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| Consideration of Ethics and Quality Indicators in Supervision and Clinical Practice |
| Sunday, May 29, 2022 |
| 10:00 AM–11:50 AM |
| Meeting Level 2; Room 258B |
| Area: AUT/DDA; Domain: Applied Research |
| Chair: Kayla Randall (Georgia Southern University) |
| Discussant: Denice Rios Mojica (Georgia Southern University) |
| CE Instructor: Katherine Brown, Ph.D. |
| Abstract: Board certified behavior analysts (BCBAs) use behavior analytic principles to inform practices in clinical interventions. BCBAs may engage in other activities for which behavior analytic principles are also applied including collaboration with individuals from other disciplines (e.g., speech/language pathologists) and supervisory relationships. The experimental evaluation of the efficacy of clinical interventions and activities is often emphasized; however, a consideration of ethics and quality indicators of such interventions and activities should be pervasive. For example, a practitioner may closely examine the extent to which treatments generalize to natural settings and maintain overtime or the extent to with their treatment is socially valid. Recent changes in the Ethics Code for Behavior Analysts (BACB, 2020) may impact ethical considerations for a variety of clinical interventions, collaborations, and supervisory practices. Therefore, the inspection of ethical implications and current practices across a wide variety of areas is necessary. This symposium provides an overview of ethical, interdisciplinary, generalization and social validity considerations for the areas of the treatment of pediatric feeding disorders, severe behavior disorders, and the supervision of early-career BCBAs. |
| Instruction Level: Intermediate |
| Keyword(s): ethics, generalization, social validity, supervision |
| Target Audience: BCBA/Ds, intermediate |
| Learning Objectives: 1) Identify a variety of areas in which ethical considerations are necessary, 2) Name specific considerations during interdisciplinary collaboration, 3) State the importance of generalization and maintenance of treatment, 4) Name quality indicators as it pertains to clinical assessments |
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Generalization to Stakeholders in the Treatment of Severe Destructive Behavior |
| ALYSSA HURD (Utah State University), Samantha Nercesian (Utah State University), Sharelene Curry (Utah State University), Katherine Brown (Utah State University) |
| Abstract: Stakeholder and generalization training are critical components in the treatment of severe destructive behavior. The Behavior Analyst Certifications Board’s Ethics Code (2020) calls for Board Certified Behavior Analysts to involve stakeholders throughout services and train interventions within contexts appropriate to the client and stakeholders. To assist practitioners, the prevalence of generalization training is needed to identify potential barriers and solutions to conducting generalization training. The purpose of this study was to conduct a consecutive case review of a university-based severe behavior program over a 10-year period to determine the prevalence of generalization training. We reviewed 268 cases for training conducted with parents and professionals, within and outside the clinic setting, and post-discharge during outpatient services. We found the majority of cases trained caregivers to implement intervention procedures whereas only a small portion trained professionals (e.g., school staff). Generalization training within the clinic using novel rooms or novel therapists occurred in less than a quarter of cases and generalization outside the clinic in home, school, or community settings occurred in just over half of cases. Post-discharge training during outpatient services occurred in about a third of cases. We discuss findings in relation to potential barriers, current ethical guidelines, and practice recommendations. |
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| An Analysis of Quality Indicators During the Stimulus Avoidance Assessment |
| KATHERINE BROWN (Utah State University), Alyssa Hurd (Utah State University), Kayla Randall (Georgia Southern University) |
| Abstract: Researchers have long noted gaps in the punishment literature, one of which is the use of preassessments to aid in the identification and selection of potential punishers. To date, the stimulus avoidance assessment has guided much of the research and clinical practice on identifying and selecting punishing stimuli for severe problem behavior in applied settings. Despite this, there is limited data surrounding the use and outcomes of this assessment. Notably, there no studies have examined important quality indicators for this stimulus avoidance assessment. Some of these quality indicators include social validity, procedural integrity, and outcome correspondence (i.e., the degree to which the results inform a subsequent treatment). The current study summarizes the results of 23 published and 30 clinical cases of the stimulus avoidance assessment. Findings highlight populations who frequently partake in this assessment as well as important quality indicators. We discuss avenues for future research, ethical considerations for identifying and using punishment procedures, and clinical applications. |
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| Ethical Considerations in the Assessment and Treatment of Pediatric Feeding Disorders |
| CAITLIN A. KIRKWOOD (Center for Pediatric Behavioral Health), Melanie H. Bachmeyer-Lee (Center for Pediatric Behavioral Health), Connor Sheehan (Center for Pediatric Behavioral Health) |
| Abstract: Children with feeding disorders represent a unique population of individuals that behavior analysts work with due to the wide range of presenting problems (i.e., difficulty chewing to total food refusal) and complex medication conditions that likely contributed to the feeding difficulty. Failure to treat feeding difficulties may lead to malnutrition, worsening current or developing new medical problems, developmental delays, behavior problems, social-stigma, long-term eating disorders, and increased caregiver stress (Piazza et al., 2017). Behavior analysts working with in home, clinic, or school settings are frequently encountering children with feeding concerns, especially given the high prevalence of feeding difficulties among children with autism spectrum disorder and related developmental disabilities. As a result, they may be presented with potential ethical dilemmas related to the assessment and treatment of feeding difficulties, such as boundaries of competency and the necessity for interdisciplinary care warranted by the complexity of feeding problems and co-occurring medical conditions. We discuss best practices in the assessment and treatment of feeding disorders and related ethical concerns and provide a decision-making model to help ensure ethical practice. |
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| A Survey of Supervisory Practices in Junior Board Certified Behavior Analysts |
| KAYLA RANDALL (Georgia Southern University), Katherine Brown (Utah State University), Denice Rios Mojica (Georgia Southern University) |
| Abstract: Individuals seeking their board certified behavior analyst (BCBA) credential, or are either a registered behavior technician (RBT) or board certified assistant behavior analyst (BCaBA) are required to undergo ongoing supervision from a BCBA or doctoral level BCBA-D as they engage in behavior analytic activities. After becoming a BCBA/D there are no such formal requirements to receive ongoing supervision or mentorship. The extent to which junior BCBA/Ds (i.e., certified within the last five years) are receiving support in the form of supervision and mentorship is unknown. This may be concerning given that some BCBA/Ds begin their career in highly specialized areas which may require additional oversight because of safety and ethical considerations. Without this oversight, BCBA/Ds may not feel supported nor feel equipped to navigate complex situations (e.g., ethical dilemma). This study presents data on a survey given to BCBA/Ds who were early in their career about their experiences with supervision and mentorship. Specifically, we examined questions related to the current practices, perceptions of supervision, and barriers to supervision. Preliminary data suggest access to supervision following certification is extremely important. Implications for recommendations for the supervision and mentorship of junior BCBAs is discussed. |
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