Table 1.

Types of adaptations

Type of adaptation	Illustrative quote
Modified Language	“I don’t want to say I dumbed it down, but I definitely put it in layman’s terms to where my family can get a visual, and understand it. I also explained it like an ice cream cone, where you have an ice cream cone as the foundation and then you put the ice cream on it, and then the sprinkles order. Kind of like the rewards do. We used a lot of visuals and other ways of trying to explain it.”
Slowed the Pace	Extended time on parent skills “Yes, I did. I spent a lot of time on the parenting skills because I felt like that’s where we had to start, and where we had to be at a good place before we could move on and be effective in teaching the child skills. If anything I just prolonged it a couple weeks, but that’s about it.”
	Extended time on behavior tracking “Behavior tracking took a while as did the antecedent consequence reinforcement stuff with the parent… [I] really wanted to make sure that she was able to—because I know that she could understand everything that we’re talking about in session, but really making sure that she was able to apply it.”
Integrated Other Treatments	“I pulled things especially from MAP. I pulled some practice skills.”
Involved Others	Involved family: “I involved the brother to get the client more engaged. That tends to be helpful, but also a lot of my clients’ aggressive behaviors are towards the brother. So, anything that I’m going to be teaching the client, the brother’s probably going to benefit from learning as well.”
	Involved teachers “Yes, both teachers, I was able to talk with them about things that they could do in the classroom that would be useful, and they did use those things and they were beneficial. So for instance, one of the things I started doing because she hated the word work −1 thought, well, homework, the word work is in homework - so let’s call them activity sheets. And so I called them activity sheets and she definitely got more on board with it. And so I had the teachers also call them activity sheets so that that would work until she was able to tolerate that word. Then I started calling them homework and it didn’t faze her at all because she wasn’t bothered by the word work anymore.”
Out of Session Components	“If they were having trouble with behavior tracking, or they didn’t really understand how to figure out the function of the behavior, then I would do it in session with them, give it to them to do for the following week, and then bring it back, and then go over again with them.”