F-1: Review records and available data (e.g., educational, medical, historical) at the outset of the case ©
Important note: Fictionalized clients are used to demonstrate the skill items in the second half of the task list, sections F-I. They make the most sense when read in order. Please remember that there is not substitute for real-life supervision and consultation. Get your case-specific advice from professionals – not from the internet! These examples are just that – examples of how behavior analytic skills might be applied.
Jada
Case example: Jada is an elementary school student. She experiences Level 3 Autism Spectrum Disorder (ASD). Level 3 is the severity level of Autism which is characterized by “requiring very substantial support.” Jada has also been diagnosed with a severe Intellectual Disability (ID). Jada has just transferred to a private school for individuals with global needs. She loves all kinds of play and messy activities, such as finger paint and water play. She also enjoys swinging on the playground, eating popcorn, and watching Disney movies. She loves to be read to, and laughs when staff make dramatic gestures while reading picture books. Jada does not use any vocal speech. She makes noises sometimes, such as humming. Jada engages in motor stimming, including upper body tensing and flapping her arms. Jada engages in severe challenging behavior, including self injury (hand to head and head to surface) and aggression (including hitting and biting). Jada has a mom, dad, and older brother living together in one home. Jada’s family has advocated for her to attend a private program, and they are excited for her to get high quality services. Jada’s new behavior analyst is Dr Brown-Davis, who is a BCBA-D employed by the private program.
Example of Item F-1: Dr. Brown-Davis gains consent to provide services to Jada from Jada’s parents, and then completes a full record review. He finds that Jada was diagnosed with ASD at the age of 19 months by her pediatrician. Prior to age 15 months, she attained developmental milestones as expected, and then was reported to regress in her language and social skills. Jada experienced suspected seizures as a toddler, and is under the care of a neurologist. Jada currently takes anticonvulsant medication and has not had a seizure in four years. She sees the neurologist every six months. Jada has been evaluated by a neuropsychologist, who diagnosed her with severe Intellectual Disability at the age of five years. She has received special education services since age three, first through a dedicated early childhood ABA center and then through her public school district. Her most recent school-based evaluation indicated that her IQ and adaptive skills were both substantially below average. Her public school IEP listed goals in color identification, matching animals, and memorizing sight words. Records indicate that Jada has an AAC device but “does not use it independently.” Special education documentation details a long history of Jada’s mother and father requesting evidence-based supports for their daughter in school, including goals that will help her live a meaningful life now and into adulthood.
Donovan
Case example: Donovan is a high school student. He has been diagnosed with Attention Deficit Hyperactivity Disorder (ADHD) and Oppositional Defiant Disorder (ODD). He attends a public school and has been placed in a support program for students with social/emotional/behavioral needs. Donovan enjoys playing video games and drawing in his sketchbook. He would like to be a welder when he is an adult. Academic achievement and attendance have been challenges for Donovan historically, and he is currently not on track to graduate with his peers due to missed work and failing grades in several classes. Donovan’s team has identified challenges including frequent non-attendance to school, walking the halls during class times, non-attendance at expected guidance appointments, and non-completion of classwork. Donovan lives with his mother and older brother. Donovan’s mother is concerned about her son’s school challenges and expresses frustration about his “lack of commitment” to his education. She wants Donovan to understand how important it is to graduate from high school. Donovan’s behavior analyst is Ms Bailey, who has just started contracting with Donovan’s school district through the agency she works for.
Example of Item F1: Ms. Bailey gains consent to provide services to Donovan from Donovan’s parent, and then completes a full record review. She finds that Donovan was diagnosed with ADHD in preschool by a neuropsychologist. He was referred for special education services in second grade due to concerns about his behavior and academic achievement. Donovan was initially found eligible for special education services as a student with ADHD. He was retained in 3rd grade due to concerns about underachievement in reading. He was identified with ODD by a school psychologist in 5th grade. His most recent school evaluation found that his IQ was in the average range, and that his phonological processing skills were in the 10th percentile (lower than 90% of age peers). Grade records suggest that Donovan earned fewer than half of the required academic credits in his first two years of high school. His records indicate that he has received social work and “learning lab” (resource room) support since elementary school to target “self management, executive functioning, and goals setting.” His IEP lists goals in comprehension, word reading, reading fluency, and self regulation. Donovan has passed vision and hearing screenings at school. No other medical problems are noted.