Behavior Measurement Procedures

Measurement

• Prepare for data collection by reading instructions, reviewing client data, viewing previous data/graphs, and gathering materials/visuals/reinforcement
• Implement continuous measurement procedures, which involves taking data every time the behavior occurs

Continuous Measurement Types

• Frequency: Counting each instance of behavior
• Duration: Timing the behavior from onset to offset
• Latency: Timing from SD [cue] to SR [response]
• Inter-response Time: Timing between successive SRs

Discontinuous Measurement

• Implement discontinuous measurement procedures, which entails recording data for a sample of behavior, not every instance

Discontinuous Measurement Types

• Partial Interval Recording: Recording Yes/No data based on whether the behavior occurred during the interval

• Whole Interval Recording: Recording Yes/No data based on whether the behavior occurred for the entire length of the interval

• Momentary Time Sampling: Recording Yes/No data based on whether the behavior is occurring at the end of the interval

• Percent Occurrence: Calculated by dividing the number of independent client responses by the total number of trial opportunities and multiplying by 100

• Discrete Categorization/Coding: Sorting data into codes/categories

• Trials to Criterion: Number of trials for client to go from baseline to mastered

Permanent-Product Recording

• Implement permanent-product recording procedures, which involves recording whether or not the behavior occurred based on physical evidence

• Enter data and update graphs, which are diagrams displaying data as points, lines, curves, or areas that represent the variation of a variable

• Positive Trend: Indicates the observed behavior is increasing

• Negative Trend: Indicates the observed behavior is decreasing

• Describe behavior and environment in observable and measurable terms

• Behavior: A living organism's directly observable/measurable actions or physical functions

• Environment: The context in which behavior occurs

Assessment

• Conduct preference assessments to assess preferred stimuli and reinforcement value
• Stimulus Preference Assessment: Assesses preferred stimuli by asking the client/stakeholder, or trial-based methods

Trial-Based Methods

• Single Stimulus: Presenting one stimulus at a time

• Paired Stimulus: Presenting two stimuli at a time

• Multiple Stimulus with Replacement: Presenting 3+ stimuli; the chosen stimulus is presented again with 2 novel stimuli

• Multiple Stimulus Without Replacement: Presenting 3+ stimuli, rotating all stimuli with novel stimuli

• Free Operant Observation: Observe client engage with stimuli in their environment

• Reinforcer Assessment: Assesses reinforcement value of preferred stimuli

Reinforcement Assessments

• Progressive Ratio: Increase the amount of work required to obtain stimuli

• Concurrent Schedule: Complete task for stimulus 1+2 to determine which stimulus results in increased task performance

• Multiple Schedule: Engage with stimulus non-contingently and contingently to observe client motivation

• Assist with individualized assessment procedures, such as social skills, development, and curriculum-based assessments

• Individualized Assessment: Curriculum based assessment to assess client's skill development in various skill areas compared to average, interviews, and scored forms

Functional Assessment

• Functional Assessment helps assess behavior by assessing client motivation for engaging in the behavior

Functional Assessment Types

• Descriptive Assessment: Directly observing client behavior and recording antecedent/consequence/environmental information to hypothesize function.
• Functional [Experimental] Analysis: Hypothesize function by manipulating environment variables and observing behavior changes
• Indirect Assessment: Gather environmental data surrounding behavior from others and use that data to hypothesize function

Skill Acquisition

• Identify the essential components of a written skill acquisition plan

Skill Acquisition Essential Components

• Identify a skill deficit

• Create a goal

• Identify measurement procedures to collect data

• Assess current skill level [baseline]

• Select/implement skill acquisition procedure

• Continuously collect data

• Modify as needed

• Prepare for sessions by gathering visuals/materials, reading all instructions, reviewing previous data, and gathering reinforcement

Reinforcement

• Reinforcement: A stimulus presented after a behavior that causes the behavior to increase or continue
• Unconditioned [Primary] Reinforcement: A stimulus that is a reinforcer despite no particular learning history
• Conditioned [Secondary] Reinforcement: A stimulus that was previously neutral but is a reinforcer because it was paired with a primary reinforcer

Schedules of Reinforcement

• Continuous Reinforcement: Reinforcement is given after every instance of behavior
• Intermittent Reinforcement: Reinforcement is given after some instances of behavior, not every instance

Intermittent Reinforcement Types

• Ratio: Reinforce after X number of behaviors

• Interval: Reinforce after X amount of time engaging in a behavior

• Fixed: Occurs when the amount of behavior required for reinforcement remains the same

• Variable: Occurs when the amount of behavior required for reinforcement changes

• FR [Fixed Ratio]: Client must perform a fixed number of behaviors to be reinforced.

• VR [Variable Ratio]: Client must perform about X number of behaviors to be reinforced, but number changes

• FI [Fixed Interval]: Client must engage in a behavior for a fixed amount of time to be reinforced

• VI [Variable Interval]: Client must engage in a behavior for about X amount of time to be reinforced

• Punishment: A stimulus presented after a behavior causes the behavior to decrease or stop

Discrete Trial Training

• DTT [Discrete Trial Training]: Controlled teaching procedure where client is presented with an sD [discriminative stimulus or “cue”] and responds with a corresponding behavior [sR] in a systematic trial-based manner.
• Mass Trial [MT]: One target stimulus is presented repeatedly until mastered
• Distractor Trial [DT]: One target stimulus is presented alongside an unknown stimulus repeatedly until mastered, only done receptively
• Random Rotation [RR]: Two target stimuli are presented together repeatedly until mastered, sD is rotated between the two receptive targets
• Expanded Trial [ET]: Three or more target stimuli are presented together repeatedly until mastered, SD is rotated between all targets to reinforce retention
• Generalization and Maintenance: Transition from learning phase of DTT to natural conditions to maintain mastery

Naturalistic Teaching Procedures

• Naturalistic teaching procedures include implementing teaching strategies using natural stimuli or environments
• Pivotal Response Training teaches foundational [pivotal] skills through play

Pivotal Response Training

• Client attention increases attention span by maintaining/redirecting to game/play when attention is lost

• Maintenance tasks check that previously mastered targets are retained by implementing prior programs in play

• Client choice/shared control teaches sharing/flexibility by taking turns, providing limited choices in low-stakes play

• Responsiveness to multiple cues encourages clients to intake many cues to react, which helps with future safety

• Contingent Reinforcement teaches that reinforcement will be given if something else happens first

• Reinforcing attempts encourages clients to try even when they are not perfect

• Direct, Natural reinforcement develops naturally occurring neutral stimuli into reinforcers

• Incidental Teaching: Implement teaching procedures in a natural environment, incorporating client interests/motivations

• NET [Naturalistic Environment Teaching]: Implementing ABA teaching procedures in environments where the client would naturally use skills

• Task Analysis: Complex a routine into smaller steps

• Chaining: Strategy to teach a task analysis; client must do all previously mastered steps before learning the next step

Chaining Types

• Backward chaining teaches a task analysis from final step to first

• Forward chaining teaches a task analysis from first step to final

• Discrimination Training: Reinforcing behavior under one stimulus condition [sD] and not another [sDelta] to teach that reinforcement is available

• Stimulus Control Transfer: Transitioning control of a behavior from one stimulus to another by pairing stimuli/fading out the original

• Prompting provides cues or assistance to encourage a desired response or reduce frustration.

Prompting Hierarchy

• Prompts range from most intrusive [most control over client behavior] to least intrusive [least control over client behavior]

  • Physical - Touch client to alert/assist in completing task
  • Verbal - Verbally prompt the client to increase response
  • Gestural - Moving the body to prompt/alert it to them
  • Model - Doing exactly what they are expected to do
  • Visual - In the environment before the sD is given
  • Positional - Moving stimuli to a prompt position
  • Material - The material that a visual comprises

• Prompt Fading: Gradually adding/removing prompts to assist client

  • Most to Least prompting moves down the prompting hierarchy to ensure errorless learning and safety
  • Least to Most prompting moves up the prompting hierarchy to facilitate independence but can increase chances of prompt dependence

• Stimulus Fading: Increase/decrease the size/presence of a stimulus to prompt behavior

• Implement generalization and maintenance procedures

Generalization Conditions

• Generalization is the process where behavior occurs in different conditions from those learned

  • Across Subjects - Engaging in behavior after observing someone else engaging/receiving reinforcement
  • Across Settings - Engaging in behavior in a different location than initially learned
  • Across People - Engaging in behavior by another person
  • Across Materials - Engaging in behavior using different stimuli than originally learned
  • Across Behaviors - Engaging in new behavior to achieve the same goal
  • Across Time - Engaging in behavior at a different time

• Maintenance ensures target behaviors are retained at a mastery level

• Shaping reinforces successive approximations towards a desired behavior

Token Economy System

• Token Economy System: A visualization of delayed reinforcement to maintain motivation where the number of tokens is required. Tokens are reinforcement after behavior to be exchanged as desired.

Behavior Reduction

• Identify essential components of a written behavior reduction plan

Behavior Reduction Essential Components

• Identify/define/create a goal for maladaptive behavior

• Assess ABCs

• Hypothesize the function of the behavior; why is the behavior happening?

• Identify possible replacement behaviors

• Select/implement antecedent/consequence-based interventions

• Create a crisis plan

• Implement, Modify, Generalize, and Maintain as needed

• Describe common functions of behavior as the person's means of achieving goals

  • Social: Behavior occurs as a direct result of another person
  • Automatic: Behavior occurs whether or not another person is involved.
  • Positive: A stimulus is being given.
  • Negative: A stimulus is being taken away.
  • Social Positive Reinforcement: Client engages in behavior to get attention or a tangible object
  • Social Negative Reinforcement: Client engages in behavior to avoid a task or escape presence of someone
  • Automatic Positive Reinforcement: Client engages in behavior to get sensory stimulation/input
  • Automatic Negative Reinforcement: Client engages in behavior to alleviate pain or reduce sensory input

• Antecedent Intervention: Changing something to change the behavior

  • MOs [Motivating Operations]: Changing the reinforcement value to change client motivation

Antecedent Intervention Types

• Medical Intervention: Medical needs are assessed to ensure no illness is motivating behavior

• Deprivation: Increasing the reinforcement value by removing access to the stimulus

• Satiation: Decreasing the reinforcement value by providing access to the stimulus

• Manipulating the Stimuli [sD’s] in the environment that may cue behaviors in order to change the behavior: Preparation Providing Choices Flexibility training Prompting Creating a safe environment Limiting distractions Incorporating special interests Behavior momentum Advances notification of transitions Teaching replacement behaviors Systematic desensitization Creating a stimulating environment Modifying tasks Alternating preferred and non-preferred tasks Alternating active and passive tasks Behavior contracts Priming rules and expectations Creating opportunities Delivery of instruction Non-contingent reinforcement Pairing teaching environment with reinforcement

• Differential reinforcement: A schedule when the target behavior is not reinforced while other behaviors are.

  • DRA [Alternative]: Not reinforcing the target and reinforce an alternative behavior that fulfills the same function
  • DRI [Incompatible]: Not reinforcing the target and reinforce an incompatible behavior that the client cannot physically do at the same time
  • DRO [Other]: Not reinforcing the target and reinforce any other behavior the client engages in
  • DRL [Low Rate]: Not reinforcing a high rate and reinforce when the behavior occurs less frequently

• Extinction: A procedure in which reinforcement for a previously reinforced target behavior is discontinued.

  • Extinction Burst: Predictable increase in behavior will occur after extinction

Crisis/Emergency Protocol

• Address a crisis/emergency, which occurs when client/staff/family/public safety is at risk

• Antecedent based Interventions to prevent crisis situations: Create Safe Environments, Dress appropriately for behaviors, and Teach replacement behaviors

Potential Crises

• Strike: When a weapon is thrown, block it and move to a safe spot

• Grab: Making physical contact without consent

  • Hold and Stabilize: Used for low risk grabs to eliminate motion/escalation. Hold client in place and prompt them to let go.
  • Pull/Push: Used for medium risk grabs to disengage from a potentially unsafe situation -Lever: Used for high risk grabs to rotate and move away from a potentially unsafe situation

• Restraints: Can limit movement which is a last resort that requires special training

Documentation and Reporting

• Communicate with supervisors when unsure of how to implement a program/take data/prompt, if a parent raises concerns, if something changes that influences behavior, if canceling a session, to ask for additional training

• Actively seek clinical direction actively from supervisors and report any variable that may influence behavior

• Report should contain:

  • Changes in routine
  • Parent/family routine changes
  • Changes at school
  • Losing favorite items or people
  • Illness
  • Not sleeping
  • Medicine changes
  • Vacation

• Generate objective session notes that describe what occurred and without the influence of bias.

Objective Language

• Objective is observable and measurable

Subjective Language

• Subjective is the opposite, influence of bias or emotion

Subjective Language Examples

• Emotions

• Subjective measurements “Everywhere" unless literal

• Comply with applicable legal, regulatory, and workplace requirements

• Data Collection: never falsify, alter, or guess. If data is lost, it must be reported, collected during session, with no delays.

• Data Storage and Transportation: It must have the dual lock protocol, and there must be no PHI leak.

Professional Conduct and Scope of Practice

• Describe RBTs supervision requirements and the role of RBTs in service-delivery system

Roles of RBTs

• The role of RBT is a paraprofessional guided by the supervision of BCBA or BCABA and can implement skill acquisition, behavior reduction programs, collect data, assist in assessment, and perform instructed tasks

• 5% of all monthly direct hours must be supervised by a BCBA or BCaBA to supervise qualifications and set up goals.

• Supervision must be face to face twice a month or video, not just voice/text

• A direct observation of ABA 1:1 skills with a client in a group setting

• What qualifies as supervision? Direct observation of ABA skills with a client, review new client, setting goals for skill development.

• RBTs must renew their certification annually

RBT Certification Requirements

• Must complete a renewal application and pay a $35 renewal fee within 45 days of expiration and 30 days to renew with a late fee after. Then, an RBT exam is needed.
• Feedback from a supervisor is essential to growth
• Follow the 3 A's if you receive feedback from a supervisor

The 3 A's

• Acknowledge a mistake

• Apologize for the mistake

• Act to immediately correct it, and consult with the supervisor

• Communicate with authorized stakeholders as specified. The RBTs must use the objective statement to communicate regarding session/client but cannot diagnose or provide clinical feedback, should defer to an authorized supervisor instead.

• Maintain professional boundaries; avoid dual relationships, conflicts of interest, social media contracts. - should have one relationship with the client.

Social Media

• Don't post about clients

• Social media conversations and discussions should follow office policy

• Do not contact or follow friends and follow clients, never have any private info leaked.

• Maintain client dignity by always best interest, and not discriminate, bully, or harass. Always encourage the client's privacy and independence