The Tag Goes in the Back

I was once working with an adolescent who could dress independently, but often put shirts on backwards. At the time, it was one of his goals, and I was on a mission to teach this to him. I came up with numerous instructional programs that failed. Some of those included giving fake instructions: The tag goes in the back; there is no tag in the front. I had some more reasonable ideas too, like attaching a giant piece of paper to the tag and trying to fade it out, a variety of prompting and fading procedures, and I’m sure many, many more that I forgot. At the time, I was spending time in AOL chat rooms to get advice (AOL chat rooms was the 1990s version of an inconvenient group text without a phone). I also reached out to famous behavior analysts who were happy to offer email advice or in-person at conferences.

Eventually, I managed to find an effective teaching procedure. It was very exciting! Keep trying until you find a way to be effective. Of course, I did multiple exemplar training to make sure he could do it with a wide variety of shirts, with different people, and in different locations. Mom called and said that he was doing it at home!

About 3-4 weeks after the program was over, I was maintaining it about 1X per week. Then, I noticed he came in with shirts with no tags. This happened a couple of weeks in a row. I called the parent, who reported the tags were bothering him so she cut all the tags off of all his shirts, removing the only indicator he had learned to determine the front from the back.

Success is judged by what happens after the program is over. This program took enormous amounts time and effort, and it was a waste of everyone’s time. It was an enormous opportunity for me to Poogi, though. In practical situations, if you look at what happened to many programs on last year’s IEP or insurance treatment plan, you will find this effect happens all the time. Everyone is so busy. There is so little time. What if we only worked on teaching things that were important enough to matter in the long run?

Behavior analytic services should only be delivered in the context of a professional relationship. Nothing written in this blog should be considered advice for any specific individual. The purpose of the blog is to share my experience, not to provide treatment. Please get advice from a professional before making changes to behavior analytic services being delivered. Nothing in this blog including comments or correspondence should be considered an agreement for Dr. Barry D. Morgenstern to provide services or establish a professional relationship outside of a formal agreement to do so. I attempt to write this blog in “plain English” and avoid technical jargon whenever possible. But all statements are meant to be consistent with behavior analytic literature, practice, and the professional code of ethics. If, for whatever reason, you think I’ve failed in the endeavor, let me know and I’ll consider your comments and make revisions, if appropriate. Feedback is always appreciated as I’m always trying to POOGI.

Lessons BCBAs Can Learn From “Don’t Touch Your Face”

By now, you have probably seen the videos of numerous public health professionals and other government leaders telling people to not to touch their face to avoid spreading the Coronavirus. Ironically, even as they are telling us not to do that, they are touching their faces.

Clearly, there are problems with this advice:

First, it misses one of the most basic rules of changing behaviors—Don’t emphasize what the person should not do. Instead, emphasize what the person should do. In this example, they could have advised us to keep your hands in your pockets, wear gloves, or keep your hands folded.  While I think it’s fine to include “don’t do something” as part of a behavior plan, it’s essential to state precisely what the student/client should do instead.

Second, it is not specific enough to follow. They don’t literally mean “never touch your face.” I’m confident they think it is OK to wash your face, put on your glasses, shave, or apply makeup. The advice really means something more nuanced—maybe like this:

When you are in a public gathering and you have an itch on your face, you should wash your hands both before and after you scratch it.

Not sure if that’s what was meant, but you get the idea.

Third, of course, no one is forcing you to touch your face. But this advice fails to appreciate that people cannot easily change behaviors that they do unconsciously. You don’t think to yourself “Hmm, I have an itch on my nose. Let’s decide if it is worth addressing. I know I want to avoid touching my face, but this itch is annoying!” No, you were already scratching it before you were aware you were doing it. Now, behavior analysis has an extensive literature on changing this type of behavior called Habit Reversal or Self-Management. But that’s a big project. Anyone familiar with that literature will realize that 98% of people are going to fail at this behavior change unless they put in a major effort to change it.

Most people will fail at their attempts to “don’t touch your face.” It makes for great video. We should know better, but often we don’t. If you sit in on meetings for parents of children with autism (even with BCBAs), you hear similar recommendations made all the time— “Don’t give in if he has a tantrum” or “Insist that he at least tastes the vegetables at dinner.” Those recommendations are about as effective as saying “Don’t touch your face.”

Behavior analytic services should only be delivered in the context of a professional relationship. Nothing written in this blog should be considered advice for any specific individual. The purpose of the blog is to share my experience, not to provide treatment. Please get advice from a professional before making changes to behavior analytic services being delivered. Nothing in this blog including comments or correspondence should be considered an agreement for Dr. Barry D. Morgenstern to provide services or establish a professional relationship outside of a formal agreement to do so. I attempt to write this blog in “plain English” and avoid technical jargon whenever possible. But all statements are meant to be consistent with behavior analytic literature, practice, and the professional code of ethics. If, for whatever reason, you think I’ve failed in the endeavor, let me know and I’ll consider your comments and make revisions, if appropriate. Feedback is always appreciated as I’m always trying to Poogi.

The Columbo Method

Columbo was a TV show that aired periodically from 1971-2003. Most episodes begin by showing who the murderer is and exactly how the murder was committed. Then, the show is all about how Columbo solves the murder, with the main focus on his interview techniques. One of my professors in graduate school recommended the show as a way to study how to do an interview for Functional Assessments, typically conducted as a first step in determining why a student is engaging in problem behaviors. At first, emulating Columbo might seem like a bizarre suggestion, but there are useful things we can learn from the show. I believe watching Columbo has made me a better interviewer.

Conducting interviews is one of those subtle social skills where it is very hard to specify exactly what we want the interviewer to do during the discussion. Conducting an effective interview is much more than reading the list of questions and transcribing the answers from the parent or teacher. It is often a delicate situation as people are often upset and emotions are high. How should the interviewer respond if the parent starts crying? If the teacher starts to get angry that this is a waste of time? If the paraprofessional starts blaming the administration for all the problems at the school? Social skills are tricky because you can’t specify in advance what to do for each and every scenario that might arise.

There is no substitute for experience, but I think watching Columbo is helpful in giving us general interview guidelines. First, he is very curious. He wants to know every little detail. Second, he listens to what the person says very carefully. Third, he looks for contradictions with what the person says and the evidence. When he sees it, he is always “confused” and asks further questions to clarify in as non-confrontational a way as possible. Finally, he is almost always extremely polite.

On the other hand, Columbo frequently is so annoying that he upsets the person he is interviewing. He wears an old, rumpled raincoat, always forgets his pencil, and gets cigar ashes everywhere. More importantly, he lies and withholds information all the time. Therefore, knowing what you should copy and what you shouldn’t is important. Still, I think anyone who has to interview people as part of their job would benefit from watching a few episodes. It leads to good discussions when teaching people about how to conduct interviews.

Behavior analytic services should only be delivered in the context of a professional relationship. Nothing written in this blog should be considered advice for any specific individual. The purpose of the blog is to share my experience, not to provide treatment. Please get advice from a professional before making changes to behavior analytic services being delivered. Nothing in this blog including comments or correspondence should be considered an agreement for Dr. Barry D. Morgenstern to provide services or establish a professional relationship outside of a formal agreement to do so. I attempt to write this blog in “plain English” and avoid technical jargon whenever possible. But all statements are meant to be consistent with behavior analytic literature, practice, and the professional code of ethics. If, for whatever reason, you think I’ve failed in the endeavor, let me know and I’ll consider your comments and make revisions, if appropriate. Feedback is always appreciated as I’m always trying to Poogi.

The Best in the World

It is amazing to me how many times over the years that I have met the best therapist, teacher, technician, or behavior analyst in the world. When I go visit programs (which I love to do!), whether schools, homes, clinics, or anywhere, people get introduced as “XXXX is the best in the world!”

Certainly, sometimes this is just an overly enthusiastic supervisor and they don’t really believe that the person I’m meeting is the best in the world. But I’m going to tell you that often they do!

It is common for people to think that their performance is better than the average person. There is an abundance of research examining this phenomenon. For example, this research found in their sample of US drivers 93% thought they were in the top 50%.

I think it is worth it for BCBAs, parents, teachers, and RBTs to be aware of this research. It is very easy to be fooled by the data or the story problem. I don’t believe this type of research has been done in behavior analysis, but based on the number of “best-in-the-world people” that I’ve met, I’m willing to bet on what would be found. Whenever you hear someone say something like “who could possibly be better than Cathy, Fred, or Kendra,” look out. Your program is probably not as good as you think it is.

When I was young, I read Sam Walton’s autobiography where he describes how he started Walmart. I don’t really remember much about that book. But I do remember him describing constantly visiting as many of his competitors’ stores as he could. Even if the store was in terrible shape, he could often find something they were doing well and say “why aren’t we doing that at Walmart?” It is what encouraged me to go on as many tours of programs for children with autism as possible. The easiest way to Poogi is to simply steal what other people are doing well. But first, you have to realize you are probably not the best in the world. No matter how good you are, there is room for tremendous improvement.

Behavior analytic services should only be delivered in the context of a professional relationship. Nothing written in this blog should be considered advice for any specific individual. The purpose of the blog is to share my experience, not to provide treatment. Please get advice from a professional before making changes to behavior analytic services being delivered. Nothing in this blog including comments or correspondence should be considered an agreement for Dr. Barry D. Morgenstern to provide services or establish a professional relationship outside of a formal agreement to do so. I attempt to write this blog in “plain English” and avoid technical jargon whenever possible. But all statements are meant to be consistent with behavior analytic literature, practice, and the professional code of ethics. If, for whatever reason, you think I’ve failed in the endeavor, let me know and I’ll consider your comments and make revisions, if appropriate. Feedback is always appreciated as I’m always trying to POOGI.

Prompting and Fading is Not Teaching

Prompting and fading procedures in textbooks, journal articles, and many trainings sound very neat and organized. They’re super simple, parent friendly, and the skill is mastered in no time. You might vocally prompt a child in what to say in a social situation; physically prompt a child how to dress; and model how to play with toys. Then, you systematically fade the prompts, and wow—the child has a new skill!

There is a lot of research supporting the use of prompting and fading procedures—studies show they are extremely likely to be effective. But in practice, often things don’t go nearly as smoothly as described in the research literature. I’ve seen children who, despite thousands of trials, are not acquiring skills. And we’ve all seen the child who becomes “prompt dependent” and doesn’t respond without a prompt.

If the research is so strong, why do these procedures go wrong in practice so often? There are a lot of possible answers:

  • There are so many different ways to prompt and fade. We simply used the wrong procedure for the situation.
  • The child didn’t have the relevant prerequisite skills to be successful with this skill.
  • Certain types of prompts are inherently more difficult to fade.

Sure, all these are possible—sometimes. But I don’t think they are the most common reason that attempts to prompt and fade fail. I think the problem is that often, when we train people to do prompting and fading, we sometimes give the misleading impression that the prompting and fading is teaching. That’s easy to do since that is what people see when they watch videos and demonstrations of prompting and fading.

The question to ask is why are we use prompting and fading procedures in the first place? The answer—we prompt and fade only so that we have the opportunity to reinforce at just the right moment. Prompting and fading procedures don’t usually work in isolation. They work by giving the BCBA, RBT, parent, teacher, or paraprofessional the opportunity to give feedback through reinforcement. Then, we slowly require more and more from the student over time. Prompting and fading doesn’t work without the feedback. If there is no feedback, or if feedback is given at the wrong time, learning is unlikely.

I’ve made this mistake so often that about ten years ago, I started to work hard to make this explicit in my trainings.  I’ve experimented with quite a few ways to make this point, and it has been getting better and better ratings over the years. Of course, it is still on a Poogi. It isn’t easy to train people this way, but it’s worth it. Once people understand this point, they will dramatically improve their teaching.

Behavior analytic services should only be delivered in the context of a professional relationship. Nothing written in this blog should be considered advice for any specific individual. The purpose of the blog is to share my experience, not to provide treatment. Please get advice from a professional before making changes to behavior analytic services being delivered. Nothing in this blog including comments or correspondence should be considered an agreement for Dr. Barry D. Morgenstern to provide services or establish a professional relationship outside of a formal agreement to do so. I attempt to write this blog in “plain English” and avoid technical jargon whenever possible. But all statements are meant to be consistent with behavior analytic literature, practice, and the professional code of ethics. If, for whatever reason, you think I’ve failed in the endeavor, let me know and I’ll consider your comments and make revisions, if appropriate. Feedback is always appreciated as I’m always trying to POOGI.
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