ABA at Home: Managing Autism Behaviors That Work with Mailande Vise

In this episode of Autism Labs, Mike Carr continues his conversation with BCBA Mailande Vise, who shares practical, experience-driven strategies for supporting individuals with high support needs especially in the home environment.

Mailande breaks down how parents can better understand and respond to challenging behaviors by identifying their underlying function. From sensory needs to attention-seeking, escape or access to preferred items, this episode explains how behavior is communication and how to teach more effective alternatives.

The discussion also explores the critical difference between receptive and expressive language, highlighting how many nonverbal individuals understand far more than they can express. Mailande shares how visual supports, choice boards and communication devices can unlock meaningful interaction.

Listeners will also learn:

• How to structure the home environment for success
• Why reinforcement strategies matter and how to avoid common mistakes
• The importance of parent training and consistency
• How to prevent regression during breaks and unstructured time
• Why starting small leads to long-term success

This episode is especially valuable for parents, caregivers and professionals supporting adolescents and young adults with autism.

Mailande’s message is clear. Progress is possible and small wins matter.

📩 Contact Mailande Vise:
 Email: mailande@viseabatherapy.com
 Phone: 601-291-0339
 LinkedIn: https://www.linkedin.com/in/mailande-vise-3448a0110/

If you're interested in joining our private Facebook community for parents and caregivers seeking residential options, guidance and peer support for profoundly autistic adults or adults with complex needs - Click Here! 

Transcript

Mike Carr (00:04):

Well, welcome back. If you didn't watch last week's episode, we're talking to Mailande Vise who has a Master's in Education and Autism and Disabilities. University of Texas graduate, yay. And BCBA. And so we're going to continue this episode talking to her about her boots on the ground experience, her recommendations with parents, some of the things that she's seen work really well for some of her clients and some of her learners. So here we go. Let me ask you a different question, one that I think you're going to have some thoughts about. So for parents of learners with higher support needs, because they tend to be the most challenging. Higher support needs can manifest themselves in terms of behavior like we've talked about, that sometimes they aggress or pica, they pick something off the ground, they stick it in their mouth, you constantly got to be aware of that.

(00:47):

They might have seizures, right? A fairly high percentage of folks that are profoundly autistic too tend to be epileptic as well. What recommendations or what thoughts do you have for those parents that might make their lives a little bit easier or that they at least should be aware of to take better care or to provide a better environment for their learners when they're at home, not in school or whatever it might be?

Mailande Vise (01:09):

I think general things is like we said, sort of arranging the environment in a way that works for their child. So if bright lights are really tough, maybe creating sort of a dim space. The reason why I hesitate on this is that this has been so individualized in my experience based off of what's going on. So one example that I've seen is a child's home. The mom was awesome and they really set up the entire environment so that there aren't breakable things and they put this big awesome swing in the middle of the living room that was super regulating for him. And so that was super cool how it's in the main space. It's just part of it. They had everything set up for them to be successful. There weren't super nice pictures on the wall, nothing framed on the wall. And so that's the first thing that I think of with that.

(02:06):

I know this isn't like a catchall answer, but just individualizing it based off of the learner. One thing that I've also seen, but this one's pretty tough and I don't actually know how I feel about this, but I get that there's a time and a place. But sometimes parents I've seen almost have to have a safety spot with limited stuff inside of their room so that if things get out of hand, their child can go in there and deescalate. Same with I've seen parents because their son is insistent on accessing locations that just aren't an option where they have drilled almost like an accordion metal sort of frame or like a fence that can be used. And so I've seen that as well, which is tough to talk about because they're sort of more intense solutions, but it works for the family and it makes the hard times a little bit easier to manage.

Mike Carr (03:03):

Yeah. We've had to lock our son out of the kitchen because he'll raid the refrigerator and then we put locks on the refrigerator so that when he is in the kitchen, because we want him to be as independent as possible. So he follows his visual schedule to prepare his breakfast step by step on his iPad and it talks to him as well. And if he wants, he can even see a video of what he's supposed to do. So he has three stimuli. He can follow along just picture by picture and he slides his finger across it or he can hear, he can press the picture and hear the audio. And even though he's nonverbal, his receptive language is there. And I think that's something, and I'd be interested in your thoughts about this. A lot of profoundly autistic individuals that have trouble speaking still have a pretty good vocabulary when it comes to listening.

(03:46):

And so they'll pick up on things. There's certain keywords he picks up on, like one's cake. And so it can be any kind of conversation and if he hears the words cake, he's going to perk up. We had him at church one time and the sermon, for some reason, the preacher or the priest was talking about examples. And in his example, he mentioned pizza. And here's Michael in the middle of the congregation, pizza, pizza, pizza, pizza, making a ruckus because he heard the word pizza, right? What has your experience been and what recommendations do you have about receptive language versus expressive language? Expressive language being a language they can actually speak and any accommodations or stories that you'd like to share about how important it is to recognize that or what you've experienced personally with some of your learners?

Mailande Vise (04:28):

I think first and foremost, I absolutely agree with you so wholeheartedly. And I think that's sort of a common mistake I see sometimes is maybe it's like newer people in the field don't realize that so many of our kids understand everything and to speak to them with competence and respect and they can understand everything and you should come in with the intention that they can understand everything and being very respectful in that sense. I think in terms of the, I totally agree, I've seen better receptive overexpressive communication and I think really utilizing your learners straights however you can. So a lot of our kids I've noticed are really strong visual learners, like incredible visual learners. And so maybe I can teach something receptively with visual aids to help them grasp it. And then maybe I can translate and use those visual aids in their communication device.

(05:23):

And so to teach in the modality that they understand best and to then help translate it sometimes. Also maybe even sort of changing the expectation for communication. So I have one learner who is maybe not always able to communicate vocally, but if he is given a choice between things, that's really helpful. And so he might not be able to expressively think of it on his own, but if you offered the choice that helps him access his language a litle bit more. So that's a great modification. I'll always talk about visual aids, but like a choice board also is a really helpful tool to scan all of the options and then be able to expressively use that as well. So sort of augmenting and enhancing their communication.

Mike Carr (06:08):

Yeah. Usually there's a lot inside someone's head going on that if you don't know that person very well, you're surprised. One of the things that we've discovered going back to crux is when you walk in and you see a 60 foot climbing wall, it's very intimidating. And so we go into the schools, the transition coordinators, the 18 to 22 year olds, and we say we're going to have a field trip through their transition coordinators and their teachers to a crux climbing gym to climb. And how many people want to climb? One person's hand goes up, they don't really know what we're talking about. And so our crew, Hayden and Ellen will go and show them the harnesses and put them on before they ever go to crux. And then they all show up at crux and who wants to climb? Nobody wants to climb. So finally get one person that's daring and with some help, you put the belay rope around them and the harness so it's all safe and someone's helping them sort of climb with a belay rope and they get a few feet up in the air and they let go and now they're floating in air and they turn around and they smile and then you cheer at them, you say, "Oh, way to go.

(07:08):

Good job." And that's pretty exciting. Now all of a sudden everyone's paying attention to them and everyone's cheering them to climb a little bit further and it's sort of cool because they're floating in the air so they know they're not going to get hurt. So they go back to the wall and they climb a little bit further. So what we have seen many times is by the end of a couple hours, most of the folks, not all, but most of the folks are climbing. Now climbing for some may be three feet and for others it might be 10 feet, but people that were very adverse or very scared or very, I don't know, were actually on the wall. Then you bring the parents in and it's amazing how many parents will tear up when they see their son or daughter 10 feet up on a wall showing persistence and drive and a desire to achieve that they didn't even know was in them and they're happy.

(08:00):

And so it goes back to hope that there's a lot of potential we've seen inside every learner's head and just because they can't talk or just because they have aggressive behavior, you said something earlier that I want to go back to, but before I do that, don't give up on them, basically don't give up on them because of that. With aggressive behavior, one of the very important things you said is there is a reason for that behavior. So while you have to keep them safe and while you may have to remove them from a situation or back off a litle bit if they're punching or kicking or biting, the solution is, well, what caused that behavior? What was that antecedent? What recommendations or what have you learned in working with parents in that space? Have you learned anything that, well, this often's a cause. And you mentioned lights and you mentioned noise or here's something you can do to suss out maybe what's causing a behavior.

(08:51):

Do you have any recommendations or thinking or stories there that you'd like to share?

Mailande Vise (08:55):

Yeah, for sure. I feel like this one is like my bread and butter.

(08:59):

Yes, when we're working with learners, we always first think about what the function of behavior is. And so you're probably aware of this already, but there's typically four functions that we consider a sensory function if it's for escape, if it's for attention or if they're trying to access some sort of tangible item or activity. And so when we're thinking about challenging behaviors, those are the four reasons we're always looking for and we're intentionally responding in a way to teach an alternate way to get that need met, whether or not it is learning how to wait or learning how to request the item or tolerate a non-preferred task. And then on the back end of that, we're very intentional with how we respond to the behavior. So if we are seeing more of those alternate skills that we want to see more of, incredible, let's reinforce it.

(09:50):

Let's like cheer them on like you're talking about the climbing gym and really amp it up so that we see more of that. But on the flip side, if we're seeing that maybe a learner is doing something because they really want to acces that item, you really want to make sure they don't get the item if you're able to so that they don't learn that behavior works. And so really sort of mapping out, we call it the ABCs of behavior, your antecedent behavior and consequence. And so teaching parents how to identify that for themselves is super helpful because we want to empower parents to have the tools to handle new situations that come up. We don't want them relying on us to have to coach them through it, right? Because novel things are going to pop up all the time. And so when working with families, if we can build that skill

(10:41):

And not only learning how to identify sort of the full picture in maybe more of a structured setting, but actually practicing it hands on, I think that's huge. And that makes me think about even the kids climbing at Crux, it is one thing to hear something and it is totally different to see it and to practice it and to experience it. And so with families, I really like choosing what is one time that's consistently tough, right? Maybe it is driving in the car, maybe something always happens. And so let's start there together and be hands-on and practice the skill together and I'll show it and I'll tell you what to do and I'll have you practice it. And I think that is so helpful. That's one of the biggest things that I've noticed as a provider is showing it. I think that is way different.

Mike Carr (11:31):

I think one of the things that you brought up, and this is a huge weakness of mine, my wife's much better at this, is the practice and that you're trying to have parents get to the point, because you're not around that much, right? I mean, there are only so many dollars to pay for BCBA hours or ABA therapy and when they're home on the weekends or vacation, having the mom and dad step in and know enough about what you've been working with their learner so they can do it as well is so important. I mean, one of the things that we discovered in talking to some of the special ed folks in the Austin area, whether it was Round Rock or Flugerville or wherever is that when kids come back from Christmas holidays and mom and dad haven't been paying attention, you sort of go back a few weeks or a few months.

(12:19):

There was a regression and behavior. They've learned some bad habits over again because mom and dad bribe them. They don't know all the techniques to mitigate a behavior that's been going on in school and they're screaming or they're doing something inappropriate. So they give them the candy bar or they give them the object or they give them whatever and then that motivates them. Once they understand, "Oh, I can misbehave and that's what I'm going to get. " Well, what are they going to do? They're going to misbehave over and over and over again. So all that great learning that's gone on working with a BCBA or an ABA person sort of has gone down the toilet. Realistically, do you have any recommendations there? Because I tend to be very impatient. And so where I've landed is I won't do everything quite honestly that I'm supposed to do, but I absolutely know the things that I'm not supposed to do and I will pick the lesser of multiple evils when it's just all I have the appetite or the patience for.

(13:09):

So for an example, we'll go out on a walk together, my son and I will. Well, he's used to getting with me bits of bars, a bit of a nutrition bar every time he does something. And so he would constantly go through multiple Atkins bars. Well, now I make him count to a hundred. So he knows he's got a bar, but he's got to count to a hundred and sometimes it's longer than a hundred. And so at least I'm trying to stretch out the reward and he's used to it now. And for most of his colleagues, they don't give him a bar at all. He maybe get water. And so you sort of change the quote bribe to encourage the behavior over time, reducing the frequency of it to where you can finally phase it out. Any other thoughts there or techniques there that you've seen, "Hey, mom and dad, if you don't have the heart or the appetite in certain situations, here's some things that work reasonably well, or here's some things that you absolutely have to avoid doing unless it's just the last resort."

Mailande Vise (14:02):

I think my first thought is I just come to it with a lot of empathy. I know that working full-time, having a child with disabilities, I mean, it's a lot. And so when parents aren't implementing strategies, it's because they have a lot going on and I think it's really important to consider that. I don't think we should forget that. And also this sort of comes up of the parent versus the therapist relationship. It's like, I want to give our parents tools, but also they're not an RBT. You want to have realistic expectations. I think that's a discussion that people have sometimes about sort of a parent relationship is different than a therapeutic one. And so it makes sense that a parent behave a little bit more. I think that every parent does. In terms of strategies, I think the best thing is to start small and build up.

(14:59):

I think it's really overwhelming when someone gives you 10,000 different tools and it's like, "Oh my God, do I do this one or that one?" And so I think just building things one at a time, right? Start with one skill, right? Maybe it's teaching functional communication where you are practicing it maybe in one consistent scenario. It sounds like your son really loves cake, right? So maybe teaching him how to request cake in that setting. And then once you guys are proficient with it, then teaching how to request the bars and other things and really helping parents start small and build up until the skill is robust and they're proficient with it instead of overwhelming them. I think in terms of good skills versus no-no skills, I think generally speaking, teaching functional communication will always be huge.

Mike Carr (15:49):

Right

Mailande Vise (15:50):

Not as device or pecs or sign or vocal, whatever that is and reinforcing it. I think that the first line of attack is always teaching replacement skills. So if your child has a hard time sharing, teaching them how to share, waiting, teaching them how to wait. I also think that it's really important to model, model, model. So let's say we're trying to, and this is a really tough one, but let's say we're trying to teach our kid how to label their internal events when they're sick, when they don't feel good, how to expose your child to that language. So your allergies are terrible and they're your kids, so you know their allergies are probably terrible. And so you model on their device like, "Oh, my head hurts. I have allergies," and you're just exposing them to it, but that goes a huge way. So those are my first things.

(16:45):

And then the no-nos if you're able to really just trying to avoid reinforcing challenging behavior. But again, I come at that with empathy where if there's a lot going on, things happen. But generally speaking, once you start to understand the functions of behavior, really just trying not to build something up. I think the flip side of that is making sure to catch your kids when they're good all the time though, right? They're waiting really nicely or they're asking. We want to make sure we give all of those awesome skills that we want to see lots of attention so that they keep doing it. So it's like the tale is oldest time of when the child's obeying, they're not noticed, but when they're running around, they get a lot of parental attention. So just trying to create space to recognize the little things sometimes.

Mike Carr (17:36):

Flipping that is so important and it's not intuitive, right? But lots of cheering, lots of clapping, lots of applause, lots of attention when they do something well and almost ignoring them when they're misbehaving. You don't give them any kind of attention because for our son, he wants attention. He doesn't care whether it's because he did something bad or something good. He just wants attention. And if he knows he can get your attention by taking that puzzle and throwing all the pieces on the floor and he watches you and he sees you react, he knows he's won and then he's going to do it again and again, again. Whereas if he does the same exact thing and he throws that puzzle on the floor and you don't react at all, well, then he's going to stop doing it because the whole motivation, the reason for that behavior was I want dad's attention.

(18:17):

And so understanding that as you're talking about mailing, I think is so important. If people would like to get in touch with you or find out more about your practice and what you do and maybe even your availability for a consult, is there an email address? Is there a website? Is there a place you would recommend that they go?

Mailande Vise (18:35):

Yeah, that would be awesome. I'm actually in the process of starting my own clinic. So yeah, please reach out. I love working with kids of any ages, but I really hold a special spot for adolescents, teenagers, young adults, the people that I think unfortunately get forgotten. So yeah, please reach out to me. My email address is mailande@viseabatherapy.com and that's M-A-I-L-A-N-D-E at V-I-S-E A- B-A-T-H-E-R-A-P-Y.com. Or you can just call my cell, which is 601-291-0339, a domain, but the website isn't up and running yet, so TBD on that one. But yeah, if anyone needs anything, I would love for them to reach out.

Mike Carr (19:20):

Awesome. Is there one piece of advice that you'd like to leave anyone watching, listening to this with before we conclude? Just something that, hey, if you don't remember anything else about what we've talked about, or if I look back at all the things that I've learned working with different parents, here's the one or two things that I really think you should take away from this conversation, what would those be?

Mailande Vise (19:41):

Yeah. My first thing that comes to mind is sort of cheesy, but it's like all of this stuff works and I've seen so many stories of things that we didn't think were possible that happen all of the time. There was a kid who was like 10 who's communicating vocally for the first time because we figured out how he learns best. Or I had a set of kids who could not get along and it created a lot of, it was just really stressful in the household and through parent training they learned how to manage things on their own and now vacations are awesome and they were empowered. And so I think just really reminding people that it works, it takes time, but the small wins are still wins. And I think my biggest tool is to start small and build your way up, take that big skill and break it down into a tiny achievable step and find what motivates your child.

(20:37):

I think those are the biggest things.

Mike Carr (20:40):

Great. Well, Mailande, thank you so much for your time today and everyone watching and listening, please come back next week for another episode of Autism Labs. Hope you have a great rest of your week. See you now.

Mailande Vise (20:51):

Awesome. Bye.