Individual Behavior Change Program Guideline 4 Natalia Szmacinski Caldwell College

Outline Describing conditions for program success Environmental conditions that preclude implementation Environmental conditions that hamper implementation Approving interventions Reinforcement and punishment Avoiding harmful reinforcers Ongoing data collection Program modifications Program modifications consent Least restrictive procedures Terminating criteria Terminating clients

THEN…. Supporters described behavior analysis as “fluid” interventions Detractors described it as “making it up as they went along” Extensions of laboratory procedures with adaptations for humans and setting Intervention protocols were not written down Consent not collected Data always collected

…NOW Behavior analysis is seen as a therapy Consent of client or surrogate must be obtained Other protocols: least restrictive procedures, avoiding harmful consequences, involving the client in program modifications Recommendation of reinforcement over punishment Ongoing data collection Termination criteria Current guidelines prevent “open-ended treatment”

GUIDELINE 4.0: The behavior analyst and the individual change program Designs programs that are based on behavior analytic principles, including assessment of effects of other intervention methods Involves the client or the client-surrogate in the planning of such programs Obtains the consent of the client Respects the right of the client to terminate services at any time

Describing conditions for program success (Guideline 4.01) The behavior analyst describes to the client or client- surrogate the environmental conditions that are necessary for the program to be effective Stated as a series of contingencies statements Find the function of the behavior and then find a way to gain control over the key maintaining variables THEN toilet training will more likely be effective and satiation can be avoided IF Billy can only have M&Ms when he uses the potty appropriately

Environmental conditions that preclude implementation (Guideline 4.02) If environmental conditions preclude implementation of a behavior analytic program, the behavior analyst recommends that other professional assistance (i.e., assessment, consultation, or therapeutic intervention by other professionals) be sought.

Environmental conditions that hamper implementation (Guideline 4.03) If environmental conditions hamper the implementation of the behavior analytic program, the behavior analyst seeks to eliminate the environmental constraints, or identifies in writing the obstacles to doing so. Minimum conditions for a program to be effective Stable environment Control over reinforcers Consistency Cooperation of key parties

Approving interventions (Guideline 4.04) The behavior analyst must obtain the client’s or client-surrogate’s approval in writing of the behavior intervention procedures before implementing them.

Reinforcement and Punishment (Guideline 4.05) The behavior analyst recommends reinforcement rather than punishment whenever possible. If punishment procedures are necessary, the behavior analyst always includes reinforcement procedures for alternative behavior in the program

Avoiding harmful reinforcers (Guideline 4.06) Cigarettes Sugar-laden food Fat-laden food The behavior analyst minimizes the use of items as potential reinforcers that may be harmful to the long-term health of the client or participant, or that may require undesirable marked deprivation procedures as motivating operations

Ongoing data collection (Guideline 4.07) The behavior analyst collects data, or asks the client, client- surrogate, or designated others to collect data needed to assess progress within the program Why?

Program modifications (Guideline 4 Program modifications (Guideline 4.08) & Program modifications consent (Guideline 4.09) Program modifications: The behavior analyst modifies the program on the basis of data Program modifications consent: The behavior analyst explains the program modifications and the reasons for the modifications to the client or client-surrogate and obtains consent to implement the modifications

Least restrictive procedures (Guideline 4.10) The behavior analyst reviews and appraises the restrictiveness of alternative interventions and always recommends the least restrictive procedures likely to be effective in dealing with a behavior problem

Terminating criteria (Guideline 4.11) The behavior analyst establishes understandable and objective criteria for the termination of the program and describes them to the client or client-surrogate

Terminating clients (Guideline 4.12) The behavior analyst terminates the relationship with the client when the established criteria for termination are attained, as in when a series of planned or revised intervention goals has been completed

Ethical Principles of Psychologists & Code of Conduct BACB APA Describing conditions for program success Environmental conditions that preclude implementation Environmental conditions that hamper implementation Approving interventions 3.10: Informed Consent Reinforcement and Punishment Avoiding harmful reinforcers

Ethical Principles of Psychologists & Code of Conduct BACB APA Ongoing data collection 6.01: Documentation of Professional and Scientific Work and Maintenance of Records Program modifications Program modifications consent Least restrictive procedures Terminating criteria Terminating clients 10.10: Terminating therapy ABA is clearly a unique field with very specific guidelines!

Case Studies Dr. G is a BCBA who provides behavior consultations for a private school for children with disabilities. Recently, the school decided to do intensive off-site training for all staff. This resulted in classes being short-staffed every day, and the staff who remained at the school no longer had time to implement interventions appropriately or collect data. Which guideline corresponds to this dilemma? How should Dr. G handle this situation?

Case Studies Ben is a teacher at a public school that provides ABA services to children with disabilities. One of his students has a DRO of 1 minute to reduce levels of stereotypy.. If the student does not engage in any stereotypy for 1 minute, he receives an Oreo. Which guideline corresponds to this case? What are some special considerations that Ben should take with this intervention?

Case Studies One of Ben’s students has recently begun dropping to the floor during programs such as matching numbers and receptive discrimination of colors. Paraprofessionals in the class suggest that the student is not on age-appropriate programs because he can expressively identify numbers and colors and that he is simply bored with his current programs. Ben decides to put in a behavior intervention that involves removing tokens whenever the student drops to the floor. Which guideline corresponds to this dilemma? What should Ben have done?

Summary Developing, implementing, and terminating an individual behavior change program requires careful planning, consideration, thoughtfulness, and responsibility. The client or client-surrogate must be involved throughout the entire process. Behavior change programs must not be harmful to the client.

Questions or comments?

References Bailey, J & Burch, M. (2011) Ethics for Behavior Analysts. 2nd Expanded Edition. Routeledge, New York. Ethical Principles of Psychologists and Code of Conduct. 2010 Amendments. http://www.apa.org/ethics/code/index.aspx Behavior Analyst Certification Board. Guidelines for responsible Conduct. http://www.bacb.com/index.php?page=57#1