|Ethical Integration of Applied Behavior Analysis Into an Acute Pediatric Medical Setting|
|Monday, May 27, 2019|
|8:00 AM–8:50 AM |
|Swissôtel, Event Center Second Floor, Vevey 3/4|
|Area: CBM/DDA; Domain: Applied Research|
|Chair: Terry J. Page (None)|
|Discussant: Terry J. Page (None)|
|CE Instructor: Terry J. Page, M.S.|
Behavior analysts often work collaboratively with other disciplines; however, behavior analytic consultation within an acute pediatric medical setting can present unique ethical challenges. During consultation, behavior analysts are typically provided short time frames to conduct assessment and implement treatment. However, behavior analysts still need to follow ethical guidelines to work with medical colleagues to rule out medical etiology and determine how to safely conduct assessments and implement treatment in a medically compromised patient population or patients who are awaiting transfer to in-patient psychiatric units. In addition, behavior analysts must disseminate behavior analysis in a setting where this technology is relatively novel to other team members, who are more familiar with pharmacologic interventions and psychotherapy to manage problem behaviors. This symposia will discuss the use of traditional and synthesized functional analyses within a pediatric medical setting as well as the implementation function-based treatment to reduce life-threatening behavior, and demonstrate the use of behavior analysis to help inform medical decision-making with medically and behaviorally complex patients.
|Instruction Level: Intermediate|
|Keyword(s): ethical collaboration, functional analysis, medical hospital, pharmacology|
|Target Audience: |
Target audience includes behavior analysts practicing in a variety of settings, specifically those working in consultation roles and as part of an interdisciplinary team and those working with medically complex populations.
|Implementing Functional Analyses and Function Based Treatment in a Medical Setting|
|KRISTIN VESPE (Children's Hospital of Philadelphia)|
|Abstract: An acute pediatric medical setting presents unique challenges when assessing problem behavior and implementing function based treatment. The patient’s length of stay can vary greatly based on the admission problem and criteria for safe discharge. The length of stay for behavioral health patients can be as short as a few hours prior to a patient discharging to an in-patient psychiatric facility. If behavioral assessment is needed in a relatively short time, synthesized functional analyses are an alternative to a traditional functional analysis. When patients present with life-threatening behaviors, such as self-decannulation, patient safety is most important when selecting assessment methodology. In one case this was achieved through the use of latency- and trial-based functional analysis. This methodology allowed behavior analysts to assess the function of the behavior while mitigating the risk of eliciting the behavior with greater frequency than the patient’s baseline rates. When function-based treatment is implemented consistently by the treatment team and results in a decrease in problem behavior, it may result in a decreased length of hospital stay and/or discharge to a less restrictive environment than initially projected.|
Integrating Applied Behavior Analysis Into a Medical Setting
|VIRGINIA KAUFMANN (Children's Hospital of Philadephia)|
Integrating applied behavior analysis into an acute medical setting allows opportunities for technology to be utilized with a diverse patient population. A transdisciplinary team within a pediatric medical hospital may include nursing, psychiatry and psychology, neurology, and other medical professionals. The ability to provide objective data regarding patient behavior can help inform medical decisions in complex cases in which the transdisciplinary team has struggled to make progress related to the patient’s behavior. This may include decisions to make changes in psychotropic or other medications, as well as providing input into difficult diagnoses. Behavioral intervention and the use of data-based decision-making has been useful with patients with a variety of medical diagnoses, including anti-NMDA receptor encephalitis, functional neurologic/conversion disorder, and avoidant/restrictive food intake disorder (ARFID), with the benefit of minimizing the amount of as needed/PRN medications given to patients, informing the transdisciplinary team on timing of standing medications, and discharging patients to less restrictive settings.