Unit 8 Flashcards
Functional Behavior Assessment
- Gathering information to generate hypotheses about the relations among specific types of environmental events & behaviors
- Indirect
- Descriptive
- Functional analysis
Functional Analysis
*Compare rates of bx in control condition (play) to test conditions
- Common test conditions:
- Demand
- Attention
- Alone
- Tangibles
In a functional analysis, a behavior analyst compares the rates of responding in which conditions?
“Test and Control Conditions”
Assessment-Intervention Link
*Identification of the function can directly guide treatment & “maybe more effective than those selected without consideration of behavioral function”
The function of a problem behavior cannot be assumed based on topography.
a. True
b. False
a. True
Explain a benefit of identifying the function of problem behavior:
“Identifying the function of Problem Bx can directly guide treatment”
Function-Based Treatment
- What makes a treatment function based?
* How do function-based treatments operate on bx?
Function-Based Treatment (Con…t)
- A function-based treatment directly addresses the identified function of the bx
- Alters some aspect of the 4-term contingency
- Does not rely on superimposing other contingencies on the existing maintaining contingencies
How Function-Based Treatments Work
- Eliminating the reinforcement contingency
- Extinction
- Altering the MO
- Noncontingent Rx (NCR)
- Establishing a new bx with the Rx contingency
- Functional communication training (FCT)
“Function-based” treatment focuses on the identified function as the basis for treatment, but also requires adjusting interventions based on the individual.
a. True
b. False
a. True
Function-Based Interventions
- Interventions for Bx maintained by:
- Social positive reinforcement
- Social negative reinforcement
- Automatic reinforcement
- Strengths & weaknesses
- Decision models
Common Treatment Elements
- Arranging the delivery of relevant reinforcers through other means
- E.g. differential Rx, noncontingent Rx
- Disrupting the response-reinforcer contingency for prob bx
- E.g Extinction
Common Treatments
- Common treatments for social positive Rx:
1. Extinction (EXT)
2. Differential positive Rx
3. Noncontingent Rx (NCR)
Describe two common elements used in function-based treatment:
“Disrupt response-reinforcer contingencies for problem behavior and arrange for reinforcers through other means”
Extinction as a Process
- A decrease in the probability of a response class following the discontinuation of the response-reinforcer contingency
- Requires
- Knowledge of Function of bx
- Ability to withhold the reinforcer
Extinction as a Procedure
- Procedural variation of EXT matters (Iwata, Pace, Cowdery & Miltenberger 1994)
- EXT of problem Bx maintained by positive RX:
- Withholding the reinforcer (attention or tangible stimuli) following the occurrence of prob bx
Withholding attention is the most effective way to apply extinction for problem behavior maintained by social positive reinforcement.
Extinction of prob bx maintained by social positive reinforcement involves withholding the stimulus that has reinforced that behavior in the past. The stimulus withheld can be attention from others if the behavior is maintained by access to attention, or a tangible item if the behavior is maintained by access to a tangible.
How does extinction for behavior maintained by tangible items differ from extinction for behavior maintained by attention?
Extinction for behavior maintained by tangible items involves withholding the items, while extinction for behavior maintained by attention involves withholding attention
Differential Reinforcement
- Reinforcing 1 response while withholding reinforcers for another
- May not always include EXT component
- Varying forms:
- DRO
- DRA
DRO
- Deliver reinforcer contingent on the nonconcurrence of response following predetermined time interval, while eliminating contingency btw prob bx & its maintaining consequence
- Initial interval length, Varies, often mean IRT
- Procedural variations (Vollmer & Iwata, 1992)
- Fixed, variable or escalating intervals
- Resetting or non-resetting DRO
- Whole-interval DRO or momentary DRO
- Functional or arbitrary reinforcer
DRA
- Deliver reinforcer contingent on appropriate alternative response, usually while withholding the reinforcer following prob bx
- Functional communication training (FCT): Common variation of DRA consisting of delivering the functional reinforcer contingent on communicative response
NCR
- Response-independent or time-based delivery of reinforcer
- Initial schedule: Can be continuous, latency to 1st prob bx or mean IRT
- Typically involves 3 components:
- Reinforcer delivery on a fixed-time schedule
- EXT for prob bx
- Schedule thinning
- Functional or arbitrary reinforcer
Identify the weaknesses of an extinction of SR+ procedure:
check all that apply
- Bx may get worse before it improves
- Restricts access to reinforcement
- Requires a high level of integrity
Identify the weaknesses of a DRO for SR+ procedure:
check all that apply
- Functional replacement skills are not taught
2. Requires a high level of integrity
Which of the following is a strength of an NCR for SR+ procedure?
-Is easy to implement
Which of the following is a strength of a DRA for SR+ procedure?
-Teaches functional alternative to problem behavior
Social Negative Reinforcement
- Common treatments for social negative reinforcement
1. Escape extinction
2. Differential negative RX
3. Antecedent-based interventions
EXT for Behavior Maintained by Negative Reinforcement
- No longer allowing escape or avoidance of aversive stimulus contingent on occurrence of problem bx
- Escape/ avoid demands/ instructions: Con..t presentation of the demands (may also include physically guiding the individual to complete the task)
- Escape or avoid social interactions: con..t engagement with the individual in the presence of prob bx
Differential Negative Reinforcement
- Differential neg Rx of other Bx (DNRO): Provides functional reinforcer contingent on absence of prob bx for a specified amount of time
- Diff neg Rx of alternative bx (DNRA): Provide escape from, or avoidance of aversive stimulus contingent on an appropriate alternative response
- With or without Ext
Name the three common interventions used for social negative reinforcement:
“Escape extinction, DNRA, and antecedent-based interventions”
DNRA
- Alternative Bx:
- Communicative response (FC)
- Functional reinforcer (break)
- Assistance, weaken MO (help)
- Compliance with demand
- Functional or arbitrary reinforcer
Identify the alternative behaviors commonly targeted in a DNRA:
(check all that apply)
- Complete the task
- Request break
- Request assistance
Antecedent-Based Interventions
- Noncontingent escape (NCE): Escape or break from aversive stimulus on time-based schedule independent of responding
- Initial schedule: Usually dense
- Increase time btw reinforce deliveries
- Fixed duration
- Mean IRT
Antecedent-Based Interventions (Con…t)
*Demand (for instructional) fading: Aversive stimulus removed & then gradually reintroduced contingent on low levels of prob bx
Antecedent-Based Interventions (Con…t)
- Curricular (or instructional) revision: Identify aspects of aversive stimulus that occasion prob bx & then make alterations to min or eliminate aversive properties
- Decrease aversiveness of demand context to reduce motivation to engage in prob bx
- Potential MOs (Smith et al., 1995):
- Difficult, novel or non-pretend tasks
- Session duration
- Rate of task presentation
Antony engages in hand biting during school every 20 minutes on average. This results in removal from the classroom. The BCBA scheduled a break from class every 15 minutes, regardless of Antony’s behavior. This is an example of which procedure?
A. DNRA
B. Antecedent-based
C. Escape extinction
B. Antecedent-based
Antony engages in hand biting during school every 20 minutes on average. This results in removal from the classroom. The BCBA scheduled a break from class every 15 minutes, regardless of Antony’s behavior. Which type of antecedent-based procedure is this?
a. NCE
b. Demand fading
c. Curricular revisions
a. NCE
Identify the weaknesses of a demand fading procedure:
(check all that apply)
a. Procedure can take a long time
b. It might be ineffective without extinction
c. Behavior may get worse before it improves
a. Procedure can take a long time
b. It might be ineffective without extinction
Identify the weakness(es) of an NCR for SR- procedure:
check all that apply
-Reduces time engaged in academic tasks
Automatic Reinforcement Common Treatments
- Common treatments for automatic Rx
- Sensory extinction
- Differential Rx
- Nonc-ontingent delivery of competing stimuli
Automatic Reinforcement
- Default function
- Some product of response itself reinforces response
- Nature of that product is subject to debate
- Some form of sensory stimulations is the controlling influence
Treatments for Automatic Reinforcement
- Trt attempts to target presumed form of stimulation/ identify potent competing stimulus
- If form of stimulation cannot be identified to compete with sensory reinforcers
Automatic Reinforcement
- Difficult to identify specific form of sensory consequences
- Often multiple possible sources of stimulation (e.g. hand mouthing-stimulation to hand or mouth?)
- Attempt to identify through continuous & noncontingent access to items thought to mimic putative sensory consequences
Identify the three common treatments used for behavior maintained by automatic reinforcement:
“Sensory extinction, differential reinforcement, and competing stimuli”
EXT
- Ext: Sensory products of the problem bx removed or attenuated to disrupt response -reinforcer contingency
- Protective equipment sometimes used (e.g. helmet, topical anesthetic)
- Permits response to occur
- Prevents response from producing presumed form of stimulation
- Simply preventing the response from occurring is not EXT
Extinction for behavior maintained by automatic reinforcement involves:
(check all that apply)
- Removing the sensory products of the prob bx
- Interrupting the response-reinforcer contingency
- Sometimes using protective equipment
Protective Equipment Issues
- Issues with use of protective equipment
- May prevent adaptive responding
- Social stigma
- Difficulty fading
- (May also obscure functions in functional analysis as previously discussed)
Differential Reinforcement
- Exact form of maintaining outcome is often unknown
- Differential Rx for automatically maintained bx. Deliver potent alternative Rx
- Most commonly in DRO arrangement
- Identify preferred stimulus
- Deliver stimulus contingent upon an initially brief period of omission of the automatically reinforced responses
- Gradually extending the temporal parameters of DRO schedule
DRO
Not always effective
*DRO might be best combined with other procedures (e.g. EXT) that devalue the response products
- Relatively of reinforcers?
- Alternative Rx maybe preferred over products of prob bx when delivered continuously & under conditions of low effort
- DRO schedules maybe viewed as a sort of “cost” in terms of delay to Rx
- Preference for alternative reinforcer offset by “cost” in terms of delay to RX
- DRO contingencies less discriminable?
Identify reasons why a DRO schedule may not be effective for behavior maintained by automatic reinforcement:
(check all that apply)
- Requires a dense schedule
- Requires a very small time window
- Contingencies are less discriminable
It may be best to use DRO with other procedures that lessen the value of the sensory product.
a. True
b. False
a. True
NCR and Competing Stimuli
- Competing stimuli: Noncontingent provision of items found to “compete” with response products
- Competing stimulus assessment:
- Item that best compete (i.e., highest engagement & lowest prob bx) provided continuously for longer periods of time
- Not just highly preferred items
Automatic Reinforcement: Ethical Considerations
- Should we reduce all automatically reinforced bx to 0?
- Can we provide an alternative response that provides a similar form of stimulation?
- Type of response? Does it cause significant harm?
Sensory Extinction: Sensory Rx blocked or mitigated
- Strengths: Highly effective
* Weaknesses/ risks: Maybe difficult or impossible to implement
Competing stimuli: Items that decrease the occurrence of SIB are freely provided
- Strength: May create appropriate alternative skill
* Weaknesses/ risks: Requires multiple assessments to implement
DRO for automatic Sr:
Delivery of reinforcers for not engaging in SIB
- Strength: May identify items that are preferred to SIB
* Weaknesses/ risks: Extinction cannot be implemented, No functional replacement skills taught
DRA for automatic Sr
Reinforcement for alternative Bx (toy play) provided
- Strengths: Trains appropriate alternative skill
* Weaknesses/ Risks: Extinction cannot be implemented. Maybe difficult to train appropriate alternative
Identify the weaknesses of a DRO for automatic SR procedure:
check all that apply
- Cannot use extinction
2. Functional alternatives are not taught
Treatment Decision-Making
- We are taught how to search the literature & how to implement procedures
- Practitioners also need to know When & How to select among them
Function & Effectiveness
*Function-based treatments are OFTEN, but not Always more effective than ones that are not based on the function
Some Factors to Consider
- Need an evidence base
- Topographies, context, skills
- Need a data-based evaluation
- Client specific
- Need to design the intervention well
Clinical Decision-Making
*Critical When:
- Multiple options are available
- Multiple might work under perfect circumstances
- 1 is better suited to the current circumstances & resources
Clinical Decision-Making (Con…t)
- Decision-making is bx
- In the absence of a model to guide decisions, your choice is likely to be one with:
- A longer Rx history
- A recent Rx history
- Less response effort required
Considerations for Determining Treatment Suitability
- These interventions have different advantages & disadvantages based on factors including (but not limited to):
- Client characteristics
- Functions of prob bx
- Topographies of prob bx
Will function-based treatments always be better than non-function-based treatments?
Not necessary
Considerations for Selecting Treatment
*Context & resources
- Available resources
- Staff-to-client ratio
- Staff training & oversight
- Availability of reinforcers
- Ability to provide preferred stimuli
- Disruption to the Env
- Outside influences
Considerations for Selecting Treatment (Con…t)
- Treatment fidelity
- Who is implementing treatment?
- Training
- Ease of implementation of treatment
- Degradation of trt fidelity ?& the impact on trt effectiveness
- Omission errors
- Commission errors
Fryling et al. (2012)
- Reviewed literature related to integrity & intervention efficacy (descriptive analysis & experimental analysis)
- Descriptive studies provide evidence of correlation
- Experimental studies have systematically evaluated the impact
Treatment Integrity Literature Summary
- Wilder et al. (2006)
- Level of compliance correlated with levels of integrity of a prompting procedure
- Stephenson & Hanley (2010)
- Trt outcome maintain when integrity is low if integrity was initially high
Treatment Integrity Literature Summary
- St. Peter Pipkin et al. (2010)
- Evaluated errors of both omission & commission in DRA
- Group 1: Varying omission error levels (20%, 40%, 60% & 80%)
- Group 2: Varying commission error levels
- Group 3: Covarying levels of omission & commission errors
- Group 4: One level of combined errors
Considerations for Selecting Treatment (Con..t)
- Preferences
- Caregiver
- Client
Concurrent Chain Procedures
- Initial link response produces differential access to treatments
- Pattern if initial link responses indicates preference for trt
Hanley et al. (1997)
- Purpose: Assessed preference for behavioral interventions
- Presented multiple trt alternatives to the client in a choice arrangement
- Control/ EXT, FCT, NCA
Owen et al. (2021)
- Assessed children’s & caregivers’ preferences for DNRA/ FCT, NCE & Esc Ext
- DNRA & NCE similarly decreased prob bx, but all 3 children preferred DNRA
- 3 of 4 caregivers preferred ESC EXT which produced greater compliance
Describe a concurrent chain procedure as it relates to preference for interventions:
A client is presented an initial link in a chain, which consists of a choice of two treatment procedures. The initial link selected determines the treatment that follows. The one they choose most often is the preferred treatment”
Is vocal verbal behavior required for an individual to demonstrate preference in a concurrent chain procedure?
a. Yes
b. No
b. NO
Decision Models
- Decision model for negative RX
- Decision model for positive RX
- Decision model for automatic RX
Guiding Values
- Quality if life
- Safety
- Suitability given available resources
- Current client strengths
- Prioritization of skill needs & educational opportunities
Models and Decision-Making
- Models are incomplete
- Models may exclude relevant decision makers
- Models may not help….
Saini et al. (2017)
- Purpose: Evaluate the usefulness of the escape-maintained bx trt decision model
- Novices & experts given scenarios & asked to select treatments
Saini et al. (2017) Results
- “Experts with the decision model did not have greater odds of selecting optimal trt than experts without the model…..
- “Novices with the decision model did not have better odds of selecting the optimal trt than novices without the decision model”
Explain the best way to use the decision models presented:
“As a starting point, because they are not complete and not exhaustive of all possible factors to consider.”
Which of the following is/are reasons to include caregivers when deciding on treatment procedures?
a. Social validity
b. Practicality
c. They are implementers
d. All of these
d. All of these
In the Saini study, what were the results in the survey evaluating the potential usefulness of the decision models?
*No difference in either group finding optimal trt with or without the model
Collaborate Decision-Making
- Use the model to ask meaningful ques
- Identify the range of possibly options that are:
- Evidence based
- Function based
- Suited to the circumstances
Treatment Suitability Summary
- Use models wisely
- Collaborate with caregivers to optimize trt for their circumstances (context & resources)
- Be turned in to trt fidelity issues
- Evaluate client preference or trt
- Research findings suggests clients prefer contingent Vs. noncontingent RX
The Role of the Behavior Analyst in Treatment Planning
- Assess Bx
- Identify function
- Select function-based trt
- Train & monitor implementation
- Assess the effect of Trt
- Modify the plan based on data
When reviewing the table from the Geiger et al. study, it is best to use it with:
-Caregivers
Explain how caregivers can help when using the table:
“The table can be used when addressing relevant treatment questions with the caregiver”
A Behavior Plan:
Definitions in Recent Literature
- “The method by which interventions are communicated to staff & parents for implementation” (Quigley et al. 2018, p. 436)
- “The primary mechanisms for codifying a behavioral treatment” (Williams & Vollmer 2015 p. 323)
*Behavior Plan
- A document that provides all info necessary for the consistent & effective implementation of a conceptually systematic & approved set of behavioral trt protocols
- Some alternative designations:
- Bx intervention plan (BIP), bx service plan (BSP), Bx treatment plan, Bx program, formal bx Mgmt prog
Behavior Plan Purpose
- To clearly describe & document:
- The bx of interest: For both increase & decrease
- Functional assessment(s)
- Prob bx, functional deficits & skills
- Intervention
- Other salient info
Baer et al. (1968)
- Defined ABA with 7 dimensions
- Technological dimension:
- ABA is characterized by procedures that are clearly described & easily replicable
Baer et al. (1968) on the Technological Dimension
- Programs describe “all the salient ingr” of therapy as a “Set of contingencies” btw the service recipient & the Env
- “A typically trained reader could replicate that procedure well enough to produce the same results, given only a reading of the description.”
2 Main influences on Plan Structure & Content
- “Best-practice” professional standards
* Legal/ administrative requirements of standards
Best Practice
*A process, procedure or practice which is validated by reliable research & experience as optimal in a particular context & is therefore adopted by consensus across a discipline as a standard of professional bx
Best Practice Standards
- A variety of ideas exist on what is the “best-practice” content & structure of Bx Plans
- The literature breaks into 2 categories:
- Surveys of recent plans
- Suggestions on plan structure & content
List two alternative names for a behavior plan:
“Behavior intervention plan (BIP), behavior service plan (BSP), behavior treatment plan, behavior program, formal behavior management program”
Identify information that should be included in a behavior plan:
(check all that apply)
- Problem bx definitions
- Replacement bx
- Interventions
- Functional assessment
- Functional skills
Writing the procedures of a behavior plan in detail so others can replicate the procedure is related to which dimension of behavior analysis?
*Technological
What are the two main influences on the structure and content of a behavior plan?
(check all that apply)
- Best practice professional standards
2. Legal/ Administrative requirements
Behavior Plans as per IDEA
*Poucher’s 2015 analysis if IDEA describes the following characteristics
- Must be in writing
- Based on “relevant research” in the field
- “Must incorporate the findings of an FBA”
- “Should emphasize the use of positive, inclusive & least restrictive approaches
- Use “common language to describe bxs & consequences
*4 Considerations
O ‘Neill et al. (1997) “considerations” underlying all behavior intervention plans:
- Indicate how caregiver bx will change as well as that of the client
- An assessment of functional relations relating to the bxs in ques
- Be conceptually systematic
- Fit well with the values, resources & skills of the ppl responsible for implementation (i.e., social validity)
Behavior Plan Survey
*Tarbox et al. (2013): A survey of research suggests that plans must..
- Include info pertaining to function of the bx
- Be primarily based on validated scientific research (evidence-based)
- Stress positive Rx whenever possible, & be least intrusive
Behavior Plan Characteristics
- Written, with specific info about all target bx(s) & intervention (s)
- Based on functional assessment
- Technological (i.e., easily replicable)
- Conceptually systematic, evidence-based
- Least restrictive, positive & inclusive approaches are emphasized
- Socially valid
Identify the four considerations for behavior plans according to the O’Neill et al. study:
(check all that apply)
- Behavior change of caregiver & client
- Conceptually systematic
- Implementers values, resources and skills
- Functional assessment related to behavior
List four characteristics of a behavior plan:
“A behavior plan should contain written information about target behaviors and interventions; be based on a functional assessment; be technological (replicable); be conceptually systematic (evidenced-based); be focused on the most positive, least restrictive approaches; and be socially valid”
Behavior Plan Prerequisites
- Referral/ screening: Preliminary statement
- Functional bx assessment
- Indirect assessment: Records, interviews
- Descriptive assessment: Narrative recording, scatterplot, ABC data
- Functional analysis (Whenever possible)
- Assessment of skills
Preference Assessment Revisited
- Methods for identifying an individual’s preference for items &/ or activities that may function as reinforcers
- In the bx plan:
- Not typically included on original plan
- Typically used as an ongoing activity in trt
Reinforcer/ Punisher Assessment Revisited
- A variety of techniques to evaluate the effectiveness of a stimulus as a Rx or punisher
- Can be conducted during the development of a Bx plan, or later during trt
- Reinforcer assessment is far more common than punisher assessment
- All programs must contain Rx procedures; punishment is far less common
Assessment Followed by Treatment
- Different services, different provider?
- Some funding sources provide for an initial assessment only
- Trt funding maybe based on assessment results
- The most ethical approach:
- The assessor also provides trt
Direct Supports
*Staff/ caregiver issues
-Commitment/ support
-Supervision involvement/ support
Education/ cultural/ language issues
*Regular contact with caregivers (and if applicable, their supervisors)
-Promote a group effort from the beginning or it will not work
Indirect Supports
*Funding/ administrative support
- These supports are key
- Considered Indirect cuz they refer to supports from outside of the immediate service-delivery context
- Encourage participation by all “stakeholders” & maintain open lines of communication
- Be inclusive & always look to help solve problems!
Which of the following steps should be completed before writing a behavior plan?
(check all that apply)
- Reason for referral
- Descriptive assessment
- Indirect assessment
- Assessment of skills
2 Documents in a Behavior Plan
- The Formal Bx plan
2. The Step-by-Step intervention plan
Formal Bx Plan
- The document for the permanent clinical record that describes the bx & planned interventions in conceptually systematic terms
- Often written in dense professional language & jargon specific to ABA.
- Meets regulatory requirements & funding agency need for clinical, administrative & legal documentation
Formal Bx Plan Content
- A client profile, history, goals & rationale for service as well as diagnostic, medical & other assessment info
- Collated from record reviews, interviews, current assessments & data
- Bxs targeted for increase & decrease, planned interventions
Step-by-Step Intervention Plan
-Short version of the formal bx plan that includes very specific trt protocols stated in nontechnical language for everyday use by plan implementers
Step-by-Step Intervention Plan (Con…t)
- A task analysis of the intervention:
- Provides a very detailed, step-by-step description of all planned programmed responses for each target bx
- A description of caregiver bx
- Includes directions on data collection
- Fulfills the technological dimension of ABA
Step-by-Step Intervention Plan Purpose
- Used to train caregivers
- Used by caregivers to guide their daily implementation of the plan
- Meets caregiver need for an easy-to-read instruction sheet for quick reference in context
- Simplifies presentation & clarifies procedures for oversight bodies
*Essential Elements
- Limited literature in this, mainly survey research of current practices by practitioners
- An early entry: Vollmer et al. 1992
- More recent surveys:
- Williams & Vollmer (2015)
- Quigley et al. (2018)
Common Survey Results:
Core Elements of All Plans
- Target bx(S) clearly defined
- Replacement bx(s) identified
- Data collection method described
- Functional assessment results provided
- Consequences specified for target bx -Focus on RX procedures
- Restrictive procedures monitored
- Consent is obtained
A Non-survey Paper
*Horner et al. (2000) suggest a list of key features of effective ethical bx support plans
- Build on the student’s strengths
- Identify all prob bxs (barriers)
- Specify contexts/ routines where student has problems & where they succeed
- Based on FBA
- Redesign the Environment
Horner et al. (2000):
Elements of an Effective Plan
- Account for how the student experiences the Env
- Use prevention strategies
- Teach new adaptive skills
- Avoid rewarding prob bx
- Reward positive bx
- State what to do in the most difficult situations (e.g. crisis situations)
- “Organize for success”
“Organizing for Success” Part
- Careful planning
- Key stakeholders (e.g. caregivers, family members) must be involved in the development process from the outset
- Those who implement must feel some ownership of the program!
- Sustained, accurate implementation
- Decision-making is data based
“Organizing for Success” Part 2
- Specify observable outcomes; monitor for progress; identify obstacles; make revisions as needed
- Effective procedures are practical
- Contextual fit, implementers’ skill level, environmental supports
- To be effective, a plan must be used
Which of the following are core elements of behavior plans?
check all that apply
- Clearly defined target behaviors
- Description of data collection methods
- Clearly identified replacement behaviors
- Obtained consent
A client engages in high rates of self-injury in a school setting. The team includes data collection methods, functional assessment data, and replacement behaviors. What element of a behavior plan would also likely need to be included?
crisis plan for self-injury
A Note of Caution
- The following list of sections in a formal Bx intervention prog is based on:
- Several published surveys
- A review of legal requirements
- My own clinical & admin experience
- Not all listed sections are absolute requirements for each prog
- Different Setting = different contingencies
- But remember the sore contents of any BIP as identified by surveys of professionals
Core Elements Revisited
- Target bxs clearly defined
- Replacement bxs identified
- Data collection method described
- Functional assessment results provided
- Consequences specified for target bx - Focus on Rx procedures
- Restrictive procedures monitored
- Consent is obtained
Brinkman et al. (2007):
Important Additional Information
- Background info, residential status, medical diagnoses etc
- Best-practice in “consultation reports”
- Info is salient to bx services -promotes accountability, effectiveness, safety
- May assist in future assessments, research
Sections in a Formal Bx Plan
- Basic identification info
- Rationale for bx services
- Consumer profile
- Diagnoses & medical info
- Medication list
- Functional assessment procedures
- Problem bx (reduction targets)
- Likely Reinforcers
Sections in a Formal Bx Plan
con…t
- Replacement bx (acquisition)
- Other target skills for development
- Intervention: Rationale & procedures
- Target Env
- Response measure(s) & data collection procedures
- Training plan for prog implementers
Sections in a Formal Bx Plan
con…t
- Monitoring plan/ treatment integrity checks
- Generalization & maintenance plan
- Service authorization recommendation
- Signatures and consents
Core elements of a behavior plan include target behaviors and _____. Additional information that is useful but not essential includes elements such as _____ and consumer profile.
*Functional assessment data, residential status
Section 1: Basic Information
- Consumer name
- Date of birth
- Date of original plan: 3/22/19
Rationales and Outcomes
- The rationale should be tied to an outcome statement
- Outcomes are statements about lifestyle changes
- Identified by individual (or others serving as guardians) as a personal goal/ dream to fulfill
- Stated as something concrete that the person wants to achieve or change about thr life
Rationales and Outcomes (Con…t)
*Rationale (intervention) goals should be:
-Stated in observable & measurable terms
As distinct from “short-term objectives” which are numerical bx targets
-Based on client preferences & social validity
*ANyone reading this section can quickly identify the current reason for & long-term purpose of the behavioral service
Rationales and Outcomes E.g.
- Rationale intervention goal:
- “Decrease Don’s disruptive bx in class”
- Achieving that goal will help lead to a long-term outcome:
- Don will graduate from high school”
Section 3: Consumer Profile
*The section that provides important info regarding the consumer’s background, preferences, current living & vocational status & any other characteristics that may contribute to the success or failure of the behavioral service
Section 3: Consumer Profile
- Descriptive info, including (but not limited to):
- Living situation (e.g. family profile)
- Educational status
- Work status
- Preferred & least preferred activities, foods, ppl
Section 3: Consumer Profile (Con….t)
*Descriptive info (con..t)
-Special skills/ strengths
-Functional deficits
-Imp social relationships
-Other salient professional services
Those related to functional/ diagnostic prob resulting in ABA services
Information such as where the client lives, and a description of their living situation would be found in which section of a behavior plan?
-Consumer Profile
Rationale for services should always be tied to outcome statements for the client.
a. True
b. False
a. True
Cardi relies on caregivers and direct care staff for many hygiene and daily living activities. The goal of the plan is to teach her the skills required to move into an assisted living facility.
*Rationale
Why include Medical Info
- Medical disorders/ chronic conditions can have behavioral manifestations
- The bx analyst should have (or obtain) training required to address these issues (e.g fragile X syndrome, sight or hearing impairment)
Importance of Medical Information
*Copeland and Buch (2020) state:
-“Behavior analysts protect both their clients & themselves by making sure that they do not treat the behavioral manifestations of undiagnosed or unrecognized medical or environmental conditions”
Diagnostic and Medical Info:
An Ethics Reminder
- A bx plan is a confidential document
- Typically covered by HIPAA constraints
- Releases must be obtained to share info from a BIP
Behavior plans are typically not covered by HIPAA requirements.
a. True
b. False
b. False
Section 5: Medication List
- A medication can be prescribed to:
- Produce a positive clinical effect on a prob bx
- Address a different medical issue-but can still affect an individuals; bx
- This section must be updated on a regular (as needed) basis
Why Include Medication Info
- Many clients have a medical diagnosis related to their behavioral services
- Medication can have direct & side effects on bx
- Withdrawal or rebound effects can occur when a medication is reduced
- Coordination of services is needed
Psychotropic Medication
*Medication typically prescribed to treat the symptoms of a psychiatric or behavioral disorder
Side Effects of Medications
*Physiological effects of a medication other than the clinically targeted effect
A recent survey indicated that around _____ of children with autism are prescribed some form of medication.
-50%
Functional Assessment Procedures:
Descriptive Assessment
- Functional assessment info:
- Assessment tools utilized (e.g. published interview formats)
- Who was interviewed
- # of direct observations made
- Time period of assessment
- Pattern analysis & sequence analysis results etc
Functional Assessment Procedures:
Functional Analysis
- This section should also outline any functional analysis procedures
e. g. A.B functional analysis, brief FA. analogue FA, IISCA etc - Functional analysis data & charts enhance the professional weight of the formal document
Section 7: Problem Behavior
- Lists target Bx for reduction with a clear operational definition for each
- Categorical terms maybe used (e.g. SIB, property destruction) but such terms require response definitions that clearly describe individual topographies
- This is an area in which you will be doing a lot of revisions as your program matures!
Topographical Response Definition
- Responses defined based on the physical features or form of the response
- What the bx looks like
Functional Response Definition
- Important for bx that has been determined to have multiple functions
- Responses defined in relation to thr occurrence in the presence of particular antecedents or consequences
- The antecedent condition provides the key info on the Motivational variables
- The intervention section will outline the plan for different function-based consequences
“Forceful physical contact with a pet for at least 5 seconds that results in the pet growling”
*Problem Behavior
Interviews were conducted with both parents, direct observations were completed in the home, and ABC data were collected during mealtime.
*Functional Assessment Procedures
Response Definitions Vs. Functional Response Definitions
*Some response definitions focus strictly on topography
*However….are all these screams the same?
-Scream to get someone’s attention
-Scream to be left alone
-Scream in pain
What’s Different?
The Reinforcer, The evocative antecedent, The Function of Bx
What Do You Do?
*Thus for “Screams” with different functions your bx program needs…
Differential Functional Response definitions
2 Separate Problem Behaviors
*Behavior 1: Screaming in Task
- Use interventions specific to bx maintained by socially mediated negative RX:
- Stimulus (task) fadein, high-p, response blocking, DNRA
2 Separate Problem Behaviors (Con…t)
*Behavior 2: Screaming when out of task
-Use interventions specific to Bx maintained by socially mediated positive RX: NCR, DRA, mand training etc
Revising Response Definitions
- Sometimes during trt, an original response definitions fails
- Loses stimulus control over caregiver Bx
- No longer adequately describes the full range of target topographies
Precursor Behavior
*Bx that reliably precedes another in time
*Predicts the upcoming onset of the target Bx for reduction
-Precursors tell you an EO is in effect & possibly getting stronger
‘Valuable teaching opportunities
Section 8: Likely Reinforcers
-A list of activities, stimulus conditions, edibles, recreational items etc., which have been determined as likely to function as reinforcers
*Determined via interviews, observations & the functional assessment process
Remember: Reinforcers are context & EO specific
Reinforcement Is a Process,, Not a Thing
*Remember
- A stimulus can function as a reinforcer in a specific context & in the presence of specific MO
- Ppl do not “have reinforcers,” ppl are not reinforced
- BX is reinforced under certain conditions
- Nothing ALWAYS functions as a reinforcer
Preference Assessment
- A choice procedure that helps determine what might function as a reinforcer at a particular point in time
- It is NOT a reinforcer assessment
- It does NOT test the effectiveness of a stimulus as a Bx-strengthening consequence
Preference Assessment
Con..t
- Can be part of ongoing trt
- Preferences can change quickly
- Not a static “assessment finding”
- Often used as a regularly occurring part of an early intervention trt protocol
- Can help RX-based strategies be more effective
When listing preferred stimuli in a behavior plan, which statement would be best to use?
*These Stimuli are potential reinforcers
Section 9: Replacement Behavior
*Skill targeted for strengthening, to replace a Bx targeted for reduction
2 Types of Replacement Bx
1. Functionally equivalent BX
2. Non functionally equivalent BX
Functionally Equivalent Replacement BX
- Response that matches the functional outcome of a bx targeted for reduction
- I.e. it results in the same Env change after its occurrence
Functionally Equivalent Replacement BX (Con…t)
- A target Bx for reduction is an effective member of a functional response class
- Fair Pair Rule: Decrease 1 functional response, increase another
- When we weaken 1 response, ethics requires us to provide an equally effective way for that person to meet that functional need
NonFunctionally Equivalent Replacement Behavior
- Replacement Bx that does not share the same function as the Bx targeted for reduction
- i.e., it does not result in the same Env change after its occurrence
NonFunctionally Equivalent Replacement Behavior
Con…t
- Sometimes a replacement Bx can’t have the same function as the target Bx for reduction
- A prob response may need to be replaced with a response that has a different function
- This can be ticky, but necessary
Replacement Bx & Antecedent Interventions
- Antecedent interventions focus on just such probs
- If an antecedent condition (e.g. task presentation) functions as an EO for escape, antecedent manipulations can alter the EO
Problem Behavior and Antecedent Interventions
- The goal is to reduce the establishing operation that evokes the prob Bx in the first place
- Stimulus fade in
- High-p
- Errorless learning
Section 10: Other Target Skills
- Engaging in an appropriate skill can be a replacement bx
- Some target skills are functionally related to a prob bx, others are not
- But when a person engages in appropriate skills, prob bx occurs less over time
Section 11: Intervention: Rationale & Procedures
- The program rationale states why particular interventions are appropriate & necessary
- Based on the FBA
- Social validity issues included
- Fit with the env
- Support from the stakeholers
Section 11: Intervention: Rationale & Procedures (Cont…d)
- The procedures section outlines the planned interventions to reduce prob bx & increase skills (including replacement bx)
- The interventions are described in 2 formats
- The formal plan
- The step by step plan 0.53 8.12
