work, and why we do the things that we do. It's about finding the connections, right? Behavior is information. Information is data. ABA is that framework for gathering information and understanding it, and again, this is what I think helps you remain sort of neutral and open to more connections in your approach.
Griffin Thayer
It’s a kind of philosophy; it's kind of a way you can look at and interpret the world around you.
Katherine Kar
Exactly. Challenging behaviors are stressful, not just for caregivers, but also for the students, for the children, when they're under stress. And I think that one of the most helpful things about ABA is the neutrality - understanding the needs of others and then taking action to help.
Griffin Thayer
I see that as relevant, not just for providers but also for parents, teachers, families, and caregivers. ABA can help facilitate communication more effectively.
Katherine Kar
And for those who want to learn more about ABA, the best way to learn about ABA is by working with somebody who's a trained professional. Needs are individual - what works for some people won't work all the time or won't work for everybody. ABA is not just a set of tools or activities. It's this framework for understanding things and having access to a person who's trained in this to help you understand the tools. There are parent trainings and other courses available.
Griffin Thayer
Okay. Well, thank you so much, Kate, for joining us in our flagship interview.
Katherine Kar
Thank you so much for having me. This is really fun.
Griffin Thayer
Oh yes, it was a pleasure. I loved talking with you about ABA and learning more about the work myself. This is not an area of expertise for me, so I'm absorbing all this information, too, and it's really interesting. Thank you. If people would like to learn more about you and your work, where might people be able to reach out to you?
Katherine Kar
If anybody wants to reach out to me directly, my email address is
Griffin Thayer
Thank you so much. And so, for any other viewers or listeners, if you have any questions, as Katherine is saying, you can reach out to us at www.childtherapysupport.com or visit our Facebook page at Dr. Dimitra Robokos Psychological Services PLLC. Our websites also have regular blog posts and other information about child and family mental health. Again, if you have any ideas about what you want us to cover, reach out to us and tell us what you want us to discuss. We love incorporating comments and feedback. Thank you again, Kate, for being our guest, and I hope to see you in the future. Alright. That's all for now.
Jul 1, 2024
SPEAKERS
Katherine Kar. Ed.M., BCBA, LBA & Griffin Thayer, M.A.
*This transcript has been edited for clarity.