Axial Codes
Question 1: List Open Codes from the Transcript below
Question 2: List Axial Codes from the Transcript below
Question 3: Identify the themes from the Transcript and summarize, analyze and explain the findings from the transcript using the generated themes
As part of the research study to increase our understanding of the experiences of ABA Therapists to Improve Group Therapy sessions for children living with Autism, the following four (4) focus group interviews were conducted:
INTERVIEW 1
Interviewer:
All right, it’s good to see you all today. How are you?
Respondent(s):
Good, good, good.
Interviewer:
So, I have a few questions here for you. And the goal of this research basically is to help understand the experiences of ABA therapists in order to improve group therapy session for children living with autism. So, here’s question number one for you. As an ABA therapist, do you perceive that kids with autism help each other learn during group sessions?
Respondent(s):
Children with autism benefit better from one-on-one sessions first and then after a while, we can introduce them to group session. But I’m very much more for one-on-one sessions first.
Interviewer:
So, you prefer to start one-on-one and then the intervention can subsequently proceed into group session. Do you all agree?
Respondent(s):
Yes, gradually into the group session.
Interviewer:
Oh, why do you think so?
Respondent(s):
Um, I feel like that because there are different levels of autism. Depending on the level of the disability, one-on-one can be perceived better at first than a group setting for someone with autism, depending on the severity.
Interviewer:
Okay, sounds good. I like those answers. Thank you very much. Question number two, do you personally use ABA methods when leading or conducting group therapy sessions? If not, why?
Respondent(s):
Yes, the ABA methods that we use are pretty good. From my experience one of the methods, we use is when we have the kids in the classroom, one-on-one, and we implement therapies like in 10 minute increments. And so, I saw that it benefited them it helped them to learn because, you know, some of the kid’s attention span wasn’t that long you know.
Interviewer:
So, one of the ABA therapist principles that you use is time intervals, right? You give them a 10-minute work session and then you increase the work session after each interval?
Respondent(s):
Yes. Yes, as time goes on. You know, you’re able to reinforce and reward them after each session is complete niche 10-minute session, and then gradually you can increase based on the attention span.
Interviewer:
Okay, so now let’s move on to the next question. Question number three. So now that I know that you use ABA methods in what ways could the group therapy sessions and experiences be improved?
Respondent(s):
Yes I think that how it can be improved is like we stated once before. Basically having the one-on-one, getting to know the kid or pairing with the kid, understanding what learning style will be more beneficial to the kid. And once you’re able to learn, you know what learning style to use and levels of autism of the kid, then you can gradually or slowly integrate them into a group session.
Interviewer:
Okay, moving on to question number four here. What barriers to successfully implementing or improving group therapy sessions do you anticipate as a practicing ABA therapist?
Respondent(s):
It depends on the individual child; if the child has behaviors or if the child’s attention span is where it needs to be. Learning the child’s likes and dislikes. I think that’s also important.
But if we don’t have enough history about the client and then the therapist just starts working with a client, that may be also a barrier.
Interviewer:
True. So how do you think we can solve that problem?
Respondent(s):
Um, just you have to spend quality time, learning the client as a therapist, gaining that trust, learning where they are all across the board as far as their behaviors. Then you have to understand their likes, their dislikes, what will trigger them? You know, once you establish those things, I think that you will be able to properly manage the group session well. If you establish those things, first, you kind of build trust and establish that good relationship.
Anticipate there could be different kids in the group; some kids are nonverbal/verbal. Yeah. You have those who are aggressive or violent and those that are not. There could be kids with very low or short attention span; there could be you know, different type of barriers. I feel as if you’ve figured out what those are, with the client or with the help of their parents, that’ll definitely improve the sessions by figuring out the barriers first.
Interviewer:
That’s good. That’s good. I completely agree with that. All right. Question five. What are you most worried about? When it comes to conducting group therapy for children living with autism?
Respondent(s):
What I’m most concerned with is the kid, the specific child with autism, how they will react to a group session, how they will react to the therapist, how they will react to interacting with the other children. Those things are a big concern because you don’t know some autistic kids like or don’t like at first. Some don’t like to be looked at; some autistic kids don’t like to be touched. You know, there’s just a variety of things. That’s why it’s very important to have that one-on-one session to get to know the kid, learn their barriers, learn their learning style, learn, you know, every information that you can about them so that you can have a great session with them.
Interviewer:
That’s true. All right, the final question what are the other concerns or experiences while conducting group therapy for children living with autism would you like to talk about?
Respondent(s):
I have seen, you know, individual children that kind of lashed out at the therapists, aggressive, verbally aggressive, also physically aggressive, and it all stems back to learning what triggers them, you know, because it could be some of them you can’t wear a certain perfume or cologne. Some of them can’t hear certain sounds- is just different reasons.
I also feel like it may be beneficial to maybe keep the numbers down in the group. Not only for everyone’s safety. You wouldn’t want to put you know, these kids who may feel uneasy or bothered in one area with other kids or therapist who’s trying to figure them out and possibly has not had enough one-on-one session to try and understand the kid well. So, I honestly feel that one-on-one should probably be the standard way to start out therapy with kids and then maybe work them up into group sessions.
Interviewer:
Well, thank you so much. I really enjoyed this group. I liked the way you were very honest with your answers, and you know, shared your experiences this will help us in our research. Thank you.
INTERVIEW 2
Interviewer:
All right. Welcome to this focus group. As you know, we are discussing the experiences of ABA therapists during group therapy session in order to improve the sessions for children living with autism, and here are the questions I have for you. I hope that group members will be able to give me their experiences in a way that can help contribute to knowledge and research. The first question here is, as an ABA therapist, do you perceive that kids with autism help each other learn during group sessions?
Respondent(s):
Children with autism learn at different levels and stages. So, I feel that some may help others but not all. Not all. Not all.
For example, there was an incident that I noticed. I had a child with Autism who was learning at a higher frequency level than other children in the group with autism. As a result, the other children felt like they were probably a little less intelligent because they were unable to learn as fast as you know the other intelligent child in the group.
My perception of the kids with autism helping each other learn in group during group sessions, through my experience, of being in the group setting as the therapist is that basically it’s always good to start off working with kids one-on-one before introducing them to group therapy.
Interviewer:
So, did they eventually help each other out during that group time?
Respondent(s):
So, you know each child is different. I think that grouping higher functioning children together may be beneficial than grouping autistic children functioning at different levels. The child may not benefit from a group session like that.
Interviewer:
Okay, thank you. Do you personally use ABA methods when leading or conducting group therapy sessions? If not, why
Respondent(s):
Honestly, I do. I try different things. First, I pair with the child to learn about the client a little more. I feel like you won’t fully understand the children until spend some quality time with them. So, I feel like pairing could provide positive reinforcement for the children to trust you and that could definitely make a difference.
I agree with her. Pairing with the children together leads to more positive outcomes. You know, I think this is one of the best ways to deal with autistic kids because it gives you adequate information on where they are, how they learn, what barriers they have, how well they work with others- especially if the goal is to integrate the child into a group setting.
Interviewer:
Okay, that’s good. All right. So, in what ways could the group therapy session and experience be improved?
Respondent(s):
Um, I feel to improve the sessions, you would have to communicate with all stakeholders. You know, in any way possible, get as much background information as you can on the children. You know, I feel like the more you know about the children, the more they start to feel comfortable with you or feel like you get them; the more you can help them.
I mean, of course, you want to get to know the parents of your clients because if you get to know the parents, you will learn almost everything you need to know about the child but you can also learn more by spending time one-on-one with the child himself.
I want to say how to improve the session and how those sessions and experience can be improved is through different methods, you know, and doing some analysis trying different things. That’s the way that you can find out what works and what doesn’t work for the child. Trial and error, trying different things with the kids, you know, like in a classroom setting or individually. Yeah, just trying different methods of what works you know; like doing research. Trying out new things or activities with the child and then just keep introducing different things that may improve the session. That’s what I think.
Interviewer:
Thank you. Moving on. What barriers to successfully improving group therapy sessions do you anticipate as an ABA therapist?
Respondent(s):
Like we were saying before, some autistic kids could be focusing or learning at a high frequency level and others at a lower level. I feel if you are able to figure that out, and tell the difference between the two, you’ll be able to pair them correctly.
But sometimes, there is a barrier and one is unable to pair all in a group appropriately.
The barriers are like we said earlier; they react to one another differently, and how they react to one another affects how they learn and interact with the group. Some are nonverbal you know, so learning how to understand how a nonverbal autistic kid will communicate is a barrier.
Interviewer:
True. Okay. What are you most worried about when it comes to conducting group therapy for children living with autism?
Respondent(s):
Some children may become too comfortable in one-to-one therapy sessions that adapting or transitioning into group therapy setting may be quite challenging.
For example, if the child has some type of behavior with other kids, you know, there’s always a risk of verbally or physically assaulting other kids in the group. It’s just a wide range of concerns to be worried about in before and during group setting; because we don’t know what the child has been introduced to in the past and how they would react.
Interviewer:
Okay, so finally, what other concerns or experiences while conducting group therapy for children living with autism would you like to talk about?
Respondent(s):
Biggest concern first and foremost would be how to handle the autistic child in the situation when they throw a tantrum. How to handle them when they feel afraid. How to handle them when they don’t get something that they want.
Some of them will repetitively say something over and over or they’ll make a loud sound and it’s just as a therapist, you should be able to have that patience and know how to handle that, yeah.
Interviewer:
That’s right. Thank you so much for sharing your experiences and your ideas. And this will definitely help to improve our knowledge and understanding of children living with autism and group therapy.
INTERVIEW 3
Interviewer:
Welcome to this interview, and thank you all for consenting to help out with this research. So as an ABA therapist, do you perceive that kids with autism help each other learn during group therapy sessions?
Respondent(s):
I don’t think they help each other.
I think they will benefit more from a one-on-one session
Interviewer:
Okay, so do you personally use some methods of applied behavior analysis when leading or conducting group therapy sessions? If not, why not?
Respondent(s):
Yes, we basically tell them if they don’t follow their plan that’s put in place, then they won’t be able to participate in a certain fun activity that they like. But if they do choose to follow their plan, then they’ll get a positive feedback or reward. So I also set a motivation in front of them to work for during group sessions.
So, it’s more like using positive reinforcement and/or negative reinforcement to shape up their behaviors.
Interviewer:
That’s good. So, in what ways could group therapy sessions and experiences be improved?
Respondent(s):
First and foremost is making sure that you know, establish a relationship with a child, the one-on-one type of relationship. Get to know their likes and dislikes; knowing what is comfortable to them; what fears they may have; what their strengths and weaknesses are. You can bet that can better give a behavioral therapist the ability to work with that group of children productively. And then you can get more things done, if you know their strengths and weaknesses for sure.
Interviewer:
Okay, now that we’ve talked about things we can do to improve group sessions, what are some barriers that we can encounter?
Respondent(s):
A barrier could be just basically not having that relationship established with the child; not knowing their reaction to certain things if certain things scare them, and you put them into a situation that they’ve never been in before. That could create a reaction out of them. Other barriers could be language, yeah, language. Just different things. Like that especially if the child is from a different country or culture, it may be challenging to integrate such a child into the group. Other kids may have short attention span. The child in a group may only be able to hold their attention for just a short period of time. You have to know if their attention span is five minutes, 10 minutes or 15 minutes at a time because I noticed that in the classroom with the autistic kids, they only could do sessions in like 10-minute increments because that’s all a child can tolerate. So, yeah, like that.
Interviewer:
What are you most worried about when it comes to conducting group therapy for children living with autism?
Respondent(s):
If a child is violent, their reaction if they’re scared, you know, being around other children just how they will react or engage with other children is unknown and worrisome. That’s the biggest concern, just making sure that other children are not afraid and comfortable. That’s my biggest concern.
Also, if a child doesn’t really know the therapist like that, I’ll be concerned if the child would attack the therapist or maybe other children in the group therapy session.
Interviewer:
Okay. So finally, what other concerns or experiences while conducting group therapy for children living with autism would you like to talk about?
Respondent(s):
Like I said before, if they’re high functioning, you can pretty much work with them and then there’s some very low functioning children who can only do so much; so you have the ones that’s making noises all the time, then you have the ones that you can really look at that and a crisis behavior gets triggered.
So, it’s just basically learning the child, that particular child because each child is different. Each child has a different trigger. Like it was mentoioned, some are high functioning, you can kind of do a little bit more with them. And the ones that’s lower functioning, it’s more challenging to achieve very much with them especially in a group setting.
Interviewer:
Okay. Well, sounds good. Thank you all for your contribution to this research. I appreciate your time.
INTERVIEW 4:
Interviewer:
Thank you so much for agreeing to conduct this interview with us. And as part of this research, you know, it’s to increase our understanding of the experiences of therapists in order to improve group therapy session for children living with autism. So, the first question I have for you, is as an ABA therapist, do you perceive that kids with autism help each other learn during group sessions?
Respondent(s):
No. On the contrary, I noticed that each child will pick up one another’s negative behaviors. Like one child makes a noise and the next one in the group makes a noise as well. Then he takes that home and continues to make that noise. When kids with autism are in group, they don’t focus on what is being said to them because they’re too busy worrying about what everybody else is doing around them. So, it’s like the kids don’t hear nothing that the therapist has to say. So, I don’t think group is good for kids with Autism. I would rather go for one-on-one therapy for these kids.
Interviewer:
Okay, so do you personally use ABA methods when leading or conducting group therapy sessions? If not, why not?
Respondent(s):
Yes, one method I use is observation. It’s like if I don’t know what’s going on with a child at first and I don’t know the history of the child well enough, I would carefully observe and document my observations about the child while pairing with him.
Also, I see what makes them click, how they respond to chores, how they respond to simple instructions like: “go brush your teeth”, “clean up your mess after you eat” and so on. So, these are things I look out for before I go any further with them. I am also always alert to potential conflict situation that needs to be addressed immediately, before they even occur.
Interviewer:
Okay, so what ways could group therapy sessions and experiences be improved?
Respondent(s):
I think initial therapy needs to be one-on-one, like with the instructor and just that child in a room. This helps to build a solid foundation before such a child can be transitioned into group settings.
Yeah. If you put all kids with autism in a room with one staff without building a strong foundation one-on-one, you’re not going to get the desired results. Nobody’s learning nothing new like that. They’re just getting older. And everybody’s supposed to be more tolerant. Because you’re getting older, you’re doing the same thing that you have been instructed not to do in your group setting 24/7 and you’re still doing it even when you leave. Doesn’t make sense. After you told him no. But he knows the difference between hot and cold water. But we supposed to play off the disability
Interviewer:
Okay, so what barriers to successfully improving group therapy session do you anticipate?
Respondent(s):
I mean, I will say anything that could make those session longer without a motivating operation. Motivating Operations (M.O.) is an important ABA concept that refers to the internal processes or desires of an individual that change or improve the value of a certain stimulus. The child has like many struggles already including short attention span. Thus, if there’s no type of motivating operation, then there’s no reason for the child to stay engaged in a group. So, in order for the child to like, keep it going, there has to be something that motivates them in order for them to want to learn. It may be however challenging to establish a motivating operation that all members of the group will like.
Interviewer:
Wow these are interesting points. Okay, what are you most worried about when it comes to conducting group therapy for children living with autism?
Respondent(s):
You know, if a child in the group doesn’t want to do work or participate, it may discourage other children in the group from learning as well.
I would also say like whether it be biting, kicking, punching anything like physical aggression. Yeah, basically I’m also concerned about all that because I don’t want to be hurt by no child. Yeah. Like that’s a no um, but yeah, that will be the only thing that I am really worried about in a group.
I feel like if there’s some type of attitude or trigger or anything like that, that’s very easy to figure out and calm them down; but anything as far as like, punching or other forms of physical aggressive behaviors, you got to actually figure out like, why because, you know, sometimes they’re not able to really express their feelings.
Interviewer:
Okay, so finally, what other concerns or experiences while conducting Group Therapy for children living with Autism would you like to talk about?
Respondent(s):
I’ve had some really good experiences working with children living with autism. I guess like I’ve done playing in like playrooms during group sessions. I’ve also ran programs where they’re like, can you hold a pencil together or whether it be putting out clothes. So, I’ve had experiences like that. I will call them all good experiences because I will say like is very, very common and very good to know that they’re able to do something that they weren’t able to do before as a result of therapy and intervention. So, when I come to look at it like that, I just think that is good. I actually haven’t had any bad experiences or any behaviors or anything like that.
Interviewer:
Well, thank you all so much. That’s all the questions I had.
References:
Vollstedt, M., & Rezat, S. (2019). An introduction to grounded theory with a special focus on axial coding and the coding paradigm. Compendium for early career researchers in mathematics education, 13, 81-100.
Williams, M. and Moser, T., 2019. The art of coding and thematic exploration in qualitative research. International Management Review, 15(1), pp.45-55.
Harati, Hadi, Fatemeh Nooshinfard, Alireza Isfandyari-Moghaddam, Fahimeh Babalhavaeji, and Nadjla Hariri. “Factors affecting the unplanned use behavior of academic libraries users: Towards an axial coding pattern.” Aslib Journal of Information Management (2019).
Qureshi, Henna A., and Züleyha Ünlü. “Beyond the paradigm conflicts: A four-step coding instrument for grounded theory.” International Journal of Qualitative Methods 19 (2020): 1609406920928188.
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