With some recent families I have been contracted to help parents evaluate behavioral interventions, which utilize applied behavior analysis (ABA) for their children who have behavioral challenges. As a consultant I review, evaluations, IEP’s and behavioral programs that are in place to assure their child’s needs are being met consistent with best practice. The problems I find are numerous. They result in inadequate interventions and protracted periods where time is lost helping children be successful in school and easing difficulties in the home.
Implementing a behavior program is a challenge. In order to affect a program that is going to appropriately address the needs of the whole child, schools should follow procedures to maximize the interventions they implement. Unfortunately the time, cost and availability of qualified staff is often limited. Often times the reality is that school districts cannot meet the needs of the behaviorally/emotionally challenged child. The procedure for developing a behavior program in its simplest form breaks down as follows:
A Psychological Report or other report from a doctor provides a diagnosis and/or evaluation which identifies behavior(s) that interfere with learning and recommends behavioral intervention.
Typically the psychological report will identify the challenging behaviors and ideally discuss the intensity, duration and frequency, either based on anecdotal reports or actual data and/or observations.
The Early Intervention Coordinator, CPSE or CSE Chairpersons Coordinate a Meeting Recommending that these Behavioral Challenges be Addressed by a Behavioral Program
In the IEP that is generated, “preliminary” goals both long term and short term are generated. I say “preliminary” due to the fact that most times no actual data has been gathered prior to the IEP meeting. As such goals are not individualized, as required, and they are often too broad and the criteria inappropriate, as the goals are not behaviorally defined. Also required but rarely produced is the behavior program. Once the need for a behavior program has been established the following steps should be followed:
A Functional Analysis of Behavior, FBA, has to be Performed
The child should be observed in various settings and over a sufficient period of time to observe the child performing optimally and to obtain a measure of the frequency, duration and intensity of the challenging behaviors. Ideally these observations are performed at school and home. The primary intent of an FBA is to assess the motivation for the behavior.
A Baseline Needs to be Performed
A baseline is a measure of the challenging behaviors with respect to its frequency and duration without any intervention to change the behavior in place. The baseline will ideally support the findings of the FBA with respect observations documenting the motivation of the behavior. But its intent is to measure the effectiveness of the behavior program in reducing the challenging behaviors when compared to conditions without the intervention.
Behavior Program Design and Intervention
Based upon the evaluations, FBA and baseline data a behavior program is designed. Each program is unique based on the operational definitions of the challenging behavior(s) demonstrated and how, when and where the program is being implemented. Designing a comprehensive program is a time consuming process and should address AT A MINIMUM proactive as well as reactive strategies. Based on the frequency of the behaviors, daily, weekly or monthly reviews need to be carried out to assess the effectiveness of the program with respect to progress or the lack of progress in reducing the challenging behavior and teaching competitive behaviors. There are many dimensions to good program design which need to be part of every program, but unfortunately too often are not. In all cases, teachers and parents need to be trained on how and when to implement behavior program and how and when to collect data. (Training is often not performed and this is yet another potential area where a program can breakdown.)
DATA is important. Is the program working or not? Without real data documenting the frequency of the challenging behaviors, all the above efforts are to no avail. Review of data is critical and progress has to be assessed in a timely manner. If the challenging behaviors are not decreasing the reason has to be explored. I have found data needs to be collected in two or more ways to support implementation of the program. But if there is no data or the data is only anecdotal than no real scientific assessment and decision can be made if there is no change in the challenging behaviors. If there is no change, time is lost and the child continues to suffer as does the family.
As both a Psychoanalyst and Behavior Therapist I cannot EMPHASIZE enough that any behavior program has to include the family. There are many reasons that this is true but I will only address the most basic for the purpose of this outline. First if the behaviors occur at home or not, the parents need to reinforce pro-active interventions. If the behavior does occur at home they have to implement reactive interventions. Failure to gain parent participation will most likely result in the breakdown of the programmatic intervention where it is being implemented and will result in the child’s failure to generalize the skills being taught.
This is a short list of a very complex process of developing behavioral interventions using applied behavior analysis (ABA) to address behavioral challenges. Unfortunately, most behavior programs also fail to address the feelings of the child and family.