Unit 4

Question 1

When a behavior analyst interacts
with other professionals in providing
treatment, fluency with the entire
Task List is required.

However, some specific tasks relate 
to the behavior analyst coordinating 
with others, sometimes an advocate, 
other times a translator, ambassador 
of the behavioral model, or teammate

Answer 1

A Note Before We Begin

Question 2

Practice within one’s limits of 
professional competence in applied 
behavior analysis, and obtain 
consultation, supervision, and 
training, or make referrals as 
necessary

 Note: this task applies here, but also
pertains throughout this unit

Answer 2

Task G-07

Question 3

1.02 Boundaries of Competence
a) All behavior analysts provide services, teach, and conduct research only within the boundaries of their competence,
defined as being commensurate with their education, training, and supervised experience

b) Behavior analysts provide services, teach, or conduct research in new areas (e.g., populations, techniques, behaviors) only after first undertaking appropriate study, training, supervision, and/or consultation from persons who are competent in those areas.

Answer 3

Related Code Element task G-07

Question 4

Workgroup members
Collegial advice/mentoring
Clinical consultation/collaboration
Academic collaboration/conference 
presentations
Attending conference presentations 
of other behavior analysts

Networking
Supervisor/supervisee interaction
Peer review
Interactions with the BACB

Answer 4

Common Relationships Between

Professional Behavior Analysts

Question 5

In some large state and/or private 
institutions, a team of behavior 
analysts provide caseload-based 
services, typically under the 
supervision of a seasoned BCBA® or 
BCBA-D

Less common but beneficial
 These positions are becoming more rare
 They can provide supervised experience with many differentclinical populations, including
individuals with severe and dangerous challenging behavior

Answer 5

Institutional Workgroups

Question 6

Private ABA agencies of various
sizes can provide similar (but somewhat less centralized) services to individuals in the community

 Group and individual supervision with a BCBA is typical

 Regular case presentations and group reviews can be very useful

Answer 6

Agency Workgroups

Question 7

Especially for behavior analysts early in their career provides:

- Support 
- Collegial interaction 
- Exposure to new problems 
-Closely supervised training in new clinical areas

Answer 7

Benefits of Group Practice

Question 8

Seek support and/or advice from colleagues to maintain an ethical practice
.
Everyone benefits from supervision, collegial advice, oversight, outside guidance

Answer 8

If working alone,

Question 9

a)Behavior analysts arrange for appropriate consultations and referrals based principally on the best interests of their clients, with appropriate consent, and subject to other relevant considerations, including applicable law and contractual obligations
BACB (2014)

Answer 9

Code Element 2.03 Consultation

Question 10

 A formal (typically paid) relationship

 Driven by the specific clinical needs of the recipient of services

 Consent and confidentiality pertain

 All ethical issues relating to Code sections 1.0, 2.0, 3.0, and 4.0 are pertinent to both the consultant and the behavior analyst who seeks outside consultation

Answer 10

Clinical Consultation/Collaboration

Question 11

Takes Several forms:

Co-authorship on research articles or other publications

 Conference presentations

 Curriculum development

 Departmental interactions

Answer 11

Academic collaboration takes several

forms, including:

Question 12

Each supervisee must document each and every supervision period when it occurs

The supervisee and supervisor are responsible for collecting documentation for each supervision period on the Experience Supervision Form*.

One form should be completed at the end of each
supervisory period.” – BACB®, 2015 * As of 1/1/19 each supervision period is documented with a Monthly Experience Verification Form

Answer 12

When Must Forms Be Completed?

Question 13

 You cannot fill out supervision forms late! must be filled out as you proceed
through your supervision meetings.
 Use of a supervision form to back-date a
session from more than two weeks ago that
you forgot to document – strictly forbidden!
 Remember: BACB® forms are dated
 Failure to properly document supervision will lead to the incorrectly documented sessions being deemed invalid

Answer 13

Improperly Documented

Supervision

Question 14

The BACB® also requires the supervisee and supervisor to document the supervisee’s experience(s) at the conclusion of the experience being used to meet the BACB®requirements.
 The “BACB Experience Verification Form”
 Required as of 1/1/19: Monthly and Final versions
 These forms and detailed instructions are
currently included on the section of the BACB®
website titled, “Experience Standards”

Answer 14

A Second Required Form

Question 15

This issue is NOT addressed in the
BACB ethics Code

5.03(b) is entitled, “Supervisory Delegation” but it addresses the ethics required for the supervisor in
terms of his or her expectations and responsibilities as related to the skill set of the supervisee

Answer 15

The Ethical Responsibility of the

Supervisee

Question 16

 Inform the supervisor of all activities relating to the case; maintain complete, accurate, and timely service records

 Obtain prior approval from the supervisor before changing program components

 Maintain confidentiality in regard to supervision-related issues. Refrain from such discussions with the consumer, guardian, or surrogate

Answer 16

A Suggested Partial List of Ethical

Requirements for a Supervisee

Question 17

Generally refers to individuals
outside of the direct treatment team who monitor the effectiveness of the behavior program

A behavior analyst’s clinical supervisor is somewhere in the middle, part treatment team member and part program monitor
-Dual role/conflict of interest

Answer 17

Monitoring and Oversight

Question 18

Provided by;

Peer Review Committee

Human Rights Treatment Committee

Advocacy groups

State identified oversight boards (e.g., statewide Program Review Committee)

Legal counsel (in rare cases)

Institution Review Boards (IRBs) and Human Rights Committees (HRCs) research oversight)

Answer 18

Oversight

Question 19

A group of behavior analysts who review behavior programs in their local area

• May provide feedback
• Usually provide some kind of FORMAL approval
• NOT identified in the Task List or the Ethical Compliance Code

Answer 19

Peer Review

Question 20

Requires the behavior analyst to present program plans and data to an outside impartial panel
- panel is comprised of behavior analysts that may Identify potential problems the behavior analyst might have missed

Ensures program services show PROGRESS or that barriers to success are identified

May assist in RESOLVING issues (such
as obtaining additional necessary resources)

Provides the practitioner with back-up in case of investigations/legal proceedings

Answer 20

Peer Review Benefits

Question 21

Provide the plan in ADVANCE of the meeting

Provide your formal program, but use your step-by-step plan to guide the committee through the procedures

Keep it SIMPLE – flow charts help

Present accurate and COMPREHENSIVE data. If possible, show on the chart when the last formal program review occurred.

Know what you want going in: approval, advice, assistance, etc…

Do not personalize Feedback

Answer 21

Presenting a Program To Peer Review Committe

Question 22

Be respectful and helpful

You are not the presenter’s supervisor

Follow a list of program requirements

- Use a CHECKLIST  if available
- If not, suggest the development of one to assist everyone (presenter included) to look for what is required

In many states, peer review is about
ADMINISTRATIVE review: Does the program meet regulatory/statutory requirements?

If and when peer review becomes, “I am going to make you do what I would do if this were my client,” it becomes aversive for the presenter

Answer 22

Sitting on a Peer Review

Committee

Question 23

Regularly check the BACB website,keep up with current news

Be sure to look for any changes in requirements for certification, or other updates on information on the website

This is part of what you agree to when you agree to remain in compliance with all rules and regulations

Read and regularly refer to the following documents:
The current 4th Edition Task List, as of
01/01/15
-The BACB Professional and Ethical Compliance CODE for Behavior Analysts

Answer 23

Remaining Current with the Board

Question 24

Providing the Board with timely information regarding certain issues which may impinge upon the behavior analyst’s ABILITY to perform

Must occur both before certification is provided (as part of the application process) and after certification is obtained

Answer 24

 Self-reporting

Question 25

Part C: Eligibility Affidavit of the BACB

  -The BCBA/BCaBA application requires the applicant to answer questions pertaining to issues upon which the behavior analyst is expected to SELF report
The applicant must self report on:
1.Any physical or mental condition or 
addiction that could impair 
competent and objective 
performance and/or jeopardize
public health and safety

The applicant must self report on:
2.Any investigation, disciplinary
action*, investigation/charge/ 
conviction of a felony or 
misdemeanor directly relating to 
behavior analysis services or 
public health and safet

Answer 25

Self-Reporting Before Certification

Question 26

 Code element 10.02 Timely 
Responding, Reporting, and Updating of 
Information Provided to the BACB
 Applicants/certificants must report within 
30 days the occurrence of:
 A change in name address or other vital
information
 The filing of any criminal or civil charges
against the applicant/certificant
The initiation of any disciplinary
charges, investigations or findings/ 
sanctions by a healthcare organization, 
federal or state agency, or other 
professional association against the 
applicant/certificant.
 Any other change in information 
provided by the applicant/certificant to 
the BACB

Answer 26

Self Reporting After Certification

Question 27

 Disciplines with which a behavior analyst is likely to interact include, but are not limited to:
 Teachers
 Psychologists
 Speech and language pathologists
 Occupational therapists
 Licensed clinical social workers
 QIDPs (previously QMRPs)

Answer 27

Non-Medical Treatment and

Education-Related Professionals

Question 28

General practitioner M.D.s
Specialists 
 e.g., neurologists, dermatologists, etc.
Dentists
Medical technicians (medical tests)
Nurses
Psychiatris

Answer 28

Medical Professionals

Question 29

Lawyers
Advocates
Guardians
Human Rights Committees
Legislators
Media Representatives

Answer 29

Professionals Related to

Legal Issues

Question 30

b) When behavior analysts provide behavior-analytic services, they use language that is fully understandable to the recipient of those services while remaining
conceptually systematic with the
profession of behavior analysis. They
provide appropriate information prior to
service delivery about the nature of such
services and appropriate information later
about results and conclusions

BACB (2014

Answer 30

1.05 Professional and Scientific

Relationships

Question 31

 Behavior analysts have a responsibility to operate in the best interest of clients. The term client as used here is broadly applicable to whomever behavior analysts provide services, whether an individual person (service recipient), a parent or
guardian of a service recipient, an organizational representative, a public or private organization, a firm, or a corporation

Behavior analysts’ responsibility is to all
parties affected by behavior-analytic
services. When multiple parties are involved
and could be defined as a client, a hierarchy
of parties must be established and
communicated from the outset of the defined
relationship. Behavior analysts identify and
communicate who the primary ultimate
beneficiary of services is in any given
situation and advocates for his or her best
interests

Answer 31

2.0 Behavior Analysts’

Responsibility to Clients

Question 32

Groups of individual professionals
who interact and coordinate services
for an individual

Typically an interdisciplinary team is 
led by a case manager or a QIDP
They are more likely to be face-to-
face meetings in institutional and/or 
agency settings

Answer 32

Interdisciplinary Teams

Question 33

1. Leadership and management
    Clear leader of the team; provides clear direction and management; both listens and acts; support and supervision; democratic
2. Communication
    Individuals with communication skills
3. Personal rewards, training, development
    Learning, training, individual and career
4. Appropriate resources and procedures
    Structures (team meetings, members in the same location, administrative support)
5. Appropriate skill mix
    Sufficient/appropriate skills, competencies, practitioner mix, timely replacement, coverage for a velopment opportunities
6. Climate
    Culture of trust, valuing contributions, nurturing consensus
7. Individual characteristics
    Knowledge, experience, initiative, listening skills
8. Clarity of vision
    Having a clear set of values that drive the direction of the service and care
9. Quality and outcomes of care
    Client-centered, outcomes and satisfaction, encouraging feedback, recording evidence of effectiveness of care and using that as part of a
   feedback cycle to improve care

10.Respecting and understanding roles
 Sharing power, joint working, autonomy
Nancarrow et al., 2013

Answer 33

Ten Characteristics of a Good Interdisciplinary Team

Question 34

On the IDT, the behavior analyst must be able to explain behavioral principles and processes in both technical and non-technical language, according to the needs of the moment

See Tasks G-04 and G-05

Answer 34

A Closer Look at #2: Communication

Ten Characteristics of a Good Interdisciplinary Team

Question 35

 Task I-05: Organize, analyze, and
interpret observed data

For IDTs, the behavior analyst must be 
able to translate graphical displays:
 Team members must learn to clearly see 
 Variability
 Levels 
 Trends 
 Comparisons across conditions

Answer 35

Graphs as Communication

Question 36

We must translate and communicate
the behavior analytical model for
others (non-behavior analysts)
 Leaders in our field have identified this as an important component in the repertoire of a successful behavior analyst. However….

Answer 36

Within and Without the IDT

Question 37

Foxx (1996) states, “We must recognize that innovators are
frequently not good disseminators and that many scholars find dissemination to be a base activity and a dirty word because it becomes
promotion” (citing Sherman, 1992)

But he goes on to cite a personal communication he received from Jerry Shook:
“Yet, dissemination creates a market for scientific discoveries. We must not devalue dissemination.”

The Catch-22: The scientist who built
a better mousetrap, but..

Who also dismisses marketing and dissemination might call it the…
Small Animal Spinal Crack Mechanism”
“Sugar-coated Acid Delivery System for Alimentary Liquefaction and Euthanasia” (Sad-Sale)

Answer 37

The Scholar-Disseminator

Catch-22, Part 1

Question 38

You must read this article.
“Historically, we have been a maverick group with an outsider mentality that has been passed to our students

“We delight in asking, ‘where are your data?,’ poking fun at other models, and engaging in vigorous and withering discourse regarding
our science. Although this repertoire may have served us well in establishing our field, it may be non-functional now…

What makes a good behavior analyst can be bad for public relations. What is a blessing for a scientist can be a curse for a disseminator.” (pp.149)

Answer 38

Richard Foxx: Translating the Covenant (1996)

Question 39

Foxx cites Neuringer’s 1991 article of
the same title as this slide, which states that we have a “tendency to maintain that our language is better than others” which contributes to our image as self- assured and overly-
aggressive philosophical purists

The words we use…
 Behavior: Aubrey Daniels found out..
 Extinction: Like with dinosaurs?
 Response: You don’t mean reaction?
 Consequence: That’s bad, right?
 Control group: Who is the controller?
 Manipulate variables: Like I said…!
 Intervention: Isn’t that like invasion?
 Punishment: Ah, yes. Punishment…

Answer 39

Humble Behaviorism

Question 40

Foxx cites Sciba & Deno (1991)

The term “punishment” is irreversibly
contaminated by its association with colloquial usage, often as inhumane

Misconceptions confound any discussion of efficacy or ethics

And let me quote Foxx again directly:

“Our association with and use of the word punishment places behavior analysts in the uncomfortable position of defending a term that
serves as a discriminative stimulus for the very practices we find abhorrent.” (pp.152)

Answer 40

Lets take a look at “Punishment”

Question 41

 To paraphrase Merrill Winston’s various presentations on this topic at various conferences:
 Without punishment, none of us would be
alive! Natural punishment keeps us from continuing to do really dumb stuff. In other words, “Punishment not bad; it make you not die.”

 Punishment is, at least in part, the crux of
selectionism

Answer 41

It is the word, not the process that is the problem in public discourse

Question 42

As a therapeutic procedure, we should see punishment as the behavior analytical equivalent of surgery.

But do surgeons call what they do,
“Slicing You Open”?

Bailey, 1991 in JABA
Marketing behavior analysis requires different talk
That is the name of the article
Kind of says it all
Lets do what we do and analyze the 
problem

Answer 42

Punishment as a Procedure

Question 43

Foxx (pp.151) states, “Our technical
language has been constructed via what philosophers call conceptual revision (Harzem & Miles, 1978), in that we either invent a new word e.g., operant) or stipulate that an
existing word be used in a new waye.g., punishment).

Answer 43

Conceptual Revision

Question 44

1. Coining a new term
   More difficult at first
   May meet with resistance from others in the field
2. Using a pre-existing word in a new way
    A source of conceptual or communicative confusion

Examples
New terms: Mand, tact, motivating
operation, operant
Old words used in a new or idiosyncratic way: response, consequence, radical, negative

Foxx cites Dietz and Arrington saying, “Fewer problems are created when it only involves
inventing new terms or labels”
But in a way, this leaves us back where we started: Jargon
What is the solution?
Become an Ambassador. And be a Translator

Answer 44

The Two Types of Conceptual Revision

Question 45

Forge alliances with other disciplines!
Get involved in the professional 
organizations of other disciplines
Consider alternative views and 
support diversity
Be selective in terms of confidently 
asserting your own accomplishments

Answer 45

Become an Ambassador

Question 46

Learn their language
Read their journals
Try to blend your analysis rather than insist on its superiority
Keep it simple! Jargon may confuse your audience and have negative associations (for example, using negative” as a way to reinforce!)

Answer 46

And be a Translator

Question 47

“Roughly speaking, cooperative 
arrangements are productive. Things 
are done which would not be done 
otherwise. New ways of doing things 
may be discovered as contingencies 
interlock and are mutually altered.”

Answer 47

B.F. Skinner

Question 48

What we are all saying is this:

 Maintain our technical language– all
scientific disciplines require precisely defined technical terms

 But find alternative ways to clearly communicate your ideas to non-behavior analysts

Answer 48

Work With Your Audience

Question 49

Recognize that other professions
have ethical codes that may differ
from our own

Answer 49

Ethics in Other Professions

Question 50

 Medical/dental appointments for clients
 Hospitalization of clients
 Institutional settings
 Professional teams (including IDTs)
 Psychotropic medication management

The Relationship
The doctor is in charge.  When medical issues are involved,  M.D. has the license, and the responsibility
The behavior analyst is there to help
We will expand on this in the section 
on medication management

Answer 50

Behavior analysts interact with M.D.s
and other medical professionals in
many contexts, including

Question 51

Many consumers have difficulty with
medical contexts and interventions

The behavior analyst must be available for consultation with medical staff to assist in helping the client accept medical care Desensitizing a consumer to medical treatments may require formal
programming
 Coordination with medical staff/practice sessions
 However, sometimes situational interventions (without formal programming) may be necessary
 E.g., one-time medical tests/procedures;
post-operative protective interventions

Answer 51

Behavior and Medical Interventions

Question 52

The behavior analyst may have vital
information as to how to best work with the individual within the general hospital context
With all due consents, make yourself available to help

Realize that consent for release of information is not always necessary

Answer 52

Hospitalizations

Question 53

a) Behavior analysts never disclose 
confidential information without the 
consent of the client, except as 
mandated by law, or where permitted 
by law for a valid purpose, such as
1) to provide needed professional services 
to the client

Answer 53

Code element 2.08 Disclosures

Limits to Confidentiality

Question 54

when immediate health and safety issues are at stake, you may be allowed (or even expected to):

 Break confidentiality

 Engage in short-term emergency use of restrictive” procedures (e.g., physical restraint)

Answer 54

Imminent Harm

Question 55

 Psychiatric hospitals

 Outpatient crisis centers

 Regular hospitals

 Developmental centers
• Residential ID facilities

 Community-based treatment clusters

Answer 55

 Behavior analysts and medical doctors and/or psychiatrists may interact in a variety of settings, including:

Question 56

Coordination of services is always
vital to the welfare of the individual

Provide a particularly fertile setting for
interdisciplinary cooperation

Pyles et al. (1997) provides a model for institutional decision making

Answer 56

Institutional IDTs- Institutional Settings

Question 57

The HDC paradigm is predicated on 
the idea that problem behavior is most likely related to one or more of the following:
 Medical concerns
 Functional/environmental variables
 Psychiatric illness

Three Tenets of the Model
1. If possible, medical etiologies should be ruled-out prior to initiating behavioral interventions

2. Conduct a functional assessment to rule out ecological variables prior to making a psychiatric diagnosis
3. One cannot say a psychiatric diagnosis is appropriate based solely on aggression or self-injury
   Other characteristic symptoms of the diagnosis must be present
   • Social withdrawal
   • Disorganized behavior
   • Delusions, pressured speech, etc.

Answer 57

The Howe Developmental Center’s

Behavioral Diagnostic Paradigm-HDC

Question 58

If an individual is already receiving
psychotropic medication, a psychiatric diagnosis is necessary

If one is not present in the consumer record, then the process of ruling out medical and/or environmental causes must be initiated

Answer 58

Psychiatric Diagnosis-

The Howe Developmental Center’s
Behavioral Diagnostic Paradigm-HDC

Question 59

This is not a review of the full model

The main points are these:
 If you work in an institutional setting, we strongly recommend reading this article

 Coordination of services can fully address the ethical considerations of all involved disciplines

Answer 59

Use of This Model

The Howe Developmental Center’s
Behavioral Diagnostic Paradigm-HDC

Question 60

Behavior analysts are sometimes
asked to participate in other types of
professional teams where medical doctors are involved

Answer 60

 Human rights committees

 Policy groups

 Medical case management teams
• The Florida Experience

Question 61

Psychotropic (adj.) is defined as:
-Having an effect on the mind
-Affecting mental activity, behavior, or
perception, as a mood-altering drug

Psychotropic (n.) is defined as:
 A psychotropic drug: a tranquilizer, sedative, antidepressant

Answer 61

Psychotropic (adj.) is defined as:

Question 62

Typical antipsychotics
Atypical antipsychotics
Anxiolytics
Antidepressants
Mood-stabilizers
Anti-seizure medication

Answer 62

Types of Psychotropic Drugs

Question 63

Psychotropic medication is
specifically designed to change
someone’s behavior

These medications are prescribed 
specifically when someone engages 
in some type of problem behavior, 
which has been deemed necessary 
to reduce

Answer 63

Why Must Behavior Analysts Know

About Psychotropic Medication?

Question 64

His findings: “Aggression” is the 
primary reason for institutional 
placement and the #1 reason cited 
when medication is used for 
“behavioral control.” 
However: “There is no information in 
the literature suggesting that anti-
psychotic agents are effective means 
of treating aggression”

Answer 64

Matson (2000) provided an extensive
survey of literature regarding use of
psychotropic medication with people
with intellectual disabilities

Question 65

 “Interventions based on applied
behavior analysis have the strongest
empirical basis, although there is some evidence that some other therapies have promise.”

Answer 65

Sturmey (2002)

Article titled, “Mental Retardation and
Concurrent Psychiatric Disorders:
Assessment and Treatment”

Question 66

 Pyles quotes Reudrich (1992) in 
Current Opinion in Psychiatry, who said 
that by using graphic displays and 
single subject design, “the 
developmental field may take the lead 
in expanding this practice to more 
traditional psychopharmacology with 
the non-retarded people.” (p

Answer 66

In Pyles (1997)
On the HDC Model

Question 67

Clearly defining target behavior

Collecting and presenting data

Analyzing environmental functions as distinct from endogenous causes)

Educating team members about ABA and single-subject designs (when the opportunity arises)

Answer 67

Behavior Analysts’ Skills

Question 68

Learn common medical terms and
language

Coordinate with the physician
• what information regarding any behavior would be useful, and then provide it
• Use graphs, but with care (initially

Learn the drug effects
Learn the drug side effects
Contrast this with secondary
effects)

Answer 68

Skills to Improve

Question 69

One effect is the primary effect

Other effects are called side effects

The diagnosis determines what is primary therapeutic effect and what’s the side effect

Answer 69

Medication Effects

Question 70

Same drug, two names:
 Wellbutrin for depression
 Zyban for smoking cessation

Same drug name, two effects:
 Benadryl for allergies
 Benadryl for sleep

Answer 70

Examples of Primary and Side

Effects

Question 71

Most antipsychotics: Anticholinergic 
effects (Antihistamines dry you out) 
     Haldol: Akathesia (need to move)
     Risperdal: Weight gain, Gynocomastia
     Mellaril: Heart problems

Tardive dyskinesia
Tics, rolling tongue, abnormal movement
Can be irreversible
Increasing risk over time
 Initially thought less likely with atypical

Neuroleptic malignant syndrome
 Looks like flu, fever with rigidity
 Fatal if untreated

Answer 71

Some Key Side Effects

Question 72

Defined as the critical or lethal
reaction to an erroneous dosage of a
medication

Toxicity is not exactly a side-effect,
but can have important behavior
components
 Examples: Lithium, Depakote

Answer 72

Toxicity

Question 73

A broader term used in many contexts referring to a cause and effect relationship

Effects on target behaviors
E.g., SIB and proprioceptive feedback

Effects on other behaviors
 E.g., sedative effects in teaching
contexts, attention span

Answer 73

Secondary Effects of Medications

Question 74

Changes in the effectiveness of
specific stimuli as evocative or consequent variables

 E.g., light sensitivity, sound 
sensitivity, loss or increase in 
appetite, anti-cholinergic effects
Example: Wilson and the Water 
Fountain

Answer 74

Secondary Effects as EOs

Question 75

If at all possible, attend medication
management meetings. There is no 
real substitute.
You must make every effort to do 
this.
Keep trying.

Answer 75

Facilitate Communication with the

M.D. or Psychiatrist

Question 76

Behavior analysts are most likely to 
come into contact with the legal
system in the following three broad 
areas (this list is not comprehensive)
 Documentation/confidential information
 Contracts and fees for service
 Investigations and/or litigation

Answer 76

Where ABA Meets the Law