Unit 6 - 1

Question 1

Of course not every task will relate directly to every plan
But the task list defines the basic knowledge, skills, and abilities necessary for the practice of ABA…
And the practice of ABA, out of all the domains of behavior analysis, involves writing, implementing, and monitoring effective treatment plans!

Answer 1

Individualized Plans

Question 2

Again, a reminder: Tasks refer to knowledge, skills, and abilities which are necessary for the practice of ABA

Not all plans utilize all tasks, but all tasks are needed for writing plans (e.g., you may only measure rate, and not IRT or latency, but you need to be able to make that choice when you write a plan)

Answer 2

Tasks and Behavior Plans

Question 3

Activities completed by the behavior analyst prior to the behavior intervention plan (BIP)

 Referral/screening: preliminary statement
 Indirect assessment: Records, interviews
 Descriptive assessment: Narrative recording, scatterplot, ABC data
 Preference assessment
 Functional analysis: structured-antecedent, analogue, and/or in-situ functional analysis

Answer 3

Foundations of a behavior plan

Question 4

 O’Neill & Horner (1997) identify four “considerations” underlying behavior support plans. They state that plans must:

1. Indicate how the caregivers’ behavior will change as well as that of the client
2. Be based on functional assessment
3. Be conceptually systematic
4. Be a good fit with the values, resources, and skills of the people responsible for implementation

Answer 4

Behavior Plan Features

Question 5

Least Restrictive Procedures
•Behavior analysts review and appraise the restrictiveness of procedures and always recommend the least restrictive procedures likely to be effective.”

Answer 5

BACB® Professional and Ethical Compliance Code: 4.09

Question 6

Staff/caregiver issues
•Commitment/support
•Supervision involvement
•Education/cultural/language issues

These issues can only be addressed by direct and regular contact with caregivers, and if applicable, their supervisors. This is a group effort from the outset, or it will not work. Period.

Answer 6

Other Considerations

Question 7

Indirect Supports:

Funding/administrative support:
 These supports are key. They are considered indirect because they refer to supports from outside of the immediate service delivery context.

 Encourage participation by all “stakeholders”, and maintain open lines of communication. Be inclusive, and always look to help solve problems!

Follow Through:
Time availability of the behavior analyst;
 The behavior analyst must not take cases that he or she is just too busy to take on!
 Generally, if you accept an assigned assessment, you should have time to complete the case too, if that is offered
 See Code element 1.04(c)

Answer 7

Other considerations

Question 8

Probes
During plan development, the behavior analyst may need to PROBE certain procedures to see if they are…..

Unless they are highly restrictive, probes typically do not require prior approval, but this should be discussed with a supervisor familiar with state law

Answer 8

1) Effective and

2) Realistic in the natural setting

Question 9

A Disclaimer: Published literature on this topic is sparse. What we will be discussing today is based on my own experience, having worked on behavior service plans in different states

Each state has its own list of plan requirements, so you must check your own state regulations on this!

Answer 9

The Components of a Behavior Plan

Question 10

The Two Behavior Plans

In writing and implementing a behavior intervention plan, typically best practice is to generate two separate documents..,,

Answer 10

1. The formal behavior plan

2. The step-by-step intervention plan

Question 11

Document is for the clinical record

Includes salient information about the individual and the behavior of interest
•Information collated from records reviews, interviews, assessments, and data

Describes in conceptual terms, the behavior plan, based on function, and is linked to outcome statements

Answer 11

The Formal Behavior Plan

Question 12

Document intended for caregivers/ program implementers

Much shorter document, written in clear language which avoids jargon

Functions as a task analysis

Provides a quick guide to intervention protocols, and includes information on data collection

Answer 12

The Step-by-Step Intervention Plan

Question 13

Both types of plan are necessary for the effective provision of behavioral services

The more formal plan meets regulatory and funding agency requirements for full documentation

The step-by-step plan is an immediate procedures page for daily use as a ready reference, and instruction sheet

Answer 13

Necessity of two plans

Question 14

1. Basic identification information
2. Rationale for behavior services
3. Consumer profile
4. Diagnoses and medical information
5. Medication list
6. Functional assessment procedures
7. Problem behavior (reduction targets)
8. Preference assessment results
9. Replacement behavior (acquisition)
10. Other target skills for development
11. Intervention: rationale and procedures
12. Target environment(s)
13. Response measure and data collection procedures
14. Training plan for program implementers
15. Monitoring plan/treatment integrity checks
16. Generalization and maintenance plan
17. Service authorization recommendation
18. Signatures and consents

Answer 14

Necessary parts of a formal BIP

Question 15

Consumer name

Date of birth

Date of original plan

Name(s) and credentials of author(s) of plan

Indicate if plan is new, minor revision, or major revision (with date of revision)

Answer 15

Basic information

Question 16

gives a brief statement as to why this individual requires services

Also indicate what the broad goal of the service is

Example
“Howard throws work to the ground and yells during class. The goal of this plan is to eliminate classroom tantrums/property destruction and help Howard successfully complete age level academic tasks.”

Whenever possible, the rationale should be tied to an outcome statement

For example, decreasing Howard’s tantrums is an intermediate goal as part of a long term outcome, “Howard will graduate high school”

Outcomes are statements about lifestyle changes. They are identified by the individual (or others serving as guardians) as representing a deep personal preference; an obtainable outcome they see as a way to enhance and enrich their own life course
This section allows anyone reading the program to quickly identify the need for (and purpose of) services

Answer 16

Section 2: Rationale and Outcomes

Question 17

Contains descriptive information, including (but not limited to) some or all of the following:

 Family profile
 Living situation description
 Educational status
 Job status
 Preferred and least preferred activities  Preferred and least preferred foods

Contains descriptive information, including (but not limited to) some or all of the following:

 Special skills
 Functional deficits
 Important social relationships
 Description of other professional services which may be related to the functional or diagnostic problem for which ABA services were obtained

Answer 17

Section 3: Consumer Profile

Question 18

Identifies important medical issues which may or may not be related to the issues addressed in the BIP.
Examples include:
 Seizure disorders
 Genetic syndromes  Allergies
 Chronic conditions (Asthma, Crohn’s)  Potentially contagious (Hep-B, MRSA)
AIDS has been under different legal restrictions and has not been typically included in a consumer’s behavioral record. Check the laws in your state!
 Remember: A behavior plan is a CONFIDENTIAL document, and as such falls under HIPAA-type constraints.
Releases must be obtained to share information in this document.

Answer 18

Section 4: Diagnostic and Medical

Question 19

This section is related to the prior section (see the task list, G-02)
Medication may be given to address a behavior problem, or may be given for a different problem, but still have a potential effect on the individual’s behavior
This section is vital for behavior analysts to complete and update regularly
Medications used for behavioral
purposes are called psychotropic. Can include:
 Antipsychotic agents
 Anti-anxiety agents
 Anti-depressants
 Sedatives
 Anti-seizure medication (for behavior)

Answer 19

Section 5: Medication

Question 20

Psychotropic Medications: Graphing
Psychotropic medication affects behavior directly, as its main purpose, and must be tracked on the data chart

The following require a condition or phase change line on the chart:

 Introduction of the medication (phase change)
 Dosage changes (condition change)  Discontinuation (phase change)

Answer 20

Psychotropic Medications: Graphing

Question 21

Side Effects of Medications

Medications have side effects that should be monitored (especially for effects on the individual’s behavior)

Side effects are ..,,.
E.g., If sleeping during daytime is a reductive target, what do you do if the person is given a medication that makes one drowsy?

Answer 21

direct effects on behavior

Question 22

A medication’s indirect effect on
behavior is called ……..a
E.g., Some meds cause a change in R.E.M sleep, which may indirectly affect a person’s level of concentration the next day. This is not a side effect, but a secondary effect.

Answer 22

secondary effect Changes in EOs are often secondary

effects

Question 23

Medication affects many MOs, both EOs and AOs

The EO effect
The Story of Bradley and the Polydipsia

The AO effect
 The Robber, the Cops, and the PCP

Answer 23

Medication and MOs

§ 5: medication and the BIP

Question 24

Side effects and secondary effects can profoundly affect a person’s behavior

They can also reduce the effectiveness of behavior plan procedures

They may be listed in a behavior plan so caregivers can monitor for them

Answer 24

Side Effects and Secondary Effects

§ 5: medication and the BIP

Question 25

1. Lists the processes used to complete a functional assessment, and 2. Provides a brief synopsis of that assessment 3. Includes Descriptive Assessment tools utilized, Example, published interview format; who was interviewed, number of daily observations made, time period of assessment, and Pattern analysis and sequence analysis results etc. 4. Outline any functional Analysis procedures. E.g., Structured – antecedent assessment, brief FA, analog FA In some formal programs, functional analysis data and charts are included. Tends to enhance the Professional weight of the document.

Answer 25

Section 7: functional assessment procedures and the behavior plan

Question 26

 Provides a list of target behaviors for reduction, and a clear operational definition for each.  Here you may use such terms as, SIB or aggression, but only if these are used as titles for a response definition that clearly lists and describes topographies.  This is an area where you will be doing a lot of revision as your program matures! In addition to problem behavior, the list of target behaviors should identify Pre-cursers. They predict the upcoming onset of the target behavior for reduction. Tells you an EO is in effect, and most likely increasing. And provide vital clues to rich teaching opportunities

Answer 26

Section 7: Problem Behavior

Question 27

Response definitions – behavior only versus Functional response definitions – these typically include antecedent and behavior, since the antecedent condition is motivationally tied to the functional consequence

Answer 27

Section 7: Problem Behavior (continued)

Question 28

Tarbox et al. (2013): A review of research suggests that plans must...  Include information pertaining to function of the behavior  Be primarily based on validated scientific research (evidence-based)  Stress positive reinforcement whenever possible, and be least intrusive

Answer 28

Behavior Plan Features