What Does It Mean to Say You Want to Improve?

If you ask most people, they will report that they honestly want to improve and do everything they can to continuously Poogi over time. Though they may think they mean it, they often don’t. As I’ve argued before, many of us are overconfident. Simply put, many BCBA’s think that they are better than they really are.

What do most people mean when they say they want to improve? They mean they want ideas that might be called “tweaks.” –Here is a new book with great social skills activities we can add to the mix. This is a new great assessment device that is very helpful in pinpointing skills for activities of daily living. Here is a great tip for initial staff training. In other words, since many of us think we are so great, we don’t think massive improvements are possible. As long as we aren’t a HINIBUS, we are happy to make small changes.

Though many of us work long hours and follow the latest research, we know that not all children have fantastic outcomes. We think we are doing everything possible. But we aren’t.

Sure, we can be happy to accept small changes that are improvements. But if we really want to improve, we have to believe that no matter how good you are, massive improvements are possible. I’ve discussed some of those massive improvements – here and here.

But how can we prove that massive improvements are possible? Maybe what we are doing with our current resources is the best possible? As we know, it is incredibly difficult to measure program quality well. I’m glad that many are trying and I’m hopeful about that research, but as far as I’m aware there is nothing very convincing so far.

Admittedly, my position is not based on science, but faith that science will continually lead us to better answers. But I do know that if you don’t believe it is possible to significantly improve, you will stop trying. If you believe your program doesn’t have massive room for improvements, you are almost certainly wrong.

 

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 “P” in POOGI

Poogi stands for the Process of On-Going Improvement. Many people think this is just another way of saying, continuous improvement, life-long learning, or other similar phrases. But there is a key difference between POOGI and those similar phrases. That’s the “P” for Process. What does it mean to have a process? We typically think of a “process” as a series of steps used to get a result. In Theory of Constraints, POOGI has a more specific meaning than is beyond my scope for today.

The internet reports that Deming said, “If you can’t describe what you are doing as a process, then you don’t know what you are doing.” I think this is statement is correct. We should be able to describe what we are doing as a process.

When a parent, school district, insurance company, or other person asks us how we will proceed with treatment, the BCBA should be able to clearly describe the step-by-step process we will use. If we can’t do that, it is reasonable to assume that we don’t know what we are doing.

Unfortunately, some BCBA’s don’t have a standard process and so the results are haphazard. Some BCBA’s can describe their process beautifully, but when you observe the actual implementation of the program, you see that those processes are not followed. I’ve seen both. Having a standard process that is used in reality is a key step in building the POOGI for any organization.

Once we have a standard process, we can fight like hell about how to improve the process. We can say, you know what, step 7 sucks. Let’s ditch it. Step 12 occurs too late in the process, let’s move it to step 4. But if you don’t have a standard process, the POOGI becomes impossible.

In my view, that is one of the hidden benefits of the new PFA (Practical Functional Assessment / IISCA) and SBT (Skills Based Treatment) developed by Greg Hanley and colleagues. Before PFA/SBT, there were clearly described processes in the research literature, but very few BCBA’s used them in practice.

The new PFA/SBT process is being used consistently by a very large number of practitioners. Now, we can get down to the POOGI of fighting over the effectiveness of different steps in the process. In the last several years I’ve been working on it, I’ve seen major shifts in many aspects of the process. That’s a great thing. That’s the POOGI.

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.

I Can Drive 55

Maybe Sammy can’t drive 55, but I sure can. I know driving is one of the most dangerous activities I engage in daily. In the United States, we consistently have more than 30,000 deaths every year due to motor vehicle accidents.

30,000 people sound like an enormous number to lose every year due to a trip to the store, going to work, or a visit to grandma. Yet this represents a dramatic reduction in deaths despite a bigger population with more drivers over the last 40-50 years. Probably the reason that there has been such a tremendous amount of improvement is due to advancements in technology like seat belts, airbags, and other innovations. It seems highly unlikely to me that modern drivers are dramatically better than drivers in previous generations.

My question is; can behavior analysts save even more lives by teaching people to consistently drive safer? I know there are behavior analysts that work in traffic safety, and I don’t know much about their work. But I think the first question is: Does society even want us to improve traffic safety?

Initially, most people think “of course.” But what if it meant that cars couldn’t go over 15 miles per hour so your commute increases from one hour to four hours? What if driving was not nearly as much fun after eliminating distractions?

In most activities in life, you cannot eliminate risk. Our goal is usually to keep the benefits while reducing risk as much as possible. In the treatment of people with severe behavior problems, there is always some risk of danger due to the unpredictable situations that may occur. Families are willing to accept some level of risk for the chance of significant life improvements.

We often choose between safety and effectiveness. For example, when we drive, we can go slower for safety or faster to get to work on time. Fortunately for us, recent improvements in the treatment of severe behavior problems developed by Greg Hanley and colleagues have made that decision less difficult. The Practical Functional Assessment (PFA) and Skills-Based Treatment (SBT) process allows us to have a much higher level of safety while still effectively improving outcomes for children.

 

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.