A Day in the Life of a Registered Behavior Technician

Grace Alarcon is sitting next to Peter* at a toddler-size table, unpacking his lunch. It’s Peter’s first day back at Potential after injuring himself a couple of weeks earlier. He’s reluctantly wearing a sling and desperate for a nap, but Grace, the lead registered behavior technician (RBT) at the school, persists because it’s important Peter reacclimates to his therapy schedule.

For about 15 minutes, Peter – who is nonspeaking and, like the other Intensive Behavioral Health Services clients at Potential, has autism spectrum disorder – alternates between whimpering and whining. Like any child his age, he wants to eat the bacon first, but Grace insists he tries his sandwich.

She’s gentle with him and encouraging. Peter momentarily gets the hiccups, and Grace rubs his back and offers him water. When he finally takes a bite of his sandwich, she celebrates and promptly offers him the bacon. But Peter remains tired and cranky.

A timer goes off indicating the end of lunch. Grace packs up Peter’s sandwich and snacks then sprays a paper towel. She places the towel on the table and puts Peter’s hand on top of it. Then, with her hand on top of Peter’s, they clean the table together.

Next, they do a puzzle and then an identification game.

“Where’s the red dinosaur?” she asks.

Peter picks out a red dinosaur from among several small toys on the table, and Grace congratulates him.

“Find the blue train.”

“Find the green car.”

Peter stumbles a couple of times, but he always finds his way. Still, his already-limited attention is waning. Grace decides a change of setting could help and moves them to the art room. Another student and his RBT, who share the classroom, follow.

Their day together is a constant stream of activities that each last about 10 to 15 minutes. “Every day is different,” Grace said at one point. She just as easily could have said that every hour is different.

‘The little things tend to mean the most’

Entering college, Grace knew she wanted to work with people, but she didn’t want to go into healthcare. “I was more interested in vocational work,” she says. Ultimately, she earned a bachelor’s degree in rehabilitation and human services from Penn State University. “That major opened the door to lots of other opportunities, including working with people with autism and disabilities.”

She was exposed to the position of registered behavior technician during an internship. She liked how it married her fondness for children with her growing clinical expertise. Shortly after graduating and earning her RBT certification, Grace was hired by Potential Inc., the nonprofit that operates the Springtime School. That was three years ago. Her interest in the field has only deepened since.

“I think this might be what I want to dedicate my career to,” she says.

Today, Grace is back in school, pursuing a master’s degree with the goal of eventually becoming a board-certified behavior analyst (BCBA).

“Originally, I thought I’d go into occupational therapy. But I’ve really enjoyed working with kids of all ages, particularly the older ones,” she says. “I like helping them develop functional skills like learning to tie their shoes, grocery shopping on their own, and just being more independent overall and advocating for themselves. With the little kids, it’s great to see them using their talking devices and words to indicate they want something. It’s the little things that tend to mean the most in their development.”

In one instance, the parents of a student had not realized their child could use their talking device independently. “At school, they’re taught to use it as their primary mode of communicating,” Grace says. “But this family may have been relying on other methods at home.”

When the parents discovered their child’s new ability, they were overcome with emotion.

“Their reaction is something I’ll never forget,” Grace says. “We work on certain things for such a long time – weeks, sometimes months – that once they do it by themselves, and do it consistently, it’s such a big accomplishment.”

Never a dull moment

Most days, Grace works with two clients, one from 9 AM to 3 PM and another from 4 PM to 6 PM. The activities she does with them vary by the client’s age and ability. On this afternoon, she escorts Peter to a bathroom to practice brushing his teeth. Peter is wearing a sling on his dominant arm, which makes every task that much more challenging, including this. But with Grace’s constant encouragement, he manages.

Peter has made remarkable progress in recent months. He’s mastered identical and nonidentical matching. Now he’s working on the kind of matching referenced above, where Grace asked him to identify a specific object of a certain color. He’s also started initiating when he needs to use the bathroom, and he no longer requires a schedule. Perhaps most encouragingly, Peter has become adept at playing independently.

At Potential, even playtime is an opportunity to learn and grow. Throwing a ball, for example, is a chance to develop gross motor skills. Recently, Peter picked up a toy car on his own and pushed it down a ramp, which was a form of one of the single-step play schemes Grace and other Potential staff members had been helping Peter develop.

Today, playtime is mostly just about playing. It’s one of the few moments where Peter forgets how much he wants to take a nap and seems to enjoy himself.

Grace pulls him and a classmate in a wagon around a common area outside the classrooms and then down a hallway. Peter has been showing more and more interest in interacting with his peers lately. One of the ways he’s been doing that is by climbing into the wagon with another child. Grace and others are working with him to respond to a greeting with a wave.

After the wagon ride, Grace pushes Peter around in a wingback desk chair. He smiles brightly. And then begins to nod off with the gentle swaying.

Grace catches him just in time and quickly ushers him back into the classroom, where they sit down on an area rug. Grace begins to read from a book. Peter resists and then relents. His eyes slowly close. On to the next activity.

*Peter’s name has been changed in order to protect his identity.