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.
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-4: Regarding behavior reduction programming, Dr Brown-Davis plans to complete an isolated contingency functional analysis (also called a traditional or standard functional analysis [FA]). He makes this decision because Jada’s behavior is severe and needs to be understood to be treated. He does not have hypotheses about the function of the behavior following interviews, and does not feel comfortable trialing treatments without a full assessment. Other factors that contribute to the decision to do an FA include the resources available to keep Jada safe at school (blocking pads, protective equipment, multiple staff trained in blocking skills and manual restraint, etc.). Dr Brown-Davis plans to implement function-based treatment once he understands what needs are being met through Jada’s problem behavior (i.e. what the function(s) of the behavior is/are).
Regarding skill acquisition programming, Dr Brown-Davis selects the Essential for Living (EFL) assessment and curriculum based on the information he found during the initial intake process. The EFL is a criterion-referenced measure that targets many meaningful skills for individuals with disabilities, from the most basic self-help skills to more nuanced social and occupational skills. Dr Brown-Davis hypothesizes that Jada will not be helped by simply continuing to work on arbitrary academic goals (such as naming colors). Instead, he plans to design programming centered around relevant, socially significant skills such as requesting help, communicating biological needs, and stating preferences.
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-4: Regarding behavior reduction programming, Ms. Bailey plans to complete a synthesized contingency functional analysis . She makes this decision because Donovan’s behavior is having a significant impact on his life and needs to be understood to be treated. She has a hypotheses about the function of the behavior following interviews, however she wants to either confirm or disprove her hypothesis before intervention. Other factors that contribute to the decision to do an FA include the the fact that Donovan has not engaged in severe behavior that staff could not keep his safety. Ms. Bailey plans to implement function-based treatment once she understands what needs are being met through Donovan’s problem behavior (i.e. what the function(s) of the behavior is/are).
Regarding skill acquisition programming, Ms. Bailey collaborates with the School Psychologist to identify Donovan’s academics strengths and weaknesses. The team finds that Donovan is capable of grade level work in math, however he has many missing skills in literacy. They select a phonics heavy intervention for Donovan to address some of the literacy skill deficits he possess.