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-5: Dr. Brown-Davis conducts a preference assessment for Jada based on information gathered from interviews, as well as a free operant preference assessment (observation) in an enriched environment. Interviewees explain that Jada seems to like watching Cinderella on the tablet, swinging, using a finger paint kit, using the water table in her classroom, eating butter flavored popcorn, and looking at picture books. Dr. Brown-Davis would prefer not to use edible reinforcers for Jada unless they are contextually appropriate, due to health concerns, so he leaves out the popcorn from the assessment. (Dr. Brown-Davis is open to using edible reinforcers in the short term for clients who need help building an array of other reinforcers.) He would also prefer to use reinforcers that can easily be provided and removed, for the purposes of assessment and programming, so he decides to leave out the swing to see if other items will be effective. He then observes Jada in an environment where all the included items are available (free operant preference assessment). She spends her entire session choosing to play with the finger paint. Dr. Brown-Davis finds this information from Jada helpful, but he would like to know what else she likes, so he chooses to use a multiple stimuli without replacement preference assessment. The results yield the following hierarchy: finger paint, water table, Cinderella on tablet, and books. Dr. Brown-Davis uses this information to design Jada’s assessment and treatment, but he also keeps in mind that preferences may change, so he does not treat the results of the preference assessment as “final.”