Down Syndrome and Autism with Angela Lee

ABA is a great teaching tool to teach anything to anybody. Angela Lee, BCBA and mother of 4 joins me in this episode to discuss her son Tristan and how his Down Syndrome has inspired her work as a BCBA and teaching vocational skills. 

What is Down Syndrome? 

Down Syndrome is the triplication of the 21st chromosome. As one of the very few chromosome abnormalities that is compatible with life, Down Syndrome is an over expression of DNA seen throughout all of the body systems internally and externally. A variety of medical hurdles and low IQs ranging from 40 to 65 come along with the diagnosis of Down Syndrome. The range in which an individual is affected and how their systems are affected will vary person to person and also depend on the time in which their DNA changed, from conception or throughout gestation. 

A Dual Diagnosis of Down Syndrome and Autism? 

About 12% of individuals with Down Syndrome have autism as a dual diagnosis. This is a lot more common than most people think. Autism and Down Syndrome and can actually be both treated and managed with ABA whether it’s a dual or singular diagnosis of either. Most people recognize ABA for autism but it’s not a common therapy for Down Syndrome. Angela shares her experience as a BCBA and the incredible impact ABA can have on individuals with Down Syndrome and their goals.  

Employment Opportunities for the Special Needs Community

Angela’s son Tristan is 20 years old and together they realized his only true option for work was janitorial, something he just wasn’t interested in. This sparked Angela’s ABA based employment, Riverside Coffee Shop. Angela is planning and working with individuals by providing assessment and ABA training in all the areas of need to create a functional employment experience in her coffee shop. If individuals with special needs had more vocational training to go into a job of their choice and employers had more training to work with this community, the employment opportunities would be much more broad.
 
As a mom, BCBA, and parent advocate, it’s Angela’s hope that other BCBAs and parents alike will use their passion to bring the special needs community together and create more vocational opportunities. She encourages parents to stay informed, knowledge is power. When you know more, you can do more. 
Down Syndrome and Autism

Angela Lee on Turn Around Autism

Angela attended Touro University at Mare Island for her master’s degree and went on to complete BCBA certification through FIT (Florida Institute of Technology). Her son, Tristan, who was born with Down’s Syndrome, is her inspiration for ABA next steps-Riverside Coffee Shop which provides a vocational training program that promotes community inclusion and social interaction  utilizing the coffee shop as a teaching platform.  These new skills  will lead to a more independent and productive lifestyle for teens and young adults diagnosed with Autism and other developmental differences. We target individuals who struggle with finding meaningful employment.

YOU’LL LEARN

  • Is it common to have a dual diagnosis of Down Syndrome and Autism?
  • What is the IQ for a person with Down Syndrome?
  • What are the employment opportunities for a person with Down Syndrome or Autism?
  • How can ABA train special needs employees?
  • Why are vocational programs important for increasing the rate of employment in the special needs community?
  • What therapies are common for someone with Down Syndrome?
  • What is Down Syndrome?
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Angela Lee – Turn Autism Around Podcast Transcript

Transcript for Podcast Episode: 162
Down Syndrome and Autism with Angela Lee
Hosted by: Dr. Mary Barbera
Guest: Angela Lee

Mary: You're listening to the Turn Autism Around podcast, episode number one hundred and sixty two. Today I am talking to a mom and also a board certified behavior analyst. And her name is Angela Lee. She has four children, including a son, Tristan, with Down Syndrome. So we are talking all about Down Syndrome when it co occurs with autism, which is more common than you think. And we also talk about ABA for kids with Down syndrome, whether or not they have autism too. And another thing we talk about with Angela is the fact that she is the founder of ABA Next Steps, Riverside Coffee Shop, which is a startup training program with a coffee shop that they're actually producing coffee. That's a vocational program that she started to help her son with his goals. So we talk all about Down syndrome. We also talk about how it's never too early or too late for good ABA programing. Whether you have a very young child or an older child or adults with Down syndrome with or without autism. Let's get to this important interview with Angela Lee.

Welcome to the Turn Autism Around podcast for both parents and professionals in the autism world who want to turn things around, be less stressed and lead happier lives. And now your host, Autism Mom, Behavior Analyst, and bestselling author, Dr. Mary Barbera.

Angela Lee on The Turn Autism Around Podcast

Mary: So, Angela, it is so nice to meet you and to have you here to talk about Down Syndrome and Autism.

Angela: Thanks for having me, I appreciate that.

Mary: Yeah. So we are going to start with your fall into the world of Down Syndrome. And, you know, I guess it starts with your personal journey.

Angela: OK. Well, 20 years ago, I had my son, Tristan, who was born with Down syndrome. He was born with a heart defect. So at five months old, he had the open heart surgery. He had several tubes put in his ears. Then another like touch up surgery for some chest infection.

Mary: And now he was. You have four kids. Is he the youngest, oldest.

Angela: He's the third. He's our third with two older and one younger.

Mary: OK. Did you know he was going to have Down Syndrome?

Angela: We did at about 15 weeks of pregnancy. I went in for an ultrasound and he had some markers, some genetic markers, which then prompted an amnio and genetics consult. The amnio did come back positive, so we literally had a diagnosis petri dish diagnosis. I'm going to say by about 20 weeks, 20 weeks of pregnancy.

Mary: OK, I'm sure that was a difficult thing to hear.

Angela: It was. It was devastating. You know, you have this vision in your mind of the baby that you're about ready to have and how what is it going to look like and what's he going to sound like? And then we went from not having any experience with anybody with special needs to now having this responsibility of being the parents of a child with special needs or yeah, it was, it was at first overwhelming.

What is Down Syndrome?

Mary: And what is Down syndrome?

Angela: Down syndrome is the triplication of the 21st chromosome. We have chromosomes which can replicate, and it's not a unnecessary, necessarily abnormal or unusual thing to happen. But the majority of the other chromosomes are much larger and they're not compatible with life. So that that would be probably be a miscarriage. Yeah, the triplication of the 21st chromosome is one of the one of the few chromosomal abnormalities that actually are compatible with life.

Mary: OK. And so I had a cousin with Down Syndrome when I was 10 years old, he was born, and so I was aware of there are certain physical characteristics. So what? What are those? You know, just to kind of get us on track of what is Down Syndrome.

Angela: So it's an overexpression of DNA. So it it affects every, every system in the body respiratory, circulatory, muscular, skeletal. And of course, it affects the brain. And really, depending on that person's body, it's going to kind of determine how bad each area is going to be affected. But every area will be affected. My son, for example, he has the typical Down Syndrome features, but he happens to have very nice muscle tone. So he can be very strong and he actually will have muscle definition. You might. I have another gentleman who works here with me who has Down syndrome in his speech and language at AH, is very good, but his fine motor skills are very poor. So like I said, every system will be affected. But to what degree depends on the individual

Mary: Right and in terms of intellectual disability or a low IQ that happens in?

Angela: Every case, 100 percent.

Mary: 100 percent, that's that's what you're aware of. And yeah, and so the IQ of people with Down syndrome usually fall in to the...

Angela: Probably 80 to 90 percent of individuals with Down syndrome are going to fall in between 40 and 65 IQ range. Again, what? There might be some outliers on either on either side. And if there's a mosaic downs, which means that triplication of the chromosome occurred didn't occur at initial cell division, but at some point during gestation, then there will be more mild. The effects will be more mild on the body because they'll be the less overexpression of the DNA.

Mary: Yeah, OK.

Angela: So their IQ might be higher. So that's

Mary: Yeah. And I did do a video blog on IQ and what what that means and my own time. Lucas has intellectual disability, and his IQ have been when they were tested were much younger. They were in the 60 range. But I also know people that had 60 IQs who are driving and have gone to college and they've, you know so. And I know there are, you know, actors with Down syndrome and people that are functioning, people that are getting married. And so, you know, IQs are one number, Yeah. It doesn't mean, you know, a lot in some respects, but we just wanted to cover that. So I also while I was preparing to interview you, Angela, I also looked up what the rate of Down Syndrome plus autism was because in the past, as a behavior analyst, I've worked with maybe 10 or 15 students who had both Down Syndrome and autism and the Down Syndrome Research Foundation. DSRF.org States that if you have Down Syndrome, you the child is ten to twenty five times more likely to have autism, and that 12 percent of their students, at least within that organization, have a dual diagnosis of Down syndrome plus autism. Is that does that number seem high or low or about?

Angela: It seems pretty accurate. What I do suspect is that a lot of undiagnosed dual diagnoses probably does occur, so the percentages might even be higher than what the the research is showing right now. But as we get better, we're diagnosing autism and the red flags are get out there more than maybe the more parents will see that and then request the testing.

Mary: Yeah. So your son, Tristan, he does not have a dual. He does not know, right? So he is just Down syndrome, and he does have some medical issues that are largely...

Angela: That go with Down's syndrome. Yes.

ABA and Behavior Support for Down Syndrome

Mary: OK. So. So let's talk about how you got from a mom to three kids, including a son with Down syndrome, and you also went on to have a fourth child, so..

Angela: And a puppy.

Mary: And a puppy. And now two grandchildren. So how did you move over to becoming a behavior analyst?

Angela: Well, I was in the school system as a parent educator. I worked as an RBT or what they now call an RBT so I did kind of both educational positions, and I was offered a stipend to complete my master's degree and had an emphasis. It was in special education with an emphasis on autism. And once I completed my degree, I decided I didn't want to become a teacher that I wanted to become a BCBA and at the time I was 10 years ago, they used to call it going to the dark side.

Mary: The other teachers would call the teachers...

Angela: Yeah, when a teacher wanted to become a BCBA, they were like, Oh, you're going to the dark side? I'm sure they don't say that anymore, but I did. So I signed up for a FIT and I completed their coursework and I love it. I love being a BCBA.

Mary: And you've been a BCBA for about six years now, you said. So when Tristan was little, I'm assuming you got early intervention right away speech, OT..

Angela: Yes, very busy.

Mary: You know, they the birth to three program. I'm sure. When you have a child with an immediate diagnosis and immediate needs, then you get services automatically qualified. Yeah, yeah. So but I bet you you didn't have any exposure to BCBAs back then.

Angela: No.

Mary: And you didn't know what ABA was, either did not. And so, you know, as I've been in the world of autism for over twenty five years now, you know, and as I've had experience working with 10 to 15 students with some with a dual diagnosis, some with just Down syndrome, they were on life skills classes with kids, with autism that I was working through the statewide grant and and those sorts of things. You know, all of the techniques, especially the techniques in my new book Turn Autism Around, are so appropriate for, you know, one year olds or two year olds with Down Syndrome, you know.

Angela: If I had only known. Yeah.

Mary: Well, and it's not common for parents of kids with Down Syndrome to know or ask for ABA.

Angela: I don't think so. I mean, now he's 20. I'm not sure what's going on with more recent parents of children with Down, but it's a great fit as an intervention tool for children with Down syndrome as well as autism. And I've been now that I've been using it with my son and with the gentleman who works in my coffee shop with me, who also has Down syndrome. Now I'm seeing what a great said it is for individuals with Down syndrome, even as adults behavior skills training is a great teaching tool to teach anything to anybody. And it's been really fascinating and very eye-opening for me to kind of make that shift back into like just the world of Down syndrome.

Mary: Right, right. Yeah. So we have in addition to, you know, the birth to three, I'm sure Triston went up to three to five programing and then school age programing where he had IEPs. We just recently did a podcast interview with Amanda and Kirby on IEPs. And so back then, I mean, you weren't a behavioral analyst. You didn't have your master's in special ED. Like, how did you prepare for IEPs?

Angela: Yeah, so. Well, I just did my research, probably like a lot of moms. But by the time Tristan was in, I'm going to say third or fourth grade, I actually did demand that a BCBA and that he received behavioral services as part of his IEP, because that's about the time that I figured out what it was. Had I known more, I might have even demanded some ABA skill acquisition added in there as well that I at least I did get the behavior target behavior reduction portion. But. And now that I think back about on that. Behavior support, it was awful, but I mean, the the the lady who was there, they called her behavior specialists and she didn't even have her masters or her, nor was she certified. But she was like the best that they could find at the time. And we've come a long way since then.

Mary: Right, right. And you know, I think some of it is due to, you know, parent advocates in the autism world pushing the envelope.

Angela: Absolutely, absolutely.

Mary: And the kids with Down Syndrome in the life skills class with them are like, Oh, you know, the teachers are learning. The administrators are learning about the power of ABA and behavioral supports in terms of not just reducing major problem behaviors, but also skill acquisition and preventing any problem behaviors and vocational skills as they get older.

Angela: Yeah, undoubtedly, the parents of children with autism have paved the way for all individuals with special needs not only to in terms of getting services, but as an acceptance, community inclusion. I mean, it's just it's been a huge benefit to this entire subculture, for sure.

Mary: Yeah, I just kind of had a flashback like years ago, probably 2005. I was in a life skills support classroom with teenagers, tweens and teens, and there was a 14 year old girl with Down Syndrome. And you know, we were with what was then known as the Verbal Behavior Project. So we are pushing in our services, teaching kids to mand or request. And there was an older woman in there as the teacher, and she was very upset about us coming in because we were so like focusing on manding and she she just was very blunt the one day. And she said, You know, that's great that you have her asking for, you know, treats or whatever we were getting her demand for and we were developing even vocal language at the age of 14. But she's like my IEP goal. My IEP goals aren't about this. Are about like setting the table. And nobody's helping me with setting the table, as you know, this is what the IEP calls for. So I was like, OK, let me use eBay to show you how you can reach that, you know, goal of setting the table. And I said, OK, so do you want her to carry all the plates over at once? Do you? You know, like, how do you want to do it? Because as you know, Angela and as we break skills down, that's the first step is like, OK, we can teach anybody anything. We just break down the steps and, you know, kind of convince the teacher that ABA wasn't just used for one specific thing. It could be used for any of this, anything.

Angela: Yes. Yeah.

Mary: So I do want to talk about that, the coffee shop and kind of what that is and how. But Tristan is 20 years old, you said. So is he still technically in school?

Angela: No, we graduated him last year. He was pretty much repeating the same year of high school over and over again. And I know that many parents are going to agree with me when they say that the teachers pretty much throw their hands up and said, Blame COVID. And it was a waste of his time. So we graduated him.

More Employment Opportunities for Individuals with Autism and Down Syndrome

Mary: OK. And so what? Why don't you tell our listeners and me about your coffee shop and when that started and what it entails and all that? OK.

Angela: Well, I've been I've worked at as a BCBA. I worked at a few different agencies, mostly with small children with autism. And I loved it. But last year I watched my son stayed at home for weeks and weeks and weeks on quarantine. He was not sick. By the way, this is just some alleged exposure, and he is not tech savvy, and he and two dimensional means nothing to him. So he was basically sitting in his room all day by himself at home. I think six weeks he got quarantine last year. My boss at my agency was very understanding and we tried bringing him to work with me. But he just he requires too much attention, too much support for me to do my job and support him. And he didn't like it because really, we were just having him windex the windows and shut paper, you know, some tasks like that. And one day he just said, Mom, I don't like to clean myself. I don't blame you. And that kind of made me realize that the only job opportunities for his developmental level in this area are janitorial services. And not that that's a bad thing. I mean, not that that's a bad job, but if you don't want to do it and you're not choosing to do it, then you shouldn't have to. So he told me, I said, Well, what do you want to do? And he said, I want to work at Starbucks. So I started doing some research, so what could I pull off? And I mean, and we kind of did it. I mean, I don't know how it all happened. I got a board of directors and everybody loved the idea of the project of starting a coffee shop that was going to serve as a platform for vocational training. And I figured, well, I can handle 10 or 12 kids on my caseload. Why wouldn't I be able to handle 10 or 12 students to provide them vocational training so that these kids could have choices of job opportunities and not just be shoved into a position because it's the only thing available for special needs? I eventually would not me, but I would love for the program to expand and take off into maybe like dog walking, doggie daycare, or organic gardening, shredding paper, florist. I mean, just a variety. I would love for another BCBA to come in and say, you know, my passion is organic gardening, and I want to start a program for that. And then at the end of the day, instead of having the almost zero percent employment rate, you know, maybe turning that around and getting these kids who fully have are capable of working, maybe not full time, but at least working and contributing to society instead of sitting around in their home, in their bedrooms all day and having them choose something that they want to do, not being shoved into a position that they have to do or that they don't like doing.

Mary: So does your coffee shop run every day all day long or how does that work?

Angela: Well, this particular building that my church owns, that they're renting to me at an extremely affordable price. I happen to have bathrooms that were from the 70s that were not ADA compliant. So I haven't been able to fully open the inside, I and I actually we are in the process of the remodel, so we're actually a couple of weeks away from being able to fully open. So we're super excited about that. So what we've been doing is building the coffee shop up and we make to go orders and call ahead and curbside. So we are we are getting coffee out the door, but we're not fully open for indoor seating and we cannot find a drive thru window. I guess they're not being made in the northern hemisphere at this time. So my contractor is going to try to figure out a way to use our house window as a drive thru window. So, yeah, very exciting and things are happening really quickly now. Within a couple of weeks, we should be fully open. So right now, it's just been my son who has learned a lot about, you know, the whole barista experience. And we recently hired a gentleman who was forty seven with Down Syndrome who is also in training. He's a really rapid learner, so he's picking stuff up really quickly.

Mary: So is your plan that the Riverside Coffee Shop will just be people with Down syndrome and autism? Or or will it be,

Angela: Yeah. So my plan is that everybody is going to get a full assessment and everybody is going to have a skill acquisition goals. And if they need behavior reduction, which are usually by this age, that's that's minimal, if any. Well, I am learning. I have to make it a rule that you're not allowed to smell other people's coffee. It does smell wonderful. And it's very tempting. But that was a rule that we had to make. And so really, it's just it's really about just adding structure and everybody is going to have their own treatment plan and their own goals, and it's going to be very individualized. I am going to have some small group. I will follow a life skills curriculum where we'll learn social skills for sure. If there's any major skill gaps, like if you're not reading yet and I think you're able to be, you know that you have got that capability in you, then. Absolutely. We're going to be teaching pivotal skills as well. Keyboarding, calculator, you know, any of those things that are going to help you just with the bigger picture. I'd love to teach grocery shopping, how to use your debit card, how to order up a menu, all of these things that you're using behavior, skills training and maybe a instead of whatever they're doing at school.

Mary: However, people are trying to teach that they're doing that.

Angela: For three years, my son had the same IEP goal that never got met.

Mary: Hmm. Yeah, it is frustrating, so we did do a podcast interview with someone who was running a full work program with, you know, any staff members and funding. And so what you're describing here is really a very early start up of something that we're trying to make into, you know, something with infrastructure that can be right now. Do you have funding? Is it a nonprofit or so?

Angela: We are a nonprofit, and we did recently receive an extremely generous donation, which is like changing a lot of our thinking how we're going to move forward. But in theory, what I would like to do is to take this group, get them trained, get have them gain fluency in their skills. And then if the coffee shop can hire them as a regular employee, that's what I would love to do, or that the individual could choose to take their tskill, their skills that they've mastered, and they can choose to go out, maybe to a different coffee shop and then I would support them. What I'm learning is that there needs to be some employer training, some management training. There's a lot of silly things as to why our kids aren't getting or keeping jobs. Actually, they're getting hired, but they're not keeping the jobs, which was just a little bit of coaching. We could set up those environmental supports to make them successful, to work out, you know, away from a BCBA. Yeah, yeah. So that's my that's my goal is to get kids employed.

Mary: Yeah, that would be great. I know right now Lucas is just volunteering at different places, and for him, that's good. He needs support with him and that's good for him. He doesn't have enough language to say, I want to work at Starbucks, and so we have to keep data on Lucas's speed and as affect and his prompts, you know, and basically keeping data on his happiness, which yeah, we do across tasks, across job opportunities, across vocational opportunities. We can link that data sheet in the show notes as well. That was created by Lucas's behavior analyst. But you know, as you can see, kids and adults with Down's Syndrome and autism really are very wide in terms of their strengths, their needs, their interests. And it's so great to have people like you, Angela, who are, you know, just trying things like, you're not a professional coffee shop, you know, not a professional. You are just trying to make something happen. To help your son with his goal and in the meantime, using your skills, which is so inspiring.

Angela: He's my inspiration. And I'd like to think that any mom of a child with special needs would be motivated to make a change when they would watch what I watched over the last couple of years. And I'm sure there's a lot of moms out there that have. As a matter of fact, it was funny when I was leaving my last agency and I'm telling my families that I'm leaving two of them. My family said, Yeah, I'm going to start a lawn business so that my son has a job. And then another lady does a balloon business because her son loves to pop balloons. So she started a balloon business, and she actually came and donated a lot of party balloons for our last event that we held on Saturday. So, yeah, we're out there and we're hopefully we're going to make a difference.

Mary: Yeah, are there are a lot of support groups for moms and dads of kids with Down syndrome.

Angela: I went to one support group in California when Tristan was really level little and I felt like I benefited a lot from going to that group. Not only it's like a safe place where you can talk about things that other people outside of our subculture they're just not going to understand even your mom or your sister. You know, it's the people that are exactly in the same boat as you. So I think it is really beneficial, and I encourage any especially young mom to join a support group. But I'm actually not aware of any around here. We're so broke in now.

Mary: Yeah. And I think over the years, especially with the internet, with Facebook and those sorts of things, a lot of the groups and now with COVID, they on top of everything, right? A lot of the support, it's online, you know. And I think the local support that I had and you had early on was really key too. Absolutely. But you can definitely get support and give support online.

Angela: I know. And then I think I feel like that's a that's a key point to hit on as well. Is it even if you don't think you need it because you need to take something away, you might have something to give. I mean, there might be advice from older mom, the younger mom that mom needs to hear. So you really need to think of it from both angles. The give and the take? As far as support groups.

ABA in Riverside Coffee Shop

Mary: So the ABA and I don't know how many of our listeners really know what behavioral skill tracking is, you know, behavior skills. Breaking down task analysis. But can you give our listeners just a quick snapshot of some of the areas where you use ABA in your coffee shop?

Angela: Oh, the entire coffee shop is set up at ABA Style. Everything is set up in stations. I have stations one through six. Each station has its own purpose and its own function, and each station has a task analysis that tells you what you are to do in that station.

Mary: So a task analysis just for people who don't understand that or that's a new term for them is basically just step by step. Like if you were going to make a hot tea for someone, you would have to, you know, get the get the cup or the hot water, you know, to an inch below that the cop or whatever the criteria is because you don't want them spilling hot water on themselves or others. And then you'd have to ask them...

Angela: Steep time, I have timers and everything.

Mary: So it's basically step by step and task analysis are explained in my first book, The Verbal Behavior Approach, and my second book, Turn Autism Around, where we break down tasks and that's what we do.

Angela: You know, we love our task analysis. Yes, yes. But what I have found fascinating is that my a couple, I've had families come in to see if this is going to be a good fit for their program. We're starting our first block January, just by the way. And my individuals with autism are drawn right to those task analysis, and they're pulling them. And of course, I have pictures along with words. So in case you can't read and they're looking at these and they're just loving them. But my two individuals with Down syndrome, they want everything to be modeled. They don't even want to look at those. Step by step instructions. They just want me to show me how to do it. So then behavior skills training is actually the best option so far for. My individuals with downs versus the picture step by step task analysis that the individuals with autism are drawn to. Yeah, very fascinating.

Mary: I want to link to more resources and the show notes here one is on following a picture activity schedule for these kind of tasks, like if a child can't read, Lucas uses a lot of picture schedules. And then the second one is video modeling, which is a video blog I did on video modeling. You know, if they want to be modeled, just like if you want to do something, for instance, the hair, the barbershop, we thought I think Lucas would be OK with, like putting his hair back, his head back into a shampoo bowl and getting his head shampoo versus squirting water, which tends to startle him. And so it's because I don't have any videos of that. I'm not at the hair salon. YouTube is great. We can just Google getting your hair washed in the salon. We can show him that video model. And so so those are the kind of things like whether it's a task analysis and writing broken down the picture activity schedules, which we can link or on video modeling. I think.

Angela: Interestingly enough, I did some course work on sexual harassment in the workplace. And then of course, that's going to be that's going to include in assisted living as well. And the research shows that video modeling is actually the best tool to teach that particular set of lessons, which I. Yeah. So they say to use a video model and make sure that the model is not known by the students. Mm hmm. So that was good. Interesting that you brought that up. Yeah.

Mary: And video modeling is an evidence based treatment. Hmm.

Angela: Absolutely.

Mary: And it's something that we can use. The other nice thing about a video model is it standardizes things so that it'll be the same each time.

Angela: Every time you watch it. Yeah.

Mary: It won't have to do with any distractions or kids asking questions or kids interrupting or any problem. Behaviors, just like the video modeling is very standard. So, yeah, so those are some of the ways where Angela can use ABA throughout. You know, the rule about no smelling coffee that came about.

Angela: We review the barista rules before we can enter the the coffee shop floor. We have to put on her apron. We wash our hands and we are not allowed to smell other people's food or drinks.

Mary: Yeah, there's probably enough of the smell going around in the whole shop too. Yeah. All right. Well, I think I think you gave us a lot of good information first about Down Syndrome and how the dual diagnosis of Down syndrome and autism are very common.

Angela: More common than we think, I believe.

Mary: 12% or higher. And that the same ABA techniques, whether for young one year old two year old who is just learning to talk and may have picky eating or sleeping issues or behavior problems or anything can be used. And you know, if it's mom listening and their child has Down syndrome with or without autism, I think you would agree that they should.

Angela: Absolutely. It's just good teaching. Yeah. And there's really there's a fit for everybody. And I am literally taking that same set of skills that I was using to teach those little kids, and I'm just transferring it to the big kids. And it's been a very smooth transition so far. As a matter of fact, I think I'm enjoying the the lower rates of behaviors from these young adults than I was getting from my littles.

Mary: Yeah. So the same techniques work throughout the life, so we absolutely never too early or too late for ABA to be put in place.

Angela: And so I actually even believe that brain maturing with my son, I'm going to use him as an example. I think now is a time for him that he now he's actually ready to learn how to read verses in second, third and fourth grade when we were like trying and trying to get him to learn how to read. And it just wasn't sticking. Now I feel like he's ready, so I'm like, super excited about that. So certain things are even more teachable as the brain matures.

Mary: Right? And it might not be a phonics led reading program. It might be more functional where it's functional. All where it's you know, you teach them words, be a matching and and he's more motivated because he wants to work at the coffee shop, he may be one store eventually go to Starbucks. And so reading, functional reading is just a great tool to teach.

Angela: Right? Yeah. So he could read the buttons on the cash register. Maybe the ingredients to make a latte you know, things like that?

Mary: So yeah, that's great. All right. Well, before we let you go, I'd like to end the interview the same way. Ah, my goal for this podcast is not just to help the kids or the adults with autism or, in this case, Down syndrome, but also to help the parents and professionals be less stressed and lead happier lives. So if you have any stress reduction tips or self-care tools that you use to help yourself.

Angela: My belief is that knowledge is power, and rather than sitting around wondering, Look it up, look it up. See what's out there. Make sure that you're not just reading. What is it? My daughter's Instagram? Whatever Tik Tok stuff, you know, make sure you're looking at things on peer reviewed, but do your research and that that's what's put my mind at ease. Just learning that there's hope you're not just stuck. They're like you, they're professionals that are brilliant, that have already created that wheel, you know, just look it up,

Mary: Look it up, knowledge is power. Love that, great way to end. So thank you so much for your time, Angela.

Angela: Absolutely. Thank you for having me. This has been so fun.

Mary: If you're a parent or an autism professional and enjoy listening to this podcast, you have to come check out my online course and community where we take all of this material and we apply it. You'll learn life changing strategies to get your child or clients to reach their fullest potential. Join me for a free online workshop at MaryBarbera.com/workshop, where you can learn how to avoid common mistakes. You can see videos of me working with kids with and without autism. And you can learn more about joining my online course and community at a very special discount. Once again, go to MaryBarbera.com/workshop for all the details. I hope to see you there.