How I work
We begin by discussing your concerns and exploring the person’s current skills. We set goals together, and I choose activities and support strategies to help work toward them. As we go, we review progress and adjust the plan.
The first sessions involve conversation and observation. If needed, we then use a more structured skills assessment to guide teaching.
Functional behavioral assessment
A functional behavioral assessment (FBA) helps develop hypotheses about the function of behavior.
Together with the family, we work through what happened: what came before the behavior and what happened afterward. I ask about demands, communication, the environment, and available support.
We use this information to develop hypotheses about the function of the behavior. A description alone does not establish its causes — we check our assumptions as we continue working. I do not assume that either a lack of motivation or overload is the only explanation.
We identify changes to the environment and skills worth teaching, such as asking for help or a break.
Teaching skills
I select tasks based on what the person can already do and assess what help they need. I consider their pace of learning, motivation, and need for breaks.
We also check whether the person can use these skills outside practice activities — for example, asking someone else for help, reading an unfamiliar text, or counting while shopping.
RFT — Relational Frame Theory
Relational Frame Theory describes how we learn relationships between things, words, and events — for example, “same”, “different”, “more”, or “less”. It helps explain how we can derive new relationships from those we have already learned, without practicing every response separately.
For example, if we know that A is bigger than B and B is bigger than C, we can infer that A is bigger than C. What matters is not only remembering an answer, but understanding the relationship.
PEAK, AIM and LIFE
PEAK — language, cognition, and learning
I use PEAK to develop language, understanding of relationships, and the use of learned skills in new situations. The manuals help me assess what the person can already do, choose activities, and review progress.
How is PEAK structured? The four modules
The PEAK Relational Training System, developed by Mark R. Dixon, combines behavior analysis with an approach informed by Relational Frame Theory. It includes four modules:
- Direct Training,
- Generalization,
- Equivalence,
- Transformation.
These address different ways of learning — from directly teaching responses to using learned relationships to derive new ones.
AIM — mindfulness and psychological flexibility
AIM combines applied behavior analysis, mindfulness, and Acceptance and Commitment Therapy (ACT). The manual AIM: A Behavior Analytic Curriculum for Social-Emotional Development in Children was developed for children’s social-emotional development.
I use selected elements, adapting them to the person’s age, communication needs, and abilities. Activities may help the person notice their thoughts and feelings and explore different ways to respond in difficult situations.
The aim is not to suppress emotions or teach obedience. I use these exercises as part of skills teaching, not as ACT psychotherapy.
LIFE — practical daily living skills
LIFE (Life Skills Emergence System), developed by Mark R. Dixon, is a system for assessing and teaching daily living skills to people with disabilities. It uses relationships between familiar and new tasks to support the development of practical skills.
LIFE complements PEAK by focusing on adaptive skills. I use it to plan activities that support independence, such as shopping and everyday mealtime tasks.
Not everyone needs every program or all of its elements. These tools do not guarantee a particular outcome, and there is no fixed sequence that everyone must follow.
Program resources
Family involvement
I ask family members whether they would like to help with practice activities and what they have time for. I do not assume that the family should run teaching sessions between our meetings.
After every consultation, I send guidance on next steps. At follow-up sessions, we review what you tried, what helped, and what needs to change.
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Social validity
My work is guided by Montrose M. Wolf’s concept of social validity. This means asking three questions:
The family’s perspective matters, but does not replace the person’s own. I take account of their preferences and signs of agreement or refusal, including when these are expressed without words.