POOGI for ABA

It is amazing to me how many times over the years that I have met the best therapist, teacher, technician, or behavior analyst in the world. When I go visit programs (which I love to do!), whether schools, homes, clinics, or anywhere, people get introduced as “XXXX is the best in the world!”

Certainly, sometimes this is just an overly enthusiastic supervisor and they don’t really believe that the person I’m meeting is the best in the world. But I’m going to tell you that often they do!

It is common for people to think that their performance is better than the average person. There is an abundance of research examining this phenomenon. For example, this research found in their sample of US drivers 93% thought they were in the top 50%.

I think it is worth it for BCBAs, parents, teachers, and RBTs to be aware of this research. It is very easy to be fooled by the data or the story problem. I don’t believe this type of research has been done in behavior analysis, but based on the number of “best-in-the-world people” that I’ve met, I’m willing to bet on what would be found. Whenever you hear someone say something like “who could possibly be better than Cathy, Fred, or Kendra,” look out. Your program is probably not as good as you think it is.

When I was young, I read Sam Walton’s autobiography where he describes how he started Walmart. I don’t really remember much about that book. But I do remember him describing constantly visiting as many of his competitors’ stores as he could. Even if the store was in terrible shape, he could often find something they were doing well and say “why aren’t we doing that at Walmart?” It is what encouraged me to go on as many tours of programs for children with autism as possible. The easiest way to Poogi is to simply steal what other people are doing well. But first, you have to realize you are probably not the best in the world. No matter how good you are, there is room for tremendous improvement.

Prompting and fading procedures in textbooks, journal articles, and many trainings sound very neat and organized. They’re super simple, parent friendly, and the skill is mastered in no time. You might vocally prompt a child in what to say in a social situation; physically prompt a child how to dress; and model how to play with toys. Then, you systematically fade the prompts, and wow—the child has a new skill!

There is a lot of research supporting the use of prompting and fading procedures—studies show they are extremely likely to be effective. But in practice, often things don’t go nearly as smoothly as described in the research literature. I’ve seen children who, despite thousands of trials, are not acquiring skills. And we’ve all seen the child who becomes “prompt dependent” and doesn’t respond without a prompt.

If the research is so strong, why do these procedures go wrong in practice so often? There are a lot of possible answers:

• There are so many different ways to prompt and fade. We simply used the wrong procedure for the situation.
• The child didn’t have the relevant prerequisite skills to be successful with this skill.
• Certain types of prompts are inherently more difficult to fade.

Sure, all these are possible—sometimes. But I don’t think they are the most common reason that attempts to prompt and fade fail. I think the problem is that often, when we train people to do prompting and fading, we sometimes give the misleading impression that the prompting and fading is teaching. That’s easy to do since that is what people see when they watch videos and demonstrations of prompting and fading.

The question to ask is why are we use prompting and fading procedures in the first place? The answer—we prompt and fade only so that we have the opportunity to reinforce at just the right moment. Prompting and fading procedures don’t usually work in isolation. They work by giving the BCBA, RBT, parent, teacher, or paraprofessional the opportunity to give feedback through reinforcement. Then, we slowly require more and more from the student over time. Prompting and fading doesn’t work without the feedback. If there is no feedback, or if feedback is given at the wrong time, learning is unlikely.

I’ve made this mistake so often that about ten years ago, I started to work hard to make this explicit in my trainings.  I’ve experimented with quite a few ways to make this point, and it has been getting better and better ratings over the years. Of course, it is still on a Poogi. It isn’t easy to train people this way, but it’s worth it. Once people understand this point, they will dramatically improve their teaching.

Sometimes, we assume that it is always the adult that influences the child’s behavior. But the research literature is filled with examples where it works the other way, too. For example, this research showed that children’s behavior had a huge effect on the teaching behaviors of the adults. The adults were working with a pair of preschoolers; one who engaged in problem behavior, and one who didn’t. The adults tended to spend much more time teaching the child who didn’t engage in problem behavior, and when the adults did engage with the child with problem behavior, they presented much easier tasks. The child with problem behavior shaped the adults to avoid interacting with him or her, and when the adults did interact, they were shaped to provide easier materials.

In most situations, we should expect this effect—children shaping the adults—to occur. When there are multiple teachers, paraprofessionals, parents, grandparents, siblings, daycare workers, babysitters, nannies, and others interacting with a child, there is just no way to prevent this effect from occurring under practical conditions. If you work with a child that has potential for significant problem behaviors, I believe you should start with the assumption that the child is shaping the adults with those behaviors.

If that’s true, it has two important implications for effective treatment. First, be very skeptical of frequency of problem behavior data. The data might be low, but if the data are low because the child is shaping the adults to avoid doing things he or she doesn’t like, it is very unlikely to maintain over time. Everyone is happy when problem behavior is low, but if it doesn’t last, no one will be happy in the long run. Second, it is essential that we work hard to discover what the adults are doing that is preventing the problem behavior. In my experience, there are a huge number of possibilities. If you don’t know, there is no way to adequately plan the next steps for treatment.