F-3: Identify and prioritize socially significant behavior-change goals ©
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-3: Dr. Brown-Davis knows that understanding the needs of the client, and the client’s context, is very important. He does not jump directly into assessment, but instead takes the time necessary to inform his assessment decision. He completes interviews with Jada’s parents, as well as her new school team members. He also observes Jada in her natural environment. Dr. Brown-Davis asks open ended questions about what is getting in the way of Jada’s happiness and success. He also takes time to listen to the needs of the whole family system. Dr. Brown-Davis carefully considers the safety options and resources available at school to manage Jada’s behavior. Based on the information gathered through observations and interviews, Dr. Brown-Davis learns that Jada needs support with reducing/eliminating severe problem behavior which threatens safety. He also learns that Jada does not advocate for herself (communicate) in the natural environment, nor does she participate in routines or self care tasks. She has a narrow array of interests (all revolve around sensory play). Dr. Brown-Davis decides to move forward with the hypothesis that Jada needs both behavior reduction programming and skill acquisition programming.
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 F-3: Ms. Bailey speaks with Donovan, Donovan’s mother, and school staff. She asks open ended questions about the information she found in the record review, as well as what would be most valuable from the perspective of each person. She finds that Donovan expresses disconnection from his school community and resentment towards teachers and administrators. Donovan states, “It doesn’t matter how hard I try, no one notices me in this school. I know I’m dumb, I got the memo! Why do people keep lecturing me about stuff? I just want to drop out and hang out with my friends. I can get a job at a gas station.” He is not able to provide specific insight into what he needs to learn at school, mostly remarking that school subjects are “stupid” and “irrelevant” to his life. When asked why he skips school or skips classes, Donovan says that there’s no reason for him to be in school. Donovan’s mother expresses to Ms. Bailey that she is frustrated with Donovan’s attitude, and wishes that school staff would come up with a plan to address it.