At the time of the initial referral, BCBA’s (Board Certified Behavior Analysts) are often asked to help solve a problem, and one of the first steps is to observe the problem in action. When we arrive to observe the problem, we often find a chaotic situation: The classroom doesn’t have enough staff, many other children are engaging in problem behavior, the child has three other siblings that are running around, the dog is constantly barking, the noise is overwhelming, etc.
Sometimes the chaos is planned and appropriate (Recess!) Other times the chaos is so out of control or the situation so inappropriate for the particular child’s needs that the only solution will be to remove the child from that environment. But most of the time, that’s not the case. Most of the time we can modify the chaotic environment enough for successful intervention to occur. Often, treatment can occur directly in the main environment of concern (e.g., classroom, home with siblings). If you are facing a situation that can be solved in the target environment- that’s usually best. You have a much better shot at generalization and maintenance.
Chaos can lead to a big conflict. Often chaos is just part of life, and the child has to learn to be successful in that environment. But chaos creates an assessment and treatment challenge. It makes is hard for behavior analysts to do the “analysis” part of their jobs. In addition, sometimes the proper treatment simply can’t occur in the target environment. What to do?
First, realize that you should definitely go observe the chaos. Sometimes we think that isn’t necessary. What am I going to be able to do in that environment? Let’s get him into a 1-1 environment; a clinic, private school, etc. But it is for a variety of reasons it is essential:
- You need to see the problem for yourself in order to ensure that the referral is legitimate, the problem really requires treatment, and it is an important enough problem that it is worth solving.
- You can ensure that the behavior is observable and measurable.
- You need to document the occurrence / non-occurrence of the behavior of interest in the target environment
- You need the baseline to evaluate the effects of any intervention.
- You need to ensure that the problem fits within your area of competence and you have the skills and experience needed to handle the problem
- Taking the time to observe can help build rapport with caregivers (e.g., parents, teachers, paraprofessionals, RBTs). If you don’t observe, sometimes they won’t believe that you really understand what they are going through on a day-to-day basis.
The problem comes when we spend too much time trying to do an analysis of the chaos. Often, we start doing a sophisticated analysis of antecedents, consequences, variability of the data, trends, functions, motivating operations, setting events, etc. Certainly, this process can work sometimes. There are examples in the behavior analytic literature. But someone wins the lottery too. Usually this process is unreliable and unproductive. Often the data vary by random uncontrolled variables: Today was an assembly. Mrs. Jones came for a sing-a-long. She does that 1X per month. Mom was out of mac & cheese. There was a fire drill. His brother doesn’t usually hang out, but today he wanted to play on the iPad too, etc. etc.
My suggestion on how to proceed is to set up the service in a way that allows you to be analytic and have useful data. This often means making changes to the environment or completely changing to a new environment allowing you to do the careful analysis you were trained to do. That means progressing systematically in a step-by-step fashion. Don’t try to do everything at once. We are going to start with these three behavior changes from 9:30-10:30 4X per week. Then we will move on to the next set of concerns. Keep going until you have a socially significant outcome.
Just remember that our goal is not success in therapy, but success in real life. If all you achieve is behavior change in therapy, and don’t have time for the generalization and maintenance, maybe this wasn’t an important enough problem to work on in the first place.