We recently had the pleasure of chatting with Dr. Jordan Boudreau, Founder and CEO of Autism Centers of Michigan (“ACM”). ACM is a Catalyst client offering applied behavioral analysis services for children with autism spectrum disorder in home, in centers, and through school-sponsored programs. We discussed what’s been going on there lately and plans for the future. Jordan shared some great industry related advice and insights.
DataFinch: Jordan, thank you for talking to us today. Autism Centers of Michigan has been very busy! Looking back at the past year, what are the highlights and accomplishments of which you are most proud?
ACM: Well, we opened two facilities, one in the Tri-County area and one in the Greater Lansing area of Michigan. We contracted with two mental health agencies to provide services in an additional 32 Michigan counties, and we also developed a 12-week parent training curriculum. The parent training curriculum is used with all of our families and is really helping parents get on board. The knowledge of what we’re doing makes them feel involved in the process instead of on the sidelines.
DataFinch: What does your parent training curriculum include?
ACM: It’s like a crash course in ABA. First, it goes through all the principles of behavior. Then, it delves into how we create and run programs. It concludes with behavior skills training that teaches the parents how to implement the behavior plans we have in place for the client.
DataFinch: So, parents implement the behavior plans at home when you’re not there?
ACM: Yep, exactly. They’re implementing the behavior plan, taking data, and graphing it.
DataFinch: How often do you review that data? Do you review with the parents?
ACM: Supervisors always review the client’s data and graphs prior to their weekly session. We meet with parents on a monthly basis to review programs, data, and progress…really everything. About 80% of our services are in-home and 20% are in our centers.
DataFinch: Wow, that’s great! I’ve heard of similar parent programs, but not quite as structured as this; encompassing ABA training and data collection. I’d be curious to know how much of an impact the parent curriculum is making for your learners – getting ABA more often, in more places, from more people.
ACM: That’s where I’m at as well. Currently, we rely on a word of mouth system. We see improvements in performance, but can’t attribute those improvements entirely to parents. I’m actually interviewing for a Director of Operations, and once that person is on board we’ll be starting an in-depth line of research on the parent curriculum’s measurable effects on child progress.
DataFinch: We’d love to hear more about that research! Are you located just in Michigan or in any surrounding states?
ACM: Just in Michigan right now. We serve about 70% of the state.
DataFinch: Well, we’ve discussed your accomplishments over the past year. What are some of the challenges you’ve faced during that time? How have you handled them?
ACM: Collaborating with the state of Michigan education system has been a challenge. I’ve found talking about what ABA can do and presenting the data doesn’t result in motivation or action from a school until they have a serious behavior problem that needs to be resolved. We recently contracted to provide paraprofessional training with a school system because they had problem with behavior issues in the classroom and they didn’t know how to adjust. That’s when they reached out to us to see if we could help. I’m hoping to use that partnership as a platform to collect good data and support the value of our services.
DataFinch: So, you’ve found the data is not as convincing as real life scenarios where you come in and show how you work with these kids?
ACM: Correct. There isn’t a strong motivation to utilize our services until there’s a serious issue.
DataFinch: Okay, that’s a challenge in providing school based services. What about challenges with your center based services?
ACM: Our centers are running pretty well. Actually, we recently got into a lease and already need more space. We’re deciding if we should find a new lease or push through our current lease by treating more kids in home until we can get a bigger space. The biggest issue with the clinical side of things is having waitlists and not being able to serve everyone… [there is] a shortage in behavior analysts.
DataFinch: From an organization perspective, those are good problems to have – needing more space more quickly than you thought. But, you do hate to hear that there’s an underserved population. It sounds like you guys are growing as fast as you can.
ACM: Definitely.
DataFinch: What about 2017? What are you looking forward to for your own agency and the ABA field in general? Do you feel there’s any upcoming innovations that will change the game for our industry?
ACM: I’m looking forward to implementing telehealth practices that were recently passed in Michigan. Detroit Medical Center (“DMC”) received a grant from the state for telehealth research, and being the only ABA provider in Northern Michigan, DMC asked us to be a part of that research project. We’re going to work together to provide really good telehealth services in the state, especially for rural areas that are under served.
DataFinch: How will you provide service in rural counties where internet access isn’t completely reliable or where the cost of an employee driving to the area is greater than the return?
ACM: That’s exactly the kind of things we plan to work through with Detroit Medical Center. Right now, we try to get the word out in rural areas to build up a small caseload, making the drive more manageable. We expect we’ll need to purchase hot spots so we can run Wi-Fi through mobile phones in rural areas. But the good thing is, we’re not going into this alone. We’re going into this with DMC, and together we’ll make sure everything related to our telehealth practices is HIPPA compliant. That partnership begins late summer. I’m really excited to see where it goes.
DataFinch: Are there any other states to which you are looking as a model for telehealth?
ACM: With the expansion we’re experiencing, I’ve only had time to ensure we are providing quality clinical work and meeting the needs of the contracts we’re getting into. That’s why I’m happy to be working with DMC. They will be doing a lot of leg work that we will be lucky to benefit from.
DataFinch: Do you have any advice for BCBAs or executives that are also running a quickly expanding agency? Or, advice for organizations in the same place ACM was six months to a year ago – about to embark on a journey of growth?
ACM: I found no matter what we do, it’s always about the people. It’s about taking the time to find quality employees that are committed to the agency’s mission, motivated to do the work, and show it in their work ethic. The demand for services creates a situation where you have to hire, but it’s important to ensure you have the right people in the right positions for things to run smoothly. Our ACM clinical directors are amazing. I trust them in everything they do. We can meet, and talk through issues, and as I delegate work I know it is going to get done and get done well. My focus is clinical excellence. I figure if we focus on putting a great product out there, the rest will follow.
DataFinch: So your advice would be to take your time and do it the right way, even if your client list is getting long.
ACM: Yeah. There’s a lot of pressure from the agencies to get these kids going as fast as possible, but if they’re not getting good services, what’s the point?
DataFinch: On average, how long does it take you to get a new frontline staff member up and running, providing in-home service on their own?
ACM: Usually within 30 days. All of our frontline staff become Registered Behavior Technicians (“RBT”). They go through the RBT training, the RBT Competency Assessment, and take the RBT Exam. If they can get through that process, that’s a pretty good indicator of what they can handle.
DataFinch: Have you had better luck with people that are “starting some scratch” so you can mold their practice methods? Or, do you have better luck with people who have past ABA experience?
ACM: I’m finding with people that have experience, there’s an easier flow. In either scenario, we have to shape their performance. But I find it easier to shape performance when there’s already a flow of responding.
DataFinch: Do you ever hire people that don’t know anything about the world of Autism and are really starting green?
ACM: Yes, because there’s a great need. I will hire a person if their work history shows they’re able to work on their feet and learn new processes in an efficient manner. Passing the RBT Exam can help support that. And, I always want to see work products before I hire anyone. Show me graphs, data, whatever you’ve been working on. I want a good idea of a person’s work history and work product.
DataFinch: Do you take data on your employees?
ACM: Data that is necessary for billing. We have a system where we work backwards from outcomes. So if a client is not making adequate progress, we work backwards to analyze what needs to be improved in order to reach the outcomes that match the client’s goals.
DataFinch: Is there any new research that has changed the way you provide services? Or, any discoveries you’ve personally made that changed your methodologies?
ACM: Parents immediately want us to start running programs and getting behavior changed, but I’ve discovered that is less efficient. Instead, we instituted an initial program with respondent conditioning where we have to get eye contact, imitation, and an adequate amount of time in the learning area. We upfront all of that now. Additionally, I attended a symposium at the ABAI Convention in Chicago in which the speaker talked about differential reinforcement without extinction, and how it can really benefit parent implementation of programs. Since that symposium, I’ve met with our supervisors to discuss these findings. I’m looking forward to seeing the results from that type of programming.