Effective teaching procedures: Instructor therapist performance quality checklists

Gerhardt, P. F., & Bahry, S. (2023). Make it meaningful: Creating programs that matter into adulthood for learners with autism spectrum and related disorders. Make It Meaningful, LLC.

Reviewed by David Celiberti, PhD, BCBA-D
Association for Science in Autism Treatment

Admittedly, when this book arrived, I gulped as I flipped through its 400 pages, even though I appreciated the tremendous message Drs. Peter Gerhardt and Shanna Bahry set out to share. I was immediately struck by the comprehensiveness of this book. Upon a closer look, every page seemed to convey an important lesson, challenge an assumption about the decisions we make, offer a framework to better choose and implement individualized goals, or showcase an accessible tool for putting the book’s insights into practice.

Make it Meaningful is desperately needed in the field today and, truthfully, it was needed yesterday. The need is particularly urgent as adolescents and adults with autism and their families navigate a longstanding and increasingly troubling landscape of adult services: a dearth of meaningful and accessible programs and qualified providers, persistently high rates of underemployment and unemployment, and families increasingly carrying the responsibility for care and advocacy as parents and other caregivers age and have fewer resources and less capacity to do so. As I hope readers will see in this review, many of the challenges facing the field of ABA could have been lessened if providers had been challenged and influenced by the insights offered in this book. Against this backdrop, I hope to show how Make it Meaningful offers an important opportunity to reconsider what we are asking of individuals with autism, what we are offering them in return, and how we can better support them in building lives that are genuinely meaningful.

This comprehensive book is organized into four sections, each addressing a critical component of meaningful instruction. The authors are to be commended for thoughtfully conceptualizing the book’s structure and creating a clear, logical progression throughout Make It Meaningful:

What to teach → how to teach it → how to build meaningful goals → how to evaluate and sustain program quality

This intentional progression not only makes the content easier to navigate and access but also enhances the book’s utility as a practical teaching tool for readers seeking to apply its concepts in meaningful and targeted ways. Before exploring each section in greater detail, I want to provide a brief list of the chapters included within each section to help orient the reader to the book’s overall structure and content.

Section 1: What to Teach

Chapter 1: Teaching Meaningful Skills
Chapter 2: Meaningful Goal Guide
Chapter 3: Futures Planning: Writing Goals with Long-term Considerations
Chapter 4: Breaking Down Barriers

Section 1 of Make It Meaningful lays a strong foundation by asking a fundamental question: What should we teach? The authors begin by emphasizing the importance of identifying and teaching skills that are meaningful to the individual, reminding us that what is meaningful for one individual may not be meaningful for another.

Chapter 1 introduces the concept of teaching meaningful skills and provides a framework for considering what truly matters in an individual’s life. It outlines questions to guide the decision-making process. The chapter draws upon 10 adaptive behavior domains and identifies 14 critical skills that can serve as focal points for goal planning, particularly given the multidisciplinary nature of treatment teams. The chapter ends with a powerful and sobering quote: “Anything that if you can’t do, someone else will have to do it for you.”
Chapter 2 introduces the Meaningful Goal Guide, providing readers with a tool to support the development of goals that are relevant, individualized, and connected to meaningful outcomes. Importantly, the chapter addresses not only the why and purpose of the tool, but also how it can be used. As I read this section, I had the sense that I was being guided by a sage mentor drawing upon many years of experience, particularly in how to gather the best information from those we interview and, perhaps more importantly, how to truly listen. This emphasis on listening embodies one of the central messages conveyed throughout the book: meaningful goals begin with understanding what matters to the individual.
Chapter 3 builds on this foundation by encouraging practitioners to write goals with the future in mind, or, in other words, to think ahead. Shifting our attention from what an individual can do today to what skills and supports may contribute to a meaningful future can feel overwhelming, particularly for parents of young children with autism. The authors made this process feel more manageable and actionable.
I deeply appreciated the inclusion of Chapter 4, which thoughtfully and comprehensively lays out potential barriers inherent in education and insurance funding streams. I left this chapter feeling both heard and empowered, particularly in its message that these challenges need not impede the development of meaningful goals and instructional priorities. It brought to mind a saying I once saw on an overpriced mug featured in the seat catalog during an ironically turbulent flight: “A bump in the road can be either a crisis or an opportunity. It is up to you.” Collectively, these four chapters encourage a critically important shift in perspective from asking “What skills can we teach?” to asking “What skills will make a meaningful difference in this individual’s life?”

Section 2: How to Teach

Chapter 5: Adaptive Behavior and Applied Behavior Analysis
Chapter 6: Considerations in How to Teach Meaningful Skills
Chapter 7: Identifying Meaningful Leisure Skills
Chapter 8: Meaningful Community-Based Instruction
Chapter 9: Targeting Meaningful Employment

If Section 1 asks us to reconsider what we teach, Section 2 turns our attention to the equally important question of how we teach meaningful skills.

Chapter 5 provides an important foundation by exploring the relationship between adaptive behavior and applied behavior analysis, helping readers consider how behavior analytic procedures can be better used. There are so many possible pull quotes throughout this book, but one at the outset of this chapter stood out: “…not only should the procedures we use be evidence-based, but they must also be the right evidence-based procedures used in the right way” (p. 96). This chapter is replete with wonderful insights on how to apply our tool chest of procedures well beyond the work we do in more structured settings with young children. It also emphasizes doing so in a manner that is conceptually aligned with the purpose of this book: to make our efforts more meaningful.
Chapter 6 builds on this foundation by outlining important considerations for teaching meaningful skills, encouraging practitioners to think carefully (and perhaps for many readers, differently) about context, efficiency, intensity, and our rapidly changing technological landscape and its implications for which skills become more relevant.
Chapter 7 extends this discussion into the area of meaningful leisure, highlighting the importance of more nuanced assessment and the identification of both component and support skills (e.g., tolerating losing in a game). I particularly appreciated the breakdown of solo leisure, small group leisure, and social/community leisure activities given the tendency of many teams not to pull these apart adequately.
Chapter 8 then moves instruction beyond traditional learning environments through a focus on meaningful community-based instruction (CBI), with an emphasis on how and where targeted skills are used in adulthood. The risks inherent in CBI (e.g., I recall taking one of my very first students to McDonald’s, where he absconded with a nearby patron’s large order of fries and then proceeded to bite me when I tried to take them back) are discussed openly and optimistically, leaving the reader with the message that these risks can be anticipated and managed rather than feared and avoided.
Chapter 9 brings these ideas into the domain of employment, addressing how we can move beyond simply preparing individuals for work with arbitrarily selected vocational skills to identifying and teaching skills that would help the individual access meaningful and valued employment.

Collectively, these chapters emphasize that meaningful instruction is not simply about the way we teach a skill, but about where, why, and how that skill matters. In doing so, Section 2 challenges practitioners to consider whether our instructional practices are truly preparing individuals to embrace a more meaningful life. This is particularly important given how quickly many providers tout that their services are “evidence-based,” without necessarily considering whether they are the right evidence-based procedures used in the right way (an important point aptly stated by the authors as highlighted above).

Section 3: Goal Building

Chapter 10: Goal Quality Considerations
Chapter 11: 20 Questions for Writing Meaningful Goals
Chapter 12: Balancing Value, Effort, and Risk in Meaningful Instruction
Chapter 13: Structural Integrity Considerations

Having explored what to teach and how to teach meaningful skills, Section 3 turns its attention to the process of building high-quality goals. The authors use the phrase “checks and balances,” and it ties beautifully to the content of this section. This section provides a practical roadmap for translating meaningful priorities into goals that are individualized, culturally aligned with family/community, purposeful, and, of course, meaningful.

Chapter 10 begins by outlining important considerations for goal quality, encouraging readers to look beyond whether a goal is technically measurable or well written and instead consider whether it is conceptualized thoughtfully and likely to make a difference in the individual’s life. The chapter showcases the Meaningful Goal Builder, which urges us to consider what, why, how, when, where, and with whom dimensions of our goals. I would like to echo something shared by Dr. Mary Jane Weiss in her foreword for this book about the impactful contribution of adding “in order to…” at the end of our goals as a salient prompt for us to reflect deeply on relevance, functionality, and meaningfulness.
Chapter 11 offers a particularly practical resource through its 20 Questions for Writing Meaningful Goals, providing readers with a structured way to examine and strengthen the goals they propose and ultimately implement. These questions are organized into the following categories: functionality and independence; long-term impact; level of risk; enjoyment and community access; practicality; social considerations; and family/team considerations. This instrument embodies the messages and insights shared throughout the book, and I encourage readers to take a close look at these twenty questions and perhaps complete them with a colleague, sharing notes. Even better, implement them as a multidisciplinary team, as recommended by the authors.
Chapter 12 introduces the important, and often challenging, task of balancing value, effort, and risk in meaningful instruction, reminding us that even skills with clear potential value require thoughtful consideration of the effort and risks associated with targeting them. The authors provide a helpful matrix highlighting the intersections of varying levels of value, risk, and effort.
Finally, Chapter 13, one of the briefest chapters, addresses structural integrity considerations, bringing attention to the importance of ensuring that goals are not only meaningful in intent but also appropriately constructed, easily understood, and supported by adequate face validity. Taken together, these chapters shift from identifying what matters to thoughtfully translating those priorities into goals that are meaningful, feasible, justifiable, and ultimately useful to the individual and their families.

Section 4: Assessing Quality

Chapter 14: Meaningful Outcome Measures
Chapter 15: Measuring and Meaningfully Incorporating Social Validity
Chapter 16: Quality Assurance for a Meaningful Program
Chapter 17: Leading a Meaningful Program

After exploring what to teach, how to teach it, and the creation of meaningful goals, Section 4 brings the reader to an essential final question: Did we get there? By “there,” I mean whether we truly fostered a meaningful difference.

Chapter 14 begins by addressing meaningful outcome measures and challenges readers to think beyond traditional measures of performance to consider whether the skills being targeted are producing meaningful changes in an individual’s life. The authors invite readers to reflect on broader quality-of-life outcomes that transcend the specific goals that are selected. For instance: Does the individual have choices? Are these choices honored with integrity? Does the individual have the tools to minimize harm and to change their mind in both big and small ways? There are some chapters that can be read first…this is one of them.
Chapter 15 extends this discussion through an examination of social validity, a frequently discussed concept that is often conceptualized as something to be checked off rather than fully infused into the fabric of our work. This chapter discusses the importance of not only measuring outcomes but also meaningfully incorporating the perspectives and experiences of the people most directly affected by our efforts. With a depth exemplified throughout the book, the authors break down the who, what, and how in a very constructive and accessible manner. This chapter ends with a strong ask: Don’t collect data you do not use, regardless of whether it is frequency data or social validity data.
Chapter 16 broadens the lens from individual goals to the larger program, addressing quality assurance and providing considerations for ensuring that meaningful practices are consistently embedded throughout a program rather than dependent on the efforts of just one or two individuals. A program-wide checklist is also shared.
Finally, Chapter 17 brings the book to its conclusion by focusing on leadership and the responsibility of those guiding programs to create systems and work climates that support meaningful practice. We are in an era where so many newly minted professionals are assuming leadership roles, and the recommendations of this chapter will serve them well, along with those administrators, supervisors, and mentors who can use a refresh on what inspiring leaders embody.

Collectively, these chapters reinforce that meaningful work requires more than developing good goals or using effective teaching procedures; it requires an ongoing commitment to evaluating outcomes, listening to those we serve (both our clients and our colleagues), examining the quality of our programs, and creating the conditions for meaningful practice to take root in sustainable and extensive ways. In many ways, Section 4 brings one of the central messages of Make It Meaningful full circle: assume nothing; listen, ask, re-ask, be humble, be transparent, and change course as needed.

As a bonus, the book includes digital access to over 30 tools organized within three broad areas: (1) instruments to guide program development; (2) form and datasheet templates that can be customized; and (3) job aids to enhance performance. A link is provided at the outset of this book to access these materials. The website housing these additional resources is very accessible and well organized. Many of the tools are embedded in the chapters, and some of them are showcased in the appendices. The authors have provided us with so many tools, some of which are discussed extensively in the book; however, others may be easy to miss (e.g., Appendix D highlights ways in which smartphones can support a more meaningful program).

I wholeheartedly recommend this book and trust you will turn to it time and time again. Perhaps this is where the insights of the Serenity Prayer offer a fitting reminder: there are circumstances in the landscape of adult services mentioned above that are beyond any one of us to change, but there are also many variables within our influence. As individual practitioners, family members, educators, advocates, and allies, we have the opportunity and the responsibility to do what we can to ensure that every person with autism has the greatest possible opportunity to live a life that is meaningful to them. Make it Meaningful reminds us that meaningful change does not always require us to transform the entire landscape; sometimes, it begins with the day-to day choices we make, the goals we select, the care we take in truly individualizing our efforts, the assumptions we question, the actual questions we ask of others in decision-making roles, and the opportunities we create for the individual person right in front of us. For those looking to make a broader impact, the “Final Thoughts” section of the book provides a road map for contributing to a greater ripple in how the information shared in this book can be disseminated.

In the spirit of a saying often attributed to Maya Angelou, “when we know better, we should do better,” Make It Meaningful challenges us to consider what we know now and, more importantly, what we choose to do with that knowledge.

Reference for this review:

Celiberti, D. (2026). Review of Make it meaningful: Creating programs that matter into adulthood for learners with autism spectrum and related disorders. Science in Autism Treatment, 23(9).

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Review of Make it Meaningful: Creating Programs that Matter into Adulthood for Learners with Autism Spectrum and Related Disorders