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 G-17: Dr. Brown-Davis knows, from the research literature and from clinical experience, that Jada could likely be taught to use a token economy to earn reinforcers in the context of work demands. Considering Jada’s case as a whole, Dr Brown-Davis decides against this option. He wants to teach Jada to engage in non-preferred work demands using intermittent reinforcement and shaping procedures. He does this by designing a program which calls for prompting Jada to engage in the task and then reinforcing cooperation unpredictably using escape. For example, Jada may be asked to start washing the dishes. As soon as she stands at the sink, the staff might say, “Way to go, thanks for getting started. You can be done now.” Another time, they might offer escape after she has washed two dishes. This method uses a reinforcement schedule that is unpredictable, which is not easily compatible with a token economy.
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 G-17: Ms. Bailey creates a school store in her room. Ms. Bailey clearly outlines the behaviors that students need to exhibit in order to earn tickets (conditioned reinforcer), and explains that students will be able to use the tickets to purchase from the school store every Friday. The first day the school store is in effect, Ms. Bailey finds opportunities to give tickets to every student for meeting the pre-taught expectations. Ms. Bailey also ends instruction early and provides the students an opportunity to buy from the school store at a reduced price that day. This process (the stated rule and the direct contingency) establishes the value of the tickets as a conditioned reinforcer.