Probably the Most Important Decision a BCBA Has to Make

In programs based on Applied Behavior Analysis, it is fairly rare for the BCBA to be the one working directly with the client. In the vast majority of situations, the BCBA is acting as a consultant or supervisor to a parent, paraprofessional, Registered Behavior Technician (RBT), or teacher guiding how to implement behavior change programs.

The BCBA typically will have a written document that explains how to implement the behavior change program. Then the BCBA does training on the implementation of the plan, ensures the integrity of the implementation through observation, provides both positive and negative feedback to implementers, reviews the data, problem solves when the data do not show progress in the desired direction and makes appropriate adjustments to the plan if needed.

Most people with experience will realize it virtually never works like that in reality. One basic problem with this traditional view is that it makes it sound like the BCBA makes all the decisions. If you aren’t getting feedback on what can be improved from the people implementing it, the program will be weak. Making those decisions needs to be a collaborative process. But should the BCBA even be consulted on routine day to day decisions?

Some BCBA’s want to be involved in every single decision. The program says he gets to play with trains as a reinforcer, but today he wanted to color. Is that allowed? Should the prompt be delivered after two seconds or five seconds? Some days he is very distracted by looking out the window, can I close the blinds? As a general rule, if the staff doesn’t have enough training to handle daily routine decisions, the program is likely of poor quality and progress is sure to be very slow.

On the other hand, there are BCBA’s that try to stay out of the insignificant details. They try to focus on teaching the basic behavioral principles and let the people implementing apply those principles. That can certainly work, sometimes. But there are terrible programs where the BCBA is overloaded with too many cases and staff are making decisions all the time without sufficient training. They don’t understand the basics well enough to make good decisions. This often has disastrous results.

Every time a BCBA supervises a program, there is an essential decision to make. How much autonomy do I allow from the implementers? There might be a variety of factors involved in making that decision. Things like the experience and training of the implementer, how often the BCBA will see the client, the complexity of the procedures, safety issues, among others. Both too little autonomy and too much autonomy will likely lead to terrible results.

In my view, this one decision often results in how successful a program is likely to be. Think it through carefully.

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.

People Magazine Did Not Name Me Sexiest Man Alive

People Magazine has never named me the sexiest man alive, even when I was younger. 1 I’m only mildly disappointed by their oversight. It hasn’t had a substantial impact on my life to this point. I’m sure I could improve, but I’m not focused on it.

Every aspect of our work and personal life can be substantially improved. We can improve supervision, report writing, training, scheduling, data collection, and every other aspect of our work. No child’s program is perfect; we can improve assessment, teaching procedures, organization of materials, and every aspect of a child’s program. We can all improve our diets, exercise, sleep, relationships, and finances.

Poogi (The Process of On-Going Improvement) does NOT mean improving everything all the time. That’s a sure way to have poor results. You simply cannot focus on everything. The good news is that you don’t have to. First, you have to select a reasonable goal that isn’t completely out of reach, which is sometimes a problem in applied behavior analysis. Second, only try to improve one or two areas at a time. That’s plenty.

Often, an improvement in one or two areas can lead to huge improvements in many areas. For example, if you improve problem behaviors, often language, social skills, academics, and self-help improve too. If we improve supervision, often employee morale, turnover, and client results also improve.

Of course, if you have a long enough time horizon most goals become possible. Does People Magazine have an over-80 category?

1 The ethical code of the BACB (8.01) requires that BCBA’s ensure that they do not make public false statements. Therefore, on this blog, I attempt to make sure that all statements are thoroughly fact-checked. In this case, due to time constraints I did not check People Magazine to ensure the accuracy of this statement.

 

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.

Is That What He Would Do in Real Life Situations?

Often when parents, teachers, or others observe a behavioral assessment, they report that how he behaves in the assessment isn’t how he behaves in real life! There is an understandable concern that the BCBA did not get an accurate picture of the real problem they are facing.

For many years, researchers (and very, very few BCBAs who work with clients for a living) have put kids in a very special situation to assess their challenging behaviors. This situation is called a “functional analysis.” The results were highly useful in designing treatments that dramatically improved outcomes – at least in the same context as the assessment. But how likely is it that the results of the assessment show how the behavior works in real-life situations? Well, we don’t know. That’s just assumed. And we know what happens when you assume. It is quite understandable that no one has researched this question (as far as I’m aware). It would be very difficult to show convincingly that what was found in a highly controlled environment is the same as real-life situations that have so many more variables and are completely uncontrolled.

As usual, I think Don Baer (Pages 304-305) had it right. In 2000, when talking about how likely it would be that the results of a functional analysis would show what happens in real-life situations, he said:

“…. it has a fair chance, I don’t think a high chance, but I think a fair chance of showing how this person’s behavior actually works in the real-life settings where it is a problem. Sometimes it will do that. Sometimes it will fail to do that.”

Certainly, the assessment can capture how behavior works in the real world–sometimes. But looking at the research literature, it seems clear to me that we do have at least some evidence that if often fails to do that. That’s because when tiny adjustments are made to the assessment procedures, we can get substantially different results. In real-life situations, there are an enormous number of things changing all the time. Although it’s very hard to do the research, I believe that Baer’s argument of a “fair chance” is actually optimistic.

On the other hand, Greg Hanley argues that maybe that isn’t such a big problem. We used to think that the mission of assessment was to act like detectives and determine how the behavior works in the real world. Research seems to be suggesting that even thoroughly understanding how the behavior works in at least one important context may be enough to allow us to teach critical skills that will make a socially significant difference outside of therapy. As always, much more research is needed. But I’m optimistic that we can be dramatically more successful with children with severe problem behaviors than we might have been just 5 or 6 years ago before the recent research had been published.

 

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.