Bailey and Burch (2022) Chapter 1 Week 1 PDF

Chapter One Basic Concepts and Principles Basic Concepts and Principles DOI: 10.4324/9781003160915-2 QUESTION #1. What Is Behavior Analysis? Quick Take Behavior analysis is an approach to understanding human...

Chapter One Basic Concepts and Principles Basic Concepts and Principles DOI: 10.4324/9781003160915-2 QUESTION #1. What Is Behavior Analysis? Quick Take Behavior analysis is an approach to understanding human behavior that looks at the powerful influence “Behavior analysts of the physical and social envi- think like scientists ronment on behavior. A primary part of the time and goal of behavior analysis is to caring clinicians the seek ways of modifying the envi- rest of the time.” ronment in order to produce sig- nificant behavior change. Applied behavior analysis, often referred to simply as “behavior analysis,” is an evidence-based approach to treatment. Behavior analysts think like sci- entists part of the time and caring clinicians the rest of the time. Exist- ing for more than half a century, behavior analysis is still new to many consumers around the world. Those who are aware of the behavior analysis approach often think it is a treatment for children with autism, since so much work has been done focusing on this population over the past 25 years. Behavior analysis has a reach far beyond autism, and in numerous areas, behavior analysts work directly with clients or super- vise staff. These behavior analysts are hands-on professionals who are passionate about helping others, and they are thrilled to see positive behavior changes—this is their primary reward for being in this field. As behavior analysts, we believe that environment plays such an important role because humans (and non-human animals) have evolved to adapt to the environment. When the environment changes, humans change their behavior to thrive or to simply survive. Humans do what they can to maximize the rewards that are available in the immedi- ate environment. If those rewards become scarce, a person moves to Chapter ONE Page 5 another location where there are more rewards, or they attempt to mod- ify the environment to make it richer in rewards. The aspects of the environment that are most valued are referred to as rewards or reinforc- ers because they strengthen behavior. Perhaps the most significant aspect of the environment that behav- ior analysts look at is the immediate social environment. This includes parents, of course, and grandparents if they are nearby. When a child is older, other children in the neighborhood can be a significant source of reinforcement, and after that, teenagers seek out the company of other teens almost exclusively. The analysis part of behavior analysis is a key part of this relatively new field because by determining the triggers or causes (we call them functional variables), we know which parts of the environment need to be changed. An example of a case related to the environment was a teacher who was frustrated by Noah, an elementary school student. Noah was con- stantly off task and bothering other children in the classroom. The teacher tried putting Noah at a table by himself and reprimanded him when she had a break, but nothing seemed to work. The teacher was considering the use of time-out with Noah. She had learned about this in a workshop held on a planning day. First, she called in a behavior analyst1 who observed from the back of the room.2 The behavior ana- lyst noted that Noah was not off task all the time but primarily during math period and especially when the teacher handed out the daily work- sheets. The behavior analyst obtained copies of worksheets from the teacher and asked for permission to sit with Noah while he completed his work. Over the course of the next 30 minutes, the behavior analyst switched the work sheets, alternating them from easy to hard. She dis- covered that Noah did not have the necessary skills to solve the work- sheets the teacher was giving him each day. The work was above his level, and because Noah was frustrated, he quickly gave up. On the rare occasions when Noah could solve the problems, he did so and seemed to really enjoy the work. Through careful analysis, the behavior analyst discovered that the micro-environment was aversive to Noah and he was engaging in escape behavior (off-task, bothering other students). What he needed was not a reprimand but more appropriate materials Page 6 Chapter ONE and possibly a short-term math tutor to get him up to speed with the other children. In another similar case, a behavior analyst was working in-home with parents who complained that their child, Emma, would not lis- ten to them or complete chores or her homework. The parents reported that Emma also picked on her little sister “all the time.” The behav- ior analyst began with direct observations of the child to determine the environmental variables that may have been contributing to Emma’s inappropriate behavior. After observing carefully for a few hours, the behavior analyst noticed a pattern. Emma came home from school, ran straight to her room without so much as a “Hi, Dad,” and started playing My Little Pony, a popular video game. Emma didn’t interact with her little sister at all. Dad said that Emma “knows” she is supposed to do her homework first, followed by her chores, and then she could play the video game. His method of handling Emma’s behavior was to charge up to her room and start scolding her. Emma would cry and say, “I hate you,” and attempt to push Dad out of her bedroom. It seemed to the behavior analyst that Emma was sending a message to the parents that said loud and clear, “I prefer my video game to doing chores or home- work.” Dad had come to the correct conclusion about the sequence but did not have an effective method for handling the problem. The behavior analyst suggested to Dad that the next day when Emma got home that he would be waiting for her, stop her when she came in the door, and say, “Let’s talk, Emma. How was your day?” After inquir- ing about Emma’s day, the behavior analyst guided Dad to say, “Emma, we’re going to try something new today. Here is your list of chores. As soon as they are done, come see me about your video game.” Emma pouted and started to cry, but Dad held the line just as the behavior ana- lyst had advised him. A little while later, Emma approached her dad and said, “I’m having trouble with this chore. Can you help me?” Dad explained the chore, and when it was completed, he handed over the video game. After a few days, Dad changed the routine a little, so that when Emma came in from school, he said, “Let’s take a look at your homework for today.” He escorted her to the kitchen table and helped her get started. When the homework was complete, Dad checked it, praised Chapter ONE Page 7 Emma’s good work, and gave her the short list of chores. “When you are finished with these chores, Emma, come see me and you can play your video game until dinner.” Before long, Emma began to respond to the praise and contingent access to her game with a big smile. The previous cases describe two simple cases of a behavior analysis approach to solving a behavior problem. These children did not need counseling or scolding or time-out; they just needed a change in their “These children did routines and micro-environments. not need counseling The teacher in the first case could or scolding or time- not figure this out because she had out—they just needed too many children to manage and instruct. The dad in the second case a change in their had no idea about using a video routines and micro- game as a reinforcer for chore environments.” completion. It was not surprising that he didn’t know any better. As with many parents his age, he was raised with a punishment model. Analyzing behavior in clinical settings is not always as simple as these two cases. Cases seen by behavior analysts are often very compli- cated and require a great deal of time and the use of sophisticated meth- ods such as functional behavior analysis, which we will discuss later in the book. However, the process is basically the same: Observe the behavior directly (don’t rely on interviews or second-hand information), FIGURE 1.1 A six- step behavior analysis model for solving behavior problems. Page 8 Chapter ONE look for possible triggers or “causes” of the problem behavior, develop tests to determine the actual factors, implement a possible solution, and evaluate the results (if necessary, go back to step #1 and try another approach). Technically Speaking One of the earliest cases in our field (Wolf et al., 1964) provides us with an outstanding example of how behavior analysts think about human behavior. “Dicky” was a 3-year-old child with multiple severe behavior problems. In the early 1960s, he was referred to pioneering behavior analysts Mont Wolf, Todd Risley, and Hayden Mees at the University of Washington. As a result of cataract surgery, when he was a little over 2 years old, Dicky was required to wear special corrective lenses or lose his vision entirely. For more than a year, Dicky’s parents struggled with futile attempts to get him to wear the glasses. Dicky not only would not wear his glasses, but he would throw such severe tantrums that he became unmanageable and had to be institutionalized. At the time he was referred to the behavioral team in Washington, Dicky had been diagnosed at different times as mentally retarded, autistic, psychotic, brain damaged, and schizophrenic. These varying diagnoses were the result of multiple behavior problems that included lack of normal social and verbal repertoires, poor eating habits, head-banging, face-slapping, hair-pulling, and face-scratching. At the advice of their family physi- cian, Dicky’s parents tried restraints, sedatives, and tranquilizers, all to no avail. Finally, Dicky was admitted to a children’s mental hospi- tal where more precise treatment could be offered. Enter our ground- breaking behavior analysts. Wolf et al. (1964) took one look at the interaction between Dicky and his mother and instantly identified the problem. Dicky’s mother was reinforcing the behavior (not intention- ally, mind you) with her “ineffectual fussing.” Dicky’s problem was in large part the result of out-of-whack social contingencies, not retarda- tion or supposed childhood schizophrenia. The solution: the behavio- ral team decided to use “time-out,” which had never been documented before in a case like this. Time-out involves separating the child from Chapter ONE Page 9 all sources of reinforcement for a short time, contingent on inappropri- ate behavior—in this case the severe tantrums. Dicky was returned to the hospital ward environment as soon as the tantrum stopped. Result: Within two and a half months, the severe head-banging, hair-pulling, and face-scratching were reduced to zero. Zero. While this is only part of the story, it exemplifies many key features of the way that behavior analysts think and act. First, this was a sin- gle case, involving one child in desperate need of therapy. In addition, Drs. Wolf, Risley, and Mees were interested in taking the case because it represented a complex set of socially significant behaviors of near life-threatening proportions. They quickly concluded that these were “The process of learned behaviors, and they pro- analyzing a behavior ceeded to analyze the environ- ment to identify the maintaining involves carefully variable. The process of analyz- observing the ing a behavior involved carefully interaction of the child observing the interaction of the with the caregivers child with the caregivers to see how to see how the child the child responded. In Dicky’s case, they determined that it was responds.” the mother’s attention (certainly not intentional) that appeared to be the key. Wolf and his colleagues understood that to get control over the attention, the child would need to be treated in their treatment facility where they could train and supervise the staff. After demonstrating clear and dramatic control over this most serious behavior, the behavior analysts then proceeded to attack the remain- ing problems by shaping glasses-wearing; treating the glasses-throwing which developed soon after; implementing successful interventions for teaching verbal behavior; and finally, tackling the messy problem of food throwing, food stealing, and eating with his fingers. In each case, Wolf et al. (1964) observed the target behavior, conducted an analy- sis by looking for controlling variables, and then instituted a change Page 10 Chapter ONE in procedures to reduce and then eliminate the inappropriate behavior (food throwing, food stealing, eating with fingers) or teach new behav- iors (eating with a spoon and learning to name pictures, name objects in his environment, and then to answer simple questions such as, “Where are you going tonight?”) The next step was to generalize these amazing changes to Dicky’s home environment. He improved enough within three months to make his first foray to his home, where his parents, with the training they had received from the behavior analysts, were able to put him to bed with- out his having a severe tantrum. In three more months, he was gradually faded back into the home, and the parents were given full training for all of Dicky’s significant behaviors. This is a perfect example of some fundamental ways that behavior analysts think. We think that it is important to treat socially significant behaviors not just to study them but to actually analyze and provide treatment, effective treatment. Behavior analysts focus on treatment that works to produce a socially significant change in behavior, not just a tiny statistically significant change, but a real-life, dramatic change that everyone can see. Analyzing the behavior in this case involved direct observation of the caregivers’ reaction to Dicky’s glasses-wearing and tantrum behaviors. In other cases that we’ll discuss later in the book, it was necessary to actually change environmental variables to determine the effect they had on a target behavior. To Wolf et al. (1964), Dicky was not a “participant” in an experiment. He was a troubled little boy with a family that loved him and wanted him to be at home and live a normal life. Although unstated, it was clear that this was the goal of our pioneering behavior analysts when they took on this original land- mark case more than 50 years ago. Finally, Wolf et al. (1964) were not satisfied to simply change the behavior; they wanted to generalize the results to Dicky’s home setting. It was important to this team of behav- ior analysts that the parents learn how to manage their son’s behavior. This study is a classic in the field not just because it represents one of the earliest demonstrations of how behavior analysts think and treat behavior but because of the final comment from Dicky’s mother after he Chapter ONE Page 11  FIGURE 1.2 Reducing glasses throwing using time-out. had been at home for six months: “Dicky continues to wear his glasses, does not have tantrums, has no sleeping problems, is becoming increas- ingly verbal, and is a new source of joy to the members of his family.” Key Concepts: Applied behavior analysis, environment, socially significant behav- iors, learned behaviors, maintaining variables, reinforcement, ana- lyze behaviors, effective treatments, shaping, the generalization of behavior EXERCISES: 1. Make note during the next couple of days of the behavior of people around you. Do you see any behaviors that are socially significant problems that could benefit from some sort of behavioral intervention? 2. Now, using the internet, go to the webpage for the Journal of Applied Behavior Analysis (https://onlinelibrary.wiley.com/jour- nal/19383703) and, using key words, find articles describing treatments for a behavior that you have observed. Page 12 Chapter ONE QUESTION #2. What Does Analysis Mean in ABA, and How Exactly Do You Analyze Someone’s Behavior? Quick Take The “analysis” in behavior anal- ysis refers to the behavior ana- lyst attempting to determine what “The ‘analysis’ in exactly produces or “causes” the behavior analysis target behavior to occur. This can refers to the behavior be done with precision in a labo- analyst’s attempting to ratory situation and less so in a determine what exactly classroom or home setting. Most of the time, a skilled and experi- produces or ‘causes’ enced behavior analyst can figure the target behavior to out the “controlling variables” by occur.” interviewing key people and by direct observation. The behavior analyst will ask questions such as, “What happened just before the behavior occurred?” and also, “What happened right after the behavior occurred?” We refer to these as ante- cedents and consequences. Antecedents may often trigger a response, and consequences often reward responses. This is often referred to as an A B C analysis: Antecedent >> Behavior >> Consequence When a second-grade teacher says, “It seems as though Liam is very likely to say he has a stomachache when I hand out math worksheets,” it gives the behavior analyst working in the classroom a strong clue as to the cause of Liam’s asking to go see the nurse. This can be tested to determine if the theory is correct by observing to see if Liam acts sick when science projects are scheduled or when the teacher says, “Okay, Chapter ONE Page 13 it’s time to clear your desk for our geography test.” Another question would be if Liam has stomach problems when it is time to go outside to play or when it is time to eat lunch. This informal trial-and-error method does not always work, of course, but this is where the behavior analyst, using her detective skills, would start. In a home situation, the behavior analyst would ask the parents to describe the behavior of concern, again asking for some indication of what happened before and after the incident. “Hmm, it seems like when- ever his sister is getting attention, Jeremy is more likely to throw some- thing at her, bump into her, or even pinch her to make her cry. He gets this mean little smile on his face when his sister cries. She’s only two and doesn’t understand. Jeremy is five, smart and strong. We have tried sending him to his room, but that doesn’t seem to do any good.” This situation is more complicated than the one in the classroom. In this case, there is also a victim whose response may serve as a reward for the throw- ing/bumping/pinching behavior. One way to test if this is correct is to have the parents change their interaction with the 2-year-old a few times. Rather than providing a big positive attention moment for her, they could play it down to a “Thank you, Sally,” response instead of a big smile and hug, saying, “I’m so proud of you; you’re my favorite little girl, Sally!” If the toned-down response to Sally does not set off the aggression, then it would seem that big attention is the “cause” of the problem. In both examples, the next step is to implement a treatment or inter- vention plan to see if the target behavior can be modified. Technically Speaking A more precise, and as it turns out more complex, way to find the con- trolling variables for any given behavior is to conduct a functional anal- ysis or FA. This is done by setting up a controlled setting where certain conditions can be created one at a time to see what effect each one has on a specific problem behavior. This work was initially done at Johns Hopkins University School of Medicine by Dr. Brian Iwata and his col- leagues (Iwata et al., 1982, 1994). They were working with severely Page 14 Chapter ONE challenging self-injurious behaviors (SIBs) such as head banging, self- biting and eye gouging in nine participants ranging in age from 3½ to 13½ years old. It was impossible to understand what was causing these critical behaviors, although the researchers had clues gained from infor- mal observations. They set up a multielement research design where each of four conditions could be established independently based on: social disapproval, academic demand, unstructured play, and alone. These conditions were presented for eight 15-minute sessions per day for an average of eight days per participant. Results showed that the unstructured play condition produced the least amount of SIBs overall. For five of the participants, self-injury was highest during the alone condition, indicating that the behavior was producing some sort of stimulation, even though it must have been painful. Two participants3 showed the highest level of SIB during the academic demand condition, suggesting that the responses were maintained by escape. In this condi- tion, the researchers removed the demand if the participants engaged in the SIB. One participant showed the most SIBs during the social disap- proval condition in which, when he banged his head or slapped his face, the experimenter said, “Don’t do that; you’re going to hurt yourself.” This showed that, for this participant, the behavior was maintained by attention. For two of the partici- pants, the data were so mixed that it was not possible to see any con- “Knowing the trolling variable. controlling variables Since the Iwata et al. (1982, 1994) study was first published, tells the experimenter functional analysis has become a or therapist what required prerequisite to interven- changes to make in the tions. This model of determining environment in order controlling variables for behav- to make the behavior ior has been used in thousands of experiments. Before a treatment less likely to occur and is put in place, experimenters to produce humane, and therapists alike need to know effective treatments.” whether their client is engaging in Chapter ONE Page 15 the behavior to get attention or to escape some sort of task requirement or demand, or that possibly the behavior is just a source of stimulation. Knowing the controlling variables tells the experimenter or therapist what changes to make in the environment in order to make the behavior less likely to occur and to produce humane, effective treatments. Key Concepts: Analysis, controlling variables, antecedents, consequences, multi- element research design EXERCISES: 1. If you are in a position to observe some problematic behavior, take some A-B-C data by looking for antecedents (what comes before) or consequences (what comes after). What do your data show? 2. Now, using the internet, go to the webpage for the Journal of Applied Behavior Analysis (https://onlinelibrary.wiley.com/jour- nal/19383703). Using key words, find any articles describing treatments for the behavior that you have observed. Page 16 Chapter ONE QUESTION #3. What Exactly Is Evidence-Based Treatment? Isn’t There Evidence for All Treatments? I n the summer of 2003, it was a hot, muggy Saturday evening in Mil- waukee when an 8-year-old boy with “violent tendencies” met his death at the hands of church leaders.4 These trusted religious authorities were trying to rid this innocent child of the demons they believed to be the cause of his strange and unpredictable behaviors. And while these well-intended, god-fearing souls certainly did not intend to murder this little boy, by using a “treatment” with no basis whatsoever in any clinical or behavioral research literature, they essentially sentenced him to death. While it may seem bizarre, this was not the first or only time that chil- dren have been innocent victims of misguided, uninformed adults who have no knowledge or comprehension of the concept of evidence-based treatment. This concept, which is also known as “empirically validated therapies,” refers to a fairly recent awareness (mid-1990s) by therapeutic professionals that the time has come to pass judgment on those treat- ments that cannot stand up to scientific scrutiny. It is simply no longer tolerable for pseudo-professionals who offer miracle cures to be allowed to practice their craft at the expense of naïve and trusting citizens. One such therapy is “water- intoxication,” which supposedly will promote bonding in children “Behavior analysts with “attachment disorder.” On the are relieved and proud advice of counselors at a treatment to point out that our center in Utah, the parents of a procedures have been 4-year-old girl forced her to drink so much water that it lowered the evidence-based since concentration of sodium in her the beginning of the blood, causing fatal brain swelling.5 field in the mid-1960s.” Needless to say, water-intoxication Chapter ONE Page 17 is not an evidence-based treatment. It is based entirely on a counter- intuitive, theoretical notion called “paradoxical interventions” that will supposedly discourage unwanted behavior and cause children to draw closer to their adoptive parents. Behavior analysts are relieved and proud to point out that our pro- cedures have been evidence-based since the beginning of the field in the mid-1960s. Behavior analysts always work with specific, defined behaviors, as opposed to “symptoms” or interpretations of behavior. In the behavior analytic approach, data are taken before the treatment to provide a baseline that is used for comparison with later conditions. Another key component of behavior analysis is that experimental con- trol is clearly demonstrated to show that it was the treatment that was the cause of the subsequent behavior change. Behavior analysis is unique in this respect, and as a result of 50 years of evidence-based, applied research, we can point to the development of highly effective treatments that are safe and dependable. Behavior analysts believe that all therapies should adopt a similar sort of accountability system so that consumers can be informed of the effectiveness of the treatment. In our field, we actually have two levels of empirical validation. The first is internal, where the behavior analyst, as indicated earlier, designs the treatment in such a way that effects can be seen directly by examining the graphs of the data. The second method, called social validation, involves including the consumer in the process to make a judgment about the treatment effect. We basically employ the consumer as the ultimate judge of effectiveness. If clients (or their guardians) can’t see the effect, we would conclude our inter- vention was not sufficient, and it would be back to the drawing boards to devise a better treatment. Many methods or interventions that are used in everyday therapeutic or educational settings are devised on the spot by direct-care staff, teach- ers, therapists, or caregivers. Many of these interventions have never been tested to even see if they work; that is, they are not evidence based. Evidence-based treatment involves applying well-established research findings in the development of behavioral treatments and interventions. Made-up, half-baked procedures are not only not proven effective, but Page 18 Chapter ONE they may also be unethical as well as unsafe. Sometimes this can have tragic consequences. In an institution in Florida in the 1970s, children and young adults had their mouths washed out with soap or had to wear a sign around their necks that read, “I am a thief,” as a form of punish- ment for cursing or taking another client’s belongings. This make-it- up-as-you-go-along method resulted in bizarre, inhumane punishments (Bailey & Burch, 2016, pp. 5–13) for which several staff and the psy- chologist in charge were fired. Evidence-based treatments are those that have been demonstrated to be effective in scientific journals. In applied behavior analysis, research is primarily published in the Journal of Applied Behavior Analysis, which is considered the flagship journal of our field.6 What behavior analysts do, as an important part of developing an individualized treat- ment plan, is search for interventions and treatments that have proven effectiveness in top-rated behavioral journals. In their graduate pro- grams, students are carefully trained in how to search for these proven treatments and how to adapt and apply them to any given case. To be safe and transparent, treatments should be approved by the parents or surrogates if the intention is to reduce a behavior. There are dozens if not hundreds of unproven procedures being used today to treat human behavior in clinical and educational settings across the country. Many of these unproven procedures are recommended by professionals from other fields. These professionals might have no training in research methods and no appreciation for the need to only use those procedures that have been proven effective and are verified by the scientific community. Problems can occur when procedures are developed based on articles that are theoretically based rather than fact or science based. Behavioral interventions published in the Journal of Applied Behavior Analysis are both theoretically sound and data based. Key Concepts: Evidence-based treatment, empirically validated therapies, experi- mental control, social validation Chapter ONE Page 19 EXERCISES: 1. Find an article in the Journal of Applied Behavior Analysis that addresses social validation and examine the methods used to involve consumers in the determination of treatment effectiveness. 2. Find an article that does not employ social validation and describe a way to apply this procedure. Page 20 Chapter ONE QUESTION #4. Is Behavior Analysis Just Another Fad Treatment? U nfortunately, there are many fad treatments in our cul- ture. A fad treatment is one that “A fad treatment is one becomes popular almost overnight, that becomes popular is often promoted by a celebrity, is almost overnight, is widely touted in the media, quickly often promoted by gains acceptance by average citi- a celebrity, gains zens, becomes commercially suc- cessful, and finally, is evaluated acceptance by average by behavioral scientists who deter- citizens, and finally, is mine that it is ineffective and pos- evaluated by behavioral sibly a dangerous fraud. Fads have scientists who been common since biblical times determine that it is for the treatment of illnesses and proliferate as short-term interests ineffective and possibly in styles of music, dance, fashion, a dangerous fraud.” diets, and exercise programs, as well as “challenges” such as ice bucket dunking and planking or games like Pokémon Go. While fads in the culture are usually mere distractions or diversions, when it comes to the treatment of something as serious as autism, fads may actually be pseudoscientific, costly, and ineffective and cause harm. In autism, fads have been rampant since the mid-1980s. One of the ear- liest and most pervasive fads was facilitated communication (FC) (Zane et al., 2016).7 Facilitated communication assumed that autistic children just had a communication disorder and that giving them a facilitator who could hold their hand and help them type would reveal their true selves. Sadly, this fad is still popular in some parts of the country despite hundreds of studies showing it is basically a fraud—the “facilitator” has been shown to be the one typing out the answers! Chapter ONE Page 21  Behavior analysis has been around since the mid-1960s when the first experimentally controlled studies demonstrated that the behavior of autistic children could be improved in areas such as social skills and lan- guage. Research showing that problematic behaviors such as tantrums, aggression, and self-injurious behaviors could be dramatically reduced was being published in the Journal of Applied Behavior Analysis starting in 1968. This work, however, was “under the radar” of most citizens until the publication of Catherine Maurice’s blockbuster book Let Me Hear Your Voice: A Family’s Triumph Over Autism (Maurice, 1993). This very readable and compelling first-person account of a mother who discov- ered behavior analysis, found a therapist, and proceeded to support this evidence-based treatment with her two autistic children set off a wave of interest of tsunami proportions. For a while, behavior analysis may have looked like a fad because of the immediate increased demand for behav- ior analysis services. However, since there was a scientific basis for the treatment that has been replicated over and over, rather than a fad, this was a treatment that had staying power. In many ways, behavior analysis is like the invention of ice cream, the automobile, or air conditioning “Currently, applied because it proved to be an actual behavior analysis has break-through treatment that has a the status as the gold permanent place in our society. standard for autism Currently, applied behavior anal- ysis has the status as the gold stand- treatment around the ard for autism treatment around the world.” world,8 and far from being a fad, it has become the standard by which all other treatments are compared. It is funded by major insurance com- panies and the federal government and has been endorsed by the US surgeon general. Key Concepts: Fad treatment, facilitated communication, gold standard, Journal of Applied Behavior Analysis Page 22 Chapter ONE EXERCISES: 1. Go to the internet and search for facilitated communication research and look for articles that debunk this fad treatment. 2. If you are interested in autism treatment, get a copy of Cathe- rine Maurice’s book Let Me Hear Your Voice. This first-person account of behavior analysis treatment is very compelling. Chapter ONE Page 23 QUESTION #5. So, Is It Correct That Behavior Analysts Don’t Have Theories, They Just Have Data? Y ou may recall from Question 3 the story of the 4-year-old girl who died from water-intoxication therapy. The excessive water was administered by her parents at the advice of counselors who “These are ‘theories’ had their own theory for “attach- about observable ment disordered” children. This behavior tied to theory suggested that paradoxical the observable interventions such as this would discourage inappropriate behav- environment.” ior and would somehow cause the little girl to draw closer to her parents. It is this sort of reckless theorizing that behavior analysts find totally abhorrent and often reinforces their conviction that we are sim- ply better off without this sort of theory. This is not to say that behavior analysts don’t have guesses, hunches, or ideas about how the environment affects human behavior. We do, but these are “theories” about observable behavior tied to the observ- able environment. Our speculations are tightly bound to the experi- ments being conducted, and it is rare that you will hear of any grand theory coming from a behavior analyst. While behavior analysts might be interested in understanding “attachment” (the enduring social emo- tional relationship between a child and a parent or other regular car- egiver) (Zimbardo et al., 2005), simply having a theory about how it is formed is unlikely to help us improve the relationship between a specific child that we are treating and her parents who are desperately seeking answers. We are not saying that other researchers shouldn’t pursue such lines of inquiry but rather that this is not the tradition of applied behav- ior analysis, where we have more immediate and pressing objectives. Page 24 Chapter ONE  For a child who is not “bonding” with her parents, we would first want to know what types of behaviors are of concern to the parents. These might include failure to make eye contact; a propensity for lying and stealing; and possibly even animal cruelty, starting fires, or other antisocial behaviors. Using a behavior-analytic theory of behavior (Skinner, 1953, 1969), we would analyze each behavior to determine the controlling variables. We would then set out a course of treatment for the parents whereby each behavior would be increased or decreased as desired. Nowadays, the treatment would probably not take place in a treatment center but rather in the setting where the controlling var- iables were operating. The behavior analyst would most likely spend many hours working with the parents in their home, teaching them the skills they would need, demonstrating special procedures and reinforc- ing them for behavior improvements shown by their child. Hundreds of studies have been conducted on behaviors such as these over the past 50 years, and an effective, reliable technology of parent training is well understood at this time (Wahler et al., 2004). One early study illustrates this strategy quite nicely.9 Dr. Robert Wahler, a professor at the Univer- “It is possible to sity of Tennessee, and his assis- determine procedures tants worked with two families who both had elementary school- that can be used for aged boys who were described as individual participants “stubborn,” “negativistic,” and to quickly change “headstrong.” Observations were behavior, and those made in the homes of the chil- changes can be dren. As shown in Figure 1.3, Billy engaged in 100 to nearly 200 maintained over a oppositional “units” of behavior considerable period of in the 40-minute periods set aside time.” for observational purposes. Wahler then analyzed the troubling behavior and concluded that the parents offered little in the way of negative consequences for not following requests. In addition, he found that their attention might not be all that Chapter ONE Page 25  FIGURE 1.3 This graph shows the effects of time-out and differen- tial attention on Billy’s oppositional behavior in weekly observational sessions over a 20-week period. reinforcing. The parents were trained to use time-out and differential reinforcement.10 As Figure 1.3 also shows, when the differential atten- tion condition was in place, the oppositional behavior dropped to near zero in only five weeks. This is quite dramatic, since Billy had demon- strated oppositional behavior for many months prior to treatment. As is common in this type of single-case-design research, Dr. Wahler returned to the baseline conditions (the parent quit using time-out and differential reinforcement) to determine if the behavior would reverse. You can see that the behavior did reverse very quickly over the next two weeks. When the parents again instituted the time-out and differential reinforcement, the troublesome oppositional behavior dropped quickly to zero and remained there for over two months. It is interesting to note that time-out only needed to be applied during week 12 (five times) and then not at all after that. This study exemplifies how our behavior the- ory works in practice. It is possible to determine procedures that can be used for individual participants to quickly change behavior, and those changes can be maintained over a considerable period of time. Not having a separate theory for each and every type of behavior has not been a limitation to the field of behavior analysis. Our basic and applied researchers have been quite productive over the past 50 years developing effective interventions based on B.F. Skinner’s original theory of behavior. This includes not only behavior therapy for devi- ant child behavior and parent training but also effective treatments for classrooms, residential facilities, sheltered workshops, business and Page 26 Chapter ONE industrial sites, and most recently executive coaching for CEOs of major corporations. Behavior analysis is a thriving, innovative field of productive basic and applied researchers and therapists who all derive their inspiration from one basic theory. Behavior analysts are motivated to expand and apply their knowledge primarily by the creative applica- tion of data-based approaches rather than theory testing. Key Concepts: Theory of behavior, attachment disorder, paradoxical interven- tions, time-out, differential reinforcement EXERCISES: 1. Think of a behavior-related topic that you find of interest and explore the search engine of the Journal of Applied Behavior Analysis to find studies that are relevant. 2. Look at the JABA studies (in #1) to determine if the authors engaged in the research because they were motivated by any par- ticular theories. Chapter ONE Page 27 QUESTION #6. “Behavior Is a Function of the Environment.” What Does This Mean? Quick Take Behavior analysts believe that “Behavior is learned most human behavior we see is learned over many years of fam- in a specific setting, ily upbringing, incidental learning it is reinforced in from peers, and deliberate training that setting, and it is by their parents, relatives, teach- maintained over time ers, mentors, supervisors, and oth- with consequences in ers. From the time we are young children, we learn to not talk with that setting.” our mouths full of food at the din- ner table, to be respectful of our grandparents, and not to be loud and disruptive in a library. As adults, we should have been taught to look our supervisor in the eye and say, “Thank you,” when receiving corrective feedback on the job. In all these cases, the behavior is learned in a specific setting, it is reinforced in that setting, and it is maintained over time with consequences in that setting. When there is a state trooper parked in the woods next to the interstate, many drivers will immediately hit the brakes to slow down and then speed up again once the highway patrol vehicle is out of sight. Over time, the ability to turn specific behaviors off and on as we enter and leave these settings becomes automatic. A conversation reduces to a whisper when we enter a church, synagogue, mosque, or library; that same conversation elevates to yelling at a football game when a com- pleted pass is made in the last five seconds near the goal line. Behavior analysts say that behavior is a function of the environment when they see that the behavior comes and goes in some settings and not Page 28 Chapter ONE others. While some people might say that the environment causes “The process of the behavior, this is incorrect. The behavior is actually caused by the learning to engage in training that took place in those the proper behavior settings. That training consists in the correct of the prompting of appropriate environment usually behavior, the quick delivery of takes a few trials.” reinforcers by a significant person following the behavior, and either the ignoring or disapproval of inappropriate behavior. The process of learning to engage in the proper behavior in the correct environment usually takes a few trials. For example, a fifth-grader might require a few instances of hearing, “Shhhh,” from a librarian or rabbi before the library or synagogue becomes a stimulus for whispering. The consistent application of consequences is critical to develop- ment of a pattern of behavior that occurs in one environment and not another. Children do not learn to engage in the appropriate behavior for a particular setting through “telling” alone. It is only when they expe- rience consistent social and other consequences that the discrimination occurs. During this process, some “errors” along the way are expected. To maintain order in the classroom, if a teacher presents the rule, “If you want to speak, you need to hold up your hand and wait to be called on,” she will then need to “Behavior can only always ignore those who speak and be a function of only call on children with a raised the environment hand. If the teacher makes a mis- if someone in that take and responds to someone who environment has taken excitedly says, “I know the answer, I know!” this will cause a setback. the time to apply The teacher will have to start over, consequences in a remind the students of the rule, and consistent manner to start again only calling on those make it so.” who have their hands up. Chapter ONE Page 29  Behavior can only be a function of the environment if someone in that environment has taken the time to apply consequences in a consistent manner to make it so. Technically Speaking When Skinner (1953) used the expression Behavior is a function of the environment, he was speaking specifically about the response of a person to an interior stimulus such as a toothache, as opposed to the obviously complex external stimuli described previously. He went on to say: Events which take place during emotional excitement or in states of deprivation are often uniquely accessible for the same reason; in this sense our joys, sorrows, loves, and hates are peculiarly our own. With respect to each individual, in other words, a small part of the universe is private.11 This is often expressed as a formula shown below where B = behav- ior, f = function, and E = Environment. B = f (E)12 When a person’s behavior turns on and off in the presence/absence of certain stimuli, we describe this as stimulus control. So, we might say that a person who tries to flatter his supervisor to gain advantage by saying, “I love your tie, Mr. Webb. You have great taste,” is under the control of the supervisor as a stimulus. We presume that the per- son has been reinforced for such verbal behavior at some point in time. Mr. Webb would be considered an SD (a discriminative stimulus for approach behavior), and his absence would be considered an S∆ (S-delta, a stimulus that does not cue an approach response). After a discrimination is established, other similar stimuli may set the occa- sion for the same response. We refer to this as generalization, specifi- cally stimulus generalization. Page 30 Chapter ONE  In behavior analysis, we believe the physical and social environ- ment in which we live influences our behavior in many ways. This can be seen in a whole host of circumstances. Every day at Disney World Resort, thousands of people line up in an orderly fashion to have an adventure on their favorite rides, guided by stanchions and belt barriers. Their choice of places to dine is predetermined by themes that are pres- ent throughout the park: tacos, guacamole, and chips are available at the Epcot’s Mexico pavilion, and several styles of crepes are offered at the pavilion representing France. The environmental engineers at Disney World are masters of crowd management. These engineers know how, in subtle ways, to affect the rides people choose, how they line up, and what they consume. It is to Disney’s advantage to keep people coming to the parks and the revenue flowing. In schools, the teacher is the engi- neer by designing the curriculum to encourage engagement and learn- ing, and the cafeteria staff selects menus that are intended to encourage healthy dining. Behavior can be made to be a function of a specific environment by the consistent application of SD and S∆ conditioning. We contact differ- ent environments multiple times per day, and we are better off when we respond appropriately. As parents and teachers, we can teach children to make the behavioral discriminations through the consistent applica- tion of reinforcement that is contingent on appropriate behaviors in the presence of specific stimuli. Key Concepts: Function of behavior, stimulus control, discriminative stimulus, crowd management, SD and S∆ conditioning EXERCISES: 1. As you go about your day, attend to the way in which businesses such as bookstores, grocery stores, and department stores manage Chapter ONE Page 31  customer movement and encourage certain purchasing behaviors. Take note also of the use of signage, the arrangement of counters, and displays of products designed to nudge you to buy specific merchandise. 2. If there is a particular setting that you enjoy and return to fre- quently, when you are there the next time, see if you can determine what makes the setting such an enjoyable, pleasant experience. Page 32 Chapter ONE QUESTION #7. Is Behavior Really All That Predictable? T his is really a good question and one that we hear frequently from people outside the field of behavior analysis. The brief answer is that it depends. The longer answer involves an examination of what prediction involves and expectations regarding the accuracy of the pre- diction. A few general observations regarding the prediction of behavior follow. First, the best predictor of future behavior is past behavior.13 Second, the more information we have about a person, the behavior we are trying to predict, and the circumstances under which the behavior occurs, the better our prediction will be. In behavior analysis, we use special techniques to assist us with the prediction of future behavior. We begin by having a fairly precise definition of the behavior we are studying. We initially look at behavior topographically, that is, the form of the behavior. For example, if we were studying self-injurious behav- ior of a little boy, we would look at whether the behavior was head bang- ing, face-scratching, or some other specific behavior. We would define the behavior in terms of the position of the child’s hand, whether he made a fist, how fast the movement occurred, and whether it appeared to be forceful. The second way we look at behavior is functionally; that is, regardless of the form of the behavior, what effect did it have? What seemed to be produced by the behavior? What effect did it have on the physical or social environment? See an example in Figure 1.4. If a child who is severely developmentally disabled hits his head, what do the staff or house parents do? Does he get his way? Does he get out of doing something? Do people come running and feel sorry for him? The more we know about the result of the behavior, the better we are at pre- dicting when he will do it next. As a matter of fact, one of the principal tools that behavior analysts use is a functional assessment. This is where various consequences are tested to determine which appear to be main- taining the behavior. By identifying the right consequence, we can get to the point that behavior can be predicted with good accuracy. Chapter ONE Page 33  FIGURE 1.4 In this graph, the screaming is increasing in a predictable manner during baseline; then a reinforcer for “soft” requests is put in place, and the behavior also rapidly decreases in a predict- able fashion. FIGURE 1.5 During baseline, the scream- ing is so variable that it is not possible to determine whether without treatment, it would increase or decrease in rate. It is essentially unpredictable. Before we can do anything about changing a behavior, we have to be able to predict whether it is stable or increasing or decreasing. If, during Baseline, the behavior was variable, as shown in Figure 1.5, it would be impossible to determine whether the intervention had any effect. So, the answer to the question, “Is behavior really all that predicta- ble?” is yes. If we have enough of the right kind of data, behavior is very predictable. Behavior analysts use prediction as part of our analysis of Page 34 Chapter ONE behavior and attempt as much as possible to use scientific means to predict what people are going to do. Then, we try to predict the effects of certain treatments so that we can help people change their behaviors and improve their lives. Key Concepts: Predictability, topography, function, variability, trending EXERCISES: 1. If you have access to a setting where you can make some unobtru- sive observations of behavior, observe and try to predict what the person is going to do next. 2. Graph the frequency of the behavior over time and try to predict the behavior from day to day. Chapter ONE Page 35 SUMMARY OF BASIC CONCEPTS AND PRINCIPLES B ehavior analysts think about human behavior differently than most other human service professionals. We focus on the actual behav- ior as it is presented rather than looking at the behavior as a symptom of some deeper, underlying problem. We assume that these observed behaviors are learned and are maintained in the individual’s natural environment. Although we are often presented with complex behavioral issues of unknown origin, our strategy is always to use data and proceed systematically. TASK ANALYSIS FOR EFFECTIVE BEHAVIOR CHANGE 1. Define the behavior objectively. 2. Set up a data collection system (assessment) and gain consent from caregivers to collect data. 3. Gather enough data to determine the seriousness of the problem. 4. Graph the data (determine pattern of the behavior over time/sta- bility of the behavior) and explain the results of the assessment in plain language to caregivers. 5. Conduct a functional analysis (i.e., determine the controlling variables for the behavior). 6. Use the results of the functional analysis (along with other infor- mation from interviews and informal observations. If needed, do a search of the research literature to determine what previous treatments have proven successful) to determine the controlling variables. 7. Develop a treatment plan based on #6 and gain consent from caregivers. 8. Implement the plan to make sure it works. Page 36 Chapter ONE  9. Demonstrate the treatment plan and train others such as the par- ents, teacher, stakeholders, or registered behavior technician (RBT) to implement the behavior plan. 10. Collect data throughout this process so that the effects of the treatment can be evaluated; revise as necessary. The behavior analyst is looking for socially significant behavior changes that are sizeable enough to make an important difference in a person’s life as well as improving the quality of their life to a significant degree. When possible, the behavior analyst employs a research design that demonstrates it was indeed the treatment that produced the effect and not some outside variable. The typical behavior analyst is part clinician, part detective, and part scientist. Behavior analysts are client advocates who will try to obtain ser- vices for clients in order to improve their quality of life. A behavior ana- lyst thinks of normal and abnormal “A behavior analyst behavior as being at two ends of a thinks of normal and continuum where both are learned by the same principles of behavior. abnormal behavior as Abnormal behavior may be mala- being at two ends of daptive or self-injurious, destructive, a continuum where or dangerous. The behavior analytic both are learned by view is that all abnormal behavior the same principles of is learned and can be reduced: a replacement behavior can be found, behavior.” taught to the individual, and main- tained by new contingencies of reinforcement. A child or adult who is oppositional is a person who doesn’t respond to requests. Such responses can be taught, and oppositional behaviors can be put on extinction so that they are no longer reinforced. The antisocial person is one who engages in behaviors that are inappropriate. These behaviors can likely be replaced with more socially appropriate behaviors by a careful rearrangement of the contingencies of reinforcement that surround the behaviors. Chapter ONE Page 37  All of this is routinely accomplished without the need for elaborate theories of personality, memory, motivation, or development. Behavior analysts have one core set of behavior principles (Michael, 1993) that can be applied in a wide variety of settings to help people of all ages and functioning levels. NOTES 1. Most likely a Board Certified Behavior Analyst. 2. Permission from the parents would be necessary for this “assess- ment” of his behavior. 3. In the previous description of the Iwata et al. (1982, 1994) research, we have referred to “participants.” In the original research, the par- ticipants were referred to as “subjects.” This change in language came when our field became more sensitive and readily recognized that in research settings, we are dealing with people. 4. Associated Press, August 24, 2003, “Leaders were trying to heal boy who died during prayer, pastor says.” 5. https://archive.sltrib.com/article.php?id=53270884&itype=CMSID 6. There are numerous other journals as well, including: Analysis of Verbal Behavior, Behavior Analysis in Practice, Behavior Modifi- cation, Behavior Research and Therapy, Behavioral Interventions, Journal of Organizational Behavior Management. 7. T. Zane, M.J. Weiss, S. Blanco, L. Otte, & J. Southwick (2016). Fads in special education. In R.M. Foxx & J.A. Mulick (Eds.), Con- troversial Therapies for Autism and Intellectual Disabilities: Fad, Fashion, and Science in Professional Practice, 2nd Edition. New York: Routledge, pp. 123–135. 8. https://autismtherapies.com/aba-gold-standard/ 9. R.G. Wahler (1969). Oppositional children: A quest for parental reinforcement control. Journal of Applied Behavior Analysis, 2, 159–170. 10. Differential reinforcement involves following only some selected behaviors with a pre-selected reinforcer; this is also called shaping or behavior shaping. Page 38 Chapter ONE 11. It should be noted that Dr. Kurt Lewin preceded Skinner with his for- mula B = f (P,E) where P = the person (Lewin, 1936). Skinner put a greater emphasis on the environment and left the P out of the formula. 12. Shull, R. L. (1991). Mathematical description of operant behavior: an introduction. In I. H. Iversen & K. A. Lattal (Eds.), Experimental Analysis of Behavior (Vol. 2, pp. 243-282). New York: Elsevier. (Call#: BF 319.5.O6 E97 1991) 13. This expression does not have an original author who can be cited at this time, although Guthrie (1944, p. 62) comes the closest to expressing this idea. REFERENCES Bailey, J.S., & Burch, M.R. (2016). Ethics for Behavior Analysts, 3rd Edition. New York: Routledge, Inc. Guthrie, E.R. (1944). Personality in terms of associative learning. In J.M.V. Hunt (Ed.), Personality and the Behavior Disorders. New York: The Ronald Press. Iwata, B.A., Dorsey, M.F., Slifer, K.J., Bauman, K.E., & Richman, G.S. (1994). Toward a functional analysis of self-injury. Journal of Applied Behavior Analysis, 27, 197–209. https://doi.org/10.1901/ jaba.1994.27-197 (Reprinted from Analysis and Intervention in developmental Disabilities, 2, 3–20, 1982). Lewin, K. (1936). Principles of Topological Psychology. New York: McGraw Hill, p. 216. Maurice, C. (1993). Let Me Hear Your Voice: A Family’s Triumph Over Autism. New York: Fawcett Columbine. Michael, J. (1993). Concepts and principles of behavior analysis. Kala- mazoo, MI: Association for Behavior Analysis. Skinner, B.F. (1953). Science and Human Behavior. New York: Macmillan. Skinner, B.F. (1969). Contingencies of Reinforcement: A Theoretical Analysis. New York: Appleton-Century-Crofts. Wahler, R.G. (1969). Oppositional children: A quest for parental reinforcement control. Journal of Applied Behavior Analysis, 2, 159–170. Chapter ONE Page 39 Wahler, R.G., Vigilante, V.A., & Strand, P.S. (2004). Behavioral con- trast in a child’s generalized oppositional behavior across home and school settings: Mother and teacher as one? Journal of Applied Behavior Analysis, 37, 43–51. Wolf, M., Risley, T., & Mees, H. (1964). Application of operant con- ditioning procedures to the behaviour problems of an autistic child. Behavior Research and Therapy, 1, 305–312. Zane, T., Weiss, M.J., Blanco, S., Otte, L., & Southwick, J. (2016). Fads in special education. In R.M. Foxx & J.A. Mulick (Eds.), Controver- sial Therapies for Autism and Intellectual Disabilities: Fad, Fash- ion, and Science in Professional Practice, 2nd Edition. New York: Routledge, pp. 123–135. Zimbardo, P., Johnson, R., & Weber, A. (2005). Psychology Core Con- cepts. New York: Allyn & Bacon. Page 40 Chapter ONE