Association for Behavior Analysis International

Behavior analysts demonstrate some of the highest rates of employee burnout within clinical settings (up to 72%; Slowiak & DeLongChamp, 2022). This is problematic as burnout negatively affects provider well being, reduces the quality of services, and can harm organizational health (e.g., via provider absenteeism, tardiness). Other fields take a syndromal approach wherein mentalistic burnout symptoms are measured on an individual basis and then person-centered approaches are applied (e.g., stress management training; therapy). A behavioral framework, informed by OBM, has promise for informing novel ways to identify and mitigate burnout in a manner that addresses the actual workplace variables maintaining burnout. In this panel, we discuss burnout across the perspectives of experts in OBM, supervision within clinical care, and burnout research. Panelists will discuss how burnout may be understood through a behavioral framework and how supervisors and administrators may modify the workplace environment to optimally support highly engaged staff and high quality service delivery. This panel will also provide opportunities for the audience to engage with panelists to drive meaningful conversations surrounding how to combat burnout in clinical settings.

Basic

Organizational leaders should focus on creating sustainable systems to support their supervisors in providing high-quality supervision to staff. One of the behaviors that supervisors must engage in to effectively support their staff is collecting data on integrity. Integrity is the extent to which a procedure is implemented as designed (Gresham 2004; Sanetti & Kratchowill, 2009). Research has revealed a correlation between higher levels of integrity and greater clinical outcomes (e.g., quicker skill acquisition; e.g., DiGennaro Reed et al., 2007). Unfortunately, recent survey results revealed that these data are not often collected, tracked, or analyzed in practice. Therefore, this presentation will discuss: 1) how organizations can evaluate their current processes to determine their efficiency and make necessary changes (Diener et al., 2009; McGee & Crowley-Koch, 2019); 2) how and when organizations should collect procedural integrity data; and 3) how to analyze these data at the individual provider, team, and organization levels to impact provider performance and quality service delivery. Additionally, the benefits of aggregating and analyzing integrity data and how the data can be used to inform retention and training and development initiatives will be discussed.

With BCBA certifications doubling since 2018 (BACB, 2023), the ABA field faces a critical need for mentorship programs that provide new certificants with intensive training and ongoing support. A structured mentorship model that leverages experienced clinicians to facilitate the adoption of emerging technologies and approaches is key. The tiered mentorship model incorporates implementation protocols, fidelity monitoring, and program evaluation to maximize clinician competencies and positive client outcomes. By standardizing training in values-driven, evidence-based practices, the mentorship program aims to ensure all BCBAs gain competencies needed to provide comprehensive, high-quality ABA services. Foundations of Care, a multi-tiered framework has been established to address the need for a universal, practical, and responsive approach to delivering compassionate, assent-based interventions. This approach includes an emphasis on boundary setting, the Practical Functional Assessment (PFA) and Skill-Based Treatment (SBT) processes and ensures all clients are supported with a behavior intervention plan derived from the values of these approaches. This presentation will highlight key features of the mentorship model, how it can be tailored to meet organizational needs and resources, and evidence of its effectiveness. With careful design and execution, this mentor-driven approach allows our rapidly growing field to keep pace with innovations while maintaining client-centered, compassionate care.

Supervisors are often faced with the responsibility of prioritizing administrative duties and managing caseloads over effective supervision. In light of these challenges, it becomes imperative for supervisors to continually refine their supervisory skills to maintain the highest standard of professional growth within their organizations. This presentation will focus on enhancing effective supervision by addressing three critical objectives. It will address the prioritization of key supervisee skills through objective assessments, thereby recognizing their significance in the supervisory process. It will explore the importance of preparing supervision session agendas to improve communication and productivity. Additionally, it will explore the gradual reduction of supervisory support as the supervisee demonstrates independence, as well as ethical considerations and strategies for the sensible termination of the supervisory relationship. Strategies will be discussed for guiding supervisees toward professional growth. These efforts collectively contribute to the advancement of effective and ethical organizational structure and supervision to individuals within the organization.

As Autism treatments based in Applied Behavior Analysis become widely spread and its results known to countries other than the United States, practitioners, families, and payors start seeking such treatments. In Brazil, practitioners seek training, however, the training mostly occurs via brief courses with no standardized curricula. A small number of specialization programs now offer a more structured curriculum, yet many professionals in Brazil travel to the United States to participate in short training and return advertising themselves as having expertise in specific techniques and practices within ABA without having the formal training required to be a BCBA. The best practices of supervision of an ABA-based program have not been directly trained in most Brazilian clinics, and we often observe supervisors with little to no actual relevant experience taking on roles they are not prepared to engage in. Resources to evaluate clinical competencies are in the beginning stages of being translated to Portuguese and adapted to Brazilian culture while a framework for addressing performance deficits of supervisees is being explored. Professional credentialing is under way, and we see a bright future for ABA services in Autism treatment in Brazil with some battles to win initially.

Supervisors who provide ABA services for individuals with learning and behavioral deficits.

7% of US adults, and 1 in 5 members of Gen Z, identify as lesbian, gay, bisexual, transgender, and/or queer (LGBTQ, Gallup, 2022). These population data imply the presence of a large, and likely growing, number of LGBTQ+ behavior analysts. These individuals have much to offer our field, including a particular promise to address the clear need for LGBTQ+ affirming approaches to clinical service delivery. At the same time, LGBTQ+ trainees in allied health and science fields often report experiencing discrimination, non-acceptance, and/or non-inclusion in professional settings, which can decrease both professional engagement and personal wellbeing (Boustaini & Taylor, 2020; Hsueh et al., 2021). The goal of this panel is to catalyze behavior analysts’ thinking on how they can move toward more effective and culturally-responsive approaches to mentoring LGBTQ+ behavior analysts. Panelists from a range of career stages will speak to their lived experiences navigating mentor-mentee relationships in academic and clinical service settings. Both facilitators of and barriers to effective training will be discussed. Ample time will be devoted to audience Q&A, with an explicit invitation for LGBTQ+ mentees in attendance to pose questions that speak to their lived experiences.

Behavior analysts who serve as mentors or supervisors at any level of behavior-analytic practice, research, or training.

Models for provision of ABA-based autism services should be rooted in evidence-based practices. While some best practices have been well researched in the context of service delivery (e.g., implementation of behavioral skills training in the mentorship of behavior technicians), there is a paucity of research to guide certain practices that are critical to supervisor competence and optimal client progress. These lesser explored areas include: decision support for recommendations of medical necessity, best practices in structuring a supervision session, and scalable systems for embedding clinical quality monitoring into behavior analysts’ workflows. This symposium will include presentations that address successful, scalable interventions to ensure evidence-based recommendations for medical necessity, effective structuring of supervision sessions, consistent use of best practices in clinical direction and protocol modification, and quality assessment and measurement. The presenters will provide job aides for training and data collection, behavior analytic approaches to shaping organizational behavior, and related outcomes data reflecting supervisor fluency and client progress.

Intermediate

Insurance-funded, ABA-based autism services require behavior analysts to provide a recommendation for “medical necessity” as part of their functional behavior assessment to initiate services. This recommendation requires the weekly hours of ABA needed to obtain the goals outlined in the client’s program. Data related to the recommendation practices of various organizations is not publicly available, but given that this is not on the Behavior Analyst Certification Board ® (BACB®, 2017) Task List (5th ed.) nor is this commonly addressed by verified course sequence graduate programs, it is a skill that many new behavior analysts may require explicit instruction to master. The research base does not explicitly identify best practices in making recommendations for medical necessity; however, multiple research articles evaluating treatment effects of ABA-based services include information regarding the total weekly hours of care to achieve outcomes. The present paper offers a decision support model, based on the available literature, for synthesizing individualized, clinical presentation of clients in the FBA process. The author will present a demonstration of a decision support model, paired with the clinical expertise of the individual behavior analyst, across a multi-site provider organization. Data will focus on movement toward evidence-based levels of care across clients.

The number of BCBAs has increased rapidly in the last few years, and many mentees are receiving supervision from mentors who trained under earlier task list content. With the addition of cultural humility and soft skills on the current task list, and future test content list 6, it is imperative that supervisors are versed in teaching these skills to trainees. Improving cultural humility and soft skills in behavior analysts is crucial to improve the practice of behavior analysis for diverse groups of individuals across cultures. Currently, there is not much data on teaching cultural humility and soft skills to current and future behavior analysts. This panel will discuss using culturally humble practices within supervision as a model, as well as strategies for assessing and teaching these practices with mentees using evidence-based practices. Similarly, we will discuss how soft skills can be modeled in supervision and systematically assessed and trained in mentees. The panelists are supervisors who prioritize cultural humility and soft skills in their practice. The moderator will facilitate questions from the audience as well as ones that organically transpire in the course of the conversation.

This event is designed to increase intermediate or advanced skills in providing mentorship to mentees, specifically, increase cultural humility and soft skills. Attendees should have completed the required supervision course and provided supervision to mentees, BCaBAs, or RBTs, as well as want to increase their own skills in this area. In addition, these more nuanced skills will be explicitly reviewed using objective measures and concrete ways to teach them will be provided.

Four core principles lay the foundation of the “Ethics Code for Behavior Analysts”- Benefit Others, Treat Others with Compassion, Dignity, and Respect, Behave with Integrity, and Ensure Competence. While these principles and codes assist in maximizing credibility to our profession, they, above all, aim to protect the dignity and safety of our consumers. In addition to enhancing the mastery of conceptual knowledge and technical skills, Board Certified Behavior Analysts® must also be diligent in their delivery of culturally responsive care when addressing the needs of our diverse population, providing equitable and inclusive treatment to all recipients of our services, and teaching and modeling throughout clinical practice and supervisory experiences. This symposium will begin by highlighting some of the current issues impacting culturally responsive supervision by first examining the impact of potential personal biases in service delivery. Suggestions for approaches and strategies to alleviate and promote ethical and culturally responsive training processes will be reviewed.

Attendees should be practicing certified analysts who are or will be supervising others (i.e., BCaBAs, RBTs)

Behavior analysts in supervisory roles are held accountable for their supervisory practices. As supervisors, they must prioritize the development and implementation of positive supervision and training relationships with their supervisees. One crucial aspect to consider during this process is diversity, which should be incorporated as a primary influence in shaping training and supervision practices. It is essential to recognize that each supervisee comes from a different background and culture. As a supervisor, you must be able to provide training and supervision that is responsive to their unique needs and experiences. Although our ethics code outlines supervisory practices, the execution often needs to be revised. The primary objective of the presentation is to explore various strategies and considerations that can aid in developing responsive supervision and training processes. Ultimately, the aim of enhancing supervisory practices is to ensure that supervisees receive adequate training and professional development that will enable them to provide high-quality services to their clients. By prioritizing positive relationships and diversity, behavior analysts can improve their supervisory practices and outcomes for supervisees and clients.

In the workplace, it is important that leaders can address performance concerns with staff. However, this begins with identifying processes and behaviors that yield desirable outcomes, which is known as pinpointing. Pinpointing is essential to the performance management process, as it provides guidance and direction on what is being targeted. This study evaluated the effects of individual (3 participants) versus group (3 participants) video-based BST on teaching supervisors to pinpoint. First, participants were given fictional scenarios of performance problems to practice identifying pinpoints. After participants met mastery criteria, they went two weeks without meeting with the experimenter and then completed two novel scenarios. Following this, generalization was assessed by asking participants to pinpoint a performance problem at their current place of employment. The results from this study suggest both training methods were effective at teaching participants to identify pinpoints, with group training taking almost half the training time as individual training. Additionally, training was effective at helping participants maintain the skill to identify pinpoints and promoting generalization for participants to identify pinpoints in their current work environment.

Organizational Behavior Management (OBM) interventions are often judged by both immediate effects and the long-term impact on the targeted performance, as well as the likelihood that the organization and/or its constituents will adopt the intervention (Sigurdsson & Austin, 2006). In recent literature, tools such as the Performance Diagnostic Checklist- Human Services (PDC-HS; Carr et al., 2013; Carr et al., 2016) have become popular in ABA service delivery settings with demonstrated predictive validity and reliability in empirical literature (Wilder et al., 2020). One further way to evaluate the PDC-HS is to examine its role in producing durable change. Thus, the purpose of the present experiment is to examine the predictive ability of a common OBM functional assessment tool, and how addressing supervisor behavior might contribute to maintenance and/or institutionalization. Eight registered behavior technicians (RBTs) across 4 supervisors were split into two multiple baseline designs across participants. One group of participants was exposed to a PDC-HS derived intervention alone, while the other group received the intervention in addition to their supervisors receiving a PDC-HS derived intervention to promote supervisor implementation and sustained behavior change. A mixed repeated measures analysis of variance (ANOVA) was utilized to examine the differences between these groups and an untreated control group. Overall, both PDC-HS derived interventions produced measurable behavior change without researcher led support. Ultimately, institutionalization of these interventions was inconsistent, suggesting that maintaining interventions may require support at multiple levels. Limitations and future directions will be discussed.

This symposium will review practical tools and models for training and supervision that can be used to directly measure training outcomes as well as identify factors that might affect the outcomes of training. Results from two applied research projects that used a pyramidal (train the trainer) approach to staff training will be reviewed to highlight the direct training, outcomes for service recipients, and the social validity of the tools, approaches to training, and models. The first presentation will review the Teacher Performance and Accuracy (TPRA) measure, a practical tool supervisors can use in their daily practice. It is helpful to ensure training adherence and that supervision goals align with performance outcomes. In the second presentation, we will review the outcomes of the Community Capacity Development Initiative (CCDI). We will share factors that contributed to and impeded training success, which was consistent with the model for fostering community capacity to support adults with intellectual disabilities who engage in challenging behavior (Mullins & Scott, 2022) based on organizational behavior management and knowledge translation. This symposium will help supervisors and trainers measure staff outcomes and gain an understanding of organizational and individual factors that affect training outcomes, generalization, and maintenance.

This presentation is rated “intermediate” as attendees will require basic understanding of three-term contingency trials, mastery criteria, and organizational and individual factors that affect training outcomes, generalization, and maintenance.

One of the goals of training and supervision is to ensure that our supervisees acquire the necessary knowledge and skills as a clinician, which in turn results in client progress (LeBlanc et al., 2020). The Teacher Performance and Accuracy (TPRA) measure is a measurement system for trial-based instruction (Ingham & Greer, 1992) that measures moment-to-moment interlocking three-term contingencies (i.e., Learn Units) between the teacher or instructor and the learner (Greer, 2002). The TPRA has been used to demonstrate accurate teacher performance, an objective feedback method, and the acquisition of clinical skills. In this presentation, we will discuss the use of TPRA in staff training and supervision practices and as a treatment integrity tool and the effects of the TPRA measure on teacher behaviour. We will present a mixture of both reports of their experiences and experimental data to highlight the beneficial use of this measure. The TPRA was found to be an effective tool for teacher training and supervision and leads to positive outcomes for learners.

Effective training in positive behavior support is crucial for direct support professionals (DSP) supporting adults with developmental disabilities with complex needs. The Community Capacity Development Initiative (CCDI) is a pyramidal training initiative which aims to increase community capacity in improving quality of life and decreasing problem behaviors. This sequential mixed methods design aimed to evaluate perceptions of the effectiveness of the CCDI in facilitating this capacity development. Former CCDI participants from nine agencies completed an online survey (n = 20) and follow-up interviews (individually or in groups; n = 12). Results suggest that participants maintained their knowledge and continued to apply the skills with others they supported. Further, the initiative was reported to improve the quality of life of the service users involved in the process. This presentation will review some of the factors that contributed to and impeded success, which were consistent with the model for fostering community capacity to support adults with intellectual disabilities who engage in challenging behavior (Mullins & Scott, 2022). The results of this research study may help improve the effectiveness and impact of training programs within the adult developmental service sector and improve services impacting the quality of life.

The need for individuals with disabilities to receive access to evidence-based practices and for service providers to receive quality training in implementing these practices indicate a significant need for research examining the efficacy and efficiency of specific training approaches (e.g., behavioral skills training, in-vivo coaching). Behavioral skills training is a commonly used, well-researched method for delivering training that has been shown to generate mastery and fidelity across multiple populations and skills. In this symposium, presenters will discuss various models for consulting with school-based practitioners to ensure treatment fidelity when implementing behavior analytic interventions, including pyramidal training and using in-vivo coaching paired with visual supports and self-monitoring. Presenters will share data outlining the results of studies examining the functional relation between provision of behavioral skills training, embedded in a pyramidal or in-vivo coaching model, and the treatment fidelity of school-based practitioners implementing behavior analytic interventions. Researchers will share multiple tools and discuss implications for future practice and research.

This symposium is beneficial to individuals who have a basic understanding of consultation models when supporting school-based practitioners.

This symposium will review two current studies and share applied experience related to teaching practitioners collaboration and soft skills within our field. These skills are necessary and currently required by the BACB on both task list 5 and test content 6, as well the ethics code. However, current literature reports that the majority of credentialed behavior analysts may not have receive training in these skills as part of their direct education or training (Callahan et al., 2019; Conners et al., 2019; LeBlanc & Marchese, 2020; Sellers et al., 2019). In addition, the BACB fieldwork standards require these skills be taught to competency in supervision. This is particularly important as the number of BCBAs has increased rapidly in the last few years, and more technological skills are often the focus of supervision hours. Our field is often viewed by other disciplines, as well as familes, as uncaring and "business like". To improve the interactions with those we work with, it is imperative that those certified demonstrate both collaboration and soft skills so others want to interact with us.

This event is designed to increase basic, intermediate, or advanced skills in providing supervision related to soft skills and collaboration to practitioners in the field of ABA. Attendees should have experience providing supervision to trainees, BCaBAs, RBTs, or direct care staff, as well as want to increase their own skills in this area. In addition, these more nuanced skills will be explicitly reviewed using objective measures, and concrete ways to teach them will be provided.

Autism spectrum disorder is complex and multifaceted, and individuals with this diagnosis benefit from an interprofessional approach to treatment (American Psychiatric Association, 2022; Cox, 2012; LaFrance, 2019). Unfortunately, many individuals who provide services to individuals with ASD report feeling ill-equipped to provide services collaboratively with one another (Kelly & Tincani, 2013; Friedman, et al., 2022). The present study sought to explore whether graduate students in an occupational therapy (OT) program and an applied behavior analysis (ABA) program demonstrated several key collaborative behaviors that have been identified as being crucial to interprofessional collaboration (IPEC, 2016). The study implemented a training program and demonstrated that these key skills could be taught. This study utilized a combination of interprofessional education and behavioral skills training to teach key collaboration skills to students preparing to practice in the fields of ABA and OT. Participants worked in dyads with participants from another discipline to create recommendations for assessment and treatment for case studies. The demonstration of key collaborative behaviors during these sessions increased for all participants, suggesting that a combination of BST and interprofessional education are effective in teaching key collaboration skills to graduate students in OT and ABA. This provides graduate training programs with a potential format for incorporating collaboration training into their programs to better prepare their students to collaborate on interdisciplinary treatment teams as practitioners.

This symposium will review the effectiveness of behavior skills training (BST) to develop rapport building, interpersonal, and feedback delivery skills in trainees was examined to provide supervisors with a systematic, evidence-based approach to teach trainees soft skills. This is a necessary skill in our field based on the task list 5 and test content 6 requirements, as well as to engage our clients and families in meaningful ways. A multiple baseline across skillset design was implemented with five trainees and included baseline teaching observations, BST rehearsal, post-BST teaching observations, and a generalization teaching observation. The average across participants and skillsets during baseline was 17.1%, BST 91.78%, teaching observations 86.1%, and generalization 88%. There was a significant effect reported using the Tau statistic across participants. Social validity scores indicated that the intervention was valuable to the participants. The interobserver agreement mean was 93.1% across 34.5% of all sessions, demonstrating that the data were reliable. The research study demonstrated that soft skills were taught utilizing BST to trainees effectively.

This presentation will highlight the tenets of effective instruction as they align to a behavior analytic framework. Direct, explicit, and intentional instruction will be showcased. Further, leaders, no matter the organization, can work more effectively with students, staff, and faculty using the principles of effective instruction and can interpret performance through a behavior analytic lens. Scenarios will be shared.

Behavior analysts, educators, higher education administrators

Staff training is an important component of behavior analytic service provision. Behavior analysts are responsible for training supervisees to implement programming with a high level of integrity. Pyramidal training is an efficient, cost effective training program in which expert trainers train an initial cohort and then those in the initial cohort become trainers for other staff (Erath et al., 2020; Lerman et al, 2019). This process can be helpful in residential settings with high turnover. Behavior analysts may also need to train staff to implement and collect data on skills that require special considerations, for example: operational definitions for assent provision and withdrawal, and intimate care routines (i.e. feminine care). When teaching intimate care skills, special considerations should be made to prioritize assent, the dignity of the learner, and skill generalization in the natural environment. This presentation will review pyramidal training in a residential setting, teaching staff to write operational definitions and collect data on assent behaviors, and review research that teaches intimate and personal care.

Intermediate - Prerequisite skills include understanding on behavioral skills training (BST), writing operational definitions and understanding of data collection systems, and fluency with the updated ethics code.