I have frequently discussed on this blog that while ABA has been extremely successful in the treatment of problem behavior, there is a very high risk that the effects will not last over time. That’s probably because the new behavior changes did not work under real world conditions. This has been understood since the earliest days of our field. Teodoro Ayllon and Nathan Azrin called this the relevance of behavior rule. The rule simply states that you don’t change any behaviors that won’t work in the real world after treatment ends.
This puts BCBA’s in a conflict. On the one hand, we want to focus on the long term to ensure that our treatment will work in the real world and maintain over time. On the other hand, we have pressure to handle immediate problems. The parents are upset about the behavior in church or not being able to find a babysitter. The art teacher is complaining about behavior in class, the social worker wants intervention on peer interactions, and the bus driver says he won’t stay in his seat.
The basic problem is that we only have one good long-term solution. That long-term solution is to teach the skills needed to be successful in natural situations. It requires careful programming done in a step-by-step fashion until successful. Unfortunately, for many children, that can take a significant amount of time. It is not likely to help the bus driver worried about tomorrow’s ride. If you try to put the long-term solution into effect in every natural situation, right away you will almost certainly fail to be successful.
Now, we do have a lot to offer that may help all those other situations relatively quickly. But those procedures are not long-term solutions. Those are short-term fixes to get us to the point where the long-term solution becomes possible. But those short-term fixes can actually look really good for a long time. Don’t get fooled by the data. You need to do a lot more to ensure long-term success.
In my view, in most cases, the solution to the problem is comprehensive treatment with two behavior plans. First (and most important); a plan to teach the necessary skills to ensure success over the long-term. Second; develop procedures to immediately help parents, teachers, and others who interact with the child. Those procedures will likely look very different from the procedures we are using to build the long-term skills. Although this is different than the traditional advice, I think the logic of two behavior plans is compelling.