Transcript Document

Schedule
• Today and Tuesday, 11/26
– Certification and licensing of behavior
analysts
– Professional ethics
• Thursday, 11/28: No class, Thanksgiving
• Tuesday, 12/03, E8
– 15 points: completion of the on-line
training program
– 20 points: exam over certification and
licensing, and professional ethics
1
Schedule
• Thursday, 12/05
– Return of E8
– Special grade sheet for ME2, can you benefit from
taking ME2, and if so how many pts do you need?
– ME2 study objectives handed out
– No lecture
– Good day to do course evaluations during class time
2
Schedule
• Make-up Exam 2 (Units 5 - 8)
– Wednesday, 12/11
– 2:45-4:45 PM: Be here at 2:30
• I will not permit anyone to start the exam after a
student has finished or left the room with the
answers
• You will receive a zero on the exam if you come
late and ask to start taking it after a student has left
the room with the answers
3
Unit 8: Online Ethics Training Program
• Online Training Program: citiprogram.org
– You must hand in a computer print out that you have completed
the online training on the day of U8 exam (no electronic copies
via email)
– For the computer print out – MODULES COMPLETED, which
lists the score you received on the quiz for each module
• If you have already completed this training, you only need to
print off a copy of the page that indicates that you have
completed it. You don’t need to do it again.
– Completion criterion: average of 80% across all quizzes.
Important:
Quizzes can be retaken at the end of the module, but you cannot go
back and retake quizzes after you have told the program you have
finished the quiz/module and have moved onto the next module. Thus,
you must monitor your quiz scores as you move through the program to
make sure you don’t come up short of an average of 80%.
(cont. on next slide)
4
Unit 8: Online Ethics Training Program
– If you do not hand this in on (or before) the day of E8 - no credit.
I will not accept late assignments.
– See study objectives for grading criteria
– See study objectives for instructions on logging onto the training
program
5
Certification vs. Licensing
• Certification is voluntary, licensing is legally required
• The Behavior Analysis Certification Board is the organization that
certifies behavior analysts (it is independent from ABAI)
• Individual states pass license laws, in contrast
– Because of this, just like the license laws for clinical
psychologists, those laws vary from state to state
– Compliance is overseen by licensing boards established by the
state
– There are legal penalties for violating these laws
• National certification began in 1998
• Licensing has begun only recently, but
– 10 states now have licensing laws
– 9 additional states have laws pending/in process
– A MI law is currently being drafted by the state legislature
(encountering some controversy and confusion over the licensing laws because they are so different from
state to state, and we are just beginning to see some of the problems/ramifications, more on that later)
6
Certification
• Certification was developed to meet the needs of behavior analysts,
state governments, and consumers: who is qualified to do and call
themselves a behavior analyst?
– Sets “minimum” standards for behavior analysts
• Certification is voluntary, not legally required
– That is, you do not have to be certified to call yourself a behavior
analyst or practice behavior analysis
• Primarily relevant for those who work in human services (work with
children diagnosed with autism or children and adults with
developmental disabilities)
– Thus, behavior analysts who work in other fields, such as
organizational behavior management and applied animal training,
often do not seek certification
7
Certification
• While not required, almost all human service organizations that
provide behavioral services to at-risk individuals require employees
with an MA or Ph.D. to be certified in order to be hired
– If you are planning on working in human services, you should
plan on becoming certified
– At this point, direct care staff and technicians do not have be
certified, but the BACB is initiating a new credential: Registered
Behavioral Technician
8
Certification
• Two levels of certification
– Board Certified Assistant Behavior Analyst (BCaBA)
– Board Certified Behavior Analyst (BCBA)
• Added a BCBA-D to signify doctoral level with a minimum of
10 years of experience post-Ph.D.
9
SO1: Requirements for Board Certified Assistant
Behavior Analyst
A.
BA degree in a related field:
Does not have to be in behavior analysis or psychology
B.
180 hours of specific coursework in behavior analysis (following
details not required for the exam)
1) Ethics (hence this unit): 15 hours
2) Concepts and principles: 45 hours
3) Research methods: 15 hours
4) Applied behavior analysis: 90 hours
5) Discretionary: 15 hours
(Requirements fall into five categories; hours are not credit hours but contact hours)
10
SO1: Requirements for Board Certified Assistant
Behavior Analyst
C.
Experience requirement
NFE: This ranges from 500 to 1000 hours of supervised
experience depending upon the nature of the experience and
intensiveness of supervision. Supervisor must be a BCBA.
D.
Pass the certification exam administered by the BACB
11
SO2: Before applying for the exam which of the
requirements must be met?
•
All of the other three
–
–
–
BA degree*
180 hours of coursework in behavior analysis
Experience requirement
*Don’t forget this one if I ask this on the exam
12
SO3: When you graduate from WMU with a BS in the
behavioral science major, which requirements are met?
•
Only the bachelors degree requirement
•
Not for exam:
–
The BACB has approved a sequence of our graduate courses,
however, we have not, to date, sought approval for our
undergraduate courses
–
Most of our students get certified only after obtaining their MA
degree and often skip BCaBA certification and go straight to
BCBA certification
–
It is hard to acquire the experience requirements necessary to
become certified at either level while in school
•
•
–
Time and effort it takes the students
We do not have sufficient faculty to supervise all of the students who might
like to fulfill this requirement
Some MA programs, such as UNT, do require students to fulfill
the experience requirement as part of the MA, but that
increases the number of credit hours required to complete the
degree; 45-48 credit hours, compared to 36
13
SOs 4 and 5
4A. How long does the original certification last?
• 2 years
4B. What must be done to maintain certification?
• Renew certification each year by application
• Apply for recertification after 2nd year
SO5. What are the recertification requirements?
• Complete 20 hours of continuing education every two
years (4 must be in ethics)
or
• Retake and pass the certification examination
14
SO6: Requirements for certification as a Board Certified
Behavior Analyst (BCBA)
A. MA degree in (a) behavior analysis, psychology, or
education or (b) a degree program that has a couse
sequence approved by the BACB
B. 270 hours in specific course work at the graduate level in
behavior analysis (a sequence of our graduate level
courses have been pre-approved to meet this
requirement)
C. Experience requirements (750 - 1500 hours of
supervised experience)
D. Pass the certification exam
15
SO7: Not for Exam
Renewal and Recertification: Similar to BCaBA*
A.
How long does the original certification last?
A. 2 years
B.
What must be done to maintain certification?
A. Renew certification each year by application
B. Apply for recertification after 2nd year
C.
What must be done to obtain recertification after 2nd year?
A. Complete 32 classroom hours of continuing education in
behavior analysis (4 must be in ethics) or
B. Retake and pass the certification examination
*The only difference between BCaBA and BCBA, number of
CEUs required. If a BCBA is supervising individuals pursuing certification, he/she must
also complete 3 credit hours of supervision as part of the CEU hours.
16
Licensing
• Historically, the purpose of licensing has been to
protect the public from incompetent professionals
(charlatans)
• Within psychology and human services, the laws
are primarily designed to protect at-risk
individuals
– Clinical psychologists have to be licensed
– School psychologists have to be licensed
– Typically, I/O psychologists do not
17
SO8: Two main reasons for BA license laws
• To protect at-risk individuals and integrity of the
field of behavior analysis in general
– Push for licensing came from behavior analysts who
work in human services or with other at-risk individuals
• States began to pass autism insurance laws to
cover ABA services
– Needed a way to determine who was competent to
provide those services and thus (b) who could receive
reimbursement
(these laws do not pertain to the experimental analysis of behavior; directed at applied services)
18
SO9: Two main types of license laws
• Broad title and/or practice laws
– You cannot call yourself a behavior analyst and/or
practice behavior analysis unless you are licensed
• Six states have passed this type of law
– Arizona, Kentucky, Massachusetts, Missouri, Virginia,
Wisconsin
• Restrictive laws
– Only behavior analysts who provide services to autistic
children and/or individuals with pervasive behavioral
disabilities need to be licensed
• Four states have passed this type of law
– Nevada, North Dakota, Pennsylvania, and Rhode Island
(the wording of the laws do differ, and others might object to my categories, but I am attempting to just give you
a broad overview – things are complicated right now. First type are controversial)
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NFE: “Oddities” and other regulations
• Title license law: Wisconsin
– You can practice behavior analysis without a license but
you cannot call yourself a behavior analyst
• No law: Certification is sufficient: W.VA. (6/12)
• Regulations specifically tied to autism insurance
laws (some are written into the insurance laws)
– Autism service providers that provide ABA do not have
to be licensed but must be board certified in order to be
reimbursed
– 16 states have these type of regulations
20
NFE: How will these laws affect you?
• In most cases, the licensing process is the same
as the certification process
– Some laws require certification to be licensed
– Some laws permit licensing of individuals with equivalent training
and experience
– Regardless, if you are certified, in most states you will immediately
qualify for licensing
• If you plan to work in human services, you should
become certified
– You will meet the legal requirements for licensing in states that
have license laws
– You will meet the regulatory requirements in states that don’t have
license laws and have many more job opportunities
(basically, the states have determined that the certification process is already a good process, no sense creating
something new, cont. on next slide)
21
NFE: How will these laws affect you?
If you plan to work in applied areas other than with at-risk
individuals, keep tuned, but my best guess is that you will
not need to be licensed (or certified). But I could be wrong.
– The BACB created a model license law to help states
develop appropriate wording
– The first model law was a broad title and practice law,
thus that is what many states passed
– Based on concerns expressed by some behavior
analysts the model license law was revised in 10/12
• One of the revisions was potential exemption for behavior
analysts who practice with “nonpatients” for states who wish to
adopt that language
22
NFE: How will these laws affect you?
The exemption language for states that wish to adopt it:
A behavior analyst who practices with nonhuman or
nonpatient clients and consumers, including, but not limited
to applied animal behaviorists, and practitioners of
organizational behavior management.
Thus, if states adopt this language, the laws would fall into
the category of “restrictive laws” – laws that only cover
applied behavior analysts who work in clinical settings.
(moving forward, I expect most states will adopt this language; hard to know what will happen in those
states that have already passed broad title and practice laws without such an exemption)
23
SO10: Professional Ethics
• Materials in the course pack
– All of the 12 ethical task statements for behavior analysts and the
certification exam – not for the 4600 exam, just FYI
– Dickinson article
• Task statements (6 of the 12) for the 4600 exam
• Explanations of the ethical guidelines for behavior analysts
relevant to each task
• Case study examples
– Declaration of Professional Practices and Procedures for Behavior
Analysts (to give clients before working with them – not for exam
just FYI)
• Basically a contract with the client defining the responsibilities of
each party – both the behavior analyst and the client
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Exam Questions (also indicated in S10)
• I will give you a copy of the six task statements
– You do not have to memorize them!
• I will ask two types of questions about these or similar case
studies (give you options, e.g., answer any 5 out of 8)
– Did the behavior analyst act ethically? Why or why not?
– Which task statement or statements are relevant to this
case study and why?
• A particular case study often involves more than one task
statement.
– Short open-ended questions such as:
• What should the person in the case study do?
• Is it OK for the person in the case study to start the
intervention or research, or is there something else
the person must do before starting?
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Ethics for Behavior Analysts, 2005, 2011
Mary Burch
Jon Bailey
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Task Statement 1-1
• Solicit or otherwise influence clients only through the
use of truthful and accurate representations of
intervention efficacy (effectiveness) and one’s
personal competence (within his/her area of
specialization) in applied behavior analysis.
– The second part means “don’t exaggerate your
credentials/experience within your area of
specialization (autism, OBM, applied animal
training, etc.)
(truth in advertising; I am emphasizing this because task 2 deals with restricting activities to your own area
of expertise within behavior analysis; difference is a bit confusing)
27
Case Study 1A
Dr. B, a BCBA-D, was consulting at a residential facility for
clients diagnosed with developmental disabilities that were
severe enough to prevent them from living at home or in
the community. This was a new client for Dr. B. and he
wanted to demonstrate how behavior analysis could help
the clients. One day, as soon as Dr. B. arrived, the
administrator approached him and began congratulating
him on successfully treating one of the most difficult clients
in the facility. Dr. B. then discussed the case with the
student who was helping him. The student told him that, in
fact, baseline was still underway and the treatment plan
had not yet been executed.
1. What should Dr. B. do?
2. Why is this relevant to task statement 1-1?
28
Case Study 1A
1. What should Dr. B. do?
He should meet with the administrator and explain
that no credit was due. That, in fact, baseline was
still underway and the treatment plan had not
been implemented.
2. Why is this relevant to task statement 1-1?
Solicit or otherwise influence clients only through
the use of truthful and accurate representations of
intervention efficacy
29
Case Study 1B
Dr. G. was a school psychologist working with a private
tutoring service to help children who were having trouble in
school. Some of the children were diagnosed with ADHD,
some with dyslexia. Dr. G. conducted a controlled study
with 2 of the ADHD clients and 2 of the dyslexia clients.
She found her behavioral teaching methods were much
more effective for teaching these children how to read and
do math than the methods being used. Dr. G. was excited
as was the director of the tutoring service. The director
sent press releases to several magazines and
newspapers. Dr. G. found out that the director had written
the following headline: “Dramatic New Advances in
Education: Teaching Methods at ABC Tutoring Cure
ADHD and Dyslexia.”
1. What should Dr. G. do?
2. Why is this relevant to task statement 1-1?
30
Case Study 1B
1. What should Dr. G. do?
She should immediately contact the director and explain
that the headline was not appropriate. She should rewrite
the headline and immediately contact all of the magazines
and newspapers and tell them not to print the article.
If it is too late to stop publication, Dr. G. should request
that a follow-up piece be published correcting the
misconception that it cured ADHD and dyslexia and talk
about the limitations of the study (only dealt with 2 ADHD
students and 2 dyslexia students, no evidence that ADHD
or dyslexia were “cured.”).
2. Why is this relevant to task statement 1-1?
Behavior analysts should be truthful about the
effectiveness of an intervention and should not exaggerate
their effectiveness.
31
Case Study 1C
Jake was a student in a Ph.D. program in Organizational
Behavior Management. He wanted to supplement his
income by consulting with local companies. Jake had an
MA degree in OBM and had worked with a number of
companies doing projects in classes arranged by his
professors where he was supervised by both a person in
the organization and the professor. He had also completed
two practicum courses in organizations under the
supervision of his advisor. When he developed his resume,
under “experience” he listed the companies he had worked
with and the projects he had completed for each.
1. Is there anything else Jake should include on his resume?
2. Why is this relevant to task statement 1-1?
32
Case Study 1C
1. Is there anything else Jake should include on his resume?
Yes. He should indicate that the projects were completed
as part of a course, listing both the professor and on-site
individual as supervisors.
2. Why is this relevant to task statement 1-1?
The behavior analyst must give the client an accurate and
truthful representation of his/her credentials when soliciting
clients. He is exaggerating his personal competence within
his area of specialization, which is OBM.
Solicitation and public statements include personal
resumes and curriculum vita. Without the information
above, it appears as though Jake was an independent
consultant for the organizations. That is misleading.
3. How does this situation apply/generalize to students
applying for jobs or to graduate school?
33
Task Statement 1-2
Practice within one’s limits of professional competence in
applied behavior analysis and obtain consultation,
supervision, training, or make referrals as necessary.
• Unlike Task 1, this task deals with competence in
other areas of behavior analysis and other
professional areas
– An OBM person accepting/giving advice about a child
diagnosed with autism
– A person trained in autism accepting a client or giving advice
about a client who has a brain-injury
– A behavior analyst making a “diagnosis” of autism
– A behavior analyst making suggestions about diet and
nutrition as a way to “cure” autism
– A student trained in behavior analysis doing sensory
integration, etc.
Remember: Task1 deals with one’s competence within
one’s own area of specialization
34
Task Statement 1-2
• Some discriminations are easy to make, such as indicated
earlier - an OBM specialist should not accept an autistic
child as a client or give advice about how to deal with an
autistic child (or vice versa)
• Some discriminations are harder to make
•
A student who is/has taken general behavior analysis courses: If
that individual is also an athlete, I see no problem whatsoever
with that individual working with a local coach of an athletic team,
a health club, or a senior citizen’s home that has an exercise
room for its residents and encourages them to develop exercise
programs (however, recognizing the need for medical approval
first)
35
Case Study 2A
Martin, a BCBA, moved to a new city to work at a large
long-term care facility for adults with head injuries. Martin’s
past experience was limited to clients who were
developmentally disabled. Some of his clients did engage
in aggressive behaviors. At the new facility, Martin was
assigned to work with Dan, a 23-year old who had a severe
head injury. Due to the head injury, Dan engaged in violent
and dangerous outbursts of aggression. Dan’s outbursts
had resulted in medical treatment for a few staff members.
Martin was eager to help Dan and began reading
everything he could about how to treat this type of
aggression that was directly due to Martin’s head injury.
1. Is there anything else Martin should be doing?
2. Why is this relevant to task statement 2?
36
Case Study 2A
1. Is there anything else Martin should be doing?
Even though Martin has worked with aggressive clients
before, because he has not worked with clients with head
injuries, he needs to consult with a BCBA who is an expert
in the treatment of head injury and aggression. If there is no
such person at the facility, he needs to find someone in the
area to supervise him. He should do this because of the
ethical issues involved; there could be liability issues as well
if he does not.
(ethics and law are sometimes the same; sometimes not)
2. Why is this relevant to task statement 2?
Must practice within one’s area of competence and obtain
consultation and supervision, if necessary.
(many of us consult with one another – recently consulted with two Ph.D. level behavior analysts in
human service settings: one had run into a union problem with the staff that enabled the staff to
37
implement procedures not good for the clients; incentive system for clinical staff.
Case Study 2B
Melinda, a BCaBA, is working with a child in an
after-school clinic affiliated with a university. The
child is beginning to engage in self-injurious
behavior and the parents are concerned that the
behaviors may escalate into more severe types of
behaviors. Melinda has implemented a behavioral
program to reduce/eliminate the self-injurious
behaviors. One of the parents asks Melinda, “Does
my child’s self-injurious behavior indicate that he
may have attention deficit disorder?”
– 1. How should Melinda respond?
– 2. Why is this relevant to Task Statement 1-2?
38
Case Study 2B
1. How should Melinda respond?
That diagnosis is outside my area of expertise. Your
child’s doctor would be better able to help you
determine that.
2. Why is this relevant to Task Statement 1-2?
Practice within one’s limits of professional training and
education and make referrals when appropriate.
Other potential questions that may come up with a parent:
Should I put my child on a special diet? Refer to pediatrician
or nutritionist and perhaps relevant literature
What should I say to convince the judge in my child custody
case that I am the best parent to promote this ABA
program for my child? I can’t give you advice on that - I
suggest you talk to your lawyer.
One of the problems here is that you may not have much
time to think about your reply.
39
Task Statement 1-4:
(I am not covering 1-3 from the guidelines)
Obtain informed consent within applicable legal
and ethical standards.
– Provide a written description of all procedures
and obtain consent from all clients before
research, assessment, intervention, and
changes in intervention.
– When working with clients, describe procedures
in language they can understand and obtain
assent if “consent” cannot be given.
(identical to informed consent for research ps)
40
Case Study 4A
Susan is a thirty-eight-year-old woman with developmental disabilities.
She lives at home with her mother who is her legal guardian and she
attends a vocational training program. Susan receives behavioral
programming as needed. Angie is a BCBA who works with clients at
the vocational program. Angie has been asked to provide behavioral
services for Susan. It seems as though Susan has been spending most
of her money on junk food.
Then, so that she has money, she has been asking staff to give her
loans or pay her for small favors. This behavior has escalated to the
point that at times, Susan has no money for bus transportation and she
is making everyone uncomfortable with her begging. Because begging
is not an appropriate behavior, and will interfere with Susan’s being
promoted to do more complex work which could lead to a “real” job
outside of the vocational training center, Angie feels that it would be
okay to instruct the staff to immediately begin treating begging with
social disapproval.
1.
Can Angie implement this program immediately?
2.
Why or why not?
3.
Why is this relevant to Task Statement 1-4?
41
Case Study 4A
1. No.
2. She must get consent from Susan’s mother before
implementing any program.
Angie needs to outline the objectives of the behavior
plan in writing for Susan’s mother and have her sign
the consent form. If Mom doesn’t consent, she cannot
implement the program, even if it is in the best interest
of Susan to do that.
3. Why is this relevant to Task Statement 1-4?
Give procedures in writing and obtain informed consent
(in in writing) before implementing any research or
behavior change procedure.
42
Case Study 4B
Sarah is working in a special education classroom.
Students spend part of the school day in the classroom
and they are mainstreamed the remainder of the day.
Jessie is a tall, lanky twelve-year-old who swears and
becomes disruptive in class. She is on a behavior
program that worked well until recently. Knowing her
clients very well, Sarah quickly figured out that Jessie
was bored with the reinforcers. Sarah planned some
changes in the intervention, including changing the
reinforcers, reinforcement schedule, and adding
consequences for misbehavior.
1.
2.
Because the behavior plan was already in effect, the goals of the
program were clear, and the changes were only slight changes ,
Sarah was certain that all of the permission forms that were
previously signed would cover the changes. Was she correct in
assuming this?
Why is this relevant to Task Statement 1-4?
43
Case Study 4B
1. No.
2. Why is this relevant to Task Statement 1-4?
When a behavior program is modified, the behavior
analyst needs to explain the modifications and obtain
consent again. In this case, consent would come from
the parents. The changes should also be explained to
Jessie.
(no BCaBA, or BCBA: that is OK; it is not unethical for a person who is not certified
to do BA with at-risk individuals; however, it would be both unethical and illegal
if the state had a license law and Sarah was not licensed.)
44
Case Study 4C
1.
Shakira was working on her master’s degree in behavior analysis.
Although not her thesis, she wanted to do some pilot research in a
high school that was in a low-income neighborhood. She began
volunteering at the school and she established an excellent
working relationship with the principal and some of the teachers.
She met with the school and got approval to conduct her research.
Because this was not an official psychology department
assignment and because this was a pilot study, she told the school
officials that she was going to be “flexible, implementing
procedures that would become apparent as the baseline data
became available.” The school (the teachers and principal) said
they understood the need for this flexibility and looked forward to
seeing what Shakira would do.
Was Shakira ready to begin his pilot research after obtaining
approvals from the school principal and the teachers involved in
the study?
–
45
Case Study 4C
1.
No. Shakira needed an approval of the HSIRB before starting any
research in the schools. She would also need to obtain consent
from the parents. Finally, the procedures must be planned and
written. The approval from school personnel was not sufficient.
Two-step consent process: first for baseline, then for the
intervention after she decided what type of program would be
appropriate
2.
Why is this related to task statement 1-4?
Must obtain the written consent of the participant or guardian
before beginning research and also must conduct research with
humans and nonhumans in accordance with the local human
research board (if there is one) and the HSIRB for the academic
institution with which the student is affiliated.
46
Task Statement 1-7
Identify and reconcile contingencies that
compromise the practitioner-client covenant,
including relationships among the practitioner,
the client and other parties.
•
•
Again, sometimes this is an easy discrimination to
make, sometimes it is more difficult
Is it OK to use behavioral principles to help out a
grandparent or an ill aunt or uncle, even though
you are not trained in gerontology or behavioral
medicine?
– What are the limits?
– When would it be OK, when wouldn’t it be OK?
47
Case Study 7A
A BCBA who specializes in behavioral gerontology was asked by her
sister to develop an ABA program for her their elderly mother. The
sister lives about 60 miles away and the mother has a separate
apartment in the sister’s house. The mother had lung surgery about
three months ago. The physician and surgeon have given the mother
a “clean bill of health” - that is she has no lingering medical
problems. However, the mother has stopped engaging in many
activities she used to enjoy, and is beginning to just sit around the
house complaining – usually about the sister. The sisters have a very
close relationship. The BCBA is very concerned about her mother
and also wants to help her sister. She is very grateful that her sister
has taken on the role of primary care-taker for the mother.
1. What is the BCBA’s most appropriate course of action?
2. Why?
48
Case Study 7A
1.
The BCBA should locate another BCBA in the area and refer the
sister to that individual. There is too much potential for conflict
within the family - either between the mother and the BCBA or
between the BCBA and her sister. This would require a long-term
intervention.
What if there wasn’t another BCBA in the area? What should the
BCBA do then?
2.
Why is this relevant to task statement 1-7?
Conflicts of interest here. The behavior analyst must always be
sensitive to potential harmful effects of personal and social
relationships on their work and on those persons with whom they
deal. Behavior analysts provide behavioral services only in the
context of a defined, professional or scientific relationship role.
49
Case Study 7B
Bill was a twenty-seven-year-old, single BCBA who worked
with clients and conducted research in a large state
institution. Bill had a good working relationship with the
local university’s psychology and special education
programs. One semester, Bill found himself attracted to
Kristi, one of the college students he was supervising. The
attraction seemed mutual because Kristi “flirted” with Bill
and made it a point to let Bill know she was single and
available for dating.
1. Because the feelings seemed to be mutual, was there any
problem with Bill asking Kristi for a date?
2. Why is this relevant to Task Statement 1-7?
50
Case Study 7B
1.
Yes, of course.
2. Why is this relevant to Task Statement 1-7?
Behavior analysts do not engage in dating or sexual relationships with clients,
students, or supervisees; such a relationship could impair their judgment and
constitute a form of exploitation as well. If Bill wants to date Kristi, he should
wait until her internship is over. Also, depending on the nature of the
interactions, it might be appropriate to have someone else supervise Kristi.
3. How is this relevant to student-faculty relationships? Are there any
circumstances when a student-faculty relationship is OK?
4. How is this relevant to student TAs and student supervisors in
practicum settings?
5. Is it OK for faculty to hire students as babysitters, handymen, and
house sitters?
(changing standards -)
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Case Study 7C
John was working with developmentally disabled clients
in a day training center in a small town. He was an
excellent behavior analyst and his clients not only made
good progress, but liked him a lot. He met many of the
parents of his clients at the training center and also in
the community. John decided to apply to a Ph.D.
program in behavior analysis. When he told some of the
parents about his plans, they offered to write him a
letter of recommendation.
1. Would there a problem if he accepted their offers?
2. Why is this relevant to Task Statement 1-7?
52
Case Study 7C
1.
2.
Is there a problem if he accepted their offers?
No, he can ethically accept the offers because the parents
volunteered to write the letters.
Why is this relevant to Task Statement 1-7?
He could not ask or prompt the parents to write letters – that would
be unethical. Why?
Behavior analysts do not solicit testimonials from current clients or
patients or other persons who because of their particular
circumstances are vulnerable to undue influence.
That is, if the parents said no, it might influence the care John gives
the DD client or the parents might think if they said no, it would
influence the care John gives to their children. Thus, that would
create a conflict of interest.
John should get the letter from the person who supervises him at
the day training center (or the director of the center).
53
Task Statement 1-8
Use the most effective assessment and
behavior change procedures within applicable
ethical standards taking into consideration the
guideline of minimal intrusiveness of the
procedure to the client.
54
Case Study 8A
Kevin is 7 years old and has mild autism. He does go to school. Several
times during the day, he hits the sides of his head with the palms of his
hands for 5-10 minutes at a time, but not hard enough to hurt himself. He
also has trouble attending to any task for any length of time. Alicia, a
BCBA has recently been assigned to Kevin’s classroom as a member of
a treatment team that consists of an OT, speech therapist, and the
teacher who has a certificate in special education and autism. Before
Alicia joined the team, the team developed a treatment plan that consists
of Kevin wearing a weighted vest. Weighted vests are very popular. It is
a sensory integration procedure designed to eliminate a inattentiveness
and stereotypic behavior that rare conceptually due to over or under
sensitivity to sensory input. The vests are believed to provide deep
pressure stimulation that has a calming and organizing effect on the
central nervous system.
55
(cont. on next slide)
Case Study 8A
Alicia knows that the research literature does not support this type of
intervention and that the only studies that have supported the effects of
weighted vests have serious methodological problems from an
experimental perspective.
However, the other members of the treatment team firmly believe that
weighted vests have very positive effects. Alicia knows that weighted
vests do not hurt the child (and many children seem to enjoy wearing
them), but is concerned it will not benefit Kevin. The other members of
the team believe that the vest is helping Kevin.
1. Given that Alicia is new to this treatment team and must work well with
the team members so that she can help other children as well, what
should she do given that she is clearly out numbered and her team
mates are so convinced of the effectiveness of weighted vests?
2. Why/how is this related to Task 1-8?
56
Case Study 8A
1.
2.
Alicia should first politely, but firmly, explain that she has reservations
about the effectiveness of weighted vests given her knowledge of the
literature. She should ask the team if they would be willing to bring in
data-based research articles they feel support the effectiveness of the
vests, and that she will bring in articles that have formed her opinion,
and they could discuss them. If they agree to this, she should then
critique the articles re their experimental methodology.
She should also suggest that the team evaluate the effects of the vest
on Kevin’s behavior and develop a study to do that.
She could also suggest that she believes the behaviors may be
caused by different variables or perhaps at least partially controlled by
different variables and suggest doing a functional analysis.
Alicia could suggest implementing a behavioral treatment plan in
addition to the vest, but what is the problem with that?
Uses the most effective assessment and behavior change procedures
based on research, conducts functional assessments to get data
necessary to develop an effective treatment, collects data to assess
the program
(Dr. Peterson Dr. Frieder’s evaluation of weighted vests in schools)
57
Case Study 8B
Juan, a BCBA, has just started working in a privately-owned school
for children with autism. He has been asked to work with Carl, a child
who has been shrieking and slapping himself in the face. Juan was
hired to replace a BCBA who had resigned. The previous BCBA had
completed an excellent functional analysis indicating that Carl’s face
slapping is being maintained by self-reinforcement. Juan decides, with
due and reasonable consideration, that that Carl’s face slapping is
serious enough to warrant a punishment procedure as an intervention
so that Carl does not hurt himself. When Carl slaps his face, Juan
wants Carl’s hands to be firmly pulled away from his face, and for the
therapist to say “No!” in a very loud voice. Juan does plan to submit
this program to Carl’s parents for approval.
1. Is punishment an OK procedure given the situation?
2. Is there anything else Juan should do before submitting his plan to the
parents for approval?
3. How is this related to Task 1-8?
58
Case Study 8B
1.
It is OK to accept the functional analysis done by the previous BCBA.
It is OK to use a punishment when warranted.
You must consider the alternative. We know that punishment is an effective
treatment for self-injurious behavior and that it typically suppresses behavior
immediately. A DRO reinforcement procedure typically takes much longer, as
does extinction. If the functional assessment indicates that punishment is
appropriate and the client may suffer injuries if the behavior continues, then
punishment is OK.
“A procedure’s overall restrictiveness is a combined function of (a) its
absolute
level of restrictiveness, (b) the amount of time required to produce a
clinically acceptable outcome, and (c) the consequences associated with
delayed intervention.
Furthermore, selection of a specific treatment is not based on personal
conviction. Techniques are not considered “good” or “bad” according to
whether they involve the use of reinforcement rather than punishment. For
example, positive reinforcement can produce a number of indirect effects,
some of which are undesirable.”
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Case Study 8B
2.
3.
However, behavior analysts should recommend reinforcement along
with punishment (given that punishment is necessary); thus, Carl’s
program should have some reinforcement procedures for alternative
behaviors, such as holding and playing with a toy, raising his hand to
get his teacher’s attention, and/or using a musical instrument or art
materials.
Why is this related to task statement 1-8?
Take into consideration minimal intrusiveness of the procedure punishment is considered to be an intrusive intervention procedure in
the field.
Also if extinction is used for an inappropriate behavior, use the same
reinforcer (if possible) that was maintaining the inappropriate behavior
to reinforce some incompatible appropriate behavior - woman whose
head was falling off (U2).
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NFE: Interesting study!
Hanley, Piazza, Fisher, & Maglieri (2005)
• Participants: 2 children with severe behavior disorders
• Conditions
– Functional communication training (reinforcement) with
extinction for self-injurious and aggressive behaviors
– Functional communication training (reinforcement) with
punishment for self-injurious and aggressive behaviors
• Results
– FCT with punishment was more effective in reducing problem
behavior
– When given the option, both children showed a clear
preference for the FCT with punishment condition
• Proposed reason for the preference
– Punishment suppressed the problem behavior more quickly
and more effectively than extinction, thus
– Children received a much more reinforcement because they
emitted a much higher rate of appropriate behaviors
(don’t make assumptions about punishment; punishment –therapist held hands down at the side of 61
the child, and for one also visual screening, put on hand over the eyes of the child)
Case Study 8C
Shelly, a BCaBA, has been asked by parents to provide behavioral
services to their child, who is 6 years old, severely autistic, and has
no language at all. She wets her pants and has tantrums. She
throws food if she does not like it. She screams and cries at night
when her parents try to put her to bed. The insurance company is
willing to pay for only 2 hours of behavioral services each week and
Shelly feels that this is not at all sufficient. The parents are at the
point where they are literally crying and saying they are desperate
for any level of service. Shelly is considering working with child even
though she does not believe she can do much, if any good, because
she really wants to support the parents, who believe something is
better than nothing.
1. What should Shelly do?
2. Why is this relevant to task 1-8?
62
Case Study 8C
1.
She should refuse the position, explaining that level of services is not
going to help their child. She should also try to find alternatives for the
parents, if there are any (moving to a school district or state that
provides more services and funding, or provides “scholarships” for
children who need intensive (temporary) residential treatment.
What are some of the problems if she accepted the position?
2.
3.
Why is this related to task statement 1-8?
Use the most effective assessment and treatment procedures
What other task statement is relevant?
Task 1-1: do not exaggerate the benefits of ABA.
(child would not get better, ABA doesn’t work, insurance fraud. Always say no if the parents, school district,
group home, residential treatment center does not have the resources or are unwilling to have the behavior
analyst devote sufficient time due to mixing and matching of therapies . )
63
Task Statement 1-9
• Protect confidentiality.
• Note that this is strongly related to task
statement 1-4: Obtain consent
64
Case Study 9A
Dr. C. was a BCBA who worked with a number of children in her small
community. Dr. C. most often provided treatment in the children’s
home after school hours. Two of Dr. C.’s clients, Jason and Jennifer,
were a brother and sister. Their alcoholic father was in and out of the
home and the father had abused the mother in the past. Dr. C.
attended a church where several of the members of the congregation
knew the family. They cared very much about the children and would
ask how they were doing. They would often tell Dr. C. what they knew
about the family and they would ask how the children were getting
along at school and at home. The women from the church had
donated clothing and food to the family in the past and they always
had the children on the list to receive Christmas gifts from the church.
1. How much information should Dr. C. give these caring church
members? If you were Dr. C., what should/would you say?
65
Case Study 9A
1. How much information should Dr. C. give these caring church
members? If you were Dr. C., what should/would you say?
Behavior analysts have an obligation to respect the confidentiality of
those with whom they work.
When asked about the children, Dr. C. should politely tell anyone
who asks that she cannot discuss her work with her clients. She
should then politely change the conversation.
2. Why is this relevant to task statement 1-9?
Confidentiality
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Case Study 9B
Dr. W., a BCBA, has been working on Tom’s behavioral issues for two
years. Tom lives in a supported living apartment in the community and
he works at a job with supervision from Vocational Rehabilitation. Dr.
W’s data show that Tom frequently arrives at work late, sometimes falls
asleep at work, and sometimes does not come to work at all. Tom
would rather stay at home and sleep, and a variety of behavioral
incentive programs have not been effective. Dr. W. is wondering
whether Tom might have a sleeping disorder and might benefit from a
sleep evaluation. Dr. W. has a friend who is a physician who
specializes in sleep disorders. Dr. W’s plan is to invite his friend to
lunch and tell him about Tom.
1. Can Dr. W. ethically talk to another professional about Tom to
determine if (a) the person feels a referral might be appropriate, and (b)
if the person would consider taking Tom as a patient/client?
67
Case Study 9B
1.
Can Dr. W. ethically talk to another professional about Tom to
determine if (a) the person feels a referral might be appropriate, and
(b) if the person would consider taking Tom as a patient/client?
If he talked about issues in a general way and did not divulge any
information from which Tom could be identified, it would be OK.
However, the best course of action, to insure that he would not
violate the confidentiality of Tom, would be to obtain the written
consent of Tom (or his guardian) before talking to another
professional.
Certainly, disclosing Tom’s records or giving information such as his
name or behavioral specifics to another professional would be
unethical, regardless of the purpose.
68
Case Study 9C
Sandy, a BCaBA was taking behavioral data for clients in a school setting
using her lap top computer that had a special program designed for that.
The data are saved on the computer (as opposed to being entered on a
secured web site).
What are some of the precautions that Sandy should take to protect the
confidentiality of her data?
What are some of the important laws/guidelines that Sandy must follow?
69
Case Study 9C
Electronic and digital gadgets have introduced many complications and
problems with respect to confidentiality.
1.No identifying information can be on the electronic data form or file
2.Sandy should have an encrypted section on her hard drive to which she
saves the data
3.Her lap top should be password protected
4.She should never leave her lap top unattended (in her car, for example),
in an unlocked office (even for a few minutes while going to the
bathroom), or at a table at a café while getting coffee
Laws/ethical violations she needs to know about:
1.Electronic transmission of confidential records across any unsecured
medium (email, faxes in public areas) is both illegal and unethical.
Question: what’s secured, particularly now with wireless and clouds?
What about your email? Do you mention names or other identifying
information in emails to your practicum supervisor?
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NFE: Task Statement 1-11
• Ensure that the dignity, health, and safety of one’s clients
are fully protected at all times.
– Behavior analysts do not engage in discrimination
against individuals or groups of individuals based on
age, gender, race, ethnicity, national origin, religion,
sexual orientation, disability, language, or
socioeconomic status.
– They do not engage in behavior that is harassing or
demeaning to persons with whom they interact in their
work based on the above factors.
– They operate in the best interests of the client.
– They take reasonable steps to avoid harming their
clients, research participants, students and others with
whom they work and to minimize harm where it is
foreseeable and unavoidable.
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Case Study 11A
Ahmed took a specialized undergraduate track in his
bachelor’s degree program that permitted him to take the
BCABA certification exam, which he passed. In school, he
earned very good grades and excelled at doing functional
assessments in his practicum. When he got his first job, he
discovered that one of his student clients in an elementary
school was a Sunni Muslim. Ahmed mentioned this to his
parents who were irate and insisted that he refuse to
associate in any way with this student of a rival religious
sect.
1. Ahmed is in a very sensitive situation. How should he
handle this?
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Case Study 11A
1. Ahmed is in a very sensitive situation. How should he
handle this?
Refusing to provide treatment to a person based on
religion, ethnicity, or national origin is a form of
discrimination and is not condoned. It is illegal as well.
This means that Ahmad cannot refuse treatment to this
child to satisfy his parents. If he cannot be totally
unbiased, he must make a referral to another BCBA, and
rethink his commitment to being a behavior analyst.
73
Case Study 11B
Jason, a ten-year-old with learning disabilities and social acting out,
was mainstreamed into an elementary school physical education class
at the beginning of the new school year. The school was in Florida.
Jason would frequently disrupt the whole class with his antics during
softball, which was played outside. He would squeal loudly if he missed
the ball and he would make every attempt to run in a humorous
manner so that other students would laugh. The physical education
teacher was frustrated and ready to implement his own behavioral
intervention that was to have Jason run around the track that
surrounded the softball field each time he misbehaved. The school
principal sent Dr. K., a BCBA, to meet with the phys ed teacher and
discuss alternatives. Dr. K. suggested that the first intervention simply
be that when Jason acted out, he would be sent to the bench to sit and
watch. Dr. K. explained to the phys ed teacher that this was a
procedure that was research-based and was usually effective.
1. Why was sit and watch preferable to running around the track?
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Case Study 11B
1.
2.
Why was sit and watch preferable to running around the track?
Sit and watch which is a brief time-out procedure is a better starting
point than the physically grueling, and potentially dangerous, task of
running around the track in the hot sun (remember it was FL).
Why is it relevant to Task 1-8 as well?
Because this is the first attempt at a behavior plan for Jason, the
behavior analyst needs to start with the least restrictive, intrusive
procedures.
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Case Study 11C: Excellent example of Task 1-11
Terrence lived in a group home and hated to get up in the morning to go to
work. He would fight with staff members, throw shoes at them, and pull the
bed covers up over his head. Maria was asked to develop an intervention
program for him. Before taking baseline data, she met with all of the direct
care staff who worked with Terrance. One staff member who reported no such
reaction when she was on duty described her method of getting Terrence up.
“Basically I try to treat him like my dad who lives with us. He’s on medication
just like Terrence, and I know that it makes him groggy in the morning. So, I
have to show some patience with Terrence. What I do is I go in his room and
say in my sweetest voice, ‘Terrence honey, it’s almost time to get up,’ and I
open the curtains about halfway and then I leave his room. Then I come back
about 15 minutes later and open them the rest of the way and go to Terrence
and gently rub his arm and say, ‘ How yah doin’ Terrence? It’s almost time to
get up. We’ve got some fresh coffee brewing and I’ve set out your work
clothes. I’ll be back to get you in a few minutes.’ Then about 15-minutes after
that I come back and if he’s not up I turn on his clock radio and say, ‘Terrence
sweetheart, it’s time to get up now. Here let me help you get dressed.’ I know
this takes extra effort but this is the way I would like to be treated and it’s the
way I treat my dad so I don’t mind. And it works. By the time I turn on the radio
he’s swinging out of bed and has that little half-grin on his face that says
‘Thank you for being so understanding.’”
76
NFE, but more interesting cases: Time permitting
Jose, a BCABA, was working with an autistic child in the
child’s home. The child’s parents were originally from
Jordan. In Jordan, as in many middle-eastern countries,
the offer of food and drink is an extremely important
cultural practice related to hospitality. It is considered
extremely rude not to offer a guest something to eat and
drink. Knowing this, Jose accepts the offers when he is
working in the home. One day, the mom, Aida, not only
serves him food, but gives him several large containers
of food to take home. She made the food for him
specifically. Jose graciously accepts. This has become
a regular pattern. Every two weeks Aida makes meals
for him to take home.
1. Was there a problem with this?
2. Why is this relevant to Task Statement 1-7?
77
Case Study
1.
Was there a problem with this?
Interestingly, two years ago, a similar case was hotly debated at by a panel of ethics
experts at BAAM. It came to be known as “Ambushed by the casserole!”
One panel member was adamant that this was completely unethical and in fact Jose
never should have accepted the food and drink when he was in the home. This
same panel member ended up saying that, similarly, teachers should never accept
even an apple from a student. He was making the “slippery slope” point.
Other panel members said it was OK – that Jose had to be sensitive to the cultural
background of his clients and it would have insulted the parents if he had refused
and thus could have jeopardized his work with the child.
Yet another panel member said it was OK for Jose to accept the food and drink when
he was in the home, but it went over the line when he accepted the food to take
home.
2.
Why is this relevant to Task Statement 1-7?
Jose could become too friendly with the parents and that could affect how he
interacts with the child and with them.
The apple? The teacher might come to like that student more; other students may
not have enough money to give gifts to the teacher and feel bad even if the teacher
did not show any bias toward the student who gave him/her an apple, etc.
78
More Interesting Cases, Time Permitting
• Behavior analyst in school room – teacher and she
become friends, both new to the area. First, a cup of
coffee, then drinks at a bar. Then….
slippery slope or not? (task 7)
• Behavior analyst is working in the home with a child.
The mom tells the behavior analyst that she needs to
run to the store – and that she won’t be gone long.
OK or not OK?
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THE END
• Don’t forget to bring your computer
verification of completion of the on-line
training for research ethics!
There is no second chance!
• Instructional assistance hours:
– Monday, 12/02, 5:30-7:00 PM
– It’s Katelyn’s turn
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