 Think Tech Hawaii, civil engagement lives here. Aloha, welcome to Community Matters on Think Tech Hawaii. I'm your host, Kendra Austin, and today we'll be talking about raising autism awareness in Hawaii. And joining me is my guest, Flavia Plou, who's a Board Certified Behavior Analysis. And joining me in my second half is my younger brother, Darius Austin, who's a rising senior at Laylahua High School. Today we're discussing how Hawaii's special education programs and behavioral therapists play a vital role in the development of autistic children and teens. If you want to ask a question or make a comment, you can tweet us at thinktechhi or call us at 374-2014. Welcome Flavia, welcome to our show. Thank you. Thank you very much. I appreciate it. So me and Flavia know each other because you are a behavioral therapist for my younger brother. Yes. Even though you work with my brother, I'm not really sure on exactly what you do. So can you go into detail about your job? Sure. So as a behavior analyst, what we do is we try to support our students and our clients in becoming more socially appropriate or being able to handle social interactions and being a part of society. So when someone gets diagnosed with autism, usually there are some behavioral deficits and things that they're having difficulty learning on their own. And so we step in and we try to teach them the things that they need to have that is difficult for them to actually pick up on their own. So how do you go about doing something like this? Well, usually what happens is the person who is seen by their parents is potentially having a problem. It goes to the psychologist or psychiatrist or their physician and they receive a diagnosis of autism. And within that diagnosis, usually what happens is the doctor or the physician or the psychiatrist will actually point out those deficits that they identified in their diagnosis as being issues for the kid. And they will then make a recommendation that the parents seek out autism, ABA therapy. So I know all autistic children aren't all the same. No. So how do you go about each and every one of them? Well the way we go about our services is it's very specific to the client that we serve. So our research in the science that we serve is based on behavior analysis on behavioral therapy. And within that domain of psychology, we try and are driven to support a kid's individualistic needs. So we'll come in, we'll do an assessment. We'll determine what are the issues that the kid may have with, you know, just functioning on a daily level. Whether that's communication, social, daily living skills of that sort of nature. And then what we do is we create programs to help them to acquire those skills. And could you give an example of these programs that you're talking about? So say we have a kid who usually is having tantrums. I'll pick something that's very, you know, broad. But a lot of our kids have them. Oftentimes kids will have tantrums because they either don't want you to do something or you're taking something away from them or they want your attention, right? So we go in and we do an assessment to determine the function and that would be the function of their communication, which is do their behavior and that's the tantrum. So what we do is we say, okay, you're tantrum because you get upset when someone asks you to do a certain task, right? So what we do is we teach them the appropriate way to communicate that they want a break from the task. And then we also teach them how to be able to do tasks on their own and to, you know, do tasks like everyone else in the world. So I, so you go about this. So I know there's a spectrum for autism, um, severely autistic mildly. So for a severely autistic child, how would you convey to them not to have this? But it's, you know, it's interesting. I tell, I'm a behavior analyst, so I have registered behavioral technicians that work under me and they work directly with our clients. And I tell them all the time that oftentimes what we convey to our kids doesn't necessarily have to be verbal. The kids that are nonverbal, they learn through the behavior that we present to them, right? So everything we do is teaching them something. So we teach them through our behavior and we teach them what we expect from their behavior. It's, it's interesting because, you know, oftentimes a lot of the RBTs say to me, registered behavioral technicians, they'll say, well, how am I supposed to convey that to them? And I just don't worry. It'll happen on its own. For example, I'll give you an example. So say we have a kid who has a problem with waiting to receive a candy bar, right? And so we say, okay, you have to wait. And of course, because they're not verbal waiting, you know, me saying you have to wait doesn't mean anything. But all I have to do is put a timer on and, you know, sort of like let the time lapse and they are aware of the time lapse. I mean, they can figure that out. We all sort of like know when a couple minutes has passed, right? So they have those abilities to identify things like the passage of time and things like that. So it's pretty interesting. So, so are you saying that to be a behavior therapist, it takes a lot of patience? Well, it takes a lot of patience, but it also takes a lot of education. And our discipline is based on behavioral science, which was developed by BF Skinner. And the techniques that we used are based on the research that was done in laboratories long time ago with animal subjects. And then those research programs and in those, I mean, those research experiments led to programs and then those programs we then applied to children and older adults, right? And that's where applied behavior analysis came from. So it's behavior analysis, but it's done with people and not necessarily with animals. So the basic things, and I'll give you an example so you can understand. So Skinner was able to identify the basic laws of behavior. And those basic laws of behavior apply to all behavior for all human beings, for all organisms that live and breathe. And so he broke them down. And those are the things that we use. So if you like something, you'll continue to do it. If you get something positive from it, you'll continue to do it. If you do something and it doesn't fare well for you or it's punitive or it doesn't feel right, you'll stop doing it. So those are the two principles that we actually use in our therapy. And that's the principles of reinforcement and punishment. Okay. And so does this, is this throughout the ages of the autistic child? Throughout the ages. Depending upon, okay. So in Hawaii, initially the Department of Education was the only organization that would pay for our services, right? So in like 2000, we were contracted through the Department of Education to provide services in the school. And that was through the Felix decree, which was a law that passed that said that our services needed to be taken into consideration for kids that needed it. And then the decree was for a certain period of time. And then most recently, we have Luke's law, which is a law that was passed in Hawaii that basically fought for insurance companies to pay for the services of kids diagnosed with autism. So now we receive our funding through insurance companies and Tricare and HMSA and Kaiser and Aloha Care and all of those. And so does, so any family of any, you know, tax bracket can afford it? Right, because yes, because Medicaid pays for it as well. So if someone has Medicaid, they can receive our services through that as well. So I know you're, we're talking about children and teens, but what about autistic adults? Yes. Autistic adults, they're the ones who, you know, people are still fighting for them to receive services. So Medicare, I think, has determined that if you have autism or if someone in your family has autism that you can act, that person can actually receive services throughout their lifetime. Oh wow. I think that for some of the other insurance companies, the age is to 25, yeah. So have you ever had anyone over? Sure. Oh wow. Well actually, this year I had a person who was just recently diagnosed with autism. She was 25 years old. Oh wow. Yeah, that was interesting. That experience, like. It was interesting, because she had had no services before, but she was a high functioning autistic person and her issues were more directly related to her inability to socialize or her feeling uneasy and uncomfortable with her socialization out in the community. So we sort of like helped her with that, which caused her to have anxiety and depression and things like that. So we worked in conjunction with her psychiatrists and her doctors and she was going to other therapies as well. And so our objective was to sort of like help her change her mindset and her behavior directly related to how she should communicate with others to help her to go out, to support her in that. So you can just talk to her about the various things. Talk to her, support her in going out in the community, you know, setting up the occasion for her to have, you know, small conversations with people, you know, being sort of like that person on the side who sort of like creates the, you know, learning opportunity for her and then supports her through it. Yeah. And so the goal pretty much for these programs is to have these autistic children and teens more high functioning. Well, it's not about them being more high functioning. It's about them being more functional in their community. It's about them being more independent in their community. It's about them having, you know, a sense of well-being in, you know, sort of like autonomy, which gives them, you know, a lot more confidence in themselves as well. So our objective is to make them all, you know, feel as effective in their lives as they can possibly be, right? So we try to make it so that if they want to go to college, we try to, you know, help them get to that point. If, you know, they just want to be able to have a couple of friends, we can do that as well. If we have someone who engages in aggression, then we teach them an appropriate way to communicate their wants and needs. So there is no longer a need for aggression because, of course, aggression is not necessarily socially appropriate. You know, tantruming is another one. I mean, they do it for various reasons. It always has a function. They're always trying to communicate something. So we try to determine what it is they're trying to communicate, give them an alternative way to communicate that that's appropriate. So they have no longer have a need to engage in tantrums. Has there ever been a case where it's just so difficult that you might, it takes maybe a long time to get through? Some, I mean, we have, I mean, you know, so children with autism present with different disabilities. And some children with autism do have what we consider to be regression. So you have a kid who learned something but they can't hold on to it, right? And they, if you don't continue to work on that behavior or you don't continue to help them to develop that skill, then they lose it. And then you have to start from square one, right? Those are some of the most difficult ones because those are the ones who need intensive service and supports all the time. Others don't. I mean, they, you know, learn what it is that they need to. And then we use that as a scaffold to build other skills. So it all depends on where they fall on the spectrum. And the spectrum is vast. You know, we have those that are mildly autistic and we have those that are severely autistic as well. And they also, you know, we have those who also have mental impairments as well that are in conjunction with their autism. And that could be a challenge for us as too, yeah. Well, this has been a very interesting conversation. But hold on, we'll be right back. We're taking a quick break and we'll have my second guest coming on, Darius Austin. When I was growing up, I was among the one in six American kids who struggle with hunger and hungry mornings make tired days. Grumpy days. Kind of days. But with the power of breakfast, the kids in your neighborhood can think big and be more. When we're not hungry for breakfast, we're hungry for more. More ideas. More dreams. More fun. When kids aren't hungry for breakfast, they can be hungry for more. Go to hungarees.org and lend your time or your voice to make breakfast happen for kids in your neighborhood. My name is Stephanie Mock and I'm one of three hosts of Think Tech Hawaii's Hawaii Food and Farmer series. Our other hosts are Matt Johnson and Pomei Weigert. And we talk to those who are in the fields and behind the scenes of our local food system. We talk to farmers, chefs, restaurant tours and more to learn more about what goes into sustainable agriculture here in Hawaii. We are on on Thursdays at 4 p.m. and we hope we'll see you next time. Welcome back to Community Matters, Think Tech Hawaii. Today we'll be talking about raising autism awareness. And joining me is our second guest, Darius Austin. Well, Larizzo Darius Austin, who is a rising singer at Lailahua High School. So Darius is a client of Flavia. So Darius, I want to talk to you about what are the things that Flavia's helped you with. I think she's trying to help me more with like the trying to get more friends and trying to be more social and trying to be less awkward than I am. I'm still awkward. So we'll have to like maybe some few more years probably going on to college more. Probably be normal. Probably by like, I don't know, like my late, mid late 20s. I'll be normal. You think so? Well, half the people that you'll be with in your late 20s will be awkward just like you, so you'll be just fine. So you think what Flavia helps you with is very impactful on your life? I've been with her before. I mean, I had several people before, you know, like in New York, I forgot her name. What was her name? Was it Christina? Tina? I think so. Christine, didn't it was like Leslie? Was her name or Jade? There's so many. I think there were like four or five. I haven't forgotten their names. So have you noticed any changes with all these people, these various behavior therapists? Not really, no. I usually kind of do just remain the same. Do you think with Flavia, are you a little bit less awkward? Are you more social and talkative? I think I kind of started being more, but I think I kind of did that by myself before. I think because I was trying to like, because I usually would like, when I have to like to interact, I would usually kind of like put on like a mask or something. I don't want to like sound like a psychopath, but I kind of like had to like put on like a motion that I usually put on. Okay. It was kind of like when Halloween, you remember when it was this, I think it was her dad and little girls, her dad, and they were both dressed. The dad was dressed of like Clifford and the little girls dressed like Emily Elizabeth. Yeah, I remember that. I was kind of very happy because I was like so surprised. Like, I used to remember that show as a kid. Well, you know, for Darius, I think one of the things that he may not necessarily see that we do for him is that I come in and I push him every day. And so I come in, okay, we're going to have a conversation and you have to start a subject and you have to give me four questions or five questions about it. And so it's something that he can do, but it's hard for him to do it if he does it. He's not socially motivated to do it, right? So for me, it's about helping him to practice what he already has and to make him more comfortable with doing it so that when he goes out in the world, he'll be a little less hesitant to communicate with others. So when you first met Darius, what were the first things you do to get a more comfortable relationship with him? Well, in our field, we call it parrying. And so, you know, his therapist that comes with him, she came in, they made brownies and do all that stuff. And Darius was like, I don't understand what she's doing for me. So what's brownies have to do with anything? But she was trying to create a relationship with Darius so that he would feel more comfortable to communicate with her so that we could work on things. So when I came in and we had our first conversation and he said he really wanted me to help him work on social interactions, then I did a little research and determined what it was that he might need specifically. And, you know, so we have sort of like a structured way of going about it. So he may not recognize it, but the staff is taking data and we have specific goals that we work on with him. Now, we do have fun times and we went to bowling the other day and we played pool. And, you know, it was great to see him in a situation where he was a little competitive with his brother. And, you know, so helping him deal with even, you know, competitive feelings and being able to express that appropriately with his brother was something that we worked on too. So he doesn't realize it, but I'm working every time I'm with him like right now. So is every child more open about what they need? No. Darius is, you know, very, you know, unusual in that manner because he knows exactly what it is that he wants. You know, it's not something that, you know, is an impairment of his. It's something that he wants to do in his life. Like, and I ask him often, frequently, you know, what is it that I'm here to help you with? And he says, you know, socialization. So he knows what he wants. He knows what he wants to do with his life. He knows all those things. But, you know, he doesn't necessarily know how to go about it and he needs a little support in how to, you know, change some of his behavior so that he's a little more effective in his communication style. So what about the children who don't really know what's wrong with them? Like, I don't know. We used to work on the behaviors that are socially inappropriate, like, you know, for kids that throw tantrums or kids that can't wash their hands or kids that need to sit under seats. We try to do what we can to help them to be a part of society, to be a part of the group, not to stand out so much, right? And also, for a lot of those kids, they, and Darius has a little bit of this too, their ability to focus on things that are not interesting to them, right? So when you're not focusing on things that are not interesting to you, then you can't learn what they are. And we all have things that we don't like, but we still have to do them, right? So, you know, helping them to understand that, you know, there is something to gain from it, helping them to increase their focus so that they can be more aware of some of the things out in their environment that could potentially become things that they like. If they don't pay attention to them, they'll never know. And so, do you think more kids like Darius, do they have a chance of being more independent, potentially living on their own families? Yes, absolutely. I mean, they can have families, they can live on their own, they can have jobs, all of those things. I mean, Darius wants to go to college, hit something that I know that he's capable of doing, he's a very smart guy. They can live full, enriched lives, and that's part of our objective, right? It's for all of our kids to have and all of our clients to have full, enriched lives, just like all of us, you know? And does that also apply to severely autistic children? Even for them. I mean, something as specific as having choices. So, when you go to Starbucks, how many choices are there for you, right? Billions, right? So, you have those amount of choices to you, for you, right? For some of our young kids, there are not as high functioning as Darius. It could just be that giving them options and choices just enhances and increases their livelihood or their life. So, there's a lot of things that we try to do. We try to increase their interests, we try to increase their communication, we like to make them social, just things that are just, for us, normal that they struggle with. So, Darius, do you think with more behavior, therapists like Flavia, you can live on your own one day? Living on my own? Or at least be very independent. Don't have a job. My son clothes. Fuck your own food. I mean, I do that. I cook food. Outside of mac and cheese. Honestly, yes, but at the same time, no. I may need like a companion. At least like maybe like a living apartment at the very least. Like a wife, maybe. I mean, probably live like an apartment with a roommate, I guess. Okay, yeah. At the very least. At the very least. At the very least. So, do you think you can have a relationship with children? I do not know. I really don't. I don't know. There's a girl out there that likes the things that I like. I'm sure you can find one. I have that same problem, Mary. It's okay. Trying to find a guy that likes what I like is really difficult. I don't really think like there's a girl out there that really adores 70s prog rock music. I don't think they do. You'd be surprised. You'd be surprised. So, Favi, you're very passionate about this. So, I really love to know what made you want to get into this. Well, gosh. Okay, so I've always been someone who likes to follow what interests me because that's what I did best in, right? So, when I was in college, I got into psychology. And after that, I took a couple of biology courses and chemistry courses and I loved them. So, at the end of my career or my undergraduate years, I thought about going into medical school because I wanted to be a psychiatrist. And I think, well, a child psychiatrist, that would be good for me because I really always have been really good and love kids. So, I went that route for a little bit, but in the middle of it, I realized that I really did miss the psychological, analytical part of what it was that I was learning and realized that it just really wasn't what I really wanted to do. So, I took a breather and I stepped back and I took a job at a preschool for children with autism. And I just, that was it for me. I said, I found my people and I connected with them and I felt that they were people who needed a voice. And I wanted to be someone who could support them and give them that voice. And then my career direction kind of changed into behavior analysis. And I've been doing it ever since. So, I'm going to enjoy what I do. Wow. And so, are there any pros and cons or mainly pros to what you do? There are cons. Our discipline is fairly new. I mean, I would say applied behavior analysis is maybe I don't quote me on this, but I think it's maybe like 30 or 40 years old. And so, we have growing pains of our own. We have now gotten to the point where we are certified and licensed in different states. And insurance companies are finding ways to pay us for our services. But all of that is always continuously changing is who's going to support our services and how are we going to get paid for what we do and where do we fall in the continuum of the provider list. So, because we're not, we're psychologists, but the way that we do things is a little different. And because autism is considered to be a neurological disorder, so we're treating something that is biological. So we fall somewhat of in the medical discipline. So that they're still trying to figure out where it is we fall in that. So that can be one of the cons because we're always having to shift and adjust to what they need us to do in order to provide services. The pros, I mean, to me, just being able to help people and seeing the growth that our kids go through and I'm just being able to support people in getting what they need. Like, you know, I'm completely committed to making sure that I can help Daris get what it is that he wants out of life until I'm no longer around. You know, I mean, that's just what I do. And I mean, that to me is very rewarding, you know, even for our younger kids and some of our kids, just to see them able to, some kids that can't communicate. When they start communicating their wants and needs and engage in appropriate behaviors, it's just, you know, I can't express, you know, the gratitude that comes from that. Wow, this has been such an amazing conversation. Thank you so much, Flavia and Daris, for joining me in this conversation. I really enjoyed it. It was very impactful and informational. And of course, you're welcome. And unfortunately, that brings us to the end of our show. Thank you so much for watching. We have enjoyed bringing it to you. I'm your host, Kendra Austin. We have been talking about community matters, raising autism awareness in Hawaii. If you want to see the show again, go to thinktechhawaii.com or youtube.com slash thinktechhawaii, where there will be a link to this show and many more just like this one. As you may know, ThinkTech is a 501C, three Hawaii nonprofit digital media company dedicated to raising public awareness about issues and events that affect our lives together in these islands. To keep going, we need support from our underwriters and from viewers just like you. Please help us make a contribution on the homepage of our website, thinktechhawaii.com. Thanks so much to our studio staff and to all the people who watch, care and contribute to our ThinkTech productions. We'll see you next time for more. Aloha.