Consider that you are a Behavior Analyst that has been assigned to...
Question
Consider that you are a Behavior Analyst that has been assigned to work as a supervising BCBA for a home program for Kaitie, a 4-year-old girl who has been diagnosed with autism. She attends a special education preschool program for students with ASD and Communication Disorders in a self-contained classroom, where she receives Physical Therapy, Speech Therapy, Occupational Therapy, and Discrete Trial Teaching (DTT) as part of her half-day program. Kaitie is mostly non-verbal, emitting only a few basic words such as “no”, “more”, and “I-Pad”. Most other times, Kaitie will engage in squealing noises, crying, or whining as a way to express herself. Occasionally, she will engage in tantrum behaviors such as hitting, kicking, and flopping on the floor if her needs are not met quickly enough. Kaitie’s parents have heard about Facilitated Communication as a “miracle”, and ask you about implementing a plan to include it into her program since they are eager to increase her language development. You explain that Facilitated Communication is not an evidence- based practice and therefore, you cannot recommend it as a treatment option. Upon hearing that, Kaitie’s parents become a bit resistant to your recommendations, and seem doubtful about her developing home program.
Kaitie’s home program is contracted for 15 hours of services per week, most of which are to be provided by two Registered Behavior Technicians (RBTs). There is also a parent-training component, in which you, as the BACB, provide to parents for 2 hours per week to assist with supporting parents to become active participants in Kaitie’s program, particularly to enhance the maintenance and generalization of skills learned during her therapy with the RBTs.
Part One: Develop a Rapport
First, discuss how you would approach Kaitie’s parents as resistant clients. What barriers would prevent the development of an effective rapport, and what strategies would you suggest to use as a means to establish a therapeutic relationship?
Part Two: Verbal Behavior Assessment & Intervention
Next, outline the process that you would use to establish Kaitie’s verbal behavior program, including the specific assessment and teaching methods, providing a clear rationale for your decisions. Present an overview of your assessment instrument and the hypothetical results related to the existing and target verbal operants in Kaitie’s case. Based on the results, discuss how you would set up a treatment program using Discrete Trial Training and how you would provide effective management and supervision to the RBTs who will be facilitating the DTT program. Then, discuss how you would consider maintaining and generalizing Kaitie’s behavior as part of the parent-training program. Choose a naturalistic approach in which parents can be taught to implement procedures that will generalize Kaitie’s language skills into the natural home and community environments. Finally, explain the facets of Performance Management that you would adopt to support your RBTs and Kaitie’s parents with the successful implementation of the intervention plans.
Part Three: Evaluate the Program
Describe how you would assess the overall effectiveness of the home program, and what steps you would take if (a) goals were not being achieved in a timely manner or teaching procedures were not effective and (b) steps you would take when behavioral and instructional goals are met.
Part Four: Important Considerations
Throughout your discussion, specifically outline each of the key ethical considerations that will support the necessary steps in the assessment and intervention process. Be sure to use the BACB Professional and Ethical Compliance Code (2014) as a framework, and take careful thought in supporting your discussions with specific codes and relevant rationale. Also, include a discussion to address any potential legal, cultural and social validity issues (10 - 15 pages). Make sure you have at least seven (7) scholarly sources to substantiate your work.
Kaitie’s home program is contracted for 15 hours of services per week, most of which are to be provided by two Registered Behavior Technicians (RBTs). There is also a parent-training component, in which you, as the BACB, provide to parents for 2 hours per week to assist with supporting parents to become active participants in Kaitie’s program, particularly to enhance the maintenance and generalization of skills learned during her therapy with the RBTs.
Part One: Develop a Rapport
First, discuss how you would approach Kaitie’s parents as resistant clients. What barriers would prevent the development of an effective rapport, and what strategies would you suggest to use as a means to establish a therapeutic relationship?
Part Two: Verbal Behavior Assessment & Intervention
Next, outline the process that you would use to establish Kaitie’s verbal behavior program, including the specific assessment and teaching methods, providing a clear rationale for your decisions. Present an overview of your assessment instrument and the hypothetical results related to the existing and target verbal operants in Kaitie’s case. Based on the results, discuss how you would set up a treatment program using Discrete Trial Training and how you would provide effective management and supervision to the RBTs who will be facilitating the DTT program. Then, discuss how you would consider maintaining and generalizing Kaitie’s behavior as part of the parent-training program. Choose a naturalistic approach in which parents can be taught to implement procedures that will generalize Kaitie’s language skills into the natural home and community environments. Finally, explain the facets of Performance Management that you would adopt to support your RBTs and Kaitie’s parents with the successful implementation of the intervention plans.
Part Three: Evaluate the Program
Describe how you would assess the overall effectiveness of the home program, and what steps you would take if (a) goals were not being achieved in a timely manner or teaching procedures were not effective and (b) steps you would take when behavioral and instructional goals are met.
Part Four: Important Considerations
Throughout your discussion, specifically outline each of the key ethical considerations that will support the necessary steps in the assessment and intervention process. Be sure to use the BACB Professional and Ethical Compliance Code (2014) as a framework, and take careful thought in supporting your discussions with specific codes and relevant rationale. Also, include a discussion to address any potential legal, cultural and social validity issues (10 - 15 pages). Make sure you have at least seven (7) scholarly sources to substantiate your work.
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An intervention plan for Kaitie’s autistic behaviors
The developmental challenges that face children with autism are overly critical as they generate psychological problems, not for the immediate family alone but also everyone else in society. Therefore, led by ABA professionals, people must work hand-in-hand to help these children accomplish the standard developmental milestones. While this is the case, the parents often have different thoughts on the manner to plan and execute interventions for their autistic children. Hence, BACB should take a systematic approach to alleviate any underlying conflict of interest and resistance. Besides, the professional should adopt a carefully thought treatment program taking into consideration any legal, cultural, individual, and ethical issues that might apply. This paper attempts to provide details of an effective home-based intervention program for a client called Katie who has problems communicating.
Developing a rapport
The resistance demonstrated by Kaitie’s parents is a major barrier that prevents the establishment of an effective therapeutic relationship. Resistance refers to the process of diminishing or avoiding the self-disclosing communication that a behavior therapist might request because the client feels that disclosure will lead to some form of anxiety or discomfort. Kaitie’s parents are fixated on the belief that Facilitative Communication is the most appropriate therapeutic action plan for their child. However, following the discommendation by the professional, the parents will become averse to disclose any information related to the alternative program that the professional is suggesting since they are anxious about its relative value to the child's outcomes. If the professional does not address the resistance, it will not only interfere with the ABA’s perceived efficacy but will also impede the motivation that the child might have, besides undermining the change process. Other than the resistance barrier, the culture of the family might also pose a fundamental obstacle. Fong, Catagnus, Brodhead, Quigley, and Field (2016) suppose that each person is part of one or more culture and that cultural contingencies usually shape behavior, which might not work well for the behavior analyst, especially if he or she hails from another culture. This is a clear implication that cultural differences might also contribute towards increasing resistance from Kaitie’s family/parents. Therefore, a critical challenge for the ABA is to establish a strategy to alleviate the resistance, hence develop a productive therapeutic relationship.
An ideal strategy is to allow the family to have choices and become an active director of the therapeutic process while fostering collaboration between the parents and the practitioner. To accomplish such a strategy, Taylor and Fisher (2010) express that the starting point is to consider the motivation of the family. This calls for the ABA to identify a set of activities and skills that the parents can teach the child seamlessly and which the young one can learn quickly and include them in the home program. Taylor and Fisher (2010) further point out that the success of the child will expectedly serve as the most
The developmental challenges that face children with autism are overly critical as they generate psychological problems, not for the immediate family alone but also everyone else in society. Therefore, led by ABA professionals, people must work hand-in-hand to help these children accomplish the standard developmental milestones. While this is the case, the parents often have different thoughts on the manner to plan and execute interventions for their autistic children. Hence, BACB should take a systematic approach to alleviate any underlying conflict of interest and resistance. Besides, the professional should adopt a carefully thought treatment program taking into consideration any legal, cultural, individual, and ethical issues that might apply. This paper attempts to provide details of an effective home-based intervention program for a client called Katie who has problems communicating.
Developing a rapport
The resistance demonstrated by Kaitie’s parents is a major barrier that prevents the establishment of an effective therapeutic relationship. Resistance refers to the process of diminishing or avoiding the self-disclosing communication that a behavior therapist might request because the client feels that disclosure will lead to some form of anxiety or discomfort. Kaitie’s parents are fixated on the belief that Facilitative Communication is the most appropriate therapeutic action plan for their child. However, following the discommendation by the professional, the parents will become averse to disclose any information related to the alternative program that the professional is suggesting since they are anxious about its relative value to the child's outcomes. If the professional does not address the resistance, it will not only interfere with the ABA’s perceived efficacy but will also impede the motivation that the child might have, besides undermining the change process. Other than the resistance barrier, the culture of the family might also pose a fundamental obstacle. Fong, Catagnus, Brodhead, Quigley, and Field (2016) suppose that each person is part of one or more culture and that cultural contingencies usually shape behavior, which might not work well for the behavior analyst, especially if he or she hails from another culture. This is a clear implication that cultural differences might also contribute towards increasing resistance from Kaitie’s family/parents. Therefore, a critical challenge for the ABA is to establish a strategy to alleviate the resistance, hence develop a productive therapeutic relationship.
An ideal strategy is to allow the family to have choices and become an active director of the therapeutic process while fostering collaboration between the parents and the practitioner. To accomplish such a strategy, Taylor and Fisher (2010) express that the starting point is to consider the motivation of the family. This calls for the ABA to identify a set of activities and skills that the parents can teach the child seamlessly and which the young one can learn quickly and include them in the home program. Taylor and Fisher (2010) further point out that the success of the child will expectedly serve as the most
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