BHCOE Accreditation: Get help picking out good ABA with Dr. Ellie Kazemi

A common goal I have for every child, with a diagnosis or not, is to live a life that is as safe as possible, as independent as possible, and as happy as possible. Talking with Dr. Ellie Kazemi, she too shares that inspiration. Dr. Kazemi is the Chief Science Officer at the Behavioral Health Center of Excellence. She has worked throughout the field crossing through ABA, BCBA, and OBM.

BCBAs in the Field

While BCBAs work in high percentages with individuals with autism, they have a place and need in a variety of different settings. Behavior Analysts can do important work in hospitals, schools, and even nationwide programs like FEMA and NASA. Dr. Kazemi has worked with them in her expertise of training and supervision, to observe, measure and change practices and messaging in these extremely large organizations.

Quality ABA

Dr. Kazemi shares the notion that nothing is inherently good or bad, but there are certain practices and programs that lack quality. This can be caused by a variety of factors: funding, insurance requirements, training, supervision, resources, etc. We discuss what quality ABA might look like and how to improve ABA in settings that are lacking.

What is the BHCOE

The BHCOE or Behavior Health Center of Excellence, where Dr. Kazemi works as Chief Science Officer, is an organization focusing on the improvement of the field of behavior analytics. Dr. Kazemi and her team are working on an accreditation program for ABA services and programs that can set better standards and guidelines for which these entities operate.

You can find out more about this accreditation program and Dr. Ellie Kazemi by emailing her at [email protected], as well as finding her research available online. We have also provided the link to purchase her book, Fieldwork and Supervision for Behavior Analysts.

BHCOE Accreditation: Get Help Picking Out Good ABA with Dr. Ellie Kazemi

​​Dr. Ellie Kazemi on the Turn Autism Around Podcast

Dr. Ellie Kazemi is the Chief Science Officer at Behavioral Health Center of Excellence (BHCOE), an accrediting organization focused on improving the quality of behavior analytic services. She is also a professor at CSUN, where she founded the M.S. in Applied Behavior Analysis (ABA) program and has been teaching undergraduate and graduate coursework in research methodology, organizational behavior management, and behavior therapy for over 15 years. She has received several mentorship awards including the ABAI Best Mentor Award, the Outstanding Faculty Award, the Outstanding Teaching Award, and the Outstanding Service Award. Her applied research interests involve the identification of efficient, effective strategies for practical training and supervision of staff, which includes leveraging computer technology and Artificial Intelligence (e.g., robotics, virtual or augmented reality). She has worked on several nationwide large projects (e.g., with FEMA and NASA) with a focus on effective training and measurement of intervention outcomes. Currently, she leads BHCOE’s efforts in quality measure development and conducting reliable, valid evaluations for accreditation.

YOU’LL LEARN

  • BCBAs and their work in a variety of fields.
  • How Behavior Analysts work with nationwide organizations, like NASA and FEMA.
  • How to identify quality ABA.
  • What is the benefit of ABA accreditation with BHCOE?
  • The common goal: Safety, Independence, and Happiness.
Want to get started on the right path and start making a difference for your child or client with autism? SIGN-UP FOR DR. MARY BARBERA'S FREE TRAINING

RESOURCES

Dr. Ellie Kazemi – Turn Autism Around Podcast Transcript

Transcript for Podcast Episode: 198
BHCOE Accreditation: Get Help Picking Out Good ABA with Dr. Ellie Kazemi
Hosted by: Dr. Mary Barbera
Guest: Dr. Ellie Kazemi

Mary: You're listening to the Turn Autism Around podcast. And I'm your host, Dr. Mary Barbera. Today we have a special guest, Dr. Ellie Kazemi, who is a behavioral analyst, author, professor. She is out in California. I've never met her physically, but I have been following her work for years. She is an expert at supervision and leadership within the field of ABA. And today we talk all about ABA is a science, how she has consulted with NASA and FEMA and how she has used everything she knows to help families of kids with autism, also kids with ADHD, O.D. and how we talk today, how to spot good ABA and how to make mediocre ABA better with just a wealth of information all about improving the lives of children with autism and related disorders. I loved getting to know her better. Hope you do, too. Here's Dr. Ellie Kazemi.

Narrator: 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.

Mary: Thanks so much for joining us today. Ellie, I'm super excited to have you on.

Dr. Kazemi: It's awesome to be invited on this podcast. Thank you so much, Mary.

Mary: Yeah. So I've been following your work for a while but I don't think we've ever met in person. Hopefully that will happen soon. So why don't you tell me and my listeners about your fall into the autism and ABA world?

Dr. Ellie Kazemi on the Turn Autism Around Podcast

Dr. Kazemi: Well, that was a really long journey. So I'm going to try to keep it short by explaining that I did my doctoral work in clinical psychology. My area was actually focused on learning disabilities and attention deficit hyperactivity disorder, and I was really interested in that achievement gap for these individuals. And with that came a lot of literature and clinical recommendation with oppositional defiance and how to actually have joint attention and how to bring things to be organized. And that's how I found the behavior analysis. It was in the clinical recommendations that I found this work, as well as a colleague who was actually a student who was serving in the lab and helping me at the time, who introduced me to some behavior analysis literature. So I fell in love. Absolutely in love. And that brought me to accepting a position at Cal State Northridge to become a full time faculty member there, to develop the program, to be able to have this that journey, I think, has a lot to do with how I came to ABA, but also how I then have kind of pivoted my career. I've moved away from some of the work that I was doing clinically and really moved towards supervision and leadership because when we started the program, most of our students served families of individuals with autism, and those supervisors would come to us and say, We want to do the best we can, we want to be awesome supervisors, but we don't have the tools. Can you help us? And that's when I realized, well, we can't say no. To do a great job, if we really want good quality supervision, we want the next generation of board certified behavior analysts to be competent. We need to work with these supervisors. And that really led to the work that I do a lot in supervision and quality, actually looking at the quality of interventions and quality control, because I really realized we need to move toward helping the community put forth environments, create structures, create training that help them upkeep, good quality. So that's how I fell into the field of behavior analysis. And autism specifically was working with those community partners and working and supervising the students who were providing services.

Mary: Yeah, great. And I was just on the phone with somebody recently, a young woman, a friend's daughter, and she is thinking about ABA. She's thinking about getting a master's in ABA. And she was telling me that she really envisioned herself working with families, kids with maybe ADHD or mental health problems, depression, anxiety, you know, those sorts of things. And I was saying, which I'm asking you as an expert, is I'm thinking that 90% of BCBAs out there that are working currently are working with autistic individuals. Am I off with that?

BCBAs and The Field of ABA

Dr. Kazemi: I think 90% is high percentage there. I believe the latest report that came out from the BACD sort of outlines oh, I apologize. That's my dog actually alerting everybody about the ambulance driving by. So that's…

Mary: No worries. No worries. We're dog friendly here. Lawnmower friendly here. No, no worries.

Dr. Kazemi: He literally emulates the sound of the ambulance. And so it's an interesting imitation. It's not great. You know, I think it's definitely the majority, which is what I believe is your point. The majority of individuals that are serving in the field of behavior analysis are serving individuals on the spectrum currently. But I definitely think that we do have a good percentage of individuals who are also beginning to do good work in brain injury, individuals who are helping folks with sleep disorders, pediatric issues. So we are beginning to see much more branching out into a higher and higher percentage of individuals who are serving, especially in schools, individuals who are in need of support, services that may not be on the spectrum. So we have the majority of folks who are serving individuals with autism and the need will continue to be there. But we're also seeing people do other things. When I was working in the area, that Attention Deficit Hyperactivity Disorder and learning disabilities, I was learning during that time doing my doctoral work in clinical, I was learning how to do diagnostics and actually learn to do differential diagnostics, which, you know, I was in love with. It was evidence based and I had fantastic mentors at UCLA. But what really shifted my career was a family that I became very close to because the parents had a terminal disease. She knew she only had a few months to live, and her biggest worry was that her adolescent, who was very, very bright, was highly depressed, and that the world around her would never know his potential because he would make what appeared like careless errors, some errors. And sure enough, during assessment I realized what was going on with him was a very clear executive functioning difficulties. And you could see he was unbelievably bright. But then his achievement scores, his school scores were not anywhere near those which had very much made him give up in school. And he was very clear about that then, you know, I'm not smart enough. I'm just not good enough. And when I shared my psychoeducational evaluation with her and shared, here's what's going on, here's a profile of why this is happening, she looked at me and said, that's wonderful, but what do I do? What does he do? And I think that that was really the first time I realized that I want to move toward actual effective care management more because she was right. You know, identifying those things was that first initial step. But her biggest worry was she was going to leave him, she was going to pass. And she wanted to know he'd be okay. And I was not going to be able to say that to her. I had no idea what the care management team would look like. So that really, I think, shifted my career in many ways. And I think that finding behavior analysis has been a joy for me because we can be such effective agents of change. When I worked with most of my students and there was co-occurring attentional difficulties with co-occurring difficulties with oppositional defiance, I felt that I had better control over some of those things because I was familiar with that entire population. But I think that currently only about 15 to 20% of analysts are really expanding to those other areas, which, you know, you have to get to know the population.

Mary: And what about the master's level programs? That's what I was speaking with this young woman about. As far as I know, most of them are heavily based on autism, like you were describing, with your need to get supervisory skills up for autism. Because I explained that the reason for that is not that all of these fields don't need it. I mean, I'm a registered nurse. I still am. And I was a rehab nurse and a neuro nurse. And like, we need behavior analysis in rehab centers, in nursing homes, in everywhere, you know, in schools for kids with ADHD. But the reason that it's such a large percentage and I probably overstated 90%, is because insurance pays and the whole ABA field was based on, you know, the treatment for autism after Catherine Morris's book came out. And that's the reality, not to say so. So in terms of young people who want to pursue ABA, is it true that 90% of the programs or even more are heavily based on autism?

Dr. Kazemi: You know, I think that that is a battle we have to face as well. So when we put our curriculum together, we knew that the majority of our students are going to service individuals on the spectrum. So if we don't have an autism specific course, we're not doing them justice. They must know the population well. They must understand the special things that go on for this particular population with regards to what occurs, what their trajectories can look like, all of those things, as well as understanding development, matters for that particular group of individuals we serve. But at the same time in our program, we wanted to expand students' experiences. So we have an entire course devoted to general psychopathology, what we call developmental psychopathology, and that includes things like sleep disorders and anxiety and depression. And I think that we are not completely unique. I do think that there are other programs that have a course that does allow that expansion. I haven't actually done an analysis to see how many.

Mary: So yeah, well, I think it's a growing area of need for sure. So before we move on and talk directly to parents and families that are struggling, I do want to just talk about your book really briefly. You have a book from 2018. You're working on a second edition. Can you tell our listeners the name of the book and who it's for?

Supervision for Behavior Analysts

Dr. Kazemi: Sure the book is actually for trainees or individuals who are seeking to become behavior analysts, and it's meant to be used by their supervisors to guide the supervision experience. And it is because of what I shared earlier when we started the program at Cal State Northridge, we realized there is one thing to train people in the classroom. There's one thing to even provide practice opportunities in the classroom. And then there's another to put them in the clinical setting and provide them with the opportunities to experience and receive feedback from supervisors. And in that time frame, those community partners would come back to us and ask for resources, tools, experiences and guidance. And we realized that supervisors did not have the support services they needed to be able to be good supervisors, and sometimes they needed more training. They also needed just support and material to be able to do it and to structure supervision so that it wasn't just time based, it was really competency based. Have you met these competencies? Do you actually achieve certain things to be able to be a good supervisor? The effort we put together with my colleagues would put up on my lab website for some time and it was really available. Then it was abused. Someone pressed print and started selling it as a book. So we went to Springer and asked that Springer would go ahead and host them and they were happy to do so. It's now published through Springer Book. It's called Supervision for Behavior Analysts.

Mary: Okay. Okay. We can link that in the show notes. I'm assuming you can get it on Amazon and.

Dr. Kazemi: Absolutely. And you can actually get it directly from Springer. And if you'd like, I can actually give you a code that gives anyone who is interested a discount.

Mary: Okay. We can put that in the show notes. Great. Okay, so let's kind of switch gears a little bit. We were talking very briefly and we're both behavior analysts, so we kind of are on the same page with, you know, it really doesn't matter if it's ODD or ADHD or autism or executive functioning problems or sensory processing issues or sleep. It's the same process through ABA. And I saw in your bio that you even consulted with NASA and FEMA, and FEMA is the place for flooding and stuff.

Dr. Kazemi and Her Work with NASA and FEMA

Dr. Kazemi: It's actually emergency services. My particular work is with firefighters. Yes.

Mary: Fire, firefighters and flooding and stuff when FEMA gets involved when there's a hurricane and devastating wildfires in California, for instance, FEMA would get involved. And NASA is the, you know, astronaut program and the space initiative and all that. So maybe we'll start there... Like what did you do with them? Or what are you doing with those organizations? And how does that relate to helping families and professionals working with kids with autism or other disorders?

Dr. Kazemi: As you know very well, Mary, I think the power of behavior analysis is in the fact that we don't perceive individuals as morally bad, individually bad. We don't think that things that occur are internal or specific to someone. We look to the environment to see what's been the history, what opportunities has the individual had, and then what does that environment look like? And from this perspective, that behavior is a function of its circumstances, I think allows us to become allies with anyone who's looking at a problem that involves behavior and many problems that human behavior is involved in. And so in one way or another, the other thing that I think makes us good allies as behavior analysts is that we're uniquely trained to look at behavior and measure it. For example, my colleagues that, you know, that had the FEMA grant came to us, it was the Andric Foundation, and they are a burn foundation and they care deeply about prevention of burn. And they work closely with other organizations that are firefighters and are working during fires. But they were really interested initially. As you know, they go out there, put a lot of time, effort in training young people, how to escape fires, and how to prevent burns. But they don't know what they're doing if their training is effective. And I remember sitting in a boardroom with these individuals who save lives every day and who are brilliant, their understanding of the world. I could never compare my understanding or knowledge of the world to the vast knowledge they have, and yet they didn't understand how to measure behavior so much so that they looked at me and said, you know, when we train our firefighters, we simulate, we set things on fire, we create combustion. And now they have to get out or put the fire up. We can't do that to our kids. And I thought to myself, right, you're right. You don't need that level of simulation to be able to measure the effect of your training. And so we worked closely with them to be able to actually measure how our day training, which obviously always when you say, how do I measure the outcome, it changes how you train. So they began to really identify key things that they wanted to change in their training. That relationship went so well for both. I think we learned a lot and they felt that they learned a lot such that they have asked us to come back and now we're working with them in messaging. They're really interested in being able to take the large messaging that they do to the public and ask what should be the most effective components that may be missing there. For example, when you say to someone, you know, what do you do when your clothes are on fire? They can say, stop, drop and roll, and maybe they can actually show that they can stop, drop and roll. The problem currently is that the individual may also do that. When you say your house is on fire, what do you do? And that's because the jingles of stop, drop and roll have become very well known. But, you know, from a behavioral perspective, window learning occurs under a certain very clear antecedent or what we call something right before it ever needs to happen. So all that needs to change in that messaging is that it needs to always have the when your clothes are on fire, for example, stop, drop, and roll. So we've been working with them and revisiting some of their messaging and questioning some of these things. So that's been super cool work and I think behavior analysis applies there because we can measure things and help in those ways. With NASA, it's a very different issue they brought to us where I was working with colleagues in engineering because of some of the work that we were doing in technology. They got interested in our students with, you know, fantastic students and they wanted to be involved in this grant. So we identified a problem. Some of the NASA scientists said that a big portion of what happens is that operators of engineers are working collaboratively, quite often with robots. So there is a human robot interaction and teaming that's occurring. So it's not just teams of individuals anymore, it's teams of human beings and autonomous robots that have to work together efficiently. And, you know, can we help identify key factors or components of what makes an efficient team? This project, honestly, has been a joy because the individuals who got involved, the students who got involved were probably students who will twitch at the notion of ever coding or twitch at the notion of that level of science about technology. But, you know, it's amazing when you get involved in a project where the outcome is something so cool, so important to the future that the students have been very, very interested and have been creating simulations and studying that from a very behavioral perspective. How do we measure teams and how do we measure performance and all the things that we can learn from organizational management and apply that to those projects so that individuals who've been involved in that project have been doing great and hopefully actually the lead person on that project will be continuing an internship with JPL. We're working on that at this time.

What is OBM?

Mary: Wow. So it sounds like a lot of OBM and we have done a couple of shows we can link up in the show notes on OBM, but can you refresh our knowledge of OBM, what it stands for and what it is?

Dr. Kazemi: Sure. So Organization Behavioral Management, which is what OBM stands for, is the application of behavioral principles. What we understand when we work with individuals and organizations. So we're applying those very things to understand what's happening within the culture or the setting of an organization. And we look at human behavior very similarly. So it's taking that same approach that, you know, one employee may do very well in one organization under the right circumstances, they might cheat, lie, steal, even under different circumstances. And that's how you set up an organization will influence employee behavior.

Mary: Now, really, as you're talking, I'm like everybody should have you know, FEMA should have a whole Department of Behavior analysts working for them full time, and NASA should and every hospital should. And, you know, it's amazing. But at least you're starting. And I'm sure there's other, you know, examples of behavior analysts working with organizations and making great strides. I guess, but it is fascinating. So really it's just looking at a problem, whatever the problem is, whether it's an individual with autism or an organization in terms of training or intervention and measuring. Progress and keeping things going in a positive direction. So how can we tie that into a family struggle with finding quote unquote good ABA? And you said like nothing is inherently good or bad and you know, like so maybe I'm not even asking the question, right. But there are quality issues in ABA, across the country and across the world. And so what are your thoughts on that?

Quality ABA and ABA Accreditation with BHCOE

Dr. Kazemi: I absolutely agree. I think actually an article that really spoke to this issue for me, I'm happy to give you the link to this article in which she identified that she was a behavioral analyst, much like you, and understood the impact of the science and how effective we could be and then became a parent of a child on the spectrum and in seeking treatment, because she obviously did not want to be the provider of services for her own child. What that process looked like and how she realized there's just this gap in how services are being provided versus what she was trained to do. What we understand the science may be and that, you know, she acknowledges that this may not be at all the case across organizations, but that such bad experiences can truly make people have a different perception of what we do is behavior analysts and it disheartened her as a behavior analyst who knows what we could do. Now, the positive part of this, which I really like that she's done in this article, is she goes on to say that she applied the things that she is familiar with within her home, within her organizational and the organization she has access to which the settings and that, you know, she was able to effectively employ and get the right people on board and support services for her child. But I think her story is very telling and it is absolutely what a lot of our graduates face when we put them out there to become employed. We try to recruit talent. Right. And it's not easy. You're dealing with, you know, a shortage of there's not enough of us as we list and there aren't enough programs to produce good behavior analysts in time. So, you know, we have left a dismal quality control over our graduate programs, but then we graduate them and put them out and then the good proportion of them are burned out from the systems that they're placed in and quite often when you ask them what's going on, they'll tell you there's a discrepancy between why they joined the field, which is to be effective agents of change. They wanted to make a difference in families, lives versus what they experience sometimes, which is all the paperwork and administrative and business sides of clinical care. And I think that there is a good proportion of organizations that are doing a wonderful job and organizations that really need to shape up and do things a little differently. And I think that as a whole, as a field, we're put in a wonderful place with parents and families and individuals, providing feedback to ask ourselves, How are we doing? You know, what's our mission here? Because, you know, I may be crazy, Mary, but I don't think there's a single human being on the face of the planet that says, you know, I'd like to go into autism care, but I'd like to do a subpar job or you know, I'm going to not do a great job. No one enters the field, whether you are an investor or you are a clinician or you're, you know, administrative care, it doesn't really you know, like, you know, no one joins with just this notion of I'm going to do a, you know, subpar work or maybe not the best job I can do. I do think that people come to the profession with the intent to do the best that they can. Now, what changes that likely is the contingencies in place, the type of environments are in place, what are the requirements of them? What does insurance require? What's happening within the state regulations and how do these things interplay with the labor shortage issue we have that may result in not the best type of service. So I want to begin with that because I don't think that I would give up on anyone who has joined the field. I think anyone who's tried to join the field came to us for good reasons. And I'd like to continue to recruit the talented, brilliant individuals who have the heart and care to make a difference in individuals' lives. Human care services are not easy, so I think we should continue to do that. The other thing that I think we can do and need to move toward is putting forward and adopting quality control issues. So recently, after doing a lot of my faculty work, after 15 years of that work, I've actually joined Behavioral Health Center of Excellence as their chief science officer. This is an accrediting organization, and I'm very passionate about moving toward accreditation because it provides that layer of outside objective parties coming into your organization and looking to see are you doing what's best practice in the field? If an organization is just doing what insurance companies require of them, they're likely to not make the best practice in the field because insurance companies don't necessarily know what those are. They don't necessarily have the behavior analysts on board. And even if they do, they don't have the resources to do the type of thorough job we will do as an accrediting body. And we also have actually on our website a page for families, because to me, that's where the difference is going to come, is for a family to be able to say, is this organization providing good services? The first thing that they can do is to distinguish a good service provider from a not so good service provider by identifying one that has agreed to put themselves through accreditation. Because that means they have said, yep, I agree to an outside objective party coming in reviewing to see do I have the right staff? Do I train my staff well? Do I provide my staff with the type of resources that they need to be able to be good care providers? Are they providing safety skills and are they providing safe and effective care? Are they, you know, approaching treatment, treatment, planning and coordination as we know it and best practices in our field? Or are they just doing what they need to do to get by? We also look to see if they create feedback systems with their families and do they implement those, for example, as a part of their service delivery? And most important, I think, to us lately has become this realization that a lot of service providers that are excellent really attend to what the families need, that the big picture, the goals they have for their family, and that they take care to get exactly those types of outcomes they work toward. Those outcomes will communicate that to the families. And we're very interested in looking to find organizations that are doing excellent care and say, yep, these individuals are to be able to distinguish good from the maybe not so good. Now that doesn't mean that if someone's not doing so good, we're like, we give up on you, you know? It just means that to provide resources and support it sometimes means that some contingencies have occurred that have made them move away from some of those things. I have yet to find an organization that does not care to make change and does not want to really do the job. In fact, when we speak to leadership, people are always proud of what they're trying to do. I just think that sometimes, you know, the contingencies don't set them up for success. So ideal accreditation and quality controls like that can really help organizations move toward better quality care.

Mary: Yeah, that sounds great. Yeah, I know from a medical point of view, there's like the joint commission and there's, you know, there's people that come in to not just look at the paperwork, but actually look and see how this looks? And that reminds me, I found you most recently through the National Autism Conference at Penn State. I watched it virtually. And it's a great conference. And I don't know if you know this, but I used to be the lead behavior analyst for the Verbal Behavior Project in Pennsylvania, which is now the Patten Autism ABA Supports Initiative, which runs the whole NAC conference. And early on, Mike Michalos created a rubrics, a site review, and we did that for every classroom throughout Pennsylvania that was part of our and we would go in as an independent person. So I wasn't the consultant for the site. I would go in and do ten, ten site reviews. And, you know, it was a start. Was it perfect? No, you know, and I don't think we ever published any data, but there's a lot of good research there that we did on the ground with our sleeves rolled up to really fine tune. And there were some classrooms that got all the checkboxes, but they still weren't great. And Mike said one time, you know, it's like a hollow bunny. It's like a chocolate bunny that you think is solid and you bite into it and it's hollow. So you also have to watch out for getting all the checkboxes, but still there's something off, you know? And there, you know, and from my perspective, I don't work in schools or homes anymore and I'm strictly online. And I think a couple of things. I think classrooms or organizations or wherever there is ABA going on, I think it needs to be positive 5 to 8 positives to every negative. The use of escape extinction is not good. We need to focus heavily on pairing and mandate. We need to focus on family and getting family, a parent to be the captain of the ship, if they're willing and able, to really be central through the whole situation. Those are kind of my, you know, gut reactions. Like I've done blogs go two daycares or, you know, I've been talking autism or anything. You go into two daycare classrooms and you have one where it's, Oh, Susie, I love the way you're doing that. And then you go into the second classroom and it's like put that thing away. I told you to keep your legs criss-crossed, applesauce. And, you know, even if you're saying, remember, keep your legs criss-cross applesauce, you know, it's still in the negative pile. And, you know, I'm going to put that jumper away if you don't behave and you're going to lose recess. Obviously, whether it's a master's degree in ABA, it's a new employer. It's a daycare setting, it's an autism school, it's ABA in your home. We all want to be around positive interactions. And so that's like my number one.

Dr. Kazemi: You had something that's really important for me to mention, which is, you know, my entire career I've been humbled by the experiences families are willing to share. And when they provide feedback, it sits in my heart. It's been super important to me because I don't think I would have done much of what I've done in my career without families guiding me about what their needs are. One of the things I love about our standards of issuing is that it obviously is based on the literature and what's best practice. But then actually because we ourselves are accredited by ANSI, which is a commission that actually oversees, you know, provides us with guidance about how to set standards. We have stakeholders that actually look at the standards and tell us what they need to see. That includes families and patients, who received services. And it's amazing how often they speak about the three top things that's important to them being the caseload of a supervisor. But we also get families tell us how important turnover is to them . As soon as they feel that they are getting to work with an organization or with an individual when there's turnover, that it really disrupts care for them. And the other thing that they've been telling us is when someone's here and working with my kid or my child's working with someone, the most important thing to me is to see that my kid's happy. And these directions we get from families as a part of the standards are really important for me to mention because I think good quality assurance absolutely includes that parent perspective as a part of the process.

Mary: And those are my three big goals for all kids. My typically developing son, who's in med school, as well as Lucas, who is moderate, severely affected by autism, is the child we work towards the child being as safe as possible, as independent as possible and as happy as possible. And those are from the time we start and, you know, it goes onward. And that bar is a moving bar. You just get there and then you're like, okay, we're good. And, you know, safety to Spencer versus Lucas looks different. Safety, independence look different. But that's where I am, just constantly keeping my eye on those three goals. I'm glad you brought up happiness and I think that needs to be a really big part of what we do and how we do what we do.

Dr. Kazemi: Yeah, and honestly, I wouldn't, I, it's not an Ellie thing that I'm just learning. I'm just humbled to be in the journey of individuals who are willing to share some of these things with us that really matter. And I'm not sure if you're familiar with this person, but you know, I love her. She's absolutely a role model. And she served on our Standards Committee for training sites like we also have accreditation to make sure that an organization is a good provider of supervision. She brought up how she's been trying to develop materials around exactly that teaching trainees. How can you be in an environment, implement what's prescribed, be, you know at a place where your skill sets show but absolutely at the forefront of all of that to assure that the child's happy because that is what you need for them to be learning. And I think that, you know, there are individuals like her that really have gotten this message.

Mary: I interviewed Bridget Taylor for the show a while back, and she did an article on compassionate care and, you know, really working with families to make sure that the goals are what they want to. So we can link that in the show notes as well. I think that is a good summary of both of our ideas about how to look for good quality programs. I hope that your behavioral accreditation; is that a newer thing or is that been going on? Do you have hundreds of organizations or how widespread is that?

Dr. Kazemi: Yeah, actually, BHCOE has been in existence for seven years now. I've joined within the last two years, little over about that time actually. And my work is really specific to make sure that what we do is reliable and valid with evaluations. And I continue to help with measurement development officially, but we have over 500 organizations that have been accredited over that time. And that's really important because I think that when you're starting up an accreditation, it takes many, many years of data and analysis to really make sure you understand where the field is, to even know what you can require. After those 70 years, I've finally been able to get our questionnaire for families because we do a wide scale survey to a place where we feel like, okay, we're not asking too many questions, we're actually asking the prudent questions or our observations. We do observations of the actual therapy sessions and rate those. And, you know, it takes a lot of data to be able to get to a place where you can feel confident about your tools. So I'm glad to say that we are definitely there and they've been doing this for some time. So.

Mary: Great, great. Well, I'd like to know how people can find you, find your work or do you have a website?

Contact Dr. Ellie Kazemi

Dr. Kazemi: I'm actually a public figure. So, you know, just a quick Google search. I would say that if you're interested in quality, quality control, I would absolutely say email me at [email protected]. I'm happy to provide you with that link and most of my work can be seen on ResearchGate, so I'm easy to find.

Mary: And your last name? It's Ellie Kazemi. Kazemi. Okay. K - A - Z- E - M - I, and for those that are listening, but we're going to link everything in the show notes. So you will be able to find Ellie and her very, very important work. So before I let you go, I like to end with the same question. I don't want to just help the kids. I want to help the parents and professionals listening to be less stressed and lead happier lives themselves. So what are your self-care tips or stress management tools?

Dr. Kazemi: Well, Mary, I was going to ask you the same with all of the things that you have accomplished and continue to do with your bright smile and kind gestures. Make me wonder where you get all your Zen from.

Mary: Well, I actually am answering that on podcast 200 because I am being interviewed for that show. So tune in.

Dr. Kazemi: Wonderful. Wonderful. I would say, you know, my recommendation is to know that there's a lot we want. I am battling with the fact that I know I have one life to live and I'd like to live that life filled with contributions. I'd like to know I've done something. Some, somethings in this lifetime. And I have to remind myself to just improve 1% every day and to be kind to myself and forgive myself for the mistakes I made yesterday.

Mary: I like that. Continue to improve 1% everyday. That seems like a good goal. It has been great getting to know you better. I look forward to future collaborations and I'm sure my listeners are going to love this episode. So thank you so much for your time.

Dr. Kazemi: Thank you. It's very, very nice to meet you.

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 brief online workshop at MaryBarera.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.