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Archive for April, 2015

We came across a new video about autism recovery that we are excited about! One of our parents actually found it first. When the mom talked about it, I just assumed it was another CARD video as they have been the predominant leaders in this area. Interestingly, it was not from CARD but rather a professionally produced video from UCONN!

We have been a fan of Dr. Fein since we first learned that she studied children on the spectrum. See one of our previous posts here. She is not a behavior analyst but rather a licensed clinical psychologist. She is not in the business of ABA but rather a professor in clinical psychology. You can read more about her here.

So…..now for the video. We hope it inspires you as much as it does us!

http://medvideos.org/video/215/is-it-possible-to-recover-from-autism

 

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I recently shared our publication regarding what to expect during an FBA. We also had a publication come out in January in Behavior Analysis in Practice. I wrote the article with 3 other colleagues (Patrick O’Leary, Megan Miller, and Amanda Kelly) titled, “Blurred Lines: Ethical Implications in Social Media for Behavior Analysts”. social mediaIf you would like to read the article you may purchase it here. If you are a full member of ABAI, you may be able to access it through the ABAI portal at no charge.

I am sharing this article today as a reminder that Patrick O’Leary, the lead author of the paper will be offering a webinar on this very topic. The webinar is scheduled for Thursday, April 30th, at 4pm eastern. You may complete the webinar in the comfort of your home or office. What a great way to earn your required 4 ethics credits!

If you are interested in registering, please visit our website and complete the form. Click on submit and use PayPal to complete payment with your PayPal account or to use a credit card.

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Hi and welcome to Ask Missy Mondays where I take questions from readers. Today’s question comes from Judy who writes,

Hi Dr. Olive, my child’s school BCBA recently completed a Functional Behavior Assessment (FBA) for my child. The report seemed to be very detailed. However, I disagreed with the report because the BCBA did not include an assessment of my son’s scripting. The BCBA did not interview me as part of the FBA because it was a “school FBA”. I told the school that I wanted an Independent Educational Evaluation (IEE)/FBA at the school expense. Now they are telling me that they don’t have to give me an IEE because they think their FBA is good enough. Do I have any options?

Hi Judy, and thanks for writing. This is a great question and so very similar to some of the things I’ve seen happening in recent months. For example, one of my relatives requested an IEE for their child’s initial evaluation and the district filed due process against them! You can imagine how scary it is to be told that your school district is filing AGAINST  you!

I have a couple of points to address regarding your question. For my readers who are lost with all this terminology, you may read about an FBA here, learn about what to expect from an FBA here, and finally, learn the difference between an FBA and a functional analysis here.

Right to an IEE

First, if your child has an IEP, you have the right to request an IEE as long as the school completed their FBA within the past 12 months and you disagree with it. You don’t have to say why you disagree; just merely indicate you disagree.

The school does have a right to refuse the IEE by stating that their FBA is appropriate. At that point, you would have to file due process against them. I don’t recommend taking that step unless you have legal representation. Should you file due process against the school, you will need to prove why their FBA is insufficient.

I have heard of 3 different cases in Connecticut (I’m sure there are more) where the school refused to provide the IEE and so the family proceeded with a due process. In all 3 cases, the school district settled the case after the family spent precious time and resources gathering data, experts, and attorneys.

Parent Involvement in the FBA

My second point to your question is that the BCBA has a duty to involve you, the parent in the FBA. The reasons for this are twofold. First, the BACB Guidelines for Responsible Conduct require written parent permission to assess (see Guideline #3). Second, the BACB Guideline #4 requires client or guardian involvement during individual behavior change program planning.

“The behavior analyst (a) designs programs that are based on behavior analytic principles, including assessments of effects of other intervention methods, (b) involves the client or the client-surrogate in the planning of such programs, (c) obtains the consent of the client, and (d) respects the right of the client to terminate services at any time.”

If the parent disagrees with the FBA, how could the parent possibly be involved in the planning of the program? The BCBA should minimally involve the parent/guardian throughout the FBA and the BIP.

Research on Family Involvement

My third point to your question is to highlight the research on the importance of family involvement during the assessment and intervention process. For starters, including families in the process will serve to help educate parents on the assessment and intervention process. This education may then go on to reduce parenting stress (c.f., Bristol, et al., 1993; Gallagher, 1991; and Koegel et al., 1996). Second, professionals should be conducting assessments and development interventions utilizing a multicultural lens (c.f., Harris, 1996; Heller et al., 1994). Without parent involvement, cultural competence cannot be achieved.

In summary, if your child’s BCBA, behaviorist, behavior specialist, or similar completes an FBA on your child and you disagree with it, be sure to ask your team for an independent educational evaluation (IEE).

References

Bristol, M.M., J.J.Gallagher, and K.D.Holt 1993 Maternal depressive symptoms in autism: Response to psycho-educational intervention. Rehabilitation Psychology 38:3–9.

Gallagher, J.J. 1991 The family as a focus for intervention. In Handbook of Early Childhood Interventions, S.Meisels and J.Shonkoff, eds. Cambridge MA: Cambridge University Press.

Harris, S.L. 1983 Families of the Developmentally Disabled: A Guide to Behavioral Intervention. Elmsford, NY: Pergamon Press.

Heller, T., R.Markwardt, L.Rowitz, and B.Farber 1994 Adaptation of Hispanic families to a member with mental retardation. American Journal on Mental Retardation 99:289–300.

Koegel, R.L., A.Bimbela, and L.Schreibman 1996 Collateral effects of parent training on family interactions. Journal of Autism and Developmental Disorders 26:347–359.

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I haven’t posted a poll in while. So, I thought I would see what my readers think about this topic: The Terrible Teens!

We all know that teens engage in eye rolling, talking back, and “hating my life”.

terrible teens

However, do they threaten bodily harm? or death wishes? what is normal and what should be a serious concern?

So, I would like to know, did you engage death wishes as a child, do your own children make death threats? Do your clients/students make death threats?

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Are you planning on attending the 2015 Annual ABAI Conference in San Antonio? I will be conducting the workshop below. Additionally, Abby and I will be presenting a session on Ethical Issues related to feeding interventions with our colleague Stephanie Reinoso.

Hope to see you there!

Workshop #18           CE: PSY/BACB
05/22/2015
8:00 AM – 3:00 PM
214C (CC)
PRA
CE Instructor: Melissa L. Olive, Ph.D.
Ethical Issues Related to FBAs, BIP Development, and Progress Monitoring
Keyword(s): Ethics, Behavior Interventions, FBA, BIP
MELISSA L. OLIVE (Applied Behavioral Strategies)
Description: Behavior analysts are often faced with the difficulty of completing Functional Behavior Assessments and developing Behavior Intervention Plans for their clients. This session will identify ethical issues that must be considered, what can be done to prevent ethical issues from arising, what behavior analysts can do to remedy ethical situations gone wrong, and related BACB Guidelines for Responsible Conduct. Participants in this session will recognize and describe the ethical issues related to developing BIPs, list strategies for preventing ethical issues related to developing BIPS, and discuss methods for resolving ethical issues related to BIPs. The Behavior Analyst Certification Board (BACB) Guidelines for Responsible Conduct also will be discussed. Information will be provided in a lecture format with case studies as examples. Time will be allotted for extensive question and answer. Detailed handouts will be provided.
Objectives: At the conclusion of the workshop, participants should be able to: (1) recognize and describe the ethical issues related to completing FBAs; (2) describe the process of an FBA for an Independent Educational Evaluation (IEE); (3) recognize and describe the ethical issues related to developing BIPs; (4) list strategies for preventing ethical issues related to completing FBAs and developing BIPs; (5) discuss methods for resolving ethical issues related to completing FBAs and developing BIPs; and (6)identify and describe the Behavior Analyst Certification Board (BACB) Guidelines for Responsible Conduct as they relate to completing FBAs (Guideline 3) and developing BIPs (Guideline 4) and monitoring progress toward the BIP.
Activities: Information will be provided in a lecture format with case studies as examples. Time will be allotted for extensive question and answer. Detailed handouts will be provided.
Audience: BCBAs, BCaBAs, school psychologists with training and experience in ABA, and administrators who supervise BCBAs.
Level: Intermediate

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Applied Behavior Analysis (ABA ) services by a Board Certified Behavior Analyst (BCBA) are becoming increasingly common. If you are new to our blog, you may read more about ABA services here and you may read more about a BCBA here.

Today’s post is really for BCBAs and BCaBAs. However, we always welcome parent and teacher readers because everyone can learn from one another.

Are You Doing Due Diligence?

What is “due diligence”? While there are several definitions, the most appropriate definition here is: “acting with a certain standard of care” (Wikipedia).

Standard of Care

What is the standard of care within ABA? The best resource available, in my opinion, is the practice guidelines produced by the Behavior Analysis Certification Board (BACB). The BACB created a beautiful and comprehensive manual describing the standard of care in behavior analysis. The manual is called, “Applied Behavior Analysis Treatment of Autism Spectrum Disorder: Practice Guidelines for Healthcare Funders and Managers”. You may download the manual here. The manual doesn’t talk about caseload for BCBAs who consult with teachers, classrooms, and schools. Rather, the manual discusses ABA services for individual children.

Tiered Services

One important feature regarding ABA services is the tiered model of service delivery. Just like in medical care, the licensed vocational nurse (LVN) provides direct care, he is overseen by the registered nurse (RN), who follows a treatment plan developed by a physician. In ABA, a technician provides direct care to clients. The technician is overseen by a BCaBA or a BCBA. The BCBA develops the treatment plan and oversees the individuals providing direct care.small group training

If you are a BCaBA, you must work under the guidance and supervision of a BCBA. BCBAs are independent practitioners. However, I know very few BCBAs who want to be on their own. Most of the individuals I have met, want to work alongside a team of professionals in order to solve the most complex cases. Behavior therapists are not independent practitioners either and they, too, must work under the guidance and supervision of a BCBA or BCaBA.

Caseload

How many students are on your caseload?

How many should be on your caseload? This manual has great recommendations regarding the appropriate caseload for BCBAs. The recommendation is based on the type of case. For example, a comprehensive case would require more intense supervision while a case focusing on one are of learning (e.g., toileting), may need less supervision.

Case Oversight

assesment

All ABA cases, including the technician, will need supervision. Case supervision may come in the form of indirect services (e.g., graphing, analyzing data, writing reports) or direct supervision (e.g., modeling program implementation, collecting interobserver agreement, or completing fidelity checks). While case supervision will vary from child to child, the BACB recommends 2 hours of case supervision for each 10 hours of service.

Take a moment and reflect on your cases. Are you doing due diligence?

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Raise your hand if you did NOT see the Dateline NBC special on adults with autism……..It’s been pretty popular this week and if you haven’t heard about it, perhaps you are living under a rock. We won’t judge you! You can still catch it here.

Rachel Kaplan Working on a Farm

Many parents reported online how sad the show made them feel or how depressed they were for their child’s future. I agree that it can be overwhelming to think about the cost of servicing so many adults with autism or even worse, to think of a loved one without adequate care. However, it is not all gloom and doom. Adults with autism can still learn! Don’t give up hope. To prove this fact, today’s research review describes the results of a study on 4 adults with autism. Lattimore, Parsons, and Reid conducted the study and published it in 2006.The Journal of Applied Behavior Analysis published the study in 2006.

Study Purpose

The authors set out to study and compare the outcomes for adults with autism who received job-site training. One group received training plus simulation while the other group received job-site training only. Researchers taught participants skills such as learning to prepare envelopes for mailing books, emptying trash cans, or preparing packing paper. The study authors taught these skills using principles of applied behavior analysis (ABA).

Study Design

The authors used a multiple probe design across participants to demonstrate experimental control and to analyze the effects of the intervention. This design allowed the authors to rule out extraneous explanations for the study results, and it especially controls for maturation (e.g., the participants getting better due to exposure to the task or simply getting older).

Study Results

Participants who received job-site training plus simulation training made more progress or had higher task performance than those who did not receive the additional simulation training. This was true even if the participant worked only 1 day per week!

So while the future may feel bleak given the limited resources available for adults, it is important to know that adults with autism may still learn. It is never too late to start ABA!

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