Patrick Sisk: Blending Comedy and Therapy for Extraordinary Outcomes in Autism

Welcome to Why Not Me the World?
Podcast hosted by Tony Mantor, broadcasting from Music City, USA, Nashville, Tennessee.
Join us as our guests tell us their stories. Some
will make you laugh, some will make you cry. Real
life people who will inspire and show that you are
not alone in this world. Hopefully you gain more awareness, acceptance,
and a better understanding for autism around the world. Hi,
I'm Tony Mantor. Welcome to Why Not Me the World.
Today's guest is Patrick Sisk. He's an ABA therapist by day,
comedian by night, and the stories he has to tell
are just outstanding. So welcome to the show.
Patrick.
I appreciate you coming on.
Yeah, thank you so much for having me.
It's my pleasure. So you're an ABA therapist living in Florida.
If you could tell us a little bit more about
yourself and expand on.
What you do.
Yeah, So I am a registered behavioral technician, so I
work with different clients that we have doing ABA therapy,
and so what I personally do is called it ET.
It said a DTT, which those are two different styles
of a BAT.
Is natural environment teaching, so it's much more.
And basically the word said, not to sound like I'm
talking to of anybody, but it's natural environment.
So one of my clients right now hates people, She
hate going out in public. Cuff is a lot.
I mean, she's my affolute favorite client. Yeah, you never
know what's going to come out of her mouth. But
she said words that I had to look up and
I was like, oh wow, that's an impressive cuff work.
And I'm a stand up comedian, so I'm like, oh wow, okay,
good bit. I'll have to write that one down. But
so so I help her or any of my clients
to just go through their daily life in a much
more natural environment where ett would be much more of
a classroom setting, sitting down at a.
Table and add more of a direct in.
So if it would, uh, they didn't know their colors, Okay,
point at the green card.
Now that's not the green card. That's a green card,
and you go go through that way.
But but so with me, I, like I said, I
go in home and I work with the kids on
a one to one basis and really get to know
them and get involved in their family. And I you know,
they obviously they have a line that is drawn, but
it they quickly become like part of my family because
I'm in the house element.
Sure that makes sense. So tell me what age groups
is it that you generally work with most of the time.
So I have worked I used to work in a
clinic doing DTG and now when I lived in Indiana,
then we moved down to Florida, and so now I
work with all sorts of AID groups. The youngest I've
ever worked with was I believe furry, and the oldest
I've worked with is nineteen. I currently currently my oldest
client is an eight or eighteen year old at I
have two ten year.
Olds as well.
So is this a situation of where you go into
the host on a daily basis or is it just
once in a while? How does that work?
It depends on the client.
So with so I sit down with their parents and
map about a schedule, and then also look at what
Medicaid has given them.
So medicaid gives them hours of.
How many based on their their acuity and based on
their diagnosis and what problem behaviors are presented. So I
have one girl who had sib self injurs behaviors and
so she gets more hours than one of my kids
who just strings, So it really depends on the acuity
of the kate, And so it's a case by kate.
So I have one girl who get twenty five hours
or you can get up to twenty five hours, and
then the other two I think get twelve hours of peace.
So in that in those groups, I can do forty
hours billable time.
If you've got one client that can do twenty five
hours and you've got another client can do ten hours,
and so do you have other people that you work
with that you might go into into that one person's
house once a week and then the other person comes in,
or do you try and take and keep that familiarity
going to where you see that person twenty five hours
and let somebody else handle the others.
So we've done it both ways.
The girl that I work with now as in forty
five hours, we used to split it up between three
of us. The guy it was just nobody's schedule could
quite handle all twenty five hours, and it was very quick.
We were very quick to realize that she gravitated towards
myself and and she and I have pitt it off.
She worked well for me, and again she was the
one who hate people.
So it was like, you like me. This is new territory.
I'm not used to people liking me. This is weird.
But so I ended up being able to figure out
my schedule to work so I could go do all
twenty five hours or close to it, twenty to twenty.
Five hours there and that I do.
I split it up between the other two as well,
so I've seen it work both ways. Its you have
to have a lot of good communication if there's going
to be multiple people on the cakes. But for what
we do, so there's an RBT that goes into the
home and then our supervisor, which is known as a BCBA,
and that stands for Board Certified Behavioral Analysts, I believe
is what the letter's saying for. And there are supervisor
and so my supervisor comes in what's a week to
each face and just kind of monitor and make sure
everything's going well, answers any questions that I may have,
or answers any question Mom or even the client may have,
and it's a time to sit down and really go, Okay, hey,
this is what I saw this week with her, and
she got real upset about this, but I think it
because of this, and then you know, she can go, well, yeah,
now that does make sense having tried this.
They basically just another set of eyes to help me.
So so even though I am one on one with
this with this client, I also have my supervisor who's
coming in, who's giving me the directives. So I can't
make any directives.
Of my own. Okay, So if I think, hey, she
needs to work on and and X is.
Walking down the street without mom being present, so that's
something we.
Are are working on.
So you can't do anything really on your own without
having a supervisor approve what you want.
Right.
I have to talk to my BCBA and say, hey,
this is this is something i've seen as an issue.
What do you think and then we can collaborate and
work towards that goal.
But I can't just one day wake up and go
I think I'm going to make her do this. Oh okay, yeah,
because it is not in my scope of practice. To
be able to do that, I have to have an RBT,
has to have a BCBER.
Okay, So when you get out there, have you seen
that when you split it up that it works, Like
in this particular case, the girl liked you and compared
to the other one, so you took it over. Have
you seen the reverse happen to where where it's where
you've had like three people go in for one person,
it all worked out with all three of them.
I've seen it work, not with a client of mine,
but I've seen it work in other homes where.
We've talked and shared information. It works.
I prefer her with if I'm going into their home
that it's just me, and then it's a much more
personal They know my mannerisms and then I know there
is obviously, so it's called in our realm of work,
it's called airing. So we're pairing, so we're getting to
know each other. It's like you would do if you
were getting to know somebody. Hey let's go out for
a dread, let's let's go play, let's do this, let's
do that, and so so obviously it's nothing to that
extep Right, So I sat down with her the very
first day, and this girl who doesn't like to talk,
doesn't like a lot of things, and so so I
have a giant child at heart.
I just looked at her, I said, hey, what's your
favorite animal? I thought about it for a second. Should
a tarantula?
And my god, I love Planchola's and I went on
an engine about Tarantula's and I just so happened to
know this song called the Tarantula Song that says Tarantula's tarantulas. Uh,
if there's no way you buzz for your hand through
the what it's probably because of a tarantula. And I mean,
it's a kid song, but it's goofy, it's dumb. I
would like, let's play this, and she played it, and
she's like, that's the greatest song I've ever heard.
And for the next three weeks she wouldn't say anything
but that's ang.
And so so it was just this small thing where
I said, Okay, let's let me dive into this.
I can't stan entering to us.
I don't blame you there, I have.
I've been into the Dominican Republic our mission trip where
one had crawled up onto my backpack and I was like, oh, okay,
I'm gonna.
Get to meet Jesus today. That's cool because I almost
had a heart attack.
But uh, but where where this girl found that excitement?
And I met her where she was at. Sure I
didn't try to bring her to me. I met her
where she's at and That's where I think so many
times as successful RBT, that's what we do is we
meet our clients where they're at. We don't sit there.
We got to be here, we can we can bring
them there later.
Yeah, that makes sense.
You've got to get them to get to know you
and feel comfortable with you being there.
Right exactly so.
So when I work in a clinic, uh back in Indiana,
the way the clinic would work was in the morning,
we would we would start with one client and then
around lunchtime we would sort to another client and we
would have about five or six different clients that we would.
Raptate throughout the whole the whole week.
But with here, it's much more direct. I've got three
clients and I see it in every week. And for me,
I personally like any t and bake and home just
be able.
It's somewhat more laid back.
Sure have you had anyone that you've gone to and
after a couple of days or a couple of weeks
you said to yourself, you know, I just don't think
this is going to work.
Right.
We we add one client to that I walked in
and it was and I'm a very optimistic person. I
am an optimistic person by by nature, and even I see,
you know, I can look at someone who's the worst
person to go oh man, but there they sure did
this well. And I walked I walked into this one
home and the client hadn't had or hated uh taking showers,
had a shower in three months wow, and hadn't cut
his cut his fingernails, so he had very long fingernails.
But he also was just verbally and physically aggressive. And
he was about sixteen years old at I remember looking
at my supervisor that day and I said, I don't
think this one's gonna work.
And she said why not?
And I said, I said, this kid needs more than
us coming into his house two to three.
Tops of week, because because something unfortunately.
When when whether autism, they goes undiagnosed or whatever goes undiagnosed,
then there's a mental health.
Aspect to it. Okay, there was a shoe mental health
issue with it. Where he was living with grandma.
He was unwanted by bird parents, and so there was
so much uh that I just I remember telling my boss.
I was like, I don't think.
This is gonna work, and she was like, well, let's
just try it and what's in two months, we had
to excuse ourselves from the case because of a safety
for myself and just we just didn't feel.
Safe going into the oment.
Aymore, I became that violent and that scary, and I
don't I mean, I'm a big dude, and and so
it wasn't somebody now I'm scared for my life. But
at the same extent, I was scared for my career,
scared for Okay, so what happened when this kid swings on?
May be because I told him I need to take a bath.
So whow So it became a very interesting situation.
I bet.
So you're a therapist by day and a comedian by night,
Is that right?
Yes? Yes, yes, yes, I do stand up.
But now, so do you find a way of using
your comedy to help alleviate some of this situations you
might run in on a day to day basis?
Yes, yes, so most of actually all of my clients
know that I'm a stand up comedian. And so uh
when there was one one of my clients that I
would go into her school with her and she would
very very quickly jokes ever came up. She would be like,
you know, my therapists either comedian He'll tell you a joke,
and she is. And and honestly, like, that's one of
my biggest pet thieves as a media is when someone
tell me a joke, I'm like, okay, bye. But so
with her, it always warmed my heart would be like
she was.
It was. It was the first person who was truly
proud of me.
That's awesome.
And so I was like, yeah, that's my girl.
But I find myself using comedy and I can whether
it's a tantrum and it's de escalating the situation going
hey it's calm down, or I crack a joke, Glora,
I do this that I can. I find myself using
humor in comedy, in in therapy because I think it's
it's very need and it's very it cracked that engine.
And then also flip side, I you real life situations
that are are funny, that are in my common you know,
I talked to the parents and I'll be like, hey
can I I'll even run bit by them and go
this is what I want to say. They'll be like, man,
that's that's great. So so yeah, so it definitely works
hand at hand and it's really cool. How how two
things that I never thought could work together work so
beautifully together.
That's awesome to hear. So have you gone into a house,
looked at it, looked around, and then said to yourself,
I don't know, I don't think this is going to work,
but then after whatever a period of time, it does.
Yeah.
So so my my client that uh that I go to,
now who as uh that I see the most? She
was two different therapists had already been in that house
that gotten head left and removed themselves.
It was just not a good fit.
And I hearn about how just this is the Stirl
was and how she was very actually uh she was
apparently abusive to animals and all this stuff, and so
I was like, okay, so I remember walking in You're like,
oh my goodness, this is going to be the worst
sea of the world. And and that was the day
that I sat down and talked to her about tarantulas
and and realized that she wasn't what she was on paper.
Everybody had said she this, this and this, and I
realized that they just didn't get to know it. And
so all of a sudden, and she and I started
the bond, and we started to really communicate. And and
don't get me wrong, she they're today where she'll tell
me that she hates me wow, and uh, and I
mean she she brutally on It was like one day
she looked at me and she's a batter, you're getting
back wow. And I looked at her and I was like, girl,
I've been there's no getting back.
I am bad.
And she goes, yeah, that's true, and so she sh
she's so funny, she brilliantly on it.
But I was nervous that that would work.
But now I've been there for over a year and
a half and it's one of my favorite houses to
be in.
So when she when she gets brutally honest with you
or gets upset, how do you handle it? I mean
so that you can take and bring her back.
So so with you know, one thing you have to
understand is every client is different.
Yes, every client is different.
And unfortunately a BA therapy has gotten a bad rat
other the packs.
This is how you do with it.
A B had scene and unfortunately that's not how life works, right,
and not with kids with autism, not with light the general,
that's not how. It's not a black and white world.
There's some great and sure. So so with her you
kind of just have a letter a bit for a
little bit. You have to let her get it out
of her system, or you have to sit there. She
loves the McDonald's, and so I'll sit there and you know,
I just politely reminder. I'll be like, well, that's the
way to talk to someone. You you call your friend
that you want to bring on McDonald or just remind her,
you know, hey, remember who we're talking to. You know,
let's shoot her words carefully. And it's really cool because
you can tell sometimes what she's really upset. And then
then she starts to come back down and she's like
and tied it, I'm sorry nice and like she'll apologized
and Jill, you can see where her her remorse and yeah,
instead of just she's not sitting there at you at
this right and she doesn't care.
She genuinely does start to come back down.
When she after she'd agree and go okay, yeah, I
see where I messed up.
And how old is she? She is eight feet she
just turned eighteen. So you tell me that she doesn't
like people. What's her world look like within her house,
in her home, and what's the world, like outside of
the home when you're not there to help her and
teach her.
So she yeah, so she is in a single parent home. Okay,
it's just it's just.
Her mom and then her two brothers and all three
are adopted.
Oh wow, well all Chivree are wat and the mom
is white. So it is.
It is an interesting family dynamic to say the least.
The oldest brother and her are biologically siblings, and then
third brother is just another child that was adopted and
brought into the situation. She interacts okay with them, you know,
she she treats them with love and kindness in some day.
But like anybody else you got brothers, I'm doing she
hates her guy. Sure, sure, you know, if brother A
steals some big from her, then you know, it's the
worst brother in the world.
And I hate us guys.
Okay, well, I get it. I understand why you would
be upset and then and we work through that. But again,
it's totally understandable. My six year old, Yeah, my six
year old, if my son stole her.
Candies, she would be like, he's the worst brother ever.
Sure, absolutely so, So working through that with her, just
interacting with her brothers, and it has been a challenge at times,
especially because.
Her oldest brother is also on the spectrum. Oh okay, her.
Oldest brother is UH had fetal alcohol syndrome Thomas spectrum.
Have a lot of issues and an adult ABA is
something totally different even than than ABA normal ABA for
kids and I don't and so so it's it's a
challenge to sometimes work through that because she does this,
and she can do everything right and then brother does
something from left field and it's like great, now we've
got to figure out how to call them both them
to help.
Okay, so they're both autistic. What level on the spectrum
of autism are they and how does that work with them?
Far as their ability to interact with each other and
get along at least most of the time.
Does that happen?
Both of them are are high functioning. I believe they
would be categorized maybe other level two. My client will
not be able to live on her Oh that's too bad,
and to be there, her brother wouldn't. Neither her youngest
brother who's not on the spectrum, but he so, but
I would doubt that they would ever be able to
live on their own.
Okay, So you're in Florida, and I've heard in other
states that there's like twenty one is the age out situation?
Is that true for where you're at as.
Well sown in one? I believe it is Medicaid no
longer lets some do ABA or at least in the
sense that I'm doing it currently. Once you get it
too or older, I believe you have to be you
get ABA just from a BCBA or no RBT in
bald and it's a little bit different, and it's actually
harder to come by. Even though there are when's your
adults out there that have autism and need services, well,
sometimes the system seems to just got to go, oh well,
forget about them, and which is a very scary thing.
Especially for parents that want to see their kids do
well or at least have the opportunity to do well.
It seems like autism for some reason is on the
lower end of the funding for some of these programs.
So hopefully that will get better.
Yeah, it And it's so it's it's a beaverty real thing.
And I think, uh, the mom of my client is
a little nervous for her daughter.
But at the same extent, the progress that we've made.
It is tremendous. The in the the year and a
half that I've.
Worked with her, We've gone from a girl who wouldn't
step out signed where she was so scared. The moment
she stepped outside she would start to throw up where
she was at anxiety to chat to this girl who
lasted what was it October?
I think it was or November. We went to SeaWorld.
Oh that's great.
And we spent the day at SeaWorld and and she
was around people, had we rode.
Rides and and then nothing more exciting than than a
roller coaster in my opinion, but ride it with someone
who was so scared of people, and now you's overcoming
her fears and she's having the time of her life.
It's like, this is why I'm doing what I'm doing.
Absolutely So that's a great success story. So have you
had some that you thought was going to be success
but then after you got into it you realize that
it probably wasn't going to work out the way that
you had hoped it would.
I would say that, you know that For me personally,
I've never really dealt with that because.
I am one of those people who I won't give
up unless I'm told what give up?
Like, I wasn't going to give up on the one
kid that we got pulled from their house until my
administration that look, you're not you're not allowed to go
back in.
We're safety concerns, you're not allowed to go in there.
I'm I'm My dad was an old country boy from Tennessee,
and so he taught me to, you know, not give
up and go the job to time.
So so for me personally, it I've never dealt with that.
And with ABA, it's interesting because it's not so much
I don't go in thinking that I need to fix anyone,
but it's I go in thinking, all right, let's put
some pieces together that maybe you haven't put together, and
and you know it, it's it's you know, they're the
puzzle that represents autism on the puzzle. So then so
to me, it's just me bringing along a couple of
other people going hey, let's try that, and all of
a sudden it works. And so so are there things
that haven't gone exactly?
Well?
Yeah, I've got a client who to this day, I've
been with her for almost two years now and she
still sucks her bombs as a means to calm herself
as a means to.
I'm just when she's a a stressful situation, that's for goot.
And so so we've got to figure out, Okay, how
do we substitute that behavior. That behavior is not a
behavior that we you know, you would like to see.
You know, you don't see a lot of adults walking
down Devonstreet second, Mary Bob. So, so how do we
get from A to B? Well, and it's been a challenge,
so it's still that's her go to. So now we've
gotten to the point where she doesn't do it in school, Well,
she does it when she's at home. Okay, So now
we've at least we started to eliminate the behavior. So
how do we fix it at home? Well, she normally
does it when she's stressed. Okay, so what can we
give her to do something else in other than put
her figure in her mouth?
So let's get her up pidgets.
Then now, anytime you're bored, let's just figit with this
and so now she'd.
Do it back or Okay, now maybe that doesn't work.
So now we we switched to this.
So let's let's go to drawing every time you're nervous,
let's just draw a picture. So and so it's doing
something that now her hand literally can't be in her mouth.
So you just brought up the school system. Have you
had situations where you've had to go into the school
system and guide them and help them and how has
that worked out overall for you?
So it depends on the client. I have been in
several different school systems. Some school systems are very easy
to get into and they want to help and they
want to work with you and say anything we can
do to help, all right, you know.
You let us know, and they're great.
There are other school systems that I want to want
to think that they know everything and have that big
energy and they go, well, now you can't come in here,
and we've got our own people. But yet their own
people aren't doing so uh so. And I'm sure if
that's how.
It is across the country.
But I can speak only for Florida when it comes
to school system, is that there are some school system
and then private schools that we work with us hand
in hand and want us to be there.
But then there are some school systems and.
Private schools that are like, nope, we got it covered,
and it's like nope, now you don't.
No, so let us let us help you. And that's
what we're here for us to help. Sure.
Now let's switch gears just for a second. And I'm
sure you must have a website for your comedy act,
so you could tell us that too, if you would.
Yes, So, so exactually just opening up.
We were finishing the final touch of its just www
dot pabocsis dot com and so it's it's a new
we We're totally getting it started. And but but yeah, no,
this has been a crazy journey and and my my.
Job, my company that I work for is so supportive
and they know that.
I do comedy and they love it. And they they
told me, you know, they're like, look, whenever you need
to step away from ABA, let us know, but we expect,
you know, take it to your Netflix spedule.
And so I told him, I was like, yeah, when
that happens, I'll let you know.
Do you find yourself traveling quite a lot now and
then of course going back to your ABA after it's done.
Yeah, So so right now, I try to stay around
the Florida area, so I will do shows. I'm in Orlando,
so I'll do shows all over Florida. The other last week,
I had.
A show at West Palm Beach, which.
Is about two hours away, and so Sunday night, drove there,
drove back, got an ed around two thirty or so
in the morning, and then got up and was at
my client's house by nine nine o'clock. So yeah, so
it's it's I definitely burn the candle about them about then,
uh at times and then and then I also have,
you know, a family of my own with my wife
and my two kids, and so wow, so it it's
definitely a challenge too. And but but I find it
funny because one of my kids that I work with, uh,
we work on schedule and okay, so let's you've got
to do this, you got to do this, and we've.
Got to get it all in the day.
And so like, I find myself learning from from things
that I'm teaching them or or you know, pading up
those like lesson where I go, oh, okay, I can
do that.
Yeah.
I've had a lot of people that I've talked with
that will tell me that all of a sudden they've
found themselves learning from the ones that they're supposed to
be teaching. So it works quite well lots of times.
Yeah, yeah, I mean, and I have said they they
will teach you so much. And then they're also brutally honest.
One of my one of my girls, looked at me
one day and I did something really dumb, and she
was like, are you sure you're not the one who
need therapy and just staring at it when it's you
read I'm sorry, I said no. I said that was
the funniest thing it all day. Thank you, And uh like,
trust me, i'd probably meet therapy too, and but uh,
but they're they're just they're so they're so just with
it sometimes that you're like, wow, you would so, but yeah, No, comedy.
In the definitely helped.
And you know, and I'm on Instagram, I'm at Papa
says comedy.
So so it's really weird.
When, uh, when a kid, because we have to keep
our lives separate to an extent, and so some kids.
Be like, well, can I come watch you dude comedy?
I'm like no, no, And they're like, well, do you
have social media? I'm like no, no.
Uh, you know, and so you have to you have
to play that role.
Uh you want to be involved in their.
Life, absolutely, but you have to keep that distance for
yourself too.
Exactly exactly, Yeah, So ethically, we have a born of
ethics that are you know, code of ethics that we
go by, and you know.
So it's it's one of those things where where they're
very you know, we.
We try not to tow that lump or we try
to not go over the line by any means. Didn't here,
but it's it's okay. So you know, it gets to
the point where they say, well, can you come to
my birthday? And you know, ethically, no, that's not part
of it. We can't come to your birthday. But I'll
tell you what, when I come on Monday, we'll have
a big well I'll bring ice cream and we'll have
a big party just meeting. So then you know, so
then you turn it into a way where oh, okay,
well and so she yeah, have become not so disappointing,
you know, the kid will you know, the kid doesn't understand.
The kid just want they're one of their brims at
their party.
Exactly, once you make it past that initial part of
your journey with them, they want and look at you
as they would any friend or family. Right, so of
course they're going to want to have you around because
it's an important time in their life. So they want
their friends and family around for that.
Exactly exactly, so so you it's it's it's a challenge
to toe that line, to make sure okay, where don't
cross the line ethically, but at the thanks.
That you don't want to be cold when you walk
in or they're like, hey, how are you good?
Are you what good to work? So you've got to
It's it's a it's a balancing act, it really is.
Yeah, sure is.
This has been a great conversation. You've given so much
great information. Thanks for coming on. I really appreciate you
being here today.
Yeah, thank you so much, Jenna. Anytime I can sit
back down and pop with you again, man le let
me know.
Oh I certainly will. It's been a pleasure, so we'll
be talking soon. Thanks again.
Thanks for taking the.
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