A different way of seeing: Local business owner changing the national conversation around behavioral science

In 2017, Lindsey Radcliffe, MABC, BT, CFPRS, QIDP, DDP, DSPT and CEO of Morning Star Behavioral Associates, won the Codefi 1st50K competition and brought her business, Morning Star Behavioral Associates, to the Marquette Tech District in downtown Cape Girardeau.

It's a company that works to help people with disabilities achieve and maintain independence, through a radical approach to behavior science called Applied Behavior Analysis. The staff at Morning Star focuses on listening to the needs and hopes of their clients and then coaches them in real-world skills to help them achieve their goals.

Through her business, Radcliffe has also been part of a task force in St. Louis that addresses homelessness among people with developmental disabilities. She says that from the time a patient seeks services to the time they are actually offered them can sometimes take up to nine months. If they are homeless and there is no way for the hospital to contact them when it is time for them to receive services, they often fall through the cracks. Through working with patients, Radcliffe has been able to build relationships with hospital administrators and the Missouri Department of Mental Health. Together, they have looked at systemic problems related to mental health, disabilities and people who are homeless within the health care system and created a survey protocol for medical professionals to administer to help individuals in the interim of needing services and receiving them.

"Where are these people with disabilities going once they're adults? What happens when their mom passes away?" Radcliffe asks. "The truth is, they usually go to the correctional system, or they're homeless. So, how do we create a better system, a more compassionate system, but really a common-sense system?"

It's a revolutionary approach that others are noticing and wanting to be a part of: Morning Star has a relationship with Southern Illinois University (SIU) in which they do collaborative research, with SIU's graduate assistants and PhD students doing clinical work at Morning Star. They also are working with Saint Louis University (SLU) to launch a new clinic in downtown St. Louis in hopes of helping more people with disabilities who are homeless. In addition, SLU will send students to Morning Star in Cape Girardeau for clinicals.

It is in these ways and more that Radcliffe is changing the face of what is possible within the field of behavior science. Over the course of her 12-year career, Radcliffe has worked with approximately 1,000 clients with disabilities, helping them to achieve and maintain independence in a way that aligns with the clients' specific goals. She has grown her business from one employee in 2016 to 16 employees in 2020, and is currently hiring so she can continue expanding the services Morning Star offers. All of this in addition to the bachelor's and master's degrees in psychology, business and biblical counseling that she has earned while being a mother of three children.

Her efforts come back to one thing: her desire to use her expertise to help others.

"I'm really big into providing dignity to human beings," Radcliffe says. "I believe that dignity is created when we allow somebody to fulfill their purpose, and I truly believe that everyone has a purpose."

A different approach

Radcliffe has autism.

While most people are diagnosed with autism as children after the age of four, it's a late diagnosis she received when she was 30 years old. And it was a diagnosis that made sense: Radcliffe says school was always very hard for her, and she had to work extremely hard to earn her several degrees. Although she started out attending Southern Illinois University where she played Division 1 golf, she transferred to Austin Peay during the second half of her sophomore year to get more playing time in the sport. It was here where she felt for the first time that she could succeed academically.

"I had the experience ... of people seeing me for the first time, and it was the first time that I was told that I was smart -- 'bright' was actually the word that they used," Radcliffe recalls. "They saw that I learned differently, and they didn't call it out or anything, they just accommodated and helped me for the first time."

Her mentor with whom she did her honors research was a neurobiologist. Radcliffe says that after his lecture, she would follow him back to his office and ask him to repeat everything he'd just said. It was through having a conversation about the material that Radcliffe was able to remember it "apparently better than everybody else," she says.

Once her professors discovered this was the way that she learned, they "loaded [her] up" with information. Radcliffe jokes that she was the only student at the college who had a close friendship with the research librarian, who would give her articles about the topics she was interested in; Radcliffe absorbed these at fast rates. These large volumes of "downloaded" information, as Radcliffe calls it, established the foundation for the ways she now helps people at Morning Star Behavioral Associates.

Although benefits to her autism include retaining information and seeing unique ways to apply it due to the fact that she does not see clearly-defined roles like many people do, Radcliffe says there are also challenges to being a CEO with autism. Things that many consider commonplace can be very difficult for her; for example, grip-and-grin events during which she has to meet many people. She has also experienced hurt and prejudice throughout her life from people who view her autism negatively; even now, she says she is "terrified" of people in the Southeast Missouri community knowing about her diagnosis for fear of being excluded from or treated differently within professional and personal circles. She says to even consider being public about her diagnosis, she wanted to get to a certain point in her career so she would still be able to have a place at the table.

"I don't want people to think it's not going to be hard," Radcliffe says of having autism. "It's going to be hard."

Radcliffe says the tradeoff is that she can perceive the world in ways that people without autism can't, which are an asset to creating and running her business differently. Radcliffe believes she is not the only CEO in the country who has autism, and she hopes more people with the diagnosis are able to stand up and say "this is OK," explaining to the world what autism is and how people with it both struggle in and contribute uniquely to the workplace and world.

"You can see that with all of my experiences, this is just one part of who I am. ... I want people to understand that they can think bigger, and it's OK. We don't have to put limits on ourselves. You can be your best self, and that is almost always underestimated by you yourself," Radcliffe says. "I want parents to know the possibilities of having a child on the spectrum also includes [these things I am doing]: having children, having a child that's an entrepreneur, having a child that also affects change in lives and in policy, and all these other things. ... I want them to know that autism is a gift -- I've heard it said that it's just a really hard gift to open."

Lindsey Radcliffe, MABC, BT, CFPRS, QIDP, DDP, DSPT and CEO of Morning Star Behavioral Associates, sits in her office in the Marquette Tower in Downtown Cape Girardeau. Radcliffe won the Codefi 1st50Kcompetition in 2017 and has since grown her company that helps people with disabilities achieve and maintain independence from one employee to 16 employees. As one in 59 people have autism and there are only 20,000 behavior analysts in the world, Radcliffe is creative in how she recruits talented behavior analysts to Southeast Missouri.

A unique perspective

It's a gift that, through much hard work, Radcliffe has learned to open and use for the benefit of others. Hers is a philosophy of behavior science founded on the art of listening, which is what she does for her clients and their families each day.

This philosophy comes from those she has learned from: Radcliffe's mentor and former business partner who founded Morning Star Behavioral Associates, Jim Livesay, consulted with B.F. Skinner, the founder of behavioral analysis. One of Skinner's core tenants -- the first rule of behaviorism -- is that the subject is always right. Radcliffe firmly believes in this and uses it as a jumping-off point when working with her clients.

"The person is always trying to tell us something, and they are right. So what our job is, is to use our technology and our science to give voice to the giftedness and perspectives that individuals with disabilities normally don't have an opportunity to voice," Radcliffe says. "So, that's kind of what we do. We do it through a lot of graphs, a lot of data collection. [We're] very big into the international research scene; that's what we do. But it's really incredible to watch the transformation of people."

Radcliffe works to create therapy programs that mirror real life, helping clients with budgeting, cooking, social skills and working in the community. She and her team help individuals overcome food selectivity, acquire language, stop aggression and self-injury, learn to use the toilet, and more. It's all in a day's work.

A long lineage

Perhaps Radcliffe's way into the field of behavior analysis could be seen from a long way off. She grew up in Anna, Illinois, one of the birthplaces of behavior analysis. She was adopted by her parents who ran a group home, where she played everyday with the people her parents considered part of their family. It was here that she met her best friend, Teddy, who has an intellectual disability. As a child, she and Teddy were inseparable: he would walk her home from school each day, and the two played basketball together. She coached him in the Special Olympics when she was five years old, although she jokes that he mainly just babysat her during it. Radcliffe credits the way she does things differently from other CEOs to Teddy; she says she learned from the smartest person in the room.

"He taught me everything I needed to know about working with individuals who have disabilities," Radcliffe says. "He influenced everything. He changed it all."

Her parents, too, come from a family of behavioral scientists: Radcliffe's great-grandmother was the first person in the state of Illinois to take someone out of an institution and into her home, creating the national model for group homes. Ever since, her extended family has been in the behavioral health business, helping people with disabilities for five generations through running nursing homes, day training centers and more while finding innovative approaches to care. Radcliffe sees this as her time to continue their legacy.

She does this daily from a variety of perspectives. During her time at Austin Peay, she fell in love with psychology and specifically the experimental side of it. She worked with rats to learn about their behavior and thought she wanted to do this for her career. Livesay, who was a family friend, told her he used the same knowledge and processes with humans and invited her to be a part of it.

During this time, Radcliffe also worked at a day training center for people with disabilities, where she would sit and talk with clients rather than have coffee with the staff each morning. She listened to the clients and saw many of them were almost independent but couldn't quite get there within the current system. She began brainstorming about the way the system used to work -- knowledge she had from past generations of her family who worked in the field -- the way it worked at the time and the way it could work in the future. These ideas became the 11 Categories of Independence that form the foundation of Morning Star Behavioral Associates' work today. Livesay saw Radcliffe's work and helped her start a program with a pilot of 15 people who saw life-changing results through the 11 Categories of Independence. Radcliffe says these people are still employed and doing well.

And so began Radcliffe's 10-year apprenticeship with Livesay, working as his student for eight years and then as his business partner for two. It was during this time that the Department of Mental Health in Missouri asked the duo to come across the river to provide new and dynamic solutions to the problems people with disabilities faced. Livesay retired in 2016, and Radcliffe became the CEO of Morning Star Behavioral Associates, going on to win the 1st50K competition at Codefi in Cape Girardeau, which allowed her to build the offices inside the Marquette Tech District that Morning Star is housed in today.

"We had this brainchild of creating an environment that doesn't look like a clinic, and we wanted to really reduce the stigma associated with any type of services you get here, but also provide a multi-generational mentorship program that would [work] serendipitously," Radcliffe says of her vision for Morning Star Behavioral Associates. "Our goal is to really foster independence, but also what I like to call interdependence, because truly when you're a part of a community, you have to be interdependent."

Morning Star Behavioral Associates looks different from a traditional clinic: in addition to office space, Morning Star is complete with a full universally-designed kitchen, a living room area and a creative area that houses a ping pong table, musical instruments and yard games. All of this is focused on helping clients become independent within the context of a community.

This convergent thinking is the product of Radcliffe's diverse fields of study: while completing her undergraduate studies, working at the nonprofit and playing Division I golf, she also attended business school. She then attended graduate school full-time at Southeast Missouri State University while also attending Southern Baptist Theological Seminary full-time, where she earned a master's degree in biblical counseling and a masters in applied behavior analysis. This combination, she says, gives her a unique perspective on behavioral analysis.

"Behavior analysis is founded on the concept of determinism and that everything happens for a reason, and that's very congruent with an all-powerful and all-knowing God," Radcliffe says. "I think that Jesus is very concerned about people with developmental disabilities; in fact, he says it a lot in his Word. So, I think that anything that we can do to help the individuals is the Lord's work; at least, that's what he says. It doesn't look quite like a church, but that's OK. I'm not sure Jesus would hang out in many churches."

Through her education, experiences and training, Radcliffe is grateful to have "the distinct honor of helping" people with disabilities as her job.

A growing clinic

Radcliffe helps her clients in a variety of ways. Morning Star Behavioral Associates offers an Entrepreneurial Advancement Center that helps individuals with autism and developmental disabilities aged 12 and older develop small businesses and integrate into the community. They also have a pediatric Behavioral Center for Collaboration and Change which contains the Applied Behavior Analysis Program and the School Support Program, which both use data collection to monitor children's progress toward goals. In addition, they are planning to launch Ethos, a parent training and education program that equips parents in best practices for helping their children at home. Essentially, these are programs Radcliffe has created inside the current systems and policies that "do things that haven't been done before." Listening to parents and clients in order to provide them with the resources they need all in one place is a key part of that.

Radcliffe is excited to extend this help beyond Cape Girardeau -- in 2020, Morning Star will open a new clinic within walking distance of Saint Louis University in downtown St. Louis. Central to Morning Star's mission is to go where there is a need, and Radcliffe is looking forward to being able to have a clinic where there is a large population of people who may have not previously had access to services.

One of the biggest barriers to being able to grow her business even more in these ways is a shortage of Board Certified Behavior Analysts (BCBAs) in the field: behavior science is the only proven science that is effective in treating people with disabilities, according to the federal government. There are approximately 20,000 behavior analysts in the world while one in 59 people have autism, numbers that allow behavior scientists to choose where they want to go for a job. Despite this, Radcliffe has grown her clinic from one employee in May 2016 to 16 employees in 2020, with more to come throughout this year. The clinic is for-profit, and Radcliffe takes great pride in running her business in a generous way like a nonprofit, in part through treating her employees well and creating "really good" jobs in Southeast Missouri.

Radcliffe's process for hiring and attracting talent to Cape Girardeau is one that makes sure the potential candidate's values align with Morning Star and that they will thrive as a contributing member to the Cape community once they are here. At international conference hiring events where most behavior analysts are hired, Radcliffe says there is a lot of coffee and talking with prospective employees to make sure their values align with the mission of Morning Star. Although she often tries to hire as locally as she can, her employees come from across North America and do what world-class behavioral analysts are doing; Morning Star has had staff members who worked internationally and with the United Nations.

"We try to be our quirky selves, and Cape Girardeau is a huge part of that," Radcliffe says. "We want to sell people on the lifestyle that's associated with Cape."

This means that during an interview, Radcliffe spends a day and a half with prospective employees, taking them to downtown Cape, the river and venues such as Top of the Marq. She tells them about the innovation happening in Cape Girardeau and has them meet at least two people who are a part of Codefi, to foster a conversation about the culture of the tech district. It's all part of helping them see themselves in Cape Girardeau and as potential contributors to the community.

Right now, Radcliffe is working to hire more staff members so she can grow the clinic within the next six months. Hiring more staff members will allow her to get potential clients off the current waitlist so she can then fill up the waitlist again with new clients. She also wants to partner with local schools and medical providers, as well as be involved with the new Southeast Behavioral Health hospital. And of course, she is excited to open the new clinic in St. Louis.

All of this growth centers around the clear purpose Radcliffe has for herself and the mission of Morning Star Behavioral Associates: "Our goal is to be here for Southeast Missourians. And to not only be here, but to be a valid, purposeful and tangible way to provide hope," she says.

Through the unique way Radcliffe perceives people and the world, Morning Star is poised to continue helping transform the lives of many people as they do just that.

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What is autism?

April is World Autism Month. To better understand the condition, here are some things to know, from the Autism Society at autism-society.org:

Autism is a complex, lifelong developmental disability that typically appears during early childhood and can impact a person's social skills, communication, relationships and self-regulation.

Autism is defined by a certain set of behaviors and is a "spectrum condition" that affects people differently and to varying degrees.

There is no known single cause for autism spectrum disorder, but it is generally accepted that it is caused by abnormalities in brain structure or function. Brain scans show differences in the shape and structure of the brain in children with autism compared to neurotypical children.

Researchers do not know the exact cause of autism but are investigating a number of theories, including the links among heredity, genetics and medical problems.

Other researchers are investigating the possibility that under certain conditions, a cluster of unstable genes may interfere with brain development, resulting in autism.

Still other researchers are investigating problems during pregnancy or delivery as well as environmental factors such as viral infections, metabolic imbalances and exposure to chemicals.

The prevalence of autism has risen to 1 in every 59 people -- twice as great as the 2004 rate of 1 in 125.

As we currently understand autism, the core features of autism are persistent differences in communication, interpersonal relationships and social interaction across different environments, as well as restricted and repetitive behavior, patterns, and interests.

In 2012, professionals in the United States stopped using previous labels of autistic disorder, Asperger's disorder, childhood disintegrative disorder and pervasive developmental disorder not otherwise specified (PDD-NOS) and considered all of these diagnoses to fit under the broader diagnosis of autism.

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What should neurotypical people know about autism?

I'm Lindsey Radcliffe, MABC, BT, CFPRS, QIDP, DDP, DSPT and CEO of Morning Star Behavioral Associates, and I own and run a private practice for applied behavior analysis specializing in autism treatment. The difference is that I, too, have a diagnosis of autism.

I am so glad you're asking this question, because there is a lot I think people should know about autism. I would start with the fact that there is no need to feel sorry for me; I, in fact, feel sorry for you. Autism allows me to see life in 4k resolution, whereas typically-developing people can only see the regular 3-D image. Autism has allowed me to create some of the most advanced research in the field of ABA because I see solutions rather than being distracted by the problem. I view my diagnosis as a gift rather than a curse. This doesn't mean I don't struggle, because I do. There are things in life that I am just really bad at like cocktail parties and anything with more than five people in attendance. But my true friends find that endearing.

The second thing I would tell you is: you don't "understand," so please quit saying that. People are making a very misinformed assumption that ignorance resembles humbleness, but I would submit that, in fact, it mirrors arrogance. It is only when you see a person, human to human, that you can truly understand them, creating a true diversity that passes tolerance and moves into a collaboration of equality and trust. There are many things that define who I am. Yes, autism is one of those, but I also run an extremely successful start-up business that has grown eight times in the last year, and I am a single mother of three amazing children.

I hope this gives you a glimpse into the prism of autism. My hope is that you will start to see the many layers and sides to autism and the blessings in them.

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Top autism-friendly employers

"There is an increasing need for workers with the skills, thought patterns and work ethic that are common among people on the autism spectrum," writes Lisa Jo Rudy in the article "Top 10 Autism-Friendly Employers." "Autistic adults are, in general, dependable, routinized, focused, detail-oriented and passionate about their work. Many have outstanding technical and/or math skills. And quite a few are able to find unique solutions to problems that have eluded their more conventional colleagues. People with autism often prefer repetitive work and may not have a strong desire or need for novelty."

Rudy's article lists the following national companies as the best employers who are taking innovative approaches to incorporating neurodiversity in the workplace. By having people who think in different ways in-house, they're benefitting immensely and creating solutions that move their business forward.

1. Microsoft: Hosts an Autism Hiring Program that includes a multi-day, hands-on academy to help build soft skills in people with autism with the intent to hire them.

2. SAP: Has an "Autism at Work" program through which more than 170 employees are currently employed.

3. Freddie Mac: Has an Autism Internship Program that matches candidates with jobs for their skill set while teaching soft skills.

4. Ford: Founded FordInclusiveWorks to hire and support individuals on the autism spectrum.

5. Ernst and Young: Actively recruits and hires people with autism, in addition to creating the Center for Excellence in Philadelphia to help employees with autism develop their strengths.

6. Walgreens: Runs the REDI (Retail Employees with Disabilities) program to provide training to people with disabilities and then place them in jobs at Walgreens stores nationwide that match their skill set.

7. Home Depot and CVS Caremark (Ken's Crew): Recruits and trains people with disabilities to place them in a role that matches their skills and interests at Home Depot and CVS stores nationwide.

For information on how to become an autism-friendly business through the Autism Society, visit autism-society.org and click on the "Community Inclusion" tab under "Living with Autism." For more resources on how to make your business inclusive of people with autism, visit autismspeaks.org/employers-people-autism.

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5 Tips from a CEO

Wondering how you can create an autism-friendly workplace? Here are five tips from Lindsey Radcliffe, MABC, BT, CFPRS, QIDP, DDP, DSPT and CEO of Morning Star Behavioral Associates:

1. Write processes down and use them to measure performance.

Write down the daily, weekly, monthly, quarterly and yearly tasks for all neurotypical and neurodiverse employees. If employees complete these goals, reinforce that with bonuses. Radcliffe says it is important to create clear expectations for everyone, and to "spell out" what you need employees with autism to do.

2. Have rules for meetings.

Radcliffe says clarity is key. Before each meeting, send out a memo that includes the reasons the meeting will be taking place and the outcomes to achieve from it. After these goals are met, announce that the meeting is over and don't allow discussion about other topics.

3. Create diverse workspaces within your office.

Having different physical environments and types of areas for employees to work in allows people to move about as they need to in order to concentrate better.

4. Have empathy.

Ask each of your employees how they prefer to receive feedback -- by email, in person, in a group, etc. -- and then deliver feedback on their performance to them in this manner.

5. Find the right people for the right seats.

This, again, goes for all employees in your company. Let people do what they're good at, and create an environment where people can excel by using their strengths. This allows your company to become interdependent.---