Unit 8: Very Different Assignment!

1. Unit 8: Very Different Assignment! • Topics covered: • Certification in behavior analysis • Research and practical ethics • Unit Assignment: 2 parts • 17 pts over study objectives in course pack • 18 pts for completion of first 7 modules of an on-line training program about research ethics • Research and practical ethics have the same overarching guidelines/principles, and thus there are a lot of similarities between them.

2. Unit 8: Very Different Assignment! • On-line Training Program • You must hand in a computer print out that you have completed the on-line training on the day of U8 exam, which is Tuesday, 4/18 (no electronic copies via email) • Completion = criterion established by HSIRB: 80% correct on the quiz after the unit. Quizzes can be retaken until you obtain the 80% criterion. • If you do not hand this in on the day of the exam - no credit. Late assignments will not be accepted. • See Study Objectives for grading criteria • See instructions that I handed out in class for logging onto the training program.

3. Schedule • Today and Thursday: Certification in behavior analysis and professional ethics • Tuesday, April 18, E8 • 18 points: completion of first seven modules of on-line research ethics training program (80% on quizzes = completion) • 17 points: exam over certification and practical ethics • Thursday, April 20 • Return of E8 • Special grade sheet for ME2, can you benefit from taking ME2, and if so how many pts do you need? • ME2 study objectives handed out

4. Schedule • Make-up Exam 2 (Units 4 - 8) • TUESDAY, APRIL 25 • 2:45 - 4:45 PM (be here at 2:45)

5. Unit 8: Certification in Behavior Analysis and Professional Ethics • Certification • The Behavior Analyst Certification Board is a nonprofit corporation to meet professional credentialing needs identified by behavior analysts, state governments and consumers of behavior analysis • Certification is not required to practice behavior analysis, however, many organizations, particularly those who serve vulnerable populations (children diagnosed with autism, children and adults diagnosed with DD, etc.) require employees to be certified • State of PA requires all teachers who work with children diagnosed with autism to be certified in behavior analysis (it is not the same thing as licensing, i.e., clinical)

6. Unit 8: Certification • Certification: Two levels of certification • Board Certified Associate Behavior Analyst (BCABA) • Board Certified Behavior Analyst (BCBA)

7. SO1: Requirements for Board Certified Associate Behavior Analyst • BA degree (not necessarily in behavior analysis or psychology) • 135 credit hours of specific coursework in behavior analysis (following details not required for the exam) • 10 hours ethics (hence this unit) • 40 hours definitions, principles, and concepts • 25 hours behavioral assessment, selection of intervention outcomes and interventions • 20 hours measurement of behavior, experimental evaluation of interventions, display and interpretation of behavioral data • 40 hours behavioral change procedures and systems support

8. SO1: Requirements for Board Certified Associate Behavior Analyst C. Experience requirement (from 500 - 1000 hours depending upon intensity of supervision. Supervisor must be a BCBA - see web site for details) • Pass the Associate Behavior Analyst Certification Examination administered by the Behavior Analyst Certification Board

9. SO2: Before applying for the exam which of the preceding requirements must be met? • All of the other three • BA degree • 135 credit hours of coursework in behavior analysis • Experience requirement

10. SO3: When you graduate from WMU with a BS in psychology, which certification requirements have you met? • BA requirement and 135 credit hour requirement • Credit hour requirement met by 3300, 3600, and 4600 and is pre-approved by the Certification Board so our graduates do NOT have to submit individual course syllabi • Not for exam: Experience requirement is not met • Croyden Avenue practicum provides about 140 hours of supervised experience. Most individuals fulfill experience requirements through employment in behaviorally oriented organizations after graduation. Too difficult to obtain 500-1000 of supervised practice during school.

11. SOs 4 and 5 4A. How long does the original certification last? • Three years 4B. What must be done to maintain certification? • Renew certification each year by application • Apply for recertification after 3rd year SO5. What are the recertification requirements? • Complete 24 hours of continuing education every three years or • Retake and pass the certification examination

12. SO6: Requirements for certification as a Board Certified Behavior Analyst (BCBA) • MA degree (not necessarily in behavior analysis or psychology) • 225 credit hours in specific course work at the graduate level in behavior analysis (a sequence of our graduate level courses have been pre-approved to meet this requirement - students have some options) • Experience requirements (750-1500 hours of supervised experience, depending upon intensity of supervision) • Pass the Behavior Analyst Certification examination

13. SO7: Not for ExamRenewal and Recertification: Similar to BCABA • How long does the original certification last? • Three years • What must be done to maintain certification? • Renew certification each year by application • Apply for recertification after 3rd year • What must be done to obtain recertification after 3rd year? • Complete 36 credit hours of continuing education in behavior analysis or • Retake and pass the certification examination

14. SO8: Professional Ethics • Materials in the course pack • Dickinson article • Relevant task statements (seven of the twelve) taken from the list of task statements for the certification exam • Sections of the “responsible conduct” guidelines for behavior analysts relevant to each task • Case study examples • Complete set of Behavior Analyst BoardGuidelines for Responsible Conduct (not for the exam - just FYI) • Complete set of task statements for the ethical content part of the certification examination (not for the exam, just FYI)

15. Exam Questions (also indicated in SO8) • I will give you a copy of the seven task statements • I will ask two types of questions about these or similar case studies • Which task statement or statements are relevant to this case study? A particular case study often involves more than one task statement. • Short open-ended questions such as: • What should the person in the case study do?” • Is it OK for the person in the case study to start the intervention or research, or is there something else the person must do before starting?

16. Task Statement 1-1 • Solicit or otherwise influence clients only through the use of truthful and accurate representations of intervention efficacy (effectiveness) and one’s personal competence in applied behavior analysis.

17. Case Study 1A Dr. B, a behavior analyst, was consulting at a residential facility for clients diagnosed with developmental disabilities that were severe enough to prevent them from living at home or in the community. This was a new client for Dr. B. and he wanted to demonstrate how behavior analysis could help the clients. One day, as soon as Dr. B. arrived, the administrator approached him and began congratulating him on successfully treating one of the most difficult clients in the facility. Dr. B. then discussed the case with the student who was helping him. The student told him that, in fact, baseline was still underway and the treatment plan had not yet been executed. • What should Dr. B. do? • Why is this relevant to task statement 1-1?

18. Case Study 1A • What should Dr. B. do? He should meet with the administrator and explain that no credit was due. That, in fact, baseline was still underway and the treatment plan had not been executed. • Why is this relevant to task statement 1-1? Solicit or otherwise influence clients only through the use of truthful and accurate representations of intervention efficacy Well-respected professionals attain their reputations based on the trust placed in them by others. Being truthful with clients provides the basis for long-term relationships that make for a successful career.

19. Case Study 1B Dr. G. was a school psychologist working with a private tutoring service to help children who were having trouble in school. Some of the children were diagnosed with ADHD, some with dyslexia. Dr. G. conducted a controlled study with 2 of the ADHD clients and 2 of the dyslexia clients. She found her behavioral teaching methods were much more effective for teaching these children how to read and do math than more traditional methods. Dr. G. was thrilled as was the director of the tutoring service. The director sent press releases to several magazines and newspapers. Dr. G. found out that the director had written the following headline: “Dramatic New Advances in Education: Teaching Methods at ABC Tutoring Cure ADHD and Dyslexia.” • What should Dr. G. do? • Why is this relevant to task statement 1-1?

20. Case Study 1B • What should Dr. G. do? She should immediately contact the director and explain that the headline was not appropriate. She should rewrite the headline and immediately contact all of the magazines and newspapers and tell them to hold the presses. If it is too late to hold the presses, Dr. G. should immediately write and request that a follow-up piece be published correcting the misconception that it cured ADHD and dyslexia and talk about the limitations of the study (only dealt with 2 ADHD students and 2 dyslexia students and in a highly structured environment). • Why is this relevant to task statement 1-1? Behavior analysts should be truthful about the effectiveness of an intervention and should not exaggerate their effectiveness.

21. Case Study 1C Jake was a student in a Ph.D. program in Organizational Behavior Management. He wanted to supplement his income by consulting with local companies. Jake had an MA degree in OBM and had worked with a number of companies doing projects in classes arranged by his professors where he was supervised by both a person in the organization and the professor. He had also completed two practicum courses in organizations under the supervision of his advisor. When he developed his resume, under “experience” he listed the companies he had worked with and the projects he had completed for each. • Is there anything else Jake should include on his resume? • Why is this relevant to task statement 1-1? • How does this situation apply/generalize to students applying for jobs or to graduate school?

22. Case Study 1C • Is there anything else Jake should include on his resume? Absolutely. He should indicate that the projects were completed as part of a course, listing both the professor and on-site individual as supervisors. • Why is this relevant to task statement 1-1? The behavior analyst must supply the client with an accurate and truthful representation of his/her credentials when soliciting clients. Solicitation and public statements include personal resumes and curriculum vita. Without the information above, it appears as though Jake was an independent consultant for the organizations. That is misleading. 3. How does this situation apply/generalize to students applying for jobs or to graduate school?

23. Task Statement 1-2 Practice within one’s limits of professional competence in applied behavior analysis and obtain consultation, supervision, training, or make referrals as necessary.

24. Case Study 2A Martin, a BCBA, moved to a new city to work at a large state hospital for persons with mental health problems. This was a new area of expertise for Martin: his past experience was limited to clients who were profoundly retarded with multiple physical disabilities. At the new hospital, Martin was assigned to work with Dan, a 23-year old who had a severe head injury. Due to the head injury, Dan engaged in violent and dangerous outbursts of aggression. Dan’s outbursts ahd resulted in medical treatment for a few staff members. Martin was eager to help Dan and began reading everything he could about head injury. Martin felt that the hospital had hired him to do a job and assigned him to this client, and he was committed to getting Dan’s behavior under control. • Is there anything else Martin should be doing? • Why is this relevant to task statement 2?

25. Case Study 2A • Is there anything else Martin should be doing? Behavior analysts should only accept clients whose behavior problems are commensurate with their skill level. Martin needs to consult with a BCBA who is an expert in the treatment of head injury and aggression. If there is no such person at the facility, he needs to find someone in the area to supervise him. There can be liability issues if he does not. • Why is this relevant to task statement 2? Must practice within one’s area of competence and obtain consultation and supervision, if necessary.

26. Case Study 2B Melinda, a BCABA, is working with a child in an after-school clinic affiliated with a university. The child is beginning to engage in self-injurious behavior and the parents are concerned that the behaviors may escalate into more severe types of behaviors. Melinda has implemented a behavioral program to reduce/eliminate the self-injurious behaviors. One of the parents asks Melinda, “Does my child’s self-injurious behavior indicate that he may have attention deficit disorder?” • 1. How should Melinda respond? • 2. Why is this relevant to Task Statement 1-2?

27. Case Study 2B • How should Melinda respond? That diagnosis is outside my area of expertise. Your child’s doctor would be better able to help you determine that. 2. Why is this relevant to Task Statement 1-2? Practice within one’s limits of professional competence and make referrals when appropriate. Other potential questions that may come up with a parent: Should I put my child on a special diet? Refer to pediatrician and perhaps relevant literature What should I say to convince the judge in my child custody case that I am the best parent to promote this ABA program for my child? I can’t give you advice on that - I suggest you talk to your lawyer.

28. Case Study 2C • David is a BCBA who was recently asked to provide services to a program for adults with developmental disabilities. David went to visit the program and was dismayed to see a lack of materials for training, a number of clients with behavioral problems, and a very serious shortage of staff. David asked about the staffing at the facility, and was told that due to budget cuts, there was not enough staff nearly every day. He did not feel that he could implement behavioral programs that would be effective with the number of current staff. David felt sorry for the clients, however, and wanted to help as much as he could. He was considering accepting the position and doing as much as he could by filling in as an extra pair of hands until additional staff could be hired. • 1. If you were David, what would/should you do? • 2. Why is this relevant to Task Statement 1-2?

29. Case Study 2C • If you were David, what would/should you do? David should refuse to take the position. This critical shortage of staff will prevent the implementation of behavior programs. When the facility is adequately staffed, David can offer to provide behavioral services. 2. Why is this relevant to Task Statement 1-2? If environmental conditions preclude implementation of a sound behavior analytic program, the behavior analyst should inform the client of such and make referrals to others (an OBM or systems analyst). Must practice within one’s limits of professional competence - cannot be competent in this situation.

30. Task Statement 1-4: (I am not covering 1-3 from the guidelines) Obtain informed consent within applicable legal and ethical standards. • Provide a written description of all procedures and obtain consent from all clients before research, assessment, intervention, change in intervention, changes in interventions. • When working with clients, describe procedures in language they can understand and obtain assent if “consent” cannot be given.

31. Case Study 4A Susan is a fifty-two-year-old woman with developmental disabilities. She lives at home with her mother who is her legal guardian and she attends a vocational training program. Susan receives behavioral programming as needed. Angie is a BCBA who works with clients at the vocational program. Angie has been asked to provide behavioral services for Susan. It seems as though Susan has been spending all of her money on junk food. Then, so that she has money, she has been asking staff to give her loans or pay her for small favors. This behavior has escalated to the point that Susan has no money for bus transportation and she is making everyone uncomfortable with her begging. Because begging is not really an appropriate behavior, Angie feels that it would be okay to instruct the staff to immediately begin treating begging with social disapproval. 1. At what point does Angie need to get approval from Susan’s mother? 2. Why is this relevant to Task Statement 1-4?

32. Case Study 4A • At what point does Angie need to get approval from Susan’s mother? Before implementing any procedures to change Susan’s behavior, Angie needs to outline the objectives of the behavior plan in writing for Susan’s mother. It could be that the mother feels Susan has the right to spend her money on snacks as long as she goes to work. The intervention for this problem may well be something for which the mother wishes to have some input. • Why is this relevant to Task Statement 1-4? Give procedures in writing and obtain informed consent (in in writing) before implementing any research or behavior change procedure.

33. Case Study 4B Rosemary is a thirty-two-year-old woman who has behavior problems and moderate developmental disabilities. She lives in a residential facility and attends a workshop during the day. Rosemary has some unusual behaviors with regard to her dressing and appearance. She is nearly 100 pounds overweight, is buxom, and she refuses to wear a bra. She wears skirts that she rolls up at the waist-band to make the skirts extremely short. If staff do not intervene, Rosemary tries to leave the facility in the morning wearing an excessive amount of makeup. These behaviors have been documented by Phyllis. Phyllis has been asked to design an intervention. Rosemary would no doubt be embarrassed if someone told her the behaviors were a problem and an intervention would be started soon. 1. How would/should you handle the situation with regard to Rosemary? 2. Why is this relevant to Task Statement 1-4?

34. Case Study 4B • How would/should you handle the situation with regard to Rosemary? With a client who is lower functioning than Rosemary, a behavior analyst would discuss the results of any behavioral assessment with the guardian or some other legally authorized person. In Rosemary’s case, the assessment findings pertain to adaptive behaviors. Phyllis should definitely talk to Rosemary about her findings. Phyllis can explain to Rosemary that everyone wants Rosemary to success and Phyllis will be starting a plan to help her. A female staff person could work with Rosemary to help her select an attractive wardrobe and apply makeup that is tasteful. Her behavior suggests she is trying to make herself attractive and she needs help with a fashion and makeup makeover. • Why is this relevant to Task Statement 1-4? Obtain consent/assent from the client in language that is understandable. (Maintain dignity of the client at all times)

35. Case Study 4C Shakira is working in a special education classroom. Students spend part of the school day in the classroom and they are mainstreamed the remainder of the day. Tawana is a tall, lanky twelve-year-old who swears and becomes disruptive in class. She is on a behavior program that worked well until recently when the program became ineffective. Knowing her clients very well, Shakira quickly figured out that Tawana was bored with the reinforcers. Shakira planned some changes in the intervention, including changing the reinforcers, reinforcement schedule, and adding consequences for misbehavior. 1. Because the behavior plan was already in effect, Shakira was certain that all of the permission forms that were previously signed would cover the new version of the program. Was she correct in assuming this? 2. Why is this relevant to Task Statement 1-4?

36. Case Study 4C • Because the behavior plan was already in effect, Shakira was certain that all of the permission forms that were previously signed would cover the new version of the program. Was she correct in assuming this? No. 2. Why is this relevant to Task Statement 1-4? When a behavior program is modified, the behavior analyst needs to explain the modifications and obtain consent again. In this case, consentn would come from the parents. The changes should also be explained to Tawana.

37. Case Study 4D Carl was working on his master’s degree in behavior analysis. Although not his thesis, he wanted to do some pilot research in a high school that was in a low-income neighborhood. He began volunteering at the school and he established an excellent working relationship with the principal and some of the teachers. He met with the school and got approval to conduct his research. Because this was not an official psychology department assignment and because this was a pilot study, he told the school officials that he was going to be “flexible, implementing procedures that would become apparent as the baseline data became available.” The school (the teachers and principal) said they understood the need for this flexibility and looked forward to seeing what Carl would do. 1. Was Carl ready to begin his pilot research after obtaining approvals from the school principal and the teachers involved in the study?

38. Case Study 4D 1. Was Carl ready to begin his pilot research after obtaining approvals from the school principal and the teachers involved in the study? No. Carl needed an approval of the HSIRB before starting any research in the schools. He also would, as part of that procedure, need to obtain consent from the participants. And, the procedures must be planned and written. The approval from school personnel was not sufficient. • Why is this related to task statement 1-4? Must obtain the written consent of the participant or surrogate before beginning research and also must conduct research with humans and nonhumans in accordance with the local human research board (if there is one) and the HSIRB for the academic institution with which the student is affiliated.

39. Task Statement 1-7 Identify and reconcile contingencies that compromise the practitioner-client covenant, including relationships among the practitioner, the client and other parties.

40. Case Study 7A A BCBA who specializes in behavioral gerontology was asked by her sister to develop an ABA program for her their elderly mother. The sister lives about 60 miles away and the mother has a separate apartment in the sister’s house. The mother had lung surgery about three months ago. The physician and surgeon have given the mother a “clean bill of health” - that is she has no lingering medical problems. However, the mother has stopped engaging in many activities she used to enjoy, and is beginning to just sit around the house complaining – usually about the sister. The sisters have a very close relationship. The BCBA is very concerned about her mother and also wants to help her sister. She is very grateful that her sister has taken on the role of primary care-taker for the mother. 1. What is the BCBA’s most appropriate course of action?

41. Case Study 7A 1. What is the BCBA’s most appropriate course of action? The BCBA should locate another BCBA in the area and refer the sister to that individual. There is too much potential for conflict within the family - either between the mother and the BCBA or between the BCBA and her sister. • Why is this relevant to task statement 1-7? Conflicts of interest here. The behavior analyst must always be sensitive to potential harmful effects of personal and social relationships on their work and on those persons with whom they deal. Behavior analysts provide behavioral services only in the context of a defined, remunerated professional or scientific relationship role.

42. Case Study 7B Bill was a twenty-seven-year-old, single BCBA who worked with clients and conducted research in a large state institution. Bill had a good working relationship with the local university’s psychology and special education programs. One semester, Bill found himself attracted to Kristi, one of the college students he was supervising. The attraction seemed mutual because Kristi “flirted” with Bill and made it a point to let Bill know she was single and available for dating. • Because the feelings seemed to be mutual, was there any problem with Bill asking Kristi for a date? • Why is this relevant to Task Statement 1-7? • How is this relevant to student-faculty relationships? What is the ethical responsibility of students in psychology? • How is this relevant to student TAs and student supervisors in practicum settings?

43. Case Study 7B • Because the feelings seemed to be mutual, was there any problem with Bill asking Kristi for a date? Absolutely. 2. Why is this relevant to Task Statement 1-7? Behavior analysts do not engage in sexual relationships with clients, students, or supervisees; such a relationship could impair their judgment and constitute a form of exploitation as well. Dating is also in this category. If Bill believes that Kristi is the girl of his dreams, he should wait untill her internship is over to have nonprofessional contact with her. Also, depending on the nature of the interactions, it might be appropriate to have someone else supervise Kristi. 3. How is this relevant to student-faculty relationships? What is the ethical responsibility of students in psychology? 4. How is this relevant to student TAs and student supervisors in practicum settings? (Are there any times a student-faculty relationship is OK)

44. Case Study 7C John was working with developmentally disabled clients in a day training center in a small town. He was an excellent behavior analyst and his clients not only made good progress, but liked him a lot. He met many of the parents of his clients at the training center and also in the community. John decided to apply to a Ph.D. program in behavior analysis. He asked the parents that he knew if they would be willing to write recommendation letters for him. The parents were happy to do so and some even offered to include quotes from their children who were John’s clients. • Was there a problem with this? • Why is this relevant to Task Statement 1-7?

45. Case Study 7C • Was there a problem with this? Yes. • Why is this relevant to Task Statement 1-7? Behavior analysts do not solicit testimonials from current clients or patients or other persons who because of their particular circumstances are vulnerable to undue influence. That is, if the parents said no, it might influence the care John gives the DD client or the parents might think if they said no, it would influence the care John gives to their children. Thus, it creates a conflict of interest John should get the letter from the person who supervises him at the day training center (or the director of the center).

46. Task Statement 1-8 Use the most effective assessment and behavior change procedures within applicable ethical standards taking into consideration the guideline of minimal instrusiveness of the procedure to the client.

47. Case Study 8A Jessica was referred to a behavior analyst by her teacher. The behavior analyst had worked with children extensively. Jessica was 7 years old. She caused frequent disturbances in the classroom. Her teacher, Mrs. Harris, provided a data sheet showing the date, time, and type of disturbance going back 3 weeks. Mrs. Harris identified the problem as a “willfulness” problem and requested help in setting up a time-out booth for Jessica. The behavior analyst reviewed the data sheet. Knowing that time-out was a very effective procedure, she designed the time-out procedure and had the teacher implement it. Not long after it was discovered that Jessica had a hearing problem and her disturbances were due to that. 1. What should the behavior analyst have done that she didn’t? 2. This case is also very relevant to another task statement. Which ones?

48. Case Study 8A • What should the behavior analyst have done that she didn’t? Observed Jessica directly and done a functional analysis to determine the causes of the disturbances. • What other task statements is this relevant to? Consent (1-4):she did not get consent from Jessica’s parents nor assent from Jessica. Also, 3. Also, health (1-11): ensure that the dignity, health and safety of one’s clients are fully protected at all times.

49. Case Study 8B Kevin is a six-year-old with developmental disabilities who bangs his head. Robert is a BCBA who has been recently assigned to Kevin’s classroom. Robert’s functional analysis of Kevin’s behavior shows that it is related to attention from his parents and teachers. An occupational therapist (OT) has developed the current treatment plan that includes sensory integration, joint compression, and sessions three times a week to jump on a trampoline to “use up his pent up energy.” The speech therapist recommended sign language. The physical therapist recommended a helmet. Kevin continued to bang his head with the helmet and he also started biting his fingers. The OT is very sure that her plan will eventually work and she explains at every treatment team meeting that everyone needs to be patient and give her treatment program time to work. The Special Education teacher has been, and continues to be, supportive of the OT’s program. 1. Robert is outnumbered here - how should he proceed?

50. Case Study 8B 1. Robert is outnumbered here - how should he proceed? Robert should explain to the team that clients have a right to effective treatment. His professional responsibility is to review and evaluate alternative treatments and he should request empirically-based articles from these other professionals and critique them. Emergency procedures should be used if Kevin is hurting himself. Interventions for SIB should be based on the research literature, and if Robert is not satisfied that these other treatments are supported by empirical evidence, he should say so at the next team meeting • This is also relevant to task statement 1-8. Use the most effective assessment and behavior change procedures • What other task statement is relevant? Task statement 1-11: ensure the dignity, health and safety of one’s clients are fully protected at all times; Task 1-4: also have to obtain consent from legal guardian.