Episode Transcript
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Speaker 1 (00:00):
Hi everyone.
Welcome to Around the Spectrumwhere parents, pros and those in
between pull up a chair forhonest conversations, grounded
guidance and real stories aboutraising and supporting autistic
children.
I'm your host, WendyManganiello.
As a parent, marketing leaderand longtime autism ally, I know
how overwhelming and isolatingthis journey can feel.
That's why we're here, becausewhen we sit at the same table,
(00:21):
we understand more and judgeless.
Let's get into today's episode.
This episode zooms out a bit.
We're talking about leadershipin centers today and how
leadership in those spacesimpacts real families.
If you're ever wondering whydoes this feel so hard, or is
anyone listening?
This conversation is for you.
Today we have Amanda Cox withus, and Amanda is a leadership
(00:46):
development trainer andconsultant with a master's
degree in leadership development.
She owns and operates the KnowBetter Company, where she
supports businesses with heremployees and leadership's
development, including three ABAclinics in Indiana, and she has
served over 1,000 individualsthrough training and coaching
all over the world.
Has served over 1,000individuals through training and
coaching all over the world.
(01:07):
She also coaches for theworldwide EAP Spring Health,
where she serves clients fromFortune 500 companies such as
Microsoft, BNY, Mellon, Nestle,Allstate and more.
Amanda now offers comprehensivetraining and coaching for all
AB professionals to expand theirsocial skills for retention,
improved work life and strongerclient outcomes.
Speaker 2 (01:28):
Welcome, Amanda, I'm
so glad that you're here, Wendy.
Thank you so much for having me.
Speaker 1 (01:33):
This is not Amanda's
and my first podcast together.
She has been a guest on myself-care podcast, wellness and
Wealth.
You can go listen to that.
She was on about two years ago.
This one is all about familiesand nonjudgmental talk about
raising children with autism.
There's so much information outthere and it's overwhelming.
To any parent who has gone downthe Google autism rabbit hole,
(01:55):
it's one of the first thingsyou're told as a parent is to
get eBay therapy.
There are people who eBay isthe most wonderful thing in the
world, and then there's a lotthat don't believe that.
I think some of that startswith leadership, because if you
have a great eBay company thatreally is family focused, that
makes a world of difference inwhat you're going to get and the
(02:15):
expectations that are set foryou and your family Talking to
you about that, because this iswhat you really delve into
leadership and why it'simportant.
So what's your why?
Because I'm always fascinatedwhen people are not directly
connected that become BCBAs orleaders of these ABA therapy.
Speaker 2 (02:32):
Great question.
I have been consulting with anABA owner CEO for almost five
years now.
Her internal has been only thethree clients I oversee for
leadership development trainingin Indiana.
I've been working with her andit was so organic.
She was telling me about herclient struggles, employee
struggles and relationshipswithin the clinic.
(02:53):
This is what I doprofessionally and I was like
wait, I want to know what doesRBT mean?
All of the acronyms anddifferent things.
I started getting more and morecurious.
I started getting more and morecurious.
My why is meeting thesewonderful human beings that have
dedicated their lives, theirprofessions, their careers to
helping the most vulnerablepeople in our population, like
(03:14):
children with neurodivergenciesand autism, and helping them
grow and be better leaders.
And, honestly, that has becomesuch a great purpose for me.
I have seen many BCBAs thatstarted as RBTs, that took the
test, and I've been with themfor five years, helping them
cultivate that journey and,honestly, just seeing them
(03:34):
flourish as professionalsbecause they have more capacity
and more confidence.
They translate that into thework with their children.
To me, it's fairly obvious whatmy why is, and that's truly
developing those professionalsto help them be the best they
can be for their children.
To me, it's fairly obvious whatmy why is, and that's truly
developing those professionalsto help them be the best they
can be for their clients.
Speaker 1 (03:48):
I love that and I
think that's so important as a
parent.
Knowing that somebody istrained in autism care and ABA,
that's really important, butalso some of those soft skills
that go along with that.
Because they are going in andout of families' homes, a lot of
people bring their children tothe centers too, but being able
to have those interactions onboth levels makes a huge
(04:10):
difference leaving your childwith somebody or inviting them
into your home.
So, in your experience, whatare some of the most common
challenges clinical leaders face, not just on paper but in
day-to-day of working in ABA?
Speaker 2 (04:23):
Yeah.
So thank you for sending allthese questions ahead of time,
because I was able to thinkabout it.
I'm just going to say the onething that I think is a giant
overarching thing.
Like I mentioned, I've workedwith dozens of BCBAs, rbts,
admin.
At this point, I've also askedhundreds of people.
So if you're listening to thispodcast and if you got a DM for
(04:44):
me on Instagram over the lastmonth, I've literally been
messaging people like what areyou struggling with?
They want to hear the struggles.
The number one thing that keepscoming up is that in one minute
you're talking to insurance andnext minute you're talking to
admin, and next minute you'retalking to a brand new RBT who
is their first job.
The next minute you're coachinganother BCBA and the next
(05:05):
minute you're pairing with aclient.
You have to be able to switchall of those off and on quickly,
right in those highenvironments, kids are playing,
music is going, your phone isbuzzing and your team's
messaging is going off.
You're also expected to be thecalm, the chaos, on top of being
able to literally switch theway you communicate and your
(05:29):
brain constantly, because wetalk differently to a
professional with insurance overthe phone than we would with an
RBT differently than we wouldhave been doing.
The schedule For me, I thinkthat is the biggest challenge
when it comes to theseprofessionals navigating the
(05:50):
chameleonism in a setting thatis so different than everything
else.
Is this making sense?
Speaker 1 (05:57):
Yeah, absolutely, I
was a director of five different
grants with different sets ofemployees for each grant.
I'd be talking about one thingone minute and then the phone
would ring and I would talkabout something else.
As somebody who has ADHD, whichis another neurodivergent thing,
my brain works well like that,but for a lot of people that is
a learned skill to be able toswitch on and off you come home
(06:21):
tired because not everybodylives off of that organized
chaos, for lack of a better wordand being able to adjust the
tones to who you talk to and howyou talk to and when you talk
to.
Speaker 2 (06:32):
Could you imagine
being on the phone with someone
with insurance explaining whatyou need and then, all of a
sudden, the kid's in a behavior?
So obviously I have to come upand the parent comes in and
you're explaining that behaviorand how differently you have to
convey empathy andprofessionalism, but also make
sure that you're doing your joband representing a clinic.
Those are three very realthings that could happen in less
(06:53):
than 15 minutes with theseprofessionals.
A hundred percent I love whatyou just said needs to be taught
, needs to be learned, and thatis my entire business philosophy
and leadership philosophy.
You're doing the best you canuntil you know better.
That's why it's the Know BetterCompany.
Maya Angelou says do the bestyou can until you know better.
Know better, you can do better.
(07:14):
And that's where I come in atteaching these things no
assumption, no shame, no guilt.
No one ever taught you tocommunicate three different ways
to match your audience.
You've just been communicatingthe best you can, the way you
were taught.
That gives my clients a lot ofI'm sorry I know.
The word clients, right, is sofunny because we refer to like
(07:35):
the kids we serve as clientssometimes, but so when I'm
saying client, I'm meaning thepeople who I'm training in
leadership development, softskills Maybe I should just say
my BCBAs right and giving them alot of confidence and saying no
worries about not knowing.
Perfectionism is not requiredFrom here on out.
Let's just give you theawareness that changing that
(07:55):
communication style is going tohelp you with your relationships
.
Ultimately, that's what we'relooking for.
Speaker 1 (08:01):
I think that's really
important.
We're talking aboutcommunication.
Actually, I'm in a lot of BCBAgroups and I was just reading
something this morning aboutwanting to quit.
She's been a BCBA for years andbecause she doesn't have a
child, parents feel like shedoesn't understand what it feels
like.
If you have somebody who'sworked in the profession for a
very long time.
It's about the communicationthing.
(08:21):
I think there's two sides tothat coin, right.
It's about the communicationthing.
I think that there's two sidesto that coin, right.
It's really important for BCBAsto come over to the parent's
side to see where the parent iscoming from.
We all come in with our ownbackgrounds as parents.
Some of us are more organizedthan others.
Some of us are more on top ofthings than others.
Then you have the BCBA who'strying to bring in consistency.
I'll be the first to admit,when we talk about communication
(08:44):
and consistency, my son.
Because I didn't know I hadADHD until I was probably two
years ago.
I was going to be that mom thathad no consistency.
We were going to just do thingsand have fun.
My son's diagnosis actually ledme to processes, tasks,
consistency and bettercommunication For myself because
I suddenly had to do it forsomebody else.
(09:05):
As we have this communicationand leadership.
When you're changing all ofthese hats, you have to be aware
what it's like to be a BCBAthat has no children but it
dedicates their life to kids andvice versa, the BCBA being able
to come over to the parent sideand see what it looks like when
they go home with these kidsevery day and still have the
(09:26):
rest of their life to contendwith.
I think that's another reallyimportant piece.
So you often discusstrust-based leadership.
How does it manifest in aclinical setting and how can
leaders build it, especiallywhen morale might be low or
turnover is high?
Speaker 2 (09:44):
Oh, such a good
question.
When I saw this on the list, Iwas like we need to talk about
that.
So I want to define whattrust-based leadership is first,
if that makes sense.
People might hear that and belike oh, buzzword, buzzword,
right.
Sometimes people think thattrust-based means I trust you,
no questions asked, no feedback.
There's no hierarchy or powerover it.
(10:08):
Trust-based leadership is notlike being nice all the time or
being so reserved that you can'tget feedback.
It's not avoiding hardconversations, letting poor
performance slide because youwant them to trust you.
It's really about clarity,integrity and that want to
connect, which I am a strongbeliever in.
(10:28):
Feedback is not conflict, it'sconnection.
Key principles of trust-basedleadership Number one is
transparency, and I think in aclinical setting, if you are
transparent, you are alreadygoing as you can be.
We have HIPAA and privacy, butwith your team, if you be as
transparent as you can be,that's always going to be a
great start for that trust.
(10:50):
So what that might look like ismaking sure that your BCBAs are
aware of new clients coming in.
Clients fading out timelinesfor different ops.
It might be looking likedifferent schedule shifts.
Why does this client adifferent RBT rule this week
than last week.
Understanding the why in aclinical space really helps
(11:14):
people feel a little bit safer.
It's that psychological safetythat we're all looking for when
transparency is at the front.
My leaders communicate openly.
The majority of the BCBAs andjust RBTs that I work with
they're that like supportivetype, meaning they are bleeding
parts.
They are similar to teachersand nurses in this way where
(11:35):
they want to do everything foreveryone all the time and have
this kind of like I'm okay.
I'm okay, everything's fine.
I need to help others, butsometimes that lends itself to
being reserved and not saying Ineed help or this is what
actually is going on.
So to really try to lead withthat trust-based leadership
model, number one is going to betransparency.
It doesn't always mean avoidingconflict, so I hope that
(11:59):
answers that question.
Speaker 1 (11:59):
Burnout is really
real in this industry.
Part of the issue is the lackof real conversation.
And then there's the burnoutparents feel when they have to
leave agencies or providersbecause another RPT quits,
leaving their child withoutsupport.
So there's a two-sided thing,and the fact of the matter is
that, if we're being honest, wehave more children with autism
(12:22):
than we do, BCBAs and RBTs alike.
The ability to take care ofthem and not because we can give
everybody what they want onboth sides there's other
dynamics there, but the abilityto listen and draw some
boundaries on both sides so thatit works for both the parents
(12:43):
and the providers is a reallyimportant piece that sometimes
is's not discussed.
One of the things that I used todo in my own job is by state.
You can look this up.
You can Google what BCBAs areunhappy with, and it does vary
from state to state.
Instead of looking atleadership, it starts to become
this is the standard here.
So this is what we're going todo, as opposed to uplift the
(13:06):
standards, so that you stand outand you're actually given the
best care to both.
So that brings to the nextquestion, which is you're known
for helping leaders navigatehard conversations.
That doesn't mean that BCBAsget everything they want, nor
does it mean that parents geteverything they want.
We do have things likeinsurance agencies and
governmental regulations.
(13:26):
There's a lot that goes intothe eBay field.
What does that look like in aneBay clinic to have those hard
conversations?
Speaker 2 (13:35):
Yeah, going back to
the personality that I mostly
work with, that supportive type,more perfectioning, fear of
conflict, not wanting to upsetanybody, because they are such
big hearted people and want tomake everyone happy and make
everybody feel good.
Normally that hard conversationis kicked down the road.
It starts with just having it.
I have done mock hardconversations, outlines, trials
(13:59):
in groups, anything to just getthe words out of your mouth is
where we have to start.
I am a big believer in teachpeople how you want to be
treated.
Even if you have been somebodywho doesn't give feedback and
doesn't speak up for the last 20years, you are allowed to
(14:20):
change that.
Today you are allowed to startchanging how you want to be
treated.
You reserve the right to evolve, to change, to learn, to grow.
It starts with peopleunderstanding how you need to
communicate for them to besuccessful and vice versa.
In that clinical setting, whenwe're having these conversations
(14:40):
right, because even the labelhard puts a negative connotation
on it.
Right, so we can call themcritical or vital that urgency
is so important.
I'm fine with conversations andthe best way is frequency and
normalizing.
We don't need feedback to beoverly positive all the time.
We don't want feedback to beoverly negative all the time.
(15:02):
My job is to come into clinicspaces and neutralize feedback,
meaning normalize it and have itat a cadence that is continuous
.
The employee always getsweirded out and say well, you
came out of nowhere and gave mefeedback first time six months
and that's okay.
You just say allow me toreintroduce myself.
I am now a supervisor thatgives feedback more frequently.
(15:24):
On the flip side, from somebodywho's been in the industry for a
long time, read that study SoftSkills right, the softer side
of supervision.
From the American psychologypapers I read that BCBAs more
than 50% of BCBAs got certified2019 or later.
So we're talking about youngprofessionals that haven't been
(15:46):
in the workforce.
Maybe they were teachers beforeor have some background, but
really we're talking about youngprofessionals that haven't been
in the workforce.
Maybe they were teachers beforeor have some background, but
really we're talking aboutpeople who are 24, 26, 28 years
old that really haven't been inprofessional settings yet
because they've been in gradschool or working up to this
level of professionalism.
So in a clinical setting, itreally is important from the
very beginning.
When we're in our studentprogram or in our master's
(16:07):
programs, we're also practicinggiving that feedback.
Speaker 1 (16:13):
Absolutely, and,
interestingly enough, I had the
chance to do some hiring at thecompanies.
I worked for initial interviews, that type of thing, and I was
very taken back and this couldhave been a byproduct of COVID.
I had people who were like Iwent to school for this.
They weren't necessarily goingto school for BCBA, but they
were maybe going to come in as aBT or RBT.
(16:35):
I interviewed some students inmaking for BCBA also and we
would have them come into theclinic to shadow an RBT.
I'm all all about schooling.
I have no issues with thatwhatsoever, but you have to be
able to interact with children.
There's a lot of analyticalside applied behavior analysis.
Obviously the whole thing isanalysis.
(16:58):
I was surprised, as you'resaying, about the study in 2019.
I really think at that time itwas a byproduct of COVID.
How many people had never beenby a child with autism?
And they were really taken backof what it really takes to be
able to physically, mentally,show up each day and I felt for
(17:23):
them.
That's a lot of money to spendon school for something that you
really want to do more of theacademic side, because the
academics weren't matchingperfectly to what the behaviors
were right.
This is what it's like on paper, and then this is what it's
like when you're in the clinicsetting and a child is being who
they are.
It's a really interesting thingthat you bring this up, because
(17:45):
I'd love to see a study of that, like of how many people missed
the ability to do thosesupervision hours.
Some people were starting itafter school as opposed to prior
to or while going to school.
It's an interesting thingbecause it's having those
conversations that you know youeven belong in that.
Setting for yourselfeye-opening On the other hand,
setting for yourself eye-opening, on the other hand.
(18:06):
There are some miracle BCBAsout there.
I've seen BCBAs who just runcircles around everybody in a
building and are able to bethere instantly each child it's
just amazing and get supervisionfeedback to the RBT of this is
how we handle this better.
So I know that there's a lotgoing on in clinic setting.
(18:26):
So how do you coach someone,especially when you have kids
who might be acting out or stillworking on their behaviors?
How do you coach someone tostay calm and grounded during
all those times?
Because if you've been in aclinic, it could happen.
You have various childrenacting in different ways at the
same time and, especially for aBCBA, especially when their
(18:49):
attention is all over the place.
So how do you keep themgrounded and have those calm
conversations with their RBTswhen emotions are running high
or there's an upset?
Speaker 2 (18:59):
parent.
I'm going to have everybodytake a breath.
When you just asked thatquestion, floods of information
just came.
I'm going to take you throughmy whole thing.
I really hope this is going totake you through my whole thing.
I really hope this is going tobe the meat of the podcast,
where people really take awaythings.
First, I start with biologicalreadiness, and this is so simple
, but the first thing that BCBAsforget to do is take care of
(19:22):
themselves.
I'm talking about bathroom,water, eating, brushing their
teeth.
When we are not biologicallyready in our body, we cannot
handle stress and chaos like wecan if we are.
If I show up to a parentmeeting and I haven't eaten I
have overdone it on caffeine, Ihaven't had any water today that
(19:45):
parent meeting is going to govery differently than if I had a
sniff and drank my water andemotionally and socially, I was
feeling a lot more safe andconfident and comfortable in
those relationships.
As supervisors, as CEOs, bosses, directors, leaders whatever
you are you need to be checkingon biological readiness for all
healthcare workers, period.
(20:06):
I have 20 friends that are likeI don't have time to drink
water, I don't have time to usethe bathroom Right there.
That's a cultural issue,because what we're saying is at
this job, you don't have time touse the bathroom.
You're asking a human being tonot be a human being.
When we start doing that, we'realready gonna start losing and
that's gonna be burnout.
So biological readiness isimportant.
(20:29):
If you have one-on-ones which Ihighly recommend weekly, if not
bi-weekly, with all of yourBCBAs to get a feel from what
they're doing, that would be thefirst question I ask them how
are you taking care of yourbiological readiness?
If you think about your body asa glass and you're all the way
sealed up to the top and alittle bit of turbulence
(20:49):
happened, all the water'spouring out, you're not going to
be able to have thatconversation.
But if your energy is justmidway and you're calm and
there's a little bit ofturbulence, you're not spilling
out all over the place, right?
That's the number one thing youneed to focus on getting them
ready, because we are teachingeveryone around us as BCBAs, as
(21:12):
leaders, to act, to be.
This is how we are.
And if the supervisor doesn'ttake care of themselves, doesn't
uncap me, doesn't drink water,doesn't eat, you betcha that the
trainee is going to also modelthat behavior, because what is
that trainee thinking.
This person is who I want to bewhen I grow up.
And in order to be a successfulBCBA or clinic director, I
(21:34):
can't drink water, eat or takecare of myself or use the
bathroom, so we're just modelingall of that.
I feel like there was one morepoint that you wanted me to get
to, or is that everything?
Speaker 1 (21:44):
You know that's
really good about running high.
In fact, I did open a centerfor one of the companies I work
for when I was training in theother centers for that position.
One of the things was, as agreat center director, you go
around every and see who needs abreak.
Yeah, do that, becauseotherwise you do have burnout
(22:07):
with your clients and you'regoing to be very tired at the
end of the day and veryimpatient.
I have to say that I've justfound the RBTs to have such
great horror about the kids theywork with, because the patience
it takes to work with the samechild, sometimes day in and day
out, is nothing more than, somedays, supernatural.
But, as you were saying, inorder for that to happen, they
(22:30):
have to feel calm and ready.
We were in a culture for a longtime that said never bring
anything from home into work.
I'm sure you know about thisright.
So when it comes to workingwith kids, you want to make sure
that your child has consistency, which the child sometimes
needs as part of theirassessment.
One of the things may beconsistency.
How do you allow leaders tobalance the fact that they may
(22:51):
be bringing in their stuff andnot have it come out while
working with children, because Idon't believe you get into work
and everything is gone forwhole human beings and it's
really hard to do that.
We work with a very fragilepopulation that can bleed into
if there isn't some sort ofbalance.
Speaker 2 (23:11):
So I think this is
again you alluded to its higher
level.
It's not just about peopleworking in clinics, it's just
people being people.
We all went through the era ofBrene Brown and vulnerability
and got misconstrued about whatvulnerability, appropriateness
actually is.
It's being able to say howyou're feeling at appropriate
times and appropriate moments.
(23:32):
Not keeping it all in, butcertainly not spilling it all
over the place.
Right, as a professional, it isyour responsibility to make
sure that you are managingyourself, and what that might
look like is having a therapistcoach, having a best friend.
That you call so those safespaces.
When your boss asks you, howcan I help, actually having a
(23:54):
response as opposed to nothing,because that's a safe space to
say this is where I could usesome help.
People are able to help whenyou give them actual things to
help, if that makes sense,rather than I'm so overwhelmed I
can't do this, how can somebodyhelp with that?
What I do in my coaching is if Ihave two overwhelmed, I can't
do this.
How can somebody help with that?
What I do in my coaching is, ifI have two people and I coach
both of them, I'm like, well,how can we work together?
(24:15):
And what happens is the admingoes.
Well, I test them how I canhelp and the BCBA is like I'm so
busy I don't have time to tellyou how you can help me.
I just do it myself.
I coach the admin to ask betterquestions but also encourage
the BCBA to look at their stuffand be like what can we offload,
or what can we help you with,or what's not a priority To your
(24:37):
question of that overwhelm, orhow do we manage the outside,
inside stuff?
We always think I don't havetime for this, but actually we
don't have time not to take careof that.
That means seeking a coach,seeking a therapist, asking for
help, delegating.
You do not have to solve everyproblem every day by yourself.
Speaker 1 (24:56):
You can feel the
energy change when people are in
things because they haven'tdealt with.
That I would love to know I'mgoing to fast forward because I
think we've talked about some ofthe other stuff Can you share a
story no names, but of a clinicor a leader who made a shift
that stuck with you?
Speaker 2 (25:13):
Yeah, absolutely.
This segues perfectly from herlast question.
Inside, I started working fouryears ago with a brand new BCBA.
Since then she's taken over thestudent program, the clinic and
now she is over all the clinicsother than the owner.
So she's just doing aphenomenal job.
When I first started workingwith her, all of that energy was
(25:36):
coming into the clinic.
She didn't have capacity.
We were able to find her toolsand resources that really helped
her navigate those emotions.
What that looked like wasmaking sure when she was in
clinic she had those appropriatetouch points Her clinic
director, the CEO, admin,support, coaching her on how to
appropriately communicate thoseneeds.
(25:57):
Over the last four years she'sgone from a brand new BCBA all
the way up and now she overseesthe student program, a clinic
and a lot of the BCBA day-to-dayoperations on top of having a
caseload.
Now this is somebody who alsohas a family of her own and she
does it all because she is ableto have the capacity to do it
(26:17):
and really succeed.
I really do think that has beenbecause she's been able to
communicate her needs.
So it's really just back tothose communication skills and
getting her the tools she neededto help navigate that journey.
Speaker 1 (26:30):
If you could sit
beside a brand new clinical
director for five minutes, whatwould you want them to know?
Speaker 2 (26:37):
I have had three
different answers to this since
I read the email yesterday and Ithink I'm going to respond with
start right yourself ask forfeedback on how you're doing and
ask juicy needy, beautifulquestions to get juicy needy,
beautiful answers.
And the more you can normalizefeedback within your team,
within your culture, the moreyou'll be able to give that
(27:01):
feedback easily.
The VA world is afeedback-heavy field.
If you can normalize feedback,your job, your life, your career
will be easier.
We always want to take stockhow am I communicating, how can
I improve?
If you start there and allowthat defensiveness to come down
a little bit, the relationshipin your life will improve.
(27:23):
That's what I would encouragethem to do.
Speaker 1 (27:25):
That is awesome.
I want to thank you so much forcoming on the show For those
who are listening.
First guest episode.
Thank you so much, amanda.
I will have Amanda's websiteand social media if you want to
reach out and ask her furtherquestions.
Thank you so much for havingthis conversation today.
Speaker 2 (27:43):
Yeah, absolutely,
wendy, it's always a pleasure.
Thanks for playing up a chataround the spectrum.
Speaker 1 (27:49):
If today's
conversation helped you feel a
little more seen, a little moresupported or just a bit more
grounded, we'd love it if you'dsubscribe, leave a review or
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Remember, none of us have allthe answers, but when we sit at
the same table, we understandmore and judge less.
I'm your host, wendy Mangonero.
Until next time, take care ofyourself.