POOGI for ABA

One thing that I learned from the book The Goal is it’s possible, even probable that when you have contingencies attached to data, people will engage in behaviors that are not necessarily in the best interest of the client.

For example, one teacher told me that he worked in a program where the number of trials per day was publicly posted. Now, in general, he thought this intervention had positive effects. For the most part, more well-delivered trials will promote more learning. But this intervention did produce a nasty side effect. Specifically, there was great resistance from the staff when programs were suggested that made it difficult to get a high rate of trials.

So in this program everyone was happy to work on reading that required frequent responses, math problems, and discrete trial instruction. But what about changes a child might need to make – that are absolutely critical- but don’t produce a high rate of trials? Mands for Information? Problem Solving? No one wants to work on those programs; their trial-rate graph will look terrible.

A cardinal rule that I try to follow is: If we implement this measurement, will it encourage everyone to engage in behaviors that are in the best interest of the client? Or ask, “Is there any way staff can show improvement in this measurement while doing something that is not in the client’s best interest?” If so, either don’t implement the measurement or add other procedures / measurements to attempt to prevent the negative effects.

Sometimes I’ve seen programs that are teaching 20, 30, 50, or even 60 behavior change programs at the same time. When there are that many behavior change programs, many of them often are ineffective. But let’s assume that all / most of those behavior changes do seem effective. My question always is: Will the child still be able to do this skill in one year when you are no longer working on it?

Don Baer taught us that there are really only two choices when it comes to maintenance of behavior changes.

1. The behavior change meets a natural contingency that will maintain it in the future.
2. We program maintenance forever.

Most of the time we are not in a position that we will be able to maintain behavior changes forever. Therefore the main thing that matters is that the behavior change will eventually meet a natural contingency. BCBAs talk a lot about natural contingencies, but in practice I see very little effort put into this critical concept.

It’s great that he made an independent initiation to peers during lunch 3X for 5 consecutive days.  But…

Did you have to praise and say “Wow, that’s so great talking to your friends?”

Did you have to give tokens for talking?”

Did the peer respond in a way that was reinforcing to the child- so that it might maintain initiations in the future without intervention?

If you need other reinforcers / interventions at this time, that does NOT mean that the intervention is a failure. Just don’t fool yourself that you made a meaningful difference in the child’s life. This might have been an important step- but you aren’t there yet. If you don’t get to the point where it meets a natural contingency, it almost certainly won’t maintain in the long run and it won’t really matter.

People will want to tell you their wild stories of problem behavior. These stories can go on and on and on. They often involve people getting hurt, bodily fluids, dramatic episodes in public places, and other extreme situations. It is critical that we show empathy and try to understand what that person is experiencing. If people don’t think you understand, you won’t be able to develop the necessary rapport with them to be effective.

Now, of course, the main solution is effective assessment and treatment that produces long-term success. But that takes time.

What should you do right away? Just don’t let him do that! Lock up the iPad. Block him before he reaches in the toilet and grabs the feces. Skip going to the play group. Hold her hand so she doesn’t run in the street.

This seems obvious, but often it isn’t. People will ask you “What am I supposed to do? Never make him do his homework?” No, of course not. But it is critical to prevent (as much as possible) dramatic episodes while delivering effective assessment and treatment services that will lead to long term success.

A surprisingly effective procedure in the short run is just- Don’t let him do that.