G-22: Use procedures to promote maintenance ©
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-22: Once Jada’s unsafe behaviors have consistently shown 90% reductions from baseline across her day, including in previously highly challenging contexts, Dr. Brown-Davis starts to fade out some aspects of Jada’s interventions, such as slowly fading the visual “unavailable” card and using staff vocal only. Dr Brown-Davis has been preparing for maintenance from the beginning, by teaching Jada skills that will help her in society (for example, using picture icons to communicate). Dr. Brown-Davis is aware that Jada’s disability means that her motivation profile may be permanently different from most other people in society. He is okay with this, and encourages her team to celebrate the fact that Jada is neurodivergent. He also acknowledges that complete removal of all contrived interventions may not be a realistic goal, because society is designed for neurotypical people and may not support Jada’s needs without modifications. However, he wants Jada to have her needs met in a non-contrived environment as much as possible.
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-22: Once Donovan has consistently remained in class 100% of the time for a month and has been completing similar numbers of assignments to grade level peers, Ms. Bailey begins to implement procedures to promote maintenance. Ms. Bailey has already taught the replacement skills to fluency. First Ms. Bailey removes antecedent interventions such as reduced items on a page. Next Ms. Bailey fades out contrived reinforcement and works with the classroom teacher to maintain high levels of behavior specific praise and intermittent access to Donovan’s sketchbook based on his work completion.