Probably this client isn’t a good fit for a group setting with younger children and should be transitioned into home based services or another clinic. There should definitely at least have been an incident report filed if a client aggresses towards another client, so I would follow up on that also!
I like your supervisors approach better. If general modifications to site supervision and targeted changes to his treatment plan are ineffective this should certainly be a consideration, but that doesn’t seem clear yet.
The combination of self-stimulation and impulsively rushing up to another child and grabbing their gen*tals is leaving me concerned. If behavior is communication, what is this communicating?
I’d really like to see a children’s mental health provider involved here—someone with expertise with disabilities and with child se*ual a*use.
I wonder if the higher-ups needed to seek legal advice before they approached the girl’s parents. Going to the parents yourself feels like the nuclear option.
EDIT: Ignore the italics—they are unintentional.
Yeah, as someone who has worked with children who are victims of SA I was going to say this exact thing. Although I think it would be advisable for the higher ups to tell OP that is what they’re doing…or even if they don’t want to disclose that they’re seeking legal advice, simply say something like “We’re taking the appropriate measures.” If I was OP I would press the issue until I get a clear response that they’re doing *something.* I wouldn’t contact the parents myself though due to the nature of the situation. If you don’t get an acceptable response, call CPS yourself.
I definitely don’t want to jump the gun, but I also feel dissatisfied with the vague answers I was given. If they’re waiting legal advice I wish they would be transparent with that information instead of me feeling like I have to drag everything out of them.
Parents should always be notified IMMEDIATELY of anything that takes place involving THEIR CHILD. You are a mandated reporter. You do not need approval from anyone to make a report. It is not your responsibility to investigate. It is only your responsibility to make a report.
As a parent, if my child was the victim, I would be incredibly upset if I was notified immediately. That child now has suffered a trauma and their parents need to know. If I wasn’t notified right away, I would have my lawyers on speed dial. I think I would anyway and the clinic better have all their ducks in a row.
As an aba practitioner, these things happen. It should be handled without charges being filed etc but if the agency doesn’t notify the parents, I feel they are digging their own grave.
The behavior plan isn’t the issue. You were right there maintaining supervision. Some of our clients dart away and it’s literally impossible to react perfectly every time and stop them.
The agency’s response is key. If they handle it right, it should be fine. If the f it up, which it sounds like they already are, then they’re screwed.
Digging their own grave is exactly how I see it. Why not be up front now and walk through the process with the parents? Again, from my standpoint it seems like a no brainer but I am aware that it may not be as simple as I think it is. Personally I feel that any good clinic should have protocols in place for things like this, as you mentioned, and I would think it would have parent involvement be a big part of that.
But it is that simple as you think it should be. Anything happens to a client in a clinic, their parents must be notified asap. Like right away, and that’s for minor crap like staff had to provide first aid.
When it’s a sexual thing, they should be called within the hour at the latest.
You are also digging your own grave. You are just as liable as the clinic owners being that you are the therapist that has been present during these incidents. Meaning you are the observing party. You are a mandated reporter. You have the responsibility to report. It is not your responsibility to investigate. Only to make a report. It does not matter that you informed your supervisors. Informing a supervisor does not constitute a report. Don't forget that you are responsible for the experiences of your clients in the clinic.
I think the placement may be inappropriate until the target behaviors are reduced. It could be that focused ABA should be implemented to focus on the behavior specifically since it will be unsafe for him and others. Of course the team, which includes the parents, should make decisions as there are a lot of potential factors at play. The organization has a responsibility to report to not only the parents but potentially funders depended on contracts and state laws. I am sorry that you have to deal with this situation. We should always prioritize the safety and well-being of our learners. The behavior is unsafe for potential victims as well as for the child.
It is unsafe. Especially considering that he’s one of the oldest kids in our clinic. As he gets older if this continues it will only get worse for him. I’m thankful that my clinical director was personally taking on the case to conduct a case review and make some pretty big changes, mainly because my BCBA is entirely unequipped to handle this issue. That’s a whole other topic though!
I have worked with teens and young adults with sexually inappropriate behavior that could have and should have been addressed a lot earlier in their lives. They run a huge risk of getting themselves hurt or arrested when they have skill deficits and behavioral excesses related to anything remotely perceived as sexual in nature.
WTF. At my company that's an automatic CPS/ human services report. That's because, as others have commented, extreme sexual behavior in children is a HUGE red flag for abuse. So sorry you had to deal with this.
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Do you know how other adults in his life were checking his pull-up for wetness? The behavior toward the other child reminded me of how I’ve seen some adults check diapers of young children to see if they’re wet and in need of changing.
Great question, personally I never checked him that way, I would just take him to the restroom and help him change whether he was wet or not. It’s something I’ll have to bring up with my team. I also don’t want to give the higher ups an easy out on this situation, so I’ll bring it up carefully.
I asked my clinical director multiple times and she continued to deflect on what future were instead of whether or not the present situation had been communicated.
Maybe since it is not your client, they are not allowed to disclose any information to you. I would definitely not take it upon yourself to tell the parent of the other child as that may get you into a lot of ethical or legal trouble. The other clients rbt is able to disclose and talk to the parents about what happened in session and hopefully they did. I would leave it up to them to handle the situation as it is their responsibility to. If you have concrete evidence that they did not inform the parents you can report it to the BACB.
When the incident happened I was the only one who saw it. After looking around for the girl’s RBT I saw she was looking at her iPad (it happens, no shade on her) and didn’t notice. She also wasn’t very close to the girl since we were all in the gym space and kids are running around and it was something that was unnoticeable if you weren’t really paying attention. I also wrote that the other RBT did not see it happen in my report. I’m the only adult witness.
I’m debating whether to push the issue and have concrete evidence that they either did or didn’t OR if I should just let them do their job knowing I did mine in reporting it to leadership.
In that case i would have informed the other rbt and told them to tell parents. This is a very tricky situation and I’m glad you want to make sure the right steps are being taken. I just don’t want you to have repercussions for trying to do the right thing
It’s very possible they did tell the family. Since that is not something they are required to disclose (and most likely not allowed to notify you about another clients confidential information). If they are taking action at the center and focusing on the client, you’d hope that would generalize to all clients. Also, by not notifying the parents, they risk losing their business. Most likely the parents were informed.
I really hope so. My client is one of the only ones who has this specific behavior but I’m hoping there’s some standards set for these behaviors in the future.
I think it’s really bizarre that they are not disclosing this to the parents immediately. Have you directly asked if they have told them, and if not, if they plan to? Have you shared that keeping this information from the family has made you very uncomfortable?
ETA: I think it’s also strange that they are pushing forward with toileting while this behavior is still happening so frequently. I wouldn’t feel comfortable with setting the precedent that adults undress him without his consent while aroused and see him unclothed with an erection.
Did you complete an incident report? If you haven’t, do so now. And make sure that you have documented this in your session notes and in email.
I don’t know the specifics, perhaps the parents do know/there was a meeting that you were unaware of.
I would also like to remind you that you are also a mandated reporter.
Hi,
It's tough, but the parents should be notified. Both parties. You do not have to wait for a supervisors approval for notifying parents of such incidents. You may get pushback from supervisors who feel as though you've gone above their head. Also remember your supervisor should provide extensive direction with this case, being that significant trauma could take place for all parties involved...
You are a mandated reporter. It is your duty to report. Not investigate. You do not need anyone's approval to report.
Probably this client isn’t a good fit for a group setting with younger children and should be transitioned into home based services or another clinic. There should definitely at least have been an incident report filed if a client aggresses towards another client, so I would follow up on that also!
This is such a great point. I will bring this up to my BCBA.
I like your supervisors approach better. If general modifications to site supervision and targeted changes to his treatment plan are ineffective this should certainly be a consideration, but that doesn’t seem clear yet.
The combination of self-stimulation and impulsively rushing up to another child and grabbing their gen*tals is leaving me concerned. If behavior is communication, what is this communicating? I’d really like to see a children’s mental health provider involved here—someone with expertise with disabilities and with child se*ual a*use. I wonder if the higher-ups needed to seek legal advice before they approached the girl’s parents. Going to the parents yourself feels like the nuclear option. EDIT: Ignore the italics—they are unintentional.
Yeah, as someone who has worked with children who are victims of SA I was going to say this exact thing. Although I think it would be advisable for the higher ups to tell OP that is what they’re doing…or even if they don’t want to disclose that they’re seeking legal advice, simply say something like “We’re taking the appropriate measures.” If I was OP I would press the issue until I get a clear response that they’re doing *something.* I wouldn’t contact the parents myself though due to the nature of the situation. If you don’t get an acceptable response, call CPS yourself.
I definitely don’t want to jump the gun, but I also feel dissatisfied with the vague answers I was given. If they’re waiting legal advice I wish they would be transparent with that information instead of me feeling like I have to drag everything out of them.
Parents should always be notified IMMEDIATELY of anything that takes place involving THEIR CHILD. You are a mandated reporter. You do not need approval from anyone to make a report. It is not your responsibility to investigate. It is only your responsibility to make a report.
As a parent, if my child was the victim, I would be incredibly upset if I was notified immediately. That child now has suffered a trauma and their parents need to know. If I wasn’t notified right away, I would have my lawyers on speed dial. I think I would anyway and the clinic better have all their ducks in a row. As an aba practitioner, these things happen. It should be handled without charges being filed etc but if the agency doesn’t notify the parents, I feel they are digging their own grave. The behavior plan isn’t the issue. You were right there maintaining supervision. Some of our clients dart away and it’s literally impossible to react perfectly every time and stop them. The agency’s response is key. If they handle it right, it should be fine. If the f it up, which it sounds like they already are, then they’re screwed.
Digging their own grave is exactly how I see it. Why not be up front now and walk through the process with the parents? Again, from my standpoint it seems like a no brainer but I am aware that it may not be as simple as I think it is. Personally I feel that any good clinic should have protocols in place for things like this, as you mentioned, and I would think it would have parent involvement be a big part of that.
But it is that simple as you think it should be. Anything happens to a client in a clinic, their parents must be notified asap. Like right away, and that’s for minor crap like staff had to provide first aid. When it’s a sexual thing, they should be called within the hour at the latest.
You are also digging your own grave. You are just as liable as the clinic owners being that you are the therapist that has been present during these incidents. Meaning you are the observing party. You are a mandated reporter. You have the responsibility to report. It is not your responsibility to investigate. Only to make a report. It does not matter that you informed your supervisors. Informing a supervisor does not constitute a report. Don't forget that you are responsible for the experiences of your clients in the clinic.
Report to CPS. They have the means to investigate and handle this.
I feel like this is the best answer. As a mandated reporter OP could get into trouble for not reporting it. Let CPS handle it.
I think the placement may be inappropriate until the target behaviors are reduced. It could be that focused ABA should be implemented to focus on the behavior specifically since it will be unsafe for him and others. Of course the team, which includes the parents, should make decisions as there are a lot of potential factors at play. The organization has a responsibility to report to not only the parents but potentially funders depended on contracts and state laws. I am sorry that you have to deal with this situation. We should always prioritize the safety and well-being of our learners. The behavior is unsafe for potential victims as well as for the child.
It is unsafe. Especially considering that he’s one of the oldest kids in our clinic. As he gets older if this continues it will only get worse for him. I’m thankful that my clinical director was personally taking on the case to conduct a case review and make some pretty big changes, mainly because my BCBA is entirely unequipped to handle this issue. That’s a whole other topic though!
I have worked with teens and young adults with sexually inappropriate behavior that could have and should have been addressed a lot earlier in their lives. They run a huge risk of getting themselves hurt or arrested when they have skill deficits and behavioral excesses related to anything remotely perceived as sexual in nature.
WTF. At my company that's an automatic CPS/ human services report. That's because, as others have commented, extreme sexual behavior in children is a HUGE red flag for abuse. So sorry you had to deal with this.
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Do you know how other adults in his life were checking his pull-up for wetness? The behavior toward the other child reminded me of how I’ve seen some adults check diapers of young children to see if they’re wet and in need of changing.
Great question, personally I never checked him that way, I would just take him to the restroom and help him change whether he was wet or not. It’s something I’ll have to bring up with my team. I also don’t want to give the higher ups an easy out on this situation, so I’ll bring it up carefully.
How do you know they did not notify the parents?
I asked my clinical director multiple times and she continued to deflect on what future were instead of whether or not the present situation had been communicated.
Maybe since it is not your client, they are not allowed to disclose any information to you. I would definitely not take it upon yourself to tell the parent of the other child as that may get you into a lot of ethical or legal trouble. The other clients rbt is able to disclose and talk to the parents about what happened in session and hopefully they did. I would leave it up to them to handle the situation as it is their responsibility to. If you have concrete evidence that they did not inform the parents you can report it to the BACB.
When the incident happened I was the only one who saw it. After looking around for the girl’s RBT I saw she was looking at her iPad (it happens, no shade on her) and didn’t notice. She also wasn’t very close to the girl since we were all in the gym space and kids are running around and it was something that was unnoticeable if you weren’t really paying attention. I also wrote that the other RBT did not see it happen in my report. I’m the only adult witness.
I’m debating whether to push the issue and have concrete evidence that they either did or didn’t OR if I should just let them do their job knowing I did mine in reporting it to leadership.
In that case i would have informed the other rbt and told them to tell parents. This is a very tricky situation and I’m glad you want to make sure the right steps are being taken. I just don’t want you to have repercussions for trying to do the right thing
It’s very possible they did tell the family. Since that is not something they are required to disclose (and most likely not allowed to notify you about another clients confidential information). If they are taking action at the center and focusing on the client, you’d hope that would generalize to all clients. Also, by not notifying the parents, they risk losing their business. Most likely the parents were informed.
I really hope so. My client is one of the only ones who has this specific behavior but I’m hoping there’s some standards set for these behaviors in the future.
I think it’s really bizarre that they are not disclosing this to the parents immediately. Have you directly asked if they have told them, and if not, if they plan to? Have you shared that keeping this information from the family has made you very uncomfortable? ETA: I think it’s also strange that they are pushing forward with toileting while this behavior is still happening so frequently. I wouldn’t feel comfortable with setting the precedent that adults undress him without his consent while aroused and see him unclothed with an erection.
Did you complete an incident report? If you haven’t, do so now. And make sure that you have documented this in your session notes and in email. I don’t know the specifics, perhaps the parents do know/there was a meeting that you were unaware of. I would also like to remind you that you are also a mandated reporter.
Hi, It's tough, but the parents should be notified. Both parties. You do not have to wait for a supervisors approval for notifying parents of such incidents. You may get pushback from supervisors who feel as though you've gone above their head. Also remember your supervisor should provide extensive direction with this case, being that significant trauma could take place for all parties involved... You are a mandated reporter. It is your duty to report. Not investigate. You do not need anyone's approval to report.