Special Topics Part 2 PDF

Special Topics Part 2 BEV GRAHAM, PHD, MPA, BCBA-D, LBA  Austin & Carr Ch. 5 Behavior analysis and school psychology School psychologists Behavior analysis deliver a wide array of psychoeducational actively informing practices in consultation an...

Special Topics Part 2 BEV GRAHAM, PHD, MPA, BCBA-D, LBA  Austin & Carr Ch. 5 Behavior analysis and school psychology School psychologists Behavior analysis deliver a wide array of psychoeducational actively informing practices in consultation and services assessment direct and indirect interventions assessment, intervention, consultation supervision of services support to students and educational research endeavors institutions. program evaluation techniques. The behavioral model characterizing school psychology is particularly focused on: behavior analysis influences school psychology by providing strategies for assessment and intervention that are rooted in behavioral principles these strategies employs practical, data-driven methodologies that systematically tackle school- related issues encountered by children ensures that interventions are effective and grounded in empirical evidence Consultation as a Key Service for school psychologists Consultation allows school psychologists to work collaboratively with educators to address specific student needs and improve classroom management aiming to address diverse student learning needs to tackle challenges related to classroom management Lightner Witmer, who established one of the first child psychology clinics in the 1880s, laid the groundwork for consultation Caplan in 1970 established clear frameworks for consultation as a structured mental health service delivery system Bergan’s in the 1970s further developed a systematic approach to consultation rooted in behavioral theory and principles Kratochwill and Bergan in 1990 later refined it by promoting a comprehensive approach that informs current methods of practice Assessment: Psychometric vs. Behavioral Approaches Traditional psychometric assessments employed in school psychology primarily concentrated on categorizing students according to standardized tests that evaluate their aptitudes and achievements, providing benchmarks for educational development and placement decisions. In contrast, behavioral assessment prioritizes a nuanced understanding of the variables influencing significant behaviors, aiming to identify these factors to promote meaningful behavioral improvements, thereby enhancing educational outcomes through targeted strategies. Intervention: Direct and Indirect Strategies Interventions are systematically planned adjustments to the educational environment, purposefully designed to modify student behavior in ways that align with established goals and expectations, fostering a conducive learning atmosphere. These interventions include Direct strategies, where a school psychologist engages face-to-face with the student Indirect strategies, wherein teachers, aides, or parents implement the interventions based o guidance received from the psychologist. School psychologists play a crucial role in the development of intervention strategies, often creating tailored plans and conducting training sessions for teachers, aides, and parents School psychologists also assess and evaluate the methods used, relying on data-driven approaches such as functional assessment and curriculum-based assessments to strengthen the link between assessment findings and intervention implementation. Supervision and Research Supervision is a critical component for both students studying school psychology and practicing professionals Administrative supervision in school psychology is primarily concerned with adherence to district policies educational regulations, and procedural standards Professional supervision is focused on analyzing and refining the individual actions and practices of school psychologists Program Planning and Evaluation School psychologists assume significant leadership roles in program planning and evaluation, working collaboratively to design, develop, implement, and monitor educational programs tailored to meet diverse student needs. Notable examples of program planning and evaluation initiatives may include: the establishment of inclusive educational models for preschool children with disabilities the implementation of curriculum-based measurement systems to assess student progress the training of school-based teams in functional assessment techniques and behavioral support plans for students requiring additional assistance. Translating Research into Practice Applied behavior analysis offers invaluable empirical insights that guide educators and psychologists in effectively aligning interventions with the specific needs of individual students, optimizing learning environments to facilitate engagement and progress. To maintain the integrity of interventions implemented within educational settings, it is essential to establish rigorous processes for monitoring and evaluating the fidelity of those interventions,  Austin & Carr Ch. 12: Organizational Behavior Management in Human Service Settings Organizational Behavior Management (OBM) A specialized area of applied behavior analysis that focuses on improving the performance of staff in human service settings. OBM utilizes research-based behavioral principles to enhance work-related behaviors such as quality of care and service delivery. It provides practical techniques and strategies that can be implemented by supervisors and managers to improve work performance and address issues such as staff performance, client outcomes, and staff morale. Origins and Applications of OBM OBM is rooted in the field of applied behavior analysis, which emphasizes the importance of understanding and modifying behavior through principles of reinforcement, punishment, and other environmental factors. OBM procedures have significant applications across a range of human service settings, including those that provide services to individuals with developmental disabilities, mental health concerns, substance abuse issues, and older adults. The majority of treatment services in human service settings are often provided by staff without extensive clinical training, emphasizing the importance of effective OBM strategies in maximizing personnel performance. Key OBM Management Procedure Antecedent Management Strategies: Involve implementing steps before work tasks to increase the likelihood of desired performance. On-the-job instructions: These include brief verbal directions, written materials, and meetings aimed at clarifying specific work expectations. Increasing job structure: This strategy involves providing clear and detailed guidelines regarding expected performance, including what, when, where, how, and with whom the task should be completed. Performance modeling: Demonstrating the desired work behavior directly to staff, serving as a visual prompt and guide. Consequence Management Strategies Involve the use of consequences, rewards, and feedback to reinforce desired behaviors. OBM emphasizes the use of positive reinforcement strategies to motivate and improve worker performance. These strategies aim to increase staff satisfaction and create a more positive and enjoyable work environment. Self-management Procedures: These involve empowering staff to take ownership of their own performance and self-monitor their progress which can include goal setting, self-evaluation, and self-reinforcement. Multifaceted Programs: Combine the principles of antecedent, consequence, and self-management procedures to address complex workplace challenges. Quality Assurance Models Total Quality Management (TQM): This holistic approach emphasizes continuous improvement, customer focus, and the involvement of all employees in the quality process. It aims to enhance organizational performance through systematic processes. Six Sigma: Developed by Motorola, this data-driven methodology aims to reduce defects and improve quality by using statistical tools. It focuses on process improvement and variation reduction. Lean Management: Originating from Toyota, Lean focuses on maximizing customer value while minimizing waste. It emphasizes efficiency, continuous improvement, and respect for people. ISO Standards: The International Organization for Standardization provides frameworks (like ISO 9001) for quality management systems that help organizations ensure consistent quality and improve processes. Kaizen: A Japanese term meaning “continuous improvement,” Kaizen encourages small, incremental changes to improve productivity and quality. Baldrige Criteria for Performance Excellence: This framework helps organizations assess their performance across various dimensions, including leadership, strategy, and customer results, promoting a culture of continuous improvement. Plan-Do-Check-Act (PDCA) Cycle: Also known as the Deming Cycle, this iterative process for continuous improvement involves planning a change, implementing it, checking the results, and acting on what is learned. OBM in Relation to Other Management Approaches OBM provides a well-articulated and research-supported approach to managing staff performance in human services. Other common management approaches in the human services may lack a consistent framework or scientific foundation, often resulting in inconsistent results. OBM offers clear procedures and evidence of its effectiveness, making it a more sustainable and effective management option. Future Research Directions in OBM Expanding OBM to New Settings and Performance Areas: Research to investigate the effectiveness of OBM in addressing specific performance issues across a wider range of human service settings is needed. Long-Term/Large-Scale OBM Implementation: Research to evaluate the long-term impact of OBM on organizational performance and to identify factors that contribute to long-term success is crucial. Adoption of OBM as the Preferred Management Approach: Research to understand factors that influence the acceptance and adoption of OBM as the preferred management approach in human service agencies is necessary. Importance of Consumer Satisfaction in OBM Understanding the impact of OBM on consumer satisfaction and perception is vital. Consumer satisfaction encompasses perspectives from staff, supervisors, and clients regarding the fairness, practicality, and positive effects of OBM practices. Efficiency, a key factor in OBM acceptance, involves maximizing outcomes while minimizing time and resources. Key Factors in Successful OBM Adoption Agency-Specific Considerations: OBM implementation should be tailored to the unique needs, values, and culture of individual human service agencies, ensuring a better fit and acceptance. Prioritizing Consumer Needs and Values: Prioritizing the perspectives of consumers, such as staff, clients, and management, during OBM implementation can enhance its effectiveness and adoption. PDC-HS Assessment The PDC-HS (Performance Diagnostic Checklist for Human Service) is an essential tool that can significantly improve employee performance by identifying the root causes of performance concerns. By systematically analyzing performance issues, it allows organizations to implement more targeted and effective solutions. The PDC-HS should be employed by trained supervisors for every staff performance concern, particularly when dealing with less experienced supervisors who may lack the expertise necessary to accurately assess performance issues. To enhance the accuracy of the assessment when using the PDC-HS, it's crucial to verify the supervisor's account with reliable information sourced from past records or direct observations.  Austin & Carr Ch. 13: Basic Behavioral Research and Organizational Behavior Management Organizational Behavior Management (OBM) represents a critical intersection between psychology and management practices, specifically involving the application of behavior analysis across various sectors, including business, industry, and government. The methodologies used in OBM are grounded in empirical research, helping organizations to understand the underlying behavioral factors that contribute to various problems. The application of OBM has led to tangible improvements in multiple organizational areas, including: Enhancements in service quality within medical facilities, where trained staff apply behavioral techniques to improve patient interactions and care delivery. A reduction in production times within manufacturing companies, achieved through the analysis of workflows and the implementation of incentives that motivate workers toward efficiency. Increased efficiency in university admissions departments, where streamlined processes and behavioral principles can lead to faster decision-making and improved applicant experiences. Enhanced performance management training in city government, aiming for the effective use of resources, employee training, and accountability measures that result in better public service delivery. Boosted sales performance, driven by training programs that leverage behavioral strategies to enhance sales techniques and customer interactions. Improved project completion rates among engineers, who benefit from workplace incentives designed to foster collaboration and motivation toward meeting deadlines. Increased safety and productivity on construction sites, through behavioral interventions designed to promote safer work practices and effective coordination among team members. A noticeable increase in friendliness and professionalism among police officers, achieved through training focused on interpersonal skills and community policing initiatives that emphasize positive interactions with the public. Research on Basic Behavioral Principles Matching theory offers a framework for understanding how individual behavior correlates with the environmental contingencies that influence it, seeking to quantify the relationship between inputs (or stimuli) and corresponding behavioral outputs. Matching theory posits that behaviors are maintained by the relative rates of reinforcement available from chosen alternatives, thus underlining the importance of well-structured incentive systems. Establishing a strong link between basic research findings and applied practices is essential for developing effective interventions. Austin & Carr Ch. 7 Behavioral pediatrics: The confluence of applied behavior analysis and pediatric medicine Behavioral Pediatrics Behavioral pediatrics focuses on the relationship between behavior and pediatric health care. Interventions include supportive counseling, behavioral counseling, or referral. Many interventions are based on the principle that behaviors are altered by their consequences. Many interventions from behavior analysis have been adopted into primary care practice. Examples include discipline interventions like increasing parental attention for appropriate behaviors and time-outs for inappropriate behaviors. Sleep problems interventions based on social learning theory, such as addressing bedtime resistance and night waking, are also included in primary care practices. Lack of Acceptance of Behavior Analysis The medical community has yet to broadly accept behavior analysis. Lack of familiarity with the scientific basis of the field and its methodologies is a contributing factor to the lack of acceptance. Behavior analysts use single-subject experimental designs. Medical professionals are familiar with behavioral principles but unfamiliar with behavior analytic terminology. Behavior analysts may be perceived as neglecting emotional factors, contributing to a lack of acceptance. Addressing Lack of Acceptance Behavior analysts can improve acceptance by attending medical conferences and lectures. They can offer to help physicians implement behavioral assessments or interventions. Sleep Problems Effective behavioral interventions can be used to address sleep problems. Extinction: A Straightforward Approach Extinction of bedtime tantrums involves ignoring the child's behavior. This can be challenging as it may lead to prolonged crying and potential issues with neighbors. Parents may react differently to crying, potentially causing discord within the family. Extinction has limited social validity due to its potential aversiveness to parents. Graduated Extinction: A Less Aversive Approach Graduated extinction involves ignoring bedtime behavior for increasing time intervals, starting with 5 minutes and increasing to 45 minutes by night seven. This method may be considered a differential reinforcement schedule rather than scheduled extinction. It's less aversive for parents, as they only intervene after the child cries for a specified time. The increased response requirement of 45 minutes may shift the reinforcement toward sleep. Encopresis Encopresis is the repeated involuntary passage of feces into clothing or onto surfaces. 80% to 95% of cases are linked to constipation. Etiology Constipation can be caused by a combination of factors, including: Slow gastrointestinal transit time Diet Insufficient leverage for stool passage Painful stool passage leading to negative reinforcement for holding stools Other Factors Rarely, encopresis can be related to sexual abuse highlighting the need for sensitive and comprehensive evaluations when assessing a child's situation. Some children may have an increased threshold of awareness of rectal distension, a weak internal sphincter, or a tendency to contract the external sphincter during defecation. Chronic fecal retention leads to fecal impaction, which enlarges the colon. Colon enlargement decreases bowel motility, resulting in involuntary passage of large stools and soiling. Fecal impaction is a common finding in encopresis, with estimates suggesting it occurs in 80% to 90% of cases. Differential Diagnosis In the assessment of encopresis, it's essential to consider rare anatomical and neurologic issues that could also contribute to fecal retention and inappropriate soiling. Differential diagnoses might include: Specific anatomical anomalies detectable during a physical examination, which may point to more significant underlying conditions. Hirschsprung's disease, also known as congenital ganglionitis, which is classified as a rare disorder affecting approximately 1 in 25,000 individuals. Symptoms often manifest in infancy, making it crucial for early detection and treatment. Evaluation Refer children with medical presentations to a physician for a medical exam prior to ABA intervention. Ensure timely diagnosis through collaboration between pediatrician and behavior analyst. Whenever possible obtain ROI to share coordinate care and share data and treatment goals. Downloaded from https://onlinelibrary.wiley.com/doi/10.1002/jaba.379 by Behavior Analyst Certification, Wiley Online Library on [06/11/2024]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License encopresis in three participants with developmental disabilities. Encopresis (McElhanon & Sheithauer, 2017) Tsai et al. (1981) collected data on 102 individuals with autism and reported that over 59% had not achieved bladder or bowel continence by 3.5 years of age. Besides dramatically increasing the burden of caring for an individual with developmental disabilities, not being fully toilet trained negatively impacts the individual’s hygiene, physical comfort, and independence, and causes social stigma (Cicero & Pfadt, 2002; Sells-Love, Rinaldi, & McLaughlin, 2002). …these approaches have generally been shown to be successful at establishing urinary continence (LeBlanc, Carr, Crossett, Bennett, & Detweiler, 2005), there are far fewer successful demonstrations of strictly behavioral treatments for encopresis in individuals with developmental disabilities. children with developmental disabilities such as autism spectrum disorder (ASD) are 3.8 times more likely to have constipation than typically developing children (McElhanon, McCracken, Karpen, & Sharp, 2014). Purpose of Study: The present study evaluated a combined behavioral and medical regimen to treat encopresis in three participants with developmental disabilities. Participants: Three children, each of whom were referred to an intensive outpatient clinic for encopresis, served as participants. Albert was an 8-year-old boy diagnosed with ASD who used single words, sign language, and a picture exchange system to communicate. Braydon was an 8-year-old boy diagnosed with ASD and an intellectual disability of unspecified level. He had never spoken, but could imitate motor movements, receptively identify many items, and follow both simple and complex instructions (e.g., come downstairs, put your plate in the sink, and then pick up your toys). Max was an 8-year-old boy diagnosed with developmental delay and expressive language disorder. He communicated vocally in complete sentences and could follow most spoken directions. McElhanon & Sheithauer (2017)  Design: Data were collected within a nonconcurrent multiple-baseline-across-participants design. Dependent Variable: Continent and incontinent bowel movements served as the primary dependent variables for this study. Methods: Upon arrival, therapists changed participants who were wearing sanitary undergarments into cloth underwear. The therapist then conducted a multiple stimulus without replacement (MSWO; DeLeon & Iwata, 1996) preference assessment to identify a preferred edible or leisure item that was to be delivered contingent upon continent bowel movements, if one occurred. Clinic visits consisted of a series of scheduled sits, which lasted for up to 60 cumulative min on the toilet and were interspersed with 30- min breaks. Following a continent bowel movement, participants then received enthusiastic praise along with 3 min access to the preferred item and one portion of an edible item (Albert and Braydon only). Once the reinforcement interval ended, the therapist prompted the child to wash his hands using a least-to-most prompting procedure, after which they exited the bathroom McElhanon & Sheithauer (2017)  Treatment: If an independent continent bowel movement did not occur during the initial 60-min sit, participants received a 5-min break off of the toilet but remained in the bathroom without access to preferred items or more attention than was necessary to implement the procedures. Following the 5-min break, nursing staff administered a liquid glycerin suppository, which attracts water into the rectum to gently promote a bowel movement. If a continent bowel movement did not occur during the 30-min sit that took place after administration of the glycerin suppository, the participant received a 30-min break, after which nursing staff administered a second glycerin suppository. McElhanon & Sheithauer (2017)  Overall, none of the participants had a continent bowel movement during the baseline phase, and Brayden and Max had at least occasional incontinent bowel movements. Once the intervention was instituted, two participants (Albert and Max) immediately began to have consistent continent bowel movements, and the third (Brayden) did so within 8 days of the initiation of treatment. …all caregivers reported that the participants were continuing with continent bowl movements 1 month following discharge and that two of the three participants were not experiencing any accidents. The use of suppositories as outlined in this study may have advantages over other medication regimens that have been incorporated into treatments for encopresis in the literature. McElhanon & Sheithauer (2017)  Future Research: The multidisciplinary nature of this treatment for encopresis, which included the participation of behavior analysts, a pediatric gastroenterologist, and nursing staff, could be viewed as a model for other disorders that have combined behavioral and medical etiologies. The conceptualization of encopresis as learned behavior resulting from physiological stimuli was critical in the development of this protocol. Involvement of medical professionals was also critical for the purposes of resolving any episodes of constipation and approving administration …as with any potentially aversive procedure, the use of suppositories must be justified by the potential benefits and a lack of alternative approaches. For these participants, other rigorous toilet training approaches had been unsuccessful. Key findings of this study include the fact that participants’ bowel movements became continent rapidly (range, 6 to 16 days) and that medications could be quickly eliminated McElhanon & Sheithauer (2017) Questions?