Amber Nelms 0:00

Well, hello, Sean. Welcome to Accelerate with Amber. I'm so excited to have you. Thank you for coming on today. And I am looking forward to hearing all about what you've been up to. You bring over 15 years of experience supporting individuals and families through behavioral intervention. You're a passionate advocate for caregiver involvement. And you're on a mission to create more meaningful real-world progress beyond the therapy room. And you're the founder of Hickory Learning Group. So thank you so much for being on the podcast. Let's start with how did you get into the industry?

Sean Yocum 0:41

Well, first off, thanks for having me. This is a long time coming. We've been trying to connect to get, I think, on each other's podcast, and happy I can jump on yours. How did I get into the industry? I like to say I didn't discover ABA. Like I know most people, it's like, oh, I found ABA. Like I took a grad school class or I was in an undergrad class and I learned about this. No, I kind of live the problem ABA has been claiming to solve. So growing up with my brother, I saw what great support looks like. Like when professionals would come into the home. We had some really good therapists, he had some really good teachers. But then I also saw what happens when systems are built around services instead of the actual people. And basically seeing the gap, like this huge, massive gap between kind of what is getting taught in this like controlled environment and what actually holds up in real life. And when I got into behavior analysis, it clicked really fast. It was like, okay, the science makes sense. You got reinforcement, you got contingencies, you got learning history. It basically explains everything I have already experienced in my own life. But then I started seeing how it was being applied at kind of scale and starting to see where kind of things kind of fall off and are broken. Basically turning this wonderful science that we can apply to anybody. And we kind of turned it just into this like service delivery machine. We're basically measuring success by, okay, we did these amount of hours. It's not for most people, hopefully not you, Amber. I know you're not one of them, but not like independence achieved. Like we're celebrating, like, okay, here's some success and treatment plans, but we're not looking at how are we surviving outside of therapy block, or we build an entire business around when the funding model is set up like this, keeping kids in therapy instead of actually working ourselves out of a job when we're screaming at the top of our lungs, oh, we try to work ourselves out of a job, but the funding model is not set up for that. And it just didn't sit right. It didn't sit right with me. So again, I didn't get into the field to maintain it. I got into fix it. That's what Hickory Learning Group's all about. We're trying to reform it and we build it to what we actually think matters. And basically, that is does it work when no one's watching? Because if it doesn't, it's not treatment, it's rehearsal.

Amber Nelms 2:57

Yeah. Well, I mean, you already shared this in the first question, but your work is deeply influenced by your personal experience as a sibling to an autistic brother. How has that shaped the way you approach your care, especially when it comes to empowering families?

Sean Yocum 3:12

Being a baseball coach, not to get off topic a little bit, but with being a baseball coach, I equate it to like, okay, here's the scoreboard, right? We're looking at the score. I think the experience I have with a brother changed where we're looking on the scoreboard. So most ABA providers were playing this game where the condition to win the game is the client is performing correctly during the time that I'm with them. But that's not real life. That's a controlled demonstration, right? So living with a sibling and living with my family, I can tell you like firsthand, like, we don't care about that. Like we like families don't care about what happens. It's great. Like you hear that success story, like, that's awesome. But my kid is not doing that, or my brother's not doing that at 7:30 at night when everyone's tired, routines are off, and you're not in my home to step in. And I think that's where things either hold or fall apart. So we built our entire model, or I built the entire model off of just like one basic idea that I learned from my dad in financial planning, where he was just like, I'll never forget, there's 168 hours in a week. You have to figure out how to budget your time and figure out if you can take on more responsibility and where your time needs to be allocated. And I was like, well, wait a minute, I could just apply that to anything. If you really look at it, if a kid is in therapy for 30 hours a week, right? Because we have some kids that are doing 30 to 40 hours, 25, whatever, we'll use 30. You're not even touching like 20 to 25% of that kid's life. If you actually look at the numbers. So 75% of that time is spent in the home, in the family, in the community, all in other areas of their life. So why are we designing treatment like that? It doesn't make sense to me. So at Hickory Learning Group, we basically shifted the outcome from client performance to caregiver confidence and competence. And if the caregiver can't run the plan or implement the plan or is not on board with the plan or can't generalize the skills, then it doesn't matter how clean your instructional notes look. It doesn't matter what your treatment is. If your caregiver can't implement what you're doing, then it's not socially valid. The plan is dead right there. So we measure our success based off of, okay, what's that adaptive behavioral skill set look like on a vinel? I mean, I don't care for mastering goals on a treatment plan, but if the vineland goes up and the caregiver can support that individual, that's more of a win to me. Can this family function without us? That's the answer.

Amber Nelms 5:41

You know what you're gonna love on my last town hall meeting? The core purpose of my company is to catalyze everyone to become the hero of their own lives. And one thing I was doing was giving examples for each one of those categories. What does it look like for a client to become the hero of their own lives, a staff to become the hero in their own lives, and a parent? And that's exactly what I went through. I said, it isn't our job to come in as the hero, it's to create heroes. And so every single way that you should be training the parent should equal not you coming in to rescue them. How are they stepping in and how you so it's to me, I think that's one of the most wonderful things about having a strong Y when you're running a company. And I mean, I wish more BCBAs would come and find me and you, Sean, because it is a dream, in my opinion, to have somebody at the top leading and having that. Like that's my core purpose. Everything I teach everybody comes from that. So when you look at a parent coaching, if you have that as your goal, what a huge difference, right? What a huge difference. And that's a measure of success. So I really love that you said the confidence thing. That was one of the measures that I said you should see your parent become. So that's why it's stuck in my head. I said that as an example. That's what you should see over time. The parent become more confident. If you are really hitting towards our core purpose, that is one of the demonstrations we should see happening. And I think that is one interesting thing that I've seen commonly in our field. A lot of people get attracted to the helping kind of field, be like, if you look at it subconsciously, there is a desire almost to be the one, be like, oh, I'm rescuing all these people. But if you don't slow down and ask yourself, wait a minute, is that the ultimate goal? I'm stepping in as a hero, or do we want to make heroes? That can revolutionize how you set forth and how you do things and how you step up because you don't want to take that victory away from other people. And if you can do that, to me, that's successful. Not that you don't get to also be a part of that journey, but you don't get to take all the credit. If you do things well, they should be a part of that journey.

Sean Yocum 7:54

Yeah. I 100% agree with everything you just said there. I think that's also an uncomfortable truth within our field. I think a lot of the industry, it's not built for that outcome right now. It really isn't. And it's great clinically, but I think there needs to be a little bit reform. And I think I got some ways, I got some ideas. But let's continue. Well, let's continue.

Amber Nelms 8:13

Okay. So let's also talk about technology in the field. Where do you see systems or technology in the ABA field that are most critical to help scale your ABA organization? Where do you think we're missing the mark? Where do things need to really move? I'm curious where you think that area could be improved.

Sean Yocum 8:34

That's such a great question. Improvement, I think a lot of people are terrified of AI. Like honestly, I think a lot of people are actually terrified of what AI is capable of and are not adopting it correctly. I think opening up our eyes, using our lovely science to use AI as a tool for efficiency and not as a tool for removing the clinical rigor in the study that you did. I think you can train AI to think like a clinician, but you can't remove the human element out of the clinician, if that makes sense. I think we have to not be afraid to leverage AI. I don't think someone has created the perfect system. I don't think there's one technology field out there or practice management software or CRM or scheduling that does everything that an ABA practice needs. I think every one of these has something that's a pitfall and we just live with it and we grind our teeth and we go, God, I wish this thing did this thing. I think we're still kind of a little reactive instead of predictive within technology. I just know just from speaking with setting up my systems when I first started my company, like, oh, I didn't realize how important getting your referral system was in play. Like I had referrals sitting in an inbox and I take a long time to get to it. Or I found myself when I first started like chasing authorizations instead of like tracking them, instead of like, let's get a predictive system that says this is what's going to set up. We do a great job of collecting a lot of data, but we don't actually use it to drive decision making. Majority. But if I had to say one thing, I think we're under-leveraging visibility for caregivers. I think there's a lot of platforms that are not user-friendly for the parent experience.

Amber Nelms 10:20

Well, that's definitely true.

Sean Yocum 10:22

Or even a hot take here. Imagine if funders had full visibility of our data. Imagine if you were able to allow your funders to go into your like session note software, your clinical data software, and they can actually see your session notes being done in real time. And it could be audited right there. Like I think that's a pretty good idea. Data visibility. I think if you made data visibility, it would eliminate the need for audits. If everything was just clearly visible. Now, I don't know how that works with HIPAA compliance, but if it's people within the network, they have access to that information already. I think if you were able to do something like that, I think that could be game-changing and can save a lot of money.

Amber Nelms 11:01

Interesting. Very interesting idea. So you're saying real-time data, so you wouldn't have to submit all those individual session notes, and then maybe they wouldn't even need to exist if you could just that's actually very interesting. I don't know if that's what you're proposing. That's where my brain went. My brain went from this to this. It's like, would we even need to create session notes if you could do real-time data and like create dashboards? And then you could track it and then you like a medium line brain went to like Claude scanning dashboard. Huh. I mean, I don't think we're there yet. Yeah, but I mean, maybe in another 10 years.

Sean Yocum 11:39

We are at the ability to create user accounts. If we have nothing to hide as an industry, why can't we give someone like, I don't know, let's use we're in North Carolina. Let's use like an MCO like Trillium, for example. Imagine if a Trillium rep had access to your clinical to where your session notes are with your data, they can log in at any time and see what's actually going on with those clients.

Amber Nelms 12:03

But like you already proposed, you wouldn't need to look at the session notes. If there is a way to scan like the actual continuous thing and then it report it back. I mean, I think that's an interesting concept. I think it's just so technology is so rapidly changing. I don't think audit systems no one's even proposed that or thought of it. It probably will happen, actually. That's very interesting to think about.

Sean Yocum 12:27

Don't release this podcast then. We might have an idea, Amber.

Amber Nelms 12:31

Yeah. What about systems or technologies, especially in CRM, scheduling and practice management path fires have been most critical in helping you scale? Which one has helped you scale the most of any of your tech stacks? Or is that even a question that you're asking yourself?

Sean Yocum 12:45

I mean, my my favorite tech stack, and it's not because I'm an ambassador, but I do like the Lumery Hyrasmus tech stack. I think Lumery, if you're Salesforce savvy, I think Lumery has a lot to offer within that platform. Hi Rasmus, a big selling point to me. I mentioned it, like that data visibility for parents. It is a very easy platform for parents to navigate and for parents to see things and to be able to sign notes very seamlessly, see their data. It was one of the main decisions why I went with the High Rasmus platform was the integration with like how their mission is very much about helping families.

Amber Nelms 13:22

And isn't it wonderful? Do you know I met a CEO many years ago before High Raspberry? We connected and met because I love that your heart is also for caregivers. It's huge part of what drives me and a ton of my BCBAs at Triangle because they know that's my story. That's why I got into the field. And I think it is highly essential that we have systems that really reflect and put that as a forefront. I would think most ABA companies sadly do not think about it. They don't care, they don't emphasize it. I know that is a huge importance to the Triangle ABA team. And I cannot wait to use Higher Rasmus myself moving forward with using it as well. And that was the main driver for me. I was like, this is gonna be wonderful that we'll have a better system for our families. I can't wait for them to be able to log in. And I should reach out to him again and see if we could meet. I know he's probably really busy, but I loved his heart.

Sean Yocum 14:21

Really cool heart. That whole team is great. And you do see it like there's a lot of great tech companies out there that are related to like where their core mission is about like families and helping families. Like I know a mole at Fronterra is doing some incredible stuff. His assess his assessment platform. I don't know if you had a what's the chat that we use it. Oh, it's incredible. The team at Attend, Attend Behavior. If you get a chance, check that out. That's some good parent. So attend behavior, they basically have the Ruby parent training curriculum on a app that parents can then log into and they can actually complete lessons and they can complete stuff asynchronously with competencies.

Amber Nelms 14:59

Oh, that's incredible. I love that. That's good to know. I was wondering when somebody was going to take that system. That was one of the OG, because like that is what when I was doing my master's, I focused heavily on the parent training aspect. That's what I did tons of my papers on. I was what, because of course that's my story and journey. And I was amazed how much there really was not a good curriculum out there. That was one of the only ones at the time when I was doing my master's. There's more options now, but I know we do need to keep aware of the time. I think we've covered most of the questions. Is there anything else that you wanted to share with me as we are finishing up on today's podcast?

Sean Yocum 15:38

Honestly, I think we're in a very unique error of ABA. I think we're in the prove it error right now. It's like the Taylor Swift era, how she's got, oh, I'm on my errors tour. I think we're on the errors tour right now of the prove it error. And I think this is gonna be a make or break time in the field of ABA where I think we might be at a point where the best of the best are gonna survive this. And the ones that are doing the good clinical work are the ones that are gonna come out on top of this. I encourage anybody that is thinking about starting their own practice, and you have, like you said, Amber, you have a good why and you have a mission to create heroes, like you said, and you have a great story and you have a mission, like just go for it. Just do it. Talk to Amber. Yeah. Amber's got advice. Talk to me, I'll give you advice.

Amber Nelms 16:26

Yeah. Let's go do that shit.

Sean Yocum 16:28

Yeah, honestly, I think that's a big thing. The only other thing that I would want to share is like if you're on social media, I know that like that's a big thing. Like, just watch your own behavior on social media. Like, don't dive into TikTok, Amber. Are you on TikTok?

Amber Nelms 16:42

Yeah, I have a TikTok account. Why?

Sean Yocum 16:45

Sometimes on TikTok I see some stuff, just our own field and just attacking people. And I don't know. Yeah, just just don't do it. Like, monitor your own behavior, coordinate, collaborate, learn, educate. ABA is not the only thing out there.

Amber Nelms 16:59

Yeah. But it's interesting that you would say that. I mean, I don't want to leave on a bummer, but I do think that's an interesting thing among BCBAs to some extent, is sometimes we're like criticize, like, oh, you're not doing this enough or you're not doing that enough. Like, can we please encourage each other? Can we like focus on all the things that most of us truly care about? There's a lot of us that got into this for the right reasons. And that is what we should be focusing on. Of like, I love that you're giving it your all, and not like, oh, you messed up and did this one thing or you're not doing this. Like, you suck because you're not doing this. It's like, you got into this to care for the families, you do, and the kids. Most, I would say 99% of us did. So let's not pick each other apart. I like that. Let's encourage each other to be the best we can possibly be.

Sean Yocum 17:43

Encourage each other. And the future is definitely integrated care. Like we're gonna have to work with everybody. You're gonna have to have some level of integration, specifically in like states like North Carolina, where we're a big rule state. Integrated care amongst all providers, that's gonna be the best way to help any family.

Amber Nelms 18:00

I love it. Very good. All right. Well, have a fantastic day.