POOGI for ABA

In another lifetime, I worked as a waiter at a chain restaurant. Every month or two, the district manager would visit and order as a customer. Everyone was afraid to wait on him as he always left critical notes on the “comment card.”  Somehow, I’ve always been relatively insensitive to criticism, so I would end up waiting on him since no one else wanted to do it. It didn’t bother me much. Every time I waited on him there would be a critical comment. He could always find something wrong. I remember one time he wrote “the bacon was placed on the bacon cheeseburger at the incorrect angle.” Finally, one time he wrote on the card “adequate.”

After he left, the manager of the restaurant was ecstatic! He hung the comment card on the wall, and everyone enthused for days about how the team served the district manager, and he couldn’t find anything to criticize.

Perhaps not surprisingly, with such bad management the restaurant did not do well in the long run. I left for graduate school, but the manager and the assistant manager departed in a very dramatic fashion, requiring that same district manager to run the restaurant for months. The restaurant eventually closed. The whole chain has been closing restaurants for many years, although they are still in business.

Of course, we understand that such poor management practices are likely to lead to problems.

Surely, an Organizational Behavior Management (OBM) intervention would have led to dramatically superior performance. But I think there is something more we can learn from that district manager.

The problems with being too negative are obvious. But problems can also arise if you are too positive. Specifically, I’ve seen some BCBAs that are so positive the staff don’t think they have any need to improve. This can lead to overconfidence. This is terrible for your Poogi.

This leads to a staff who think they are the best in the world and are simply not trying very hard. You have to be skeptical of your stories. The first step in the POOGI is realizing that there is a need to improve. No matter how good you are, there is always dramatic room for improvement.

Once I was involved in the long-term treatment of a child with severe behavior problems. The treatment was by all measures a huge success:

• Problem behavior reduced to zero for several years.
• Huge increases in language, social skills, academics, and general education participation.
• Strong generalization–able to work with many different people who had received training.
• Parent training was conducted, and the student was very successful at home.
• Behavior plan was very complex initially, and then faded to a very simple, practical, and easy to implement plan.
• Very high satisfaction among teachers, therapists, school district leaders, and parents.
• The student was improving in a wide variety of language and academic skills programs.

After a few years, the child lost funding. A new team took over to reduce costs. We had warned the new BCBA that the new therapist had inadequate training. Within three months, severe behavior problems had returned. I had the opportunity to see this child 3-5 years later when the student was placed in a segregated school that served children with severe behavior problems. It was apparent that the behavior was so severe at this point that it was likely to be life-long problem.

For many years after this experience, I questioned “what else could I have done?” If the funding source reduces expenses and puts a low-quality team in place, nothing can be done about that. Not my fault. Right? Wrong. It is easy to blame the team that took over. Why didn’t the new BCBAs do X, Y, and Z? But that’s the wrong approach to the Poogi. Now I understand I could have done a lot better.

The problem was I was fooled by my own data.  A review of the data by traditional standards made the program very hard to criticize. But I wasn’t doing the right thing in this case despite what the data showed. This was a student with severe behavior problems, and there were still contrived contingencies in place. We did a lot of work on making those contingencies more natural, but we weren’t there yet. As we know, if a behavior doesn’t work with natural contingencies, it is only a matter of time before the behavior comes back.

But what was I doing? I was helping the team teach high level language skills, reading skills, math skills, and eating independently with peers in the school cafeteria. That’s what everyone was concerned about at the time. Plus, there had been no serious behavior problems for years. What I could have done is introduced some maintenance challenges. That might have showed the team (and me!) what was really important. I can tell you no one cares about any of that now. The only thing that matters is what maintains over time.

I believe this story also demonstrates another problem we have as BCBAs. You can work on the wrong things, and still look really good for a very long time. I have seen this many, many times before. Only if you are focused on the client’s continued success after you are no longer working with him or her are you likely to choose the right goals.

We all love hearing about the children who are huge success stories. It is amazing when a child we work with is able to go on to college, make friends, go to school without special education services, or in general lead a rich and meaningful life. Several times, I have heard from parents many years after treatment, and it is always thrilling to get these types of reports.

Unfortunately, those victories aren’t the typical case. Some of the clients that we work with are going to require lifelong support. Therefore, it is essential that BCBAs have an idea of what environments our clients are likely to experience later in life. I was lucky–during my training I had the opportunity to work with all age ranges from babies to adults. But most BCBAs aren’t so lucky. Many receive training with just one or two different types of populations or age ranges.

One thing that I think every BCBA should do is visit programs. It is a great way to Poogi. But don’t only visit programs that are doing similar work to what you are doing. If you work with babies or preschoolers, go visit a middle school or high school program and see what it is like. If you work with highschoolers, go see an adult program. If you have never visited other programs, I can virtually guarantee it will be an eye-opener, and lead to new ideas about how to substantially POOGI your current program.

What you start to see is that we spend time on things that don’t matter in the long run. Visiting programs is sometimes a wake-up call that teaches us to focus on the things that are really going to make a difference.