Toks Bakare is the founder of asktoks.com. A trained Behaviour Analyst who has over a decade of experience in the field of developmental psychology, Ms Bakare is a specialist consultant who has relocated to Nigeria to fill a gap by providing Applied Behaviour Analysis (ABA) services to children with developmental disorders and Autism Spectrum Disorders. She talks to Joy Ehonwa about her motivation, being an entrepreneur, and what every Nigerian should know about autism.
CN: Tell us a bit about your professional background
I am a UK trained Behaviour Analyst and Principal Consultant of asktoks.com, with over a decade of experience in developmental psychology. As an independent specialist consultant, I work with children, providing cutting-edge behaviour treatment, Applied Behaviour Analysis (ABA), which has led to positive improvements in the lives of many affected by autism spectrum disorders, pervasive developmental disorders, and other related disorders.
I hold a Bachelor’s Degree in Psychology and Philosophy and have assisted with research on autism and Applied Behaviour Analysis internationally, in peer reviewed journals. My experience in ABA includes extensive consultant’s training, experience, research, teaching, and management on the UCLA Multi-Site Young Autism Project, at the UK replication site.
CN: What is the story behind asktoks.com?
After nearly a decade in the UK, studying, training and working for a community interest organisation that researches treatment for children with autism, I came to Nigeria to research real life experiences, to understand the way the system worked for children with special needs, and to identify the need for specialist services in Nigeria. The few centres and schools that were available delivered outdated and sometimes harmful programs they called therapies. Children were misunderstood and quite often misdiagnosed, many were being neglected, and attitudes towards these disorders was ignorant at best. The clear and urgent need for my expertise was striking so I left England, relocated and set up an organisation for delivering ABA treatment in Nigeria called asktoks.com. Now, asktoks.com is a platform for families in need of professional behavioural advice, treatment and support. We are a medium used to create an engaged, informed community, shaping the future of how we understand and interact with people with neurodevelopmental disorders.
CN: What exactly are the services asktoks.com offers?
Asktoks.com is one of the few social enterprises of its kind in Africa, in the health and education sector, focused on providing the specialist treatment children with neurodevelopmental disorders need. In a nutshell the company provides behaviour treatment, trains specialised therapists and is an information hub for resources on neurodevelopmental disorders and the broader mental health issues.
Applied Behaviour Analysis (ABA) programmes are designed and we work with primary caregivers including parents, nannies, teachers, and therapists to effectively implement these treatment plans.
Services involve an initial assessment in which children are examined in the major developmental areas i.e. their cognitive skills, motor skills, emotional development, and their ability to have fun and interact with others. A treatment plan is developed and specific activities are designed to enhance areas of deficiency.
Extensive training in the techniques of Applied Behaviour Analysis (ABA) is provided for parents and facilitators (or therapists) who implement the ABA treatment program with the children. There is a focus on the development of local expertise to create jobs for the under-skilled in the form of mid-level workers who are trained to become therapists. Capacity building with institutional staff such as teachers and primary healthcare workers is also conducted through dedicated practical training sessions. For example, implementation and training workshops for parents and therapists in several states including Imo State, Lagos State, and the Federal Capital Territory. Through the International Board of Continuing and Credentialing Education Standards (IBCCES), we run training courses to certify mid-level workers to implement interventions designed by a specialist. The training program is an accredited certification in neurodevelopmental disorders for professionals in Nigeria. Alongside this, we launched an International Skills Transfer Program to attract higher level specialists into Nigeria to design behaviour interventions for the children.
Being able to deliver treatment services in applied settings means having to partner with schools, nurseries, and other places in the local community (like churches), to help them quickly identify signs of developmental disorders and behavioural problems that will prevent educational development in school. Beyond early identification, asktoks.com also works on building capacity within these communities to better equip them to deal with the problems and challenges children face.
CN: How do parents find you, do you partner or collaborate with clinics or hospitals?
Parents contact us either through referrals, schools, paediatricians, our website, social media platforms or our interdisciplinary partners. Yes, we collaborate with paediatric clinics to improve early identification of neurodevelopmental disorders and provide early intervention. Lagos State University Teaching Hospital (LASUTH) and The Pediatric Partners Hospital are examples of such hospitals. We also work closely with schools for the improvement of special education needs services.
CN: What were your biggest challenges starting out?
Naturally one of the major barriers to providing treatment services in an underserved country is the availability of specialized human resources to deliver and implement the interventions we design. Training in mental and developmental disorders is extremely limited and so we have to train every technician, therapist and mental health care professional that works with us from scratch.
Beyond human resources are the other types of resources lacking in the country, needed to deal with mental and developmental problems. For example, once a child is diagnosed and receiving some level of treatment, finding appropriate school placements or a bed in a ward dedicated to this need is difficult and in some cases not possible.
Although the private demand for our services from individual families is high, this demand comes from a very small proportion of the population. For a number of reasons including stigmatization related to developmental disorders, families often delay getting the help they need, deny or ignore the fact that they need help at all. In some cases attitudes and spiritual beliefs can be a barrier to parents, teachers and other caregivers accepting help for their children with developmental disorders. These attitudes ultimately impede our ability to implement effective interventions.
At the national level, demand for intervention services that could reach a wider proportion of the population is low. There has been little to no interest from government institutions to scale up interventions. At the same time there is no public system of support for families of children with mental and developmental disorders which means many could not access our services even if they wanted to.
The above issues speak to an inherent knowledge gap on mental and developmental disorders in Nigeria.
CN: What are your primary responsibilities at work?
Key responsibilities can be categorised into the following three groups:
1. Clinical responsibilities. These include but are not limited to:
- Running consultation sessions with the children in which their behavioural programs are designed and delivered.
- Creating the appropriate supporting documents for the consultations including writing reports.
- Conducting ABA assessments to evaluate a child’s suitability for an ABA program and to determine the areas of learning deficit.
- Training therapists and mid-level workers to implement behaviour interventions.
2. Leadership and managerial responsibilities. These include but are not limited to:
- Strategic planning and management of the organisation.
- Systems building and development within the organisation.
- Managing the asktoks.com team.
3. Advocacy work. These include but are not limited to:
- Disseminating information about autism, neurodevelopmental disorders and mental health issues to the population.
- Conducting various community development programs to increase awareness and build capacity.
- Giving talks, attending and participating in conferences etc.
CN: How would you rate the customer satisfaction level?
On a scale of 1 to 10 I’d rate satisfaction at 15.
In my work with children and most especially with infants and their primary caregivers, I get to see the trajectory of the child’s life changing before my eyes and in a matter of months. The interventions I implement change the potential a parent is able to see in their own child, they change how a parent interacts with his or her child and they ensure the child is not seen as their disorder or their deficits but as a child who has the ability to learn. That kind of impact is often beyond what the parents conceived was possible before starting treatment, and they are always eternally grateful for the improvement. Trainees including parents, teachers, nannies and therapists are also thankful for finally and often for the first time in several years being given the skills to communicate with these children in a way that is effective and elicits results.
CN: What is the most challenging project you have ever worked on or handled?
I was commissioned by an institution for children with special educational needs to improve the education of the children in attendance and to improve and increase skills set of staff members. On first assessment of the school, I met children that were apparently “making no progress” and staff that were de-motivated, misguided and resistant to change. Being younger than 90% of the staff, a woman (in a nation of men) and a foreigner in their eyes, I was expected to turn the place around practically overnight.
I knew that working with the children and implementing education programs that measured observable progress would be the easy part. The real challenge at the time was working with the adults at the institution; the staff members that were sceptical of my expertise and reluctant to change their limiting views of the children. Many of the staff did not believe they had any control over the progress the children actually made; they did not believe they could make any difference to the children’s lives. “I believe one day Jonny will be ok” was a common opinion among the staff. So I needed them to see achievable, tangible potential in the children rather some pipe dream.
I think this pessimistic attitude to change was and remains one of the greatest challenges I face in my work.
CN: What do you consider to be the best career decision you have ever made?
Taking the decision to leave a secure job in England, move to Nigeria and set up asktoks.com.