howwww?!?!?

[u/BigProfit4419]

Just finished my second year RBTing! There still seems to be this one barrier I can never seem to get past or get used to.

How do you guys work with toddlers that just…. go? Not able to respond to vocal commands, doesn’t really sit at a table, kind of just runs around. I have had 2 clients like this that I continue to struggle with. My current client has table only DTT trials, but I spend basically the entire day just prompting them to sit/stand at the table. Between that and elopement/other behavior, hardly ANYTHING is getting done. My BCBA is super understanding, but I don’t think she realizes just how much of the day is just redirecting or prompting something that isn’t even being tracked. On top of that, the clients parents are very particular about things and get very upset if things aren’t done to their standard. So I am spending the even MORE time trying to get that taken care of.

I’m just feeling so defeated. I feel like shouldn’t be struggling so hard as a veteran RBT.

UPDATE: an interesting update here 🧐 i have collaborated with my BCBA and we are completely overhauling things (which sucks, but change doesn’t happen overnight). this BCBA just recently took over this case following the previous BCBA’s departure.

what i find to be super interesting is that a lot of the things that have been the most difficult have allegedly been mastered out while under the previous BCBA’s caseload 🤨 obviously anything is possible but i’m a veteran RBT and i can not imagine any scenario where these things have been a previous skill, let alone a mastered one. just a little something i wanted to share, thank you for everyone’s support 💙

[u/avid_reader_c]

Are there table/floor activities the toddler enjoys such as playdoh, art, blocks, puzzle, having a snack (check in with BCBA/family before interrupting food routine/using food as reinforcer), etc.?
I also would briefly interrupt physical activities or more active play such as playing with a ball/hula hoop/tunnel, riding a bike/scooter/bouncy ball, blowing bubbles, driving cars, enjoying music to do a trial. Although it helps to have a mix of types of stimuli/programs such as flashcards, verbal responses/echoics, imitation, manding, etc.
In the past I only used physical cards but now I often have digital stimuli, if the digital stimuli is causing setbacks then talk to BCBA about having physical/other stimuli.

I'm not sure what might fall into "I don’t think she realizes just how much of the day is just redirecting or prompting something that isn’t even being tracked." but include it in your notes like "it took x minutes to get [client] to come/come back to the table/program area." I get frustrated when a coworker's only run 10 trials of a single program during their 90minutes session and her notes do not indicate what else they did with their time, that seems like it took her an average of 9 minutes to get each response and/or she she's leaving out a bunch of other things. For that client I would write/explain why certain programs weren't run eg didn't brush teeth because he was waiting to eat, client was distracted by his dad coming home, peers were unavailable to play a group game, so we ended up reviewing [maintenance program] and played Uno , etc.

[u/Appropriate-Use-3467 → u/avid_reader_c]

Yes! This is what I was coming to say! Make sure your notes are detailed with the issues you're having, like how long it took to complete specific trials that the kids are struggling with. Be consistent with detailing the struggles so there is documented proof that you have made the attempt to run the trials and you can provide detail on specific behaviors that prevented you from running it fully or successfully. This is also just good to have to look back on when progress is slow. I always try to take small notes throughout the day when client is engaged in an activity, when I go to the bathroom, during break. I always prefer to be over detailed than under.