Podcast
·41 min read

Being A BCBA On A Pediatric Team

Providing Behavioural Health Services on a Multidisciplinary Team Featured Image

Erika Ng chats with Michele Shilvock, a BCBA and local pioneer in multidisciplinary service delivery at a pediatric clinic, Paramount Pediatrics. Previously a social worker and with more than 22 years in the field of behavioral health, she has a lot of interesting insights to share.

Interview Highlights w/ Michele Shilvock as a BCBA in a pediatric clinic:

  • Michele Shilvock is providing behavioral health services to children and youth in British Columbia. She works as a BCBA in a pediatric clinic in Surrey, BC, called Paramount Pediatrics. [0:34]
  • At Paramount Pediatrics, Michele gets to provide support for their clients by collaborating with pediatricians, clinical counselors, occupational therapists, dieticians and pediatric nurses, among many others. She is an innovative BCBA who is part of a growing group of BCBAs that have begun services outside a solely neurodivergent community in pediatric medicine. [0:53]
  • Michele is serving a wide variety of clients from toddlers to teenagers, with complex behavioral and mental health needs. A significant part of her role is to work with parents and caregivers just to support the behavioral needs of their child. [1:22]
  • Michele has a four-year-old daughter and when she was born, she was in the NICU (Neonatal Intensive Care Unit) and has some complex medical needs. They were referred to a pediatrician in Surrey when they were discharged from BC Women’s Hospital in Vancouver. There she met Dr. Ansah, and they got to know each other throughout her daughter’s appointments [4:37]
  • Dr. Ansah had a vision to open a practice and create an innovative multidisciplinary team which would be one of a kind in BC. Although this model does exist outside of Canada in the States and internationally. [5:31]
  • Paramount Pediatrics started and the clinic has doubled in size within its first two years of opening. They now have three pediatricians, three clinical counselors, an OT, a lactation specialist, a specialist for infants, nurse practitioner, respiratory therapists and Michele as their behavior analyst [6:25]
  • Michele brings to the team a different lens from the behavior analytic field. Michele was open to the idea that behavior analysis could extend beyond autism by applying its principles to assist families in so many different ways. They agreed that her role as a BCBA at the pediatric clinic would be to provide parent coaching and support to children not just on the autism spectrum. [7:07]
  • Before Michele was a behavior analyst, she was a social worker and a behavior interventionist. She then moved straight into being a behavior analyst full time, which was over 22 years ago! [7:18]
  • There are two ways to access Paramount’s services. You can access all the associates privately by booking them directly, or pediatricians will refer families to them. [8:13]
  • Michele does a lot of school-age work in her practice. The most common query would be around Attention Deficit Hyperactivity Disorder (ADHD). Often it is that population of neurodivergent individuals that are coming to see their pediatrician. Typically in these situations, the team at the pediatric clinic will want Michele to be involved as a BCBA. [10:41]
  • Michele works with the family to develop a behavior-based plan, and then they’ll supplement that sometimes with medication. [12:07]
  • Michele brings in a lot of proactive, collaborative, problem-solving-based strategies to help families work together with their children. [13:13]
  • Michele often works with the registered dieticians. They also work at BC Children’s Hospital and have a wealth of experience and knowledge. [14:13]
  • Of all the clients that come to the clinic, 60% don’t have a formal diagnosis. ADHD is not something that’s typically diagnosed young, so there might be some query of ADHD with related symptomotology. [15:02]
  • Michele often uses SORF (Systematic Observation of Red Flags), which is a tool that’s been developed out of Florida using the M-CHAT for autism assessments. She’ll often do early reviews with parents who have concerns because she has the time to sit and really look at that child across daily routines. [15:55]
  • When Michele was doing social work, she was at the South Fraser Child Development Center, or The Centre For Child Development now. She was part of a collaborative team where they met children and they all worked as a team to decide who would take on which pieces of a case. [16:59]
  • There’s so much more to an individual than their behaviors including feelings, history, medical needs and more [17:49]

“A collaborative model really has the capacity to meet the values of the child and their family..”

— Michele Shilvock

  • If the patient is being referred through a pediatrician, they will sometimes will refer to Michele as the BCBA and clinical counselors at the same time. Usually one of them will do the first point of contact with the family and then they will communicate together. [20:14]

“When a family is getting an assessment, they’re far better served when they can go somewhere that has all the [professionals] doing the assessment.”

— Michele Shilvock

  • With Michele’s role as the behavior analyst, and the clinical counselor’s role is more mental health driven, there can be overlap. There are times where they might all work at the same thing, but in different parts. [21:49]

“If we’re going to provide the right support, it often means we’re going to divide and conquer.”

— Michele Shilvock

  • The model requires professionals to share the same values with the families that they serve. They also share similar values in the types of services they want to give to families of all backgrounds and all abilities. That’s what separates Paramount from other hybrid models. [25:57]
  • At Paramount, it’s families first. They do this by trying to create a holistic model of support for them. [28:36]
  • It’s not a well-known thing that behavior analysts serve children outside of the field of autism, but they do. There’s feeding clinics. There’s toileting clinics. There’s specialized groups now doing work outside of autism. If you’re looking for an individualized service, you can contact Paramount. [31:08]
  • The best advice that Michele has ever received as a BCBA is to find your passion and pursue it. As a parent, hold grace for yourself. Don’t be so hard on yourself as a human being and parents. Be easy on yourself. [33:04]
  • Michele’s personal habit that has contributed to her success is she gets up at four o’clock in the morning every day to meditate. [33:42]

“Hold grace for yourself, don’t be weird and so hard on yourselves. As human beings and mamas and parents, be easy on yourself.”

— Michele Shilvock

Guest Bio: Michele Shilvock (BCBA in a pediatric clinic)

Michele Shilvock is a Board Certified Behaviour Analyst who has been working in the field of autism and family behaviour support for over 22 years with children ranging in age from under 1 to 22 years of age. Michele has a vast amount of experience designing intensive treatment programs, addressing problem behaviours in the home and school settings and in providing direction and coaching as it relates to early childhood development. In addition to direct treatment design, delivery and coaching, she also provides community based training and education, school consultation and has been a speaker throughout BC.

Her approach is driven by evidence-based research and approaches rooted in science. Her focus is on working closely with families and community partners to help establish collaborative working relationships. As a mother herself, she is rooted in working from a family-centered style, operating as part of a team with all members to build up each individual’s potential through strengthening members’ knowledge and skills. She recognizes the vast amount of questions and challenges families experience on a daily basis and how overwhelming it can be to navigate the amount of parenting advice that is out there to access on your own. Therefore she is dedicated to designing and supporting families with individualized strategies that are specific for each child and their unique ways of learning and engaging and providing families the tools needed to navigate parenthood.

Photo Of Michele Shilvock

“To see a person go from some pretty scary stuff to integrated in the classroom full-time, feeling like they have a voice, that’s a success story for me.”

— Michele Shilvock

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Read the Transcript of Interview on Being a BCBA in a Pediatric Clinic

Erika Ng

Welcome to Behavioral Health Collective podcast, a community of behavior analysts who are passionate about sharing our science by connecting families to information that promotes meaningful behavior change. We are a community of practitioners who seek to empower parents by sharing effective behavioral strategies, and evidence-based practices from the perspective of behavior science. While also advocating for better access to behavioral health services for a wide variety of families.

Thank you so much for tuning in. I’m Erika Ng, the founder of the Behavioral Health Collective. I’m so thankful to have connect with today’s guest, Michele Shilvock and to be speaking with us really experienced behavior analyst today. She’s blazing a new way of providing behavioral health services to children and youth in British Columbia.

She works in a multidisciplinary team at a pediatric clinic in Surrey, BC, which is called Paramount Pediatrics. Here she gets to provide reference support for their clients by collaborating with pediatricians, clinical counselors, occupational therapists, dieticians, pediatric nurses, among many others. She is an innovative behavior analyst who is part of a growing, collective and group of the BCBA’s that have begun services outside a solely neurodivergent community.

In BC, this includes the feeding sleep and toileting needs of families, that the families had children encounter. She’s serving a wide variety of clients from toddlers to teenagers, with complex behavioral and mental health needs. A significant part of her rule is to work with parents and caregivers just support the behavioral needs of their child, while her colleagues address their respective areas. Together they provide a robust support team to their clients. Parents may sometimes be facing a number of concerns with their child, but not know where to turn, or they may end up working with one practitioner to address a specific concern, leaving them still without answers or supports to address other concerns.

Your child may have both complex mental health and behavioral challenges that limit their ability to be involved at school, the community, or maybe result in additional stress in the home. In more challenging situations, perhaps their behaviors put themselves or others in danger. This is where the multidisciplinary team can be of help.

I can’t tell you how often I see families that need this type of support in my work in the school system. Unfortunately, our province doesn’t have many services that offer such diverse multidisciplinary teams at Paramount Pediatrics. Families are left to find their own individual practitioners and then have to use our funding or out of pocket funds to facilitate that collaboration between their clinicians.

So if you want to have a team meeting and you’re paying for each clinician to be there on their own time, therefore this collaboration time can be limited as the funds are eaten up very quickly. Today, we’ll hear from Michele Shilvock that how she came to be an associate at Paramount Pediatrics. Also learn more about their model for their multidisciplinary services, her role there as a behavior analyst, and then also get her perspective on the future of multi-disciplinary behavioral health services in Canada and beyond. Without further ado, let’s get to the interview.

Hi Michele, how are you?

Michele Shilvock

I’m good. How are you, Erika? 

Erika Ng

Good. Thank you so much for joining me today. I really appreciate it.

Michele Shilvock

So excited to do this. 

Erika Ng

Great. Yeah. I’m looking forward to hearing about your work. And I know that when I first spoke with you, I was just, I left that phone call, just so excited and energized to hear more about your work. Cause it just sounds like such a great model and I’m really excited to share with families today. 

So, without further ado, we can jump right into our questions. So, you work on a multidisciplinary team and that’s our theme today. So I’m just wondering to start, if you could give listeners some context by, you know, what what is Paramount Pediatrics like as a, as an environment and how did it get started?

How you came on board with them and then also, what kind of services do you offer there? 

Michele Shilvock

Oh my gosh. I could talk about this forever. Okay. So my parlay to into Paramount Pediatrics is a unique one, I suppose. I have a four year old daughter and when she was born, we, she was in the NICU and has some complex medical needs.

So we were referred to this pediatrician in White Rock at Surrey when we were discharged from a women’s hospital in Vancouver and it was Dr. Ansah, and so we got to know each other when my daughter was an infant and every appointment lasted twice as long, because he would say, tell me more about what you do.

What is this behavior analyst? I want to understand what you’re doing. Do you just work with children with only autism spectrum? And so he was asking all these really great questions and each visit, which were frequent for us. I realized there was more to his questions than just curiosity. He had this vision to open this practice and leave where he was to create this innovative multidisciplinary, one of a kind in BC model that’s exists outside of Canada. 

It exists in the States and internationally, but it’s not as popular here yet. And so his vision was to open this clinic that would have pediatricians, nurse practitioners, dieticians, lactation specialists, sleep coaches, toileting, you know, coaches clinical counselors and a behavior analyst.

So he said to me, So this clinic’s going to open and I want you to come have coffee with my wife and I, so we can share our vision. So we sat in this little coffee shop in White Rock, and I just said yes, right away cause I’m always coming from a place of, yeah and, I suppose, so two years ago, Paramount Pediatrics started and we’ve we, the clinics doubled in size. We’ve three pediatricians, three clinical counselors, an OT, a lactation specialist, a specialist for infants. So a sleep, toileting, feeding, all that stuff, nurse practitioner respiratory therapists, behavior analyst. It’s big. It’s a big team and still growing. So. 

Erika Ng

Wow. That’s incredible. 

So, was he inspired simply by getting to know you to hire a behavior analyst? Or was he at all familiar with what a behavior analyst was? 

Michele Shilvock

He had an idea of who, or what we, who we were, and what we did. But I suppose I bring a different lens to the behavior analytic field. My background is social work.

So before I was behavior analyst, I was a social worker and a behavior interventionist. And then did move straight into being a behavior analyst full time. 22 plus years ago now almost 23. So he liked the energy and the fact that I was open to the idea that ABA could extend beyond autism and these principles could apply and assist so many families in so many different ways.

And so that was kind of, we agreed that would be my role, would be to really provide parent coaching and support to children. Not just on the autism spectrum. Yeah. 

Erika Ng

Wow. Very cool. So cool. So I guess on that note, what sorts of families would you serve? So who kind of walks in the door there cause that’s a really wide range of professionals that you have there. So yeah. Who access to services?

Michele Shilvock

Well, so there’s two ways to access at least a Paramount there’s two ways to access. You can access all the associates privately. So you can just ring Paramount Pediatrics and say I would like to see a clinic, the clinic, one of the clinical counselors, or the behavior analysts. And book in with us, or what the three pediatricians will refer their families to us directly.

So families have already had a referral to a pediatrician for a variety of reasons, but so you sometimes will think about, maybe I see my pediatrician because my child is experiencing constipation, but constipation is part of a bigger issue. And so then all of a sudden there’s conversations about, you know, sleep needs and feeding needs and challenging behavior in the day or the evening and what’s happening at school.

So, those are sort of the two ways people can access us, but the gamut of families I can see like the array is huge. So I chatted with a family today with a teenage, teenager, with OCD, ADHD suspected ODD. Oppositional Defiant Disorder, Attention Hyperactivity Disorder, Obsessive Compulsive Disorder.

So there’s a lot of interdisciplinary work there. Psychologist involved already, doing treatment for the OCD, and then I’ll be working with the family on it on different pieces of managing more ADHD, executive function kind of needs. But then I might work with an 18-month old who has speech delay, and concerns about global just developmental delays are happening and why and so I might provide parent coaching for that family and work with their child directly or social, emotional needs of children, you know, that are struggling with making those peer connections and regulation and so all these beautiful strategies and tools that we know are evidence-based and work well with a variety of children. I have the opportunity to work with all these kids. I love it.

Erika Ng

That’s incredible. So I guess kind of to segway into what do some of those cases look like? I suppose. So what what may be some of the other, I guess you gave a couple examples there, but what are some of the challenges that families might be facing prior to accessing services and that some examples of how you fit into that team?

So I guess you just gave one or two, but just if there are listeners out there where a story kind of resonates with them, just to give that a variety of stories that you hear. 

Michele Shilvock

Love it. So I’ll give you a few different and then how maybe I bridge with other team members as well. So I definitely do a lot of school age work at the practice.

So a lot of query attention, hyperactivity disorder, attention deficit disorder. So a lot of that kind of pop population of neurodivergent individuals are coming to see their pediatrician. Maybe they’re asking about medication, the schools are asking about medication and the first thing the team at Paramount will do is they’ll want me to be involved, to see, let’s look at behavior management strategies first. Are there things we can do without the need for medication?

That doesn’t mean medication won’t play a part, but let’s let’s take an inventory of what’s happening, what’s working, what’s not. So I’ll have a consult with a family and kind of do a bit of a review of that with them, and then determine where’s the support needed in the home, in the school. So I do go to both environments and provide strategy-based support for families.

And then I’ll work with the pediatrician to sort of explain what I’m thinking. The approach is I’m gonna take the behavior plan, and then they’ll use that to monitor what they’re going to do next. I’ve had families with toileting and when I say toileting, I mean, pretty toileting needs where there’s medications involved and they’re getting pretty serious.

So I’ll work with the family to develop a behavior-based plan, and then we’ll supplement that sometimes with medication. So I have a person right now who is doing some bedtime some bad wetting while they’re sleeping in the night. And so there’s medication that we can can be provided to help sort of stall the urination at night. 

Like pediatrician’s teaching you so much. And so we’re gonna work with the pediatrician to create a behavior plan that’s going to involve that, but a fade out plan for that medication pretty quickly. So those are ways that I might use the pediatrician in a collaborative way, lot of where there might be some counseling going on, the team might be accessing counseling through one of our clinical counselors. But the parents are looking for some coaching around strategies, parent coaching strategies for how to navigate those these youth, I might be working with the parents to develop a plan so we can cohesively together. Work at a place that is value driven about that youth. So what that youth saying they’re needing and wanting, and then I’ll bring in a lot of proactive, collaborative problem solving based strategies to help the families work together with their children. So that’s another way. 

Erika Ng

That’s so cool, and that’s so great that you’re right there. I was just gonna say, sorry that like you were right there in house together to collaborate with that counselor. It’s not, you know, they’re not in some of their practice or something where you gotta set up a meeting or whatever it just to have that free and open communication just sounds amazing as well.

Michele Shilvock

Yeah. I can’t speak enough about how amazing it is for me to be able to poke my head around a corner and look in the other room where the occupational therapist is and say, can I just run something by you? Should I be referring this family to you? What are your thoughts? What do you think clinical counselors? The same scenario? You know, what do you think? What are your thoughts? How can we build this plan together to best support everyone’s values really, it’s really amazing. I do a lot of work with the dieticians there they’re registered dieticians and, you know, work at children’s hospital and have that kind of wealth of experience and knowledge and so sometimes we have littles who are still on bottles and we’re trying to get food into their repertoire and so there’s a behavioral piece to that, but then there’s a health and wellness nutrition piece to that. So, we work together a lot in that capacity as well. 

Erika Ng

Wow. Collaboration. It’s a beautiful thing.

It’s amazing. I’m kind of curious. So you just gave a lot of great examples. What percentage of people that clients that you serve maybe do not have some sort of preexisting diagnosis? Like I’m sure, maybe a diagnosis comes out of the work that happens at the clinic sometimes, but how many people walk in the door without a diagnosis? I’m just curious. 

Michele Shilvock

Oh gosh, I’m guessing totally. But if I think about the intakes I do. There’s at least a 60% don’t have a formal diagnosis. Yeah, like they might get one down the road, but you know, ADHD is not something that’s typically diagnosed young, so there might be some query ADHD kind of symptomology.

I do see a lot of girls that maybe. Are coming because of behavioral issues to see their pediatrician, but there’s more to that and so, you know, looking at assessments for autism is definitely playing a part. So I feel like I’ve also been able to bring a lot of awareness around masking and autism and there’s pieces to the pie that I’ve also been able to bring to the practice to help.

I do a lot of SORF, which is a tool that can be used out of, that’s been developed out of Florida using the M-CHAT for autism assessments. And so I’ll do a lot of early reviews with parents who have concerns because we can, I have the time to sit and really look at that child across routines. Just say, here’s some more thoughts, here’s, let’s go back to the pediatrician now and have another conversation. Yeah. 

Erika Ng

Awesome, wow. So many different, different clients that you’re working with and tools you’re bringing out. That’s amazing. 

So, now you mentioned you’re almost, it’s almost in 23 years, you’ve been in the field. That’s an incredible wealth of experience that you have. So, and I’m sure you’ve seen a lot, so I’m guessing what are that what are the benefits that you’ve seen in working in this kind of team? Cause I’m sure it probably feels quite different from prior to starting there maybe work on your own or on other teams in the past, but what has been so beneficial to the multi-disciplinary model and especially into those more complex cases?

Michele Shilvock

Oh, such a good question. Okay. This is not my first exposure to collaboration. So when I was doing social work, I was at a the South Fraser Child Development Center, or that’s what it was The Centre For Child Development now. So I was part of a collaborative team where we met children and we all worked as a team to kind of decide who would take on which pieces.

So this resonated for me. This idea of this collaborative-based model of what we do and how we can work with a family together. And now I’m forgetting the second part of your questions, so. 

Erika Ng

Alright. I guess, what are the benefits to that multidisciplinary model? 

Michele Shilvock

Okay. So here’s the thing, even as a behavior analyst, you know, I, we sometimes get a bad rap because we see behavior, right?

We look at a child and we see behavior first. There’s so much more to an individual than the behaviors. There is the feelings, their history, you know, their medical needs. There’s so much more to providing the right support, intervention, whatever language you want to use. So for me a collaborative model really has the capacity to meet the values of the child and their family. 

At its core inside out, not just a medical model, which is really geared towards treating a very acute need and then discharging a medical model. And I live it cause I’m my own child. So I know that. So this is a a more holistic wraparound service, every element of a child’s needs. So they come to a pediatrician with one specific sort of starting place, but it usually trickles to many different needs and still having the capacity in one place to access all of those potential services. I don’t know. I mean, I think that’s pretty amazing. 

Erika Ng

Yeah. Yeah, absolutely. And that does sound so unique. I mean, you mentioned it’s happening in other places, but you’re right. That does sound so different and to have the pediatric element and yeah, shifting away from just that one professional serving that one need, like have a model. Yeah. 

Michele Shilvock

I compare it, you know, I, we talk about autism and you know that’s sort of a connection for both you and I, but I think about how, when a family is getting an assessment, they’re far better served when they can go somewhere that has all the people doing the assessment. Under the same umbrella. 

Erika Ng

Absolutely. 

Michele Shilvock

So the same thing is here, right? The capacity to really meet each of those needs instead of a parent coming with one need and getting referred to three other people and being put on three other waitlists for who knows how long. 

Erika Ng

Yeah. And then the timing of services is off, you know, they see someone two months before the other.

So, I’m actually curious. Do you all, are there multiple professionals sometimes at the same intake or do you do your own assessments kind of close in time and then have a case conference? Or how does that work? 

Michele Shilvock

Okay, so. Pediatricians first, if they’re being referred through pediatrician, if the pediatricians sometimes will refer to BCBA and clinical counselors at the same time. Usually one of us will do the first point of contact with the family and then we will communicate together.

Erika Ng

Okay. 

Michele Shilvock

So we in the clinical counselor, so the clinical counselor, or I might reach out to the family first and then we’ll connect between the two of us to sort of discuss what that initial intake unfolded, what that looked like. We often will still triage with the pediatricians first to sort of get a better lay of what’s going on and what their thoughts are.

Make sure it’s a good fit. Refer internally if we can, if we’re not the right fit. That’s the great thing of having three clinical counselors is that there’s bound to be someone with an extra teeth in the area. 

Erika Ng

Yeah. Okay. That makes sense. 

And I guess, so to kind of go off of that a little more, so say a family comes to you, they’ve had some behavioral and maybe mental health concerns of, you know, an adolescent kind of situation, just as an example.

And maybe they’ve tried some sort of standardized parenting class or something of that nature, and they’ve tried some things themselves, but they end up coming to you folks, maybe through the pediatrician. What made the services there and through yourself kind of look like after that process. So, you know, the counselors involved, you’re involved, are you both seeing that individual you know, after that intake process at one at a time, or are you sometimes both seeing them or how does that kind of work as you, as they get involved?

Michele Shilvock

Okay. Yeah, so it can vary depending on the needs. 

Erika Ng

Okay.

Michele Shilvock

So, if my role is behavior, a clinical counselor’s role is more mental health-driven and yes, there’s overlap. So there has to be a lot of discussion around that, so, there are times where we might all work at the same but in different parts. So right now I, we work with a family where there’s several diagnoses for this young person, and the clinical counselors working on one piece.

And I’m working with the school team on and the parents on another piece. So, we communicate regularly to determine where our progressions are going and if we need input from the other. So there has to be a lot of ongoing communication, to just make sure we’re moving together, but. 

Erika Ng

That’s awesome. 

Michele Shilvock

You know, no man is an island, right? So, you know, if we’re going to really provide the right support, it often means we’re going to divide and conquer. What those elements are those pieces are going to cover. I sometimes will do the flip. So I think I mentioned this earlier where the clinical counselors working with the child and I’m working with the parents to review behavior strategies, like what are your coaching strategies? Or. So, what did the coaching I’m doing to support and mentor those families with the strategies they’re doing? 

Erika Ng

Okay. That’s amazing. Wow, I love it, it’s so fluid and flexible to just, it sounds so individualized. 

Michele Shilvock:

It is.

Erika Ng

Which is a beautiful thing. It’s not like a standard process. It’s, you know, what does this client and family need? That’s 

Michele Shilvock

Yeah, amazing! 

Erika Ng

So I guess you have given a few examples, but are there any other cases that stand out as real success stories and not just you know, because it’s like one component of the team that any real success stories, it had to do a lot with like a whole team component? 

Michele Shilvock

Oh gosh. Yeah. Okay. So here’s the cool thing about this practice. Our PD, Dr. Ansah has really does discovers that there was a really cool way of doing some genetic testing around best-suited medications. So we had a young person coming in that I’ve [00:24:00] known and displayed some pretty significant challenging behavior that we’re putting themselves and others around them at risk.

And I’ve been the only person involved at that point and then a bit of a psychologist who was somewhere else and COVID hit. COVID made things really hard because everybody’s shut down. Like pediatric practice when they could, reopen their doors. You know, and so all of a sudden we’ve had the capacity to re-evaluate medication through nutrition in a way that it was genetically the best fit for this person and profile the medication differently. And once the medication was able to be sort of, reconfigured, then we could bring in a clinical counselor to really start to provide the grounding support needed around anger management and where that anger was coming from.

And that opened the door for me to feel like I could really do good work with the school-based team. To see this person go from some pretty scary stuff to integrate it in the classroom full-time successfully participating, advocating for their own needs now. Having feeling like they have a voice that’s a success story for me, you know. It wasn’t happening with one of us and it took COVID, but we were able to really provide that wraparound multi-disciplinary model that gave this person their fullest, enable them to reach their fullest potential, because there was more than one of us involved and we weren’t waiting. We weren’t waiting for referrals or appointments, you know, if the medication wasn’t working, we could, I could call the pediatrician.

And say, here’s what I’m seeing, what are your thoughts? You know, if you want to see this person, do you know, like that kind of happened, it was a main thing. 

Erika Ng

Yeah, that is incredibly exciting to hear just that, that it seemed to work so beautifully. Everybody working in tandem, you know, kind of doing their part and you’re right. Like there is kind of a timeline there, like sometimes certain things need to come into place before another professional can do the work that they need to do and so, wow, that is. That’s a great example of success. 

Michele Shilvock

And I just want to say this really quickly the one other that’s like the opposite end that was equally as powerful, but good was with a dietician. The dietician there I worked with. We had really a baby who was a suspected autism subsequent diagnosis. Yes, but we were both working prior to that, and trying to get them off a bottle and sitting through routines. And because of COVID I was going into the house, the dietician wasn’t, but we were able to create a real clear understanding for all the routines going on for this family and how to build in foundation, routine-based strategies that I could support parents with so that these feeding based strategies actually were going to make sense and work because the foundation was in place. So it didn’t take it wasn’t as complicated, it’s not like it’s dramatic but had the same impact. 

Erika Ng

For sure and such as a practical yeah, no, absolutely. Like that’s such a practical example too, that I’m sure a lot of families face. So that’s amazing. I love that. So, this is very exciting to hear these stories. So I guess thinking about the future and the success that you guys are having at Paramount with this kind of team.

Where do you see this working? Is this working anywhere else in Canada? And then if not, w where is it working? And then is it something that might be feasible to adopt more of in the future in BC? I mean, it sounds like it was doctors and who just like, had this beautiful idea. Do you see, what would need to change I suppose, to shift more towards this model? 

Michele Shilvock

Well, I think there’s hybrids starting to creep up.

I know Vancouver has a clinic that has elements, but not as fully wrapped around as Paramount is at this point. I think it requires people to share the same values you know, we talk about values with the families that we service as practitioners. We also need to share similar values in the types of services we want to give to families of all backgrounds and all abilities.

And so I think that’s what separates Paramount, maybe from other hybrid models. Do I think it could happen? Most definitely, with the right people behind it. A hundred percent, but I work at Paramount because it’s families first. And I think that there’s something beautiful about that, where we can put families first and really try and create a holistic model of support for them that covers all those pieces.

So I there’s nobody else in BC that I know of that is doing to our capacity and knowing where we’re going to, where Dr. Ansah wants to see the clinic grow. I don’t see anybody hitting all those key cause there’s so many unique pieces, OT, respiratory therapists, nurses, you know, like it’s pretty unique.

Erika Ng

Yeah, absolutely. And is it happening elsewhere? Like you mentioned, maybe in the States, did you say that? 

Michele Shilvock

Dr. Ansa would know better than I do, but there are international clinics that have similar models to this, but it was new to the West Coast of Canada, for sure. That’s not a model that’s familiar out here, but our model is to refer out.

See also

Erika Ng

And so does it just take, you know, the will of one professional that, you know, brings a group together, like Dr. Ansah did? Like, is that really what it would take to have more of these clinics pop-up?

Michele Shilvock

I think so. I mean, I, Dr. Ansah is a pretty special individual and it’s hard for people to say no to him. When you see the passion and the drive he has to provide this service to families and he wants you to be part of that model, it’s like, alright. 

Erika Ng

Yeah. Wow. 

Michele Shilvock

I’ll do that, sign me up!

Erika Ng

Cool. Yeah. Yeah. That’s amazing. Well, he is, yeah. Obviously initiated something amazing that is really helping clients. And you said it’s only two years old, is that you said? 

Michele Shilvock

Yeah. I mean, he has, he’s been in practice longer than that, but 

Erika Ng

For sure. 

Michele Shilvock

Paramount is this big entity is only a couple of years old now. 

Erika Ng

Wow. 

Michele Shilvock

We’re located in South Surrey and a newer built. So it’s a new building. And some days we feel like we’re already accruing the space. 

Erika Ng

Wow! That’s incredible and I’m sure you have families coming from all over? 

Michele Shilvock

Yeah. 

Erika Ng

To be served? 

Michele Shilvock

Yeah. 

Erika Ng

Okay. Like all over the province? 

Michele Shilvock

I do know that I think he has a few that are far, but definitely we’re in the Fraser Valley and there’s people coming from the North shore to see him. So 

Erika Ng

Oh, wow! That’s incredible. Testament to the work that’s being done there, but you guys so very cool. So just before we wrap up, I just want to make sure it’s really clear for family. So if someone did want to access services at Paramount what is their first step, if they have some concerns about their child?

Michele Shilvock

So if they’re just looking for an individualized service, they can contact Paramount. So, you know, it’s not always a well-known thing, that behavior analyst service children outside of the field of autism, but we do. You know, there’s feeding clinics. There’s toileting clinics. There’s specialized groups now doing work outside of autism.

So you can access a bit, you can access behavior analyst or me there. Just self-referral clinical counselors. Self-referral all the infant services, self-referral but OT, occupational therapists, respiratory therapists, you know, nurse practitioner, dietician are all referrals through the pediatrician. So that’s your second point, but families can go to their GP as long as they have a reason for referral and ask to be referred and families can go to a GP. GP’s will have pediatricians they like to refer to, but you as a parent can also say, this is the pediatrician I want to be referred to for whatever reason, because of their specialty or what they offer. So parents can kind of be a bit more of an advocate when they’re asking for referrals to pediatricians. 

Erika Ng

Okay, that sounds great. And I will be sure I put the link to your website, your personal website, and also at Paramount in the show notes for people. So thank you. 

So yeah, Michele, thank you so much. It’s been so interesting to hear about the innovative work that you guys are doing there and really exciting. And thank you for sharing all the success stories and it’s very clear that you are so passionate about the work that you do there and it sounds like, all of your colleagues are as well. So thank you so much for sharing that. 

Michele Shilvock

Thank you! We do love it to represent the clinic, though. 

Erika Ng

Yeah. It sounds like really positive environment. So, thank you for that. 

Just before we wrap up, I have a couple like lightning questions for you. So just like shorter responses just to get, you know, get to know you a little bit better for the listeners too.

So, first of all, what is the best advice you’ve ever received as a behavior analyst or as a parent?

Michele Shilvock

Oh, my gosh. They’re so separate as a behavior analyst, best advice find your passion and pursue it – Pat Veranda. She, I remember her telling me that. 

As a parent, I would say the best advice I’ve ever been given is like, hold grace for yourself, don’t be weird, so hard on ourselves as human beings and mamas and parents. So trying, be easy on yourself.

Erika Ng

That’s great advice. Do you have a personal habit of yours, do you think that has contributed to where you’ve gotten to today and the success that you’ve had?

Michele Shilvock

Ooh, yeah, I get up at four o’clock in the morning every day to meditate. It’s crazy. 

Erika Ng

Amazing! 

Michele Shilvock

I meditate in the morning. 

Erika Ng

Wow, that is. I really respect that. 

Michele Shilvock

In the still of silence in my 

Erika Ng

So important. Yes. Those quiet moments, do you have an internet resource of some sort, like a website or anything that you could recommend that you use on a regular basis or that you would recommend to families? 

Michele Shilvock

Oh, okay. ADHD, I always refer families to understood.com made a wealth of resources. Amazing. 

Erika Ng

Understood.com. So I’ll write that down and put them in the show notes as well. And do you have a book that you’d recommend to families? That’s kind of a go to resource? 

Michele Shilvock

If too I love Gordon Neufeld is Showing Up. Tina Bryson and Gordon Neufeld wrote Showing Up. I think that’s a great just general parenting resource.

And I’m also a big fan of The Explosive Child by Ross Greene or families with more challenging. 

Erika Ng

Okay. Great. Thank you again. I’ll put all that into the show notes, so thanks for that. 

Michele. It’s been such a pleasure, I really appreciate you taking the time and passionately sharing what you do.

Michele Shilvock

Oh, thanks for having me. It’s great what you’re doing, so excited. 

Erika Ng

Well, we’re excited to have people like you, so thank you. Have a great evening. 

Michele Shilvock

Yeah, you too. Thanks.

Erika Ng

To follow up with few of the things that Michele had mentioned, and then also had to get in touch with her. You can find her at micheleshilvock.com. So that’s her personal website M I C H E L E. So one L in Michele. Shilvock, S H I L V O C K .com. All one word, Michele Shilvock. And you can find her on Instagram at Michelle Schulberg Consulting, which is her handle.

The book that she mentioned is The Power of Showing Up by Tina Bryson and Daniel Siegel and The Explosive Child by Ross Greene, the website that she mentioned, especially for families of children with ADHD is understood.com and finally, you can find Paramount Pediatrics at all one word paramountpediatrics.com. 

Until next time. Thank you so much for joining me and for listening to Behavioral Health Collective podcast. Take care!

The comments and views expressed in this podcast do not constitute or replace contractual behavior, analytic consultation, or professional advice. Views expressed are solely the perspective of the speaker and do not represent the views or position of their colleagues, employer, or other associates.

Please seek out a behavior analyst with BACB website, if you would like to receive further behavior consultation. Until next time. Take care.

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Erika Ng
Board Certified Behavior Analyst (BCBA) and Special Education Teacher. On a mission to improve collaboration between behavioral health clinicians by sharing their stories and ways that they work together to improve client outcomes. Fascinated by the amazing changes that behavior science can accomplish through many unique applications. Excited about evidence-based practices and being a lifelong learner.

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