Timothy Zercher 0:00

Well, Nicole, thank you so much for joining. I'm super excited to talk with you today.

Nicole Stewart 0:03

Yes, I am excited to be here and thank you so much for having me.

Timothy Zercher 0:07

Absolutely. I'd like to start off with, if you wouldn't mind, telling us about how you got pulled into behavior analysis. What kind of kept you passionate over the last number of years in the field as well?

Nicole Stewart 0:20

So it was an accident. I feel like it's always a good reminder that people don't have to choose, make a choice like immediately. You don't have to say, This is what I'm gonna do for the rest of my life. I was pre-med in college and I double-majored because that's the type of person I am. Yeah. And I had to do an internship for my public health major, and New England Center for Children was at my college career fair. And I was like, I like kids, I thought about teaching. I'll do an internship here. And I, my first day, I was like, oh, this is it. This is what I'm supposed to do. But it wasn't, I wasn't like, oh, AB, I knew what ABA was, and I thought about it, and I knew I feel like it was like, oh, I get to hang out with kids one-on-one. I get to teach them things. I loved it so quickly.

Timothy Zercher 1:17

That's awesome. That's awesome. I think it's rare for most fields. I think it's less rare for behavioral analysis that you love it at your first introduction. I think it's more common in this field where you get just a taste and it's like, oh, this is where I want to spend my career. So now that you're into your career, you've challenged kind of the traditional high-intensity ABA model and advocated for lower dosage, more individualized care. What made you start kind of questioning the standard approach and what kind of brought you to this perspective that you have now?

Nicole Stewart 1:48

Yeah, that's a good question because you think with my background, I worked in residential. So that's like theoretically around the clock ABA. I worked in public schools, I worked in private schools, I was a clinical director of a center providing school placements to children who there was no other school that could appropriately serve their needs other than an intensive one-to-one ABA program. And I testified on their behalf. And I still believe that these are children who needed that. I think what I realized, though, is that it was kind of born out of the school-based model. And the idea of an additional 10 hours of services and an additional 20 hours of services and 30 hours of services isn't right for every child. But then we're closing out services for all these kids who could benefit from something, but not everything. And I had a client during COVID who was preschool aged, not functionally nonverbal, very, very limited language. And I, his parents could only afford it was COVID. So they didn't want to do a program where they would have further exposure to other people. They had their own reasons, which people had given me feedback online that they feel like parents don't get to want. They should do what their children need, not want. But I think parenting is very complex. And they had their reasons for not wanting to do a comprehensive ABA program, but for still feeling like their child needed some access to behavioral support. And so I worked with him for 30 minutes once a week, and I collabed the nanny would observe, and I collaborated with the nanny and mom. And by the end of the year, the nanny had a lot of strategies herself that were behaviorally based on how to help promote language and how to help facilitate play. And he and I would have these crazy sessions where he was like obsessed with my cats for whatever reason, who are not here. That's just why I recorded my attic because it's the only room I can close them out of. And he was obsessed with my cats. And we would literally go around my house and I'd be like, he'd go, Where's Hamilton? And I'd point to a corner and he'd go, Not there. And this is a kid who was functionally nonverbal at the start of treatment. And we could have, granted, it's a scripted conversation, but we could have a whole conversation and he could answer questions correctly. And then he'd see Hamilton and he'd be like, It's a cat, you know, and he's commenting. And we did that in 30 minutes a week. Wow. I just felt how many people are not getting services because they can't, for many reasons, make 10 hours or 20 hours or 30 hours or 40 hours work in their schedule. And so how many people are we excluding?

Timothy Zercher 4:38

Yeah. I love that. I love it. It's a powerful story and a powerful example of how it can work. I know that you also work heavily with ADHD, emotional regulation, and other complex needs that might not be kind of in the standard autism path. Where do you think traditional ABA still has the most room to evolve?

Nicole Stewart 4:57

Ooh, that's a hard question. Because we have lots of spaces for we have many strengths and many areas for growth. But I do think that we are accessible to all of these other diagnoses. And again, I think if we stepped outside of the box that we're currently in, whether it's the number of hours or it's the type of diagnosis or it's the type of treatment we're providing, because oftentimes when I work with kids with ADHD, I'm doing a lot more modeling, exposure, shaping. Those are all ABA. I just think that we've gotten stuck in like, oh, we do task analyses and discrete trial as like our defaults. And I do all these other things. And I think my teacher background also sometimes comes in there too. But I think that we could be more we could provide more support to a lot more diagnoses if we kind of got back to our roots and our creativity of like the principles of behavior in a more holistic way.

Timothy Zercher 5:59

Absolutely. So ABA especially is, or at least can be, a pretty competitive space. How do you go about gaining new clients? What works best for you right now?

Nicole Stewart 6:12

Yeah, I have found that networking and relationship develop building has been the most effective. I have developmental pediatricians that I work with. I have schools that I work with, I have parents who pass along my information. And I feel like word of mouth, especially in a small community, I live in New Jersey. And what can be challenging is that sometimes like I'll get people who I'm like, oh, your kid goes to the same school as my kid, things like that. But I think word of mouth has been the most effective way because I think people are going to be like, they're lending their trust. So when a developmental pediatrician says, Oh, you should go see Nicole, if you trust the developmental pediatrician, you're more likely to trust the person they're referring you to. And I think that is much more powerful than many other ways of getting clients.

Timothy Zercher 7:05

Yeah, which makes sense. I mean, I think if you can, word of mouth is always the best, is always the best. Because it it bypasses so much of the basic proof that you're legitimate, that you're valuable, that you do because Lisa worked with you and I like Lisa, and Lisa says you're great, so you must be okay.

Nicole Stewart 7:23

Right. You're already coming in on this like positive footing of like, I like Lisa, so it even makes actual surface easier because they trust you much more readily. Exactly. Yeah, exactly.

Timothy Zercher 7:35

Yeah, which makes complete sense. So I know that you've kept your business fairly small, and I believe that that's a conscious choice. Tell me more about why and how that's allowed you to kind of focus on other priorities within the business.

Nicole Stewart 7:50

Yeah, I mean, so I was a clinical director. The clinic that I was working at went from one kid that was there for their school placement to 20 kids for their school placement, plus kids receiving after-school services. Huge growth, huge expansion. I got to see the business side. I got really burnt out being the person who was also navigating when parents are unhappy, when staff are not performing as expected. And for me, that wasn't the right fit was being managing more and more people. I wanted to be able to just work directly with the families and the clients that I wanted to directly work with. And other people really enjoy the troubleshooting of staff not meeting expectations and families being disappointed. Like other people enjoy that stuff, or the HR pieces or the business management pieces. Those were just not things that I enjoy doing. And so I really focus on what lights me up and what, you know, the Marie Kondo, like what brings me joy, and crafting a business model around what brings me joy. And so working directly with families and helping parents, helping people with adults with ADHD, helping people better understand themselves and doing that direct work was something that I just enjoyed so much and wanted to focus on. What I did miss was teaching staff and training people. And so because I feel so passionately about expanding ABA outside of autism, I feel like I've that piece, that dissemination piece really hits my desire to train and teach as well. And so I feel like I've maintained that. And I feel like I'm trying to grow the space without necessarily growing my business right now.

Timothy Zercher 9:40

That makes sense. And it allows you to grow your impact without necessarily growing the business as well.

Nicole Stewart 9:46

But maybe one day, you know, I've considered hiring BCBAs. I think maybe that's a future goal, is like I can hire BCBAs who can do the same work that I can do. You know, like a group private practice that social workers might have or psychologists might have, maybe something a little bit different. Yes. Yeah. I just feel like I'm not there yet. But maybe one day I will be.

Timothy Zercher 10:08

That makes sense. That makes sense. So last question then from us, because we're a marketing agency that specializes in behavioral health. We always have to ask some marketing type questions. What is one marketing tactic or marketing strategy, especially outside of word of mouth, that you're either considering doing for your team or that you're just watching really carefully in the market?

Nicole Stewart 10:27

Yeah. So what I've learned, I would say, in the last six months that I'm trying to do more of, because I think now my business kind of has these two parts. The one part is my direct work, and the other part is my dissemination and helping people start their own businesses, their own small practices. I found in that section that email marketing is really effective. And having like newsletter and subscribers. And I found that emails for me, and I think it's again my comfortability. I'm not that comfortable with social media always. Like I record a video and then I'm like, oh, that was terrible. Let me re-record it for six hours. And then I'm like, wow, that was my whole day. Okay. On video. I found that for me, I'm like a quicker, like I can make a little quick email that's like, hey guys, have you seen this new thing I'm doing? Check it out. This is why it's great. And then I can shoot that off and I get better conversion than I find in social media. So there's like more reinforcement in it for me as well.

Timothy Zercher 11:22

That makes sense. Well, and if you like it more, let's be honest, you'll do it more. And consistency pays long-term returns almost more than anything else. Almost more than any more than talent, more than even sometimes quality, consistency matters more.

Nicole Stewart 11:39

Yeah, that's such a good point. Yeah. But if you have any marketing tips, I'm open to them.

Timothy Zercher 11:44

Always. I don't know that all our listeners want to hear me ramble, but perfect. Well, thank you so much, Nicole. I really appreciate you uh you join us. I appreciate the insights you were you were able to share as well.

Nicole Stewart 11:53

Yeah, of course. Happy to be here.

Timothy Zercher 11:55

Absolutely. Thank you.