Part H- Selecting and Implementing Interventions
H-1: State Intervention Goals in Observable and Measurable Terms
Review (C-1)
Operational Definitions of target behaviour should be:
Objective: Should describe the aspects of the target behaviour that can be observed (i.e. topography of the behaviour)
Clear: Easy to understand, any ABA clinician should be able to read it and collect data on the target behaviour without requiring clarification
Complete: Should include the beginning and end of the target behaviour, what constitutes as the target behaviour, and what is not the target behaviour
Example: “This intervention is meant to increase time spent creating blog content for deolbehavioursolutions.com. Creating blog content is defined as time consecutively spent on Microsoft Word, where the individual is actively engaging in writing content for the blog, without any interruptions such as scrolling through social media or answering calls. An example of this would be if the individual is sitting at their desk and writing content for the blog for thirty minutes, without looking at social media. The blog content creation does not include research or changes made to the website.” (Deol, 2021) This definition was used as part of an assignment during my Masters degree. (Deol, 2021)
H-2: Identify Potential Interventions Based on Assessment Results and the Best Available Scientific Evidence
Determine need for behaviour-analytic services
Identify goal and determine social-significance
Conduct assessments
Identify Evidence-based interventions
H-3: Recommend Intervention Goals and Strategies Based on Such Factors as Client Preferences, Supporting Environments, Risks, Constraints, and Social Validity
Review (F-2, F-3, F-4)
F-2: When identifying if there is a need for Behaviour-Analytic services, clinicians should ask the following 10 questions:
Would this behaviour produce reinforcement in the clients natural environment, after the intervention is complete?
Is this behaviour a necessary prerequisite for more complex or function skills?
Will this behaviour increase the individual’s access to new environments, where novel behaviours can be acquired and used?
Will changing this behaviour increase the likelihood others interacting with the individual in an appropriate, supportive, and meaningful way?
Is this a pivotal behaviour or behavioural cusp?
Is this behaviour age appropriate?
Is a replacement behaviour being taught while this behaviour is being reduced or eliminated from the client’s repertoire?
Does the behaviour represent the actual goal or is it indirectly related?
Is this the real behaviour of interest?
If the goal is more broadly defined, will this behaviour help to achieve it?
F-3: When identifying a behaviour-change goal and determining if it’s socially significant, clinicians should ask the following 9 questions:
Does the behaviour cause self-harm or harm to others?
Will the individual have many opportunities to use this new behaviour?
How long has the skill deficit or challenging behaviour been occurring?
Will engaging in this kill increase rates of reinforcement for the individual?
Will this goal be of importance when learning future skills or independent functioning?
Will changing this behaviour reduce negative/unwanted attention from others?
How likely is the success in changing this behaviour?
How much will it cost?
Will changing this behaviour produce reinforcement for significant others?
F-4: Clinicians should conduct assessments of relevant skill strengths and deficits to individualize the behaviour planning for each individual. When we focus on creating goals, with our client’s strengths incorporated, it can lead to higher rates of success for the program. We can focus on programming for skill deficits, by incorporating what the client already enjoys and does well.
When recommending intervention goals, clinicians should always be mindful of the following:
Client preferences: This will help in gaining buy-in to implement the intervention and have the family and client onboard for the intervention.
Supporting Environments: An enriched environment can support in decreasing challenging behaviours and support in increasing appropriate behaviours. It will also support in the acquisition of the skill, as well as the maintenance and generalization.
Risks: As with anything in life, there are risks. It’s important to make the supported individual and their family/caregiver aware of the risks of any procedures that you are suggesting to implement.
Constraints: Think of the constraints that you have as a clinician (e.g., staffing, provision of services, cost or implementing services) and the constraints that the family may have (e.g., cost of services, language barriers, timing of services). When discussing these factors with the family, it’s important to be open and honest since this will build a lasting relationship.
Social Validity: It’s part of the 7 Dimensions of ABA! We need to ensure that our interventions follow the Applied dimension. If it’s not socially significant, does it really matter if we implement the intervention? No! Make sure every intervention will improve the supported individual’s life in some aspect.
H-4: When a Target Behaviour is to be Decreased, Select an Acceptable Alternative Behaviour to be Established or Increased
Review (G-14)
Think about functionally equivalent behaviours (behaviours that serve the same function as the challenging behaviour) when identifying alternative behaviours.
Example: An individual engages in aggression towards others in his environment, a clinician could teach the individual to hit a punching bag, instead of another individual.
Clinicians need to understand that the supported individual is engaging in the behaviour due to the consequences that follow the behaviour. You want to recreate the same consequences with an alternative behaviour that is safe and socially valid for the individual.
H-5: Plan for Possible Unwanted Effects When Using Reinforcement, Extinction, and Punishment Procedures
Side Effects of Reinforcement:
Negative emotional side effects may occur when reinforcement criteria is not met
Delay in reinforcement can lead to increase in challenging behaviours
Challenging behaviour may be incidentally reinforced
Review (B-9)
B-9:
Side Effects of Extinction:
Increase in frequency, duration and intensity or extinction burst
Change in topography or increase in variability
Emotional responses may occur such as crying, swearing, depression, etc.,
Extinction induced -aggression,
Resurgence
Side Effects of Punishment:
Emotional and aggressive reactions
Operant aggression: Individual engages in aggression following punishment since it has previously lead to escape from the punishment
Response aggression: Individual aggresses towards objects or individuals nearby
Escape and avoidance: Individual may attempt to escape the room where the punisher is provided or attempt to avoid the individual who provided the punisher
Behavioural contrast: As the target behaviour decreases, a different challenging behaviour may increase
H-6: Monitor Client Progress and Treatment Integrity
Review (C-8)
Validity: Data is directly relevant to the phenomenon measured and reasons for measuring it
Accuracy: The extent to which the observed value matches the true value, or the event as it exists in nature
Reliability: Consistent measurement
Inter-Observer Agreement!!!
When clinicians monitor their client’s progress and regularly conduct treatment-integrity checks, it leads to better intervention and reliability of the treatment’s effectiveness.
H-7: Make Data-Based Decisions about the Effectiveness of the Intervention and the Need for Treatment Revision
Review (C-11)
Visual Analysis: Interpreting data displayed in a graph. It helps to identify if the behaviour changed in a meaningful way and if that change can be attributed to the independent variable.
When clinicians monitor their client’s effectiveness of the intervention, the client will benefits since their interventions will be sound and of quality. When a treatment revision is required, the clinician can change it quickly, so that the client does not learn an incorrect response.
H-8: Make Data-Based Decisions About the Need for Ongoing Services
Review (C-11)- Visual Analysis
Review (F-2)- Need for Behaviour-Analytic Services
As your clients progress through their ABA supports, it’s important to review their data-typically by checking for maintenance and generalization- to determine if they continue to require service.
Remember, if a client no longer requires service, we should not be providing recommendations to continue with services.
H-9: Collaborate with Others Who Support and/or Provide Services to Clients
As clinicians, we owe it to the our supported individuals to collaborate with their families, caregivers, and any other service provider. Remember, you are working to benefit the supported individual and they will receive the most benefit if we (BCBAs) collaborate with others.
Step 1: Gain informed consent from the supported individual/their family/caregiver before assessment, to implement program, to collaborate with other professionals, etc.,
Step 2: Collaborate with other professionals (when required). Share only items that are necessary for the other professional to know and for information that you have received signed consent.
