|The Use of Technology to Enhance Functional Analysis and Skill-Based Treatment of Problem Behavior|
|Saturday, September 3, 2022|
|8:00 AM–9:50 PM |
|Meeting Level 2; Ecocem Room|
|Area: AUT; Domain: Applied Research|
|Chair: Kara LaCroix (TACT, LLC)|
|Discussant: Sigmund Eldevik (Oslo Metropolitan University)|
|CE Instructor: Kara LaCroix, M.Ed.|
In recent years, technology has proven to be more helpful than ever when it comes to the assessment and treatment of problem behavior (Schieltz & Wacker, 2020). This symposium highlights the use of technology to minimize time spent in analysis, train practitioners to implement skill-based treatment, and provide consultation at a distance. The first presentation will share the emerging technology of the Problem Behavior Multilevel Interpreter (PB.MI), a computer programed designed to provide real time visual displays of functional analysis data. The PB.MI allows practitioners to efficiently make decisions about when the exact moment functional control is achieved to minimize exposure to potentially unsafe situations. The second presentation will describe the effects of a computer-based instruction (CBI) program designed to teach practitioners to implement skill-based treatment with integrity. The third presentation will describe Balance, a parent-implemented problem behavior prevention program delivered entirely through telehealth and an online platform. Finally, the last presentation will provide a behavior-analytic conceptualization of safety and trust. The presenter will describe how the commitments of trauma-informed care can be applied to the treatment of problem behavior in a telehealth service delivery model.
|Instruction Level: Basic|
|Target Audience: |
|Learning Objectives: At the conclusions of this symptoms, attendees will be able to: a. Provide a summary of the PB.MI and how it can be helpful in decreasing the amount of time spent in assessment b. Evaluate the efficacy of computer-based instruction on the implementation of skill-based treatment c. Articulate the steps of a parent-implemented problem behavior prevention program supported through telehealth d. Describe the conceptualization of safety and trust from a behavior analytic perspective|
|Computerized Support for Decision Making During Functional Analysis: The Problem Behavior Multilevel Interpreter (PB.MI)|
|JOHN E. STAUBITZ (Vanderbilt University Medical Center, TRIAD), Z. Kevin Zheng (Vanderbilt University), Joshua Jessel (Queens College, City University of New York), Tess Fruchtman (Queens College, City University of New York), Nibraas Khan (Vanderbilt University), Nilanjan Sarkar (Vanderbilt University School of Engineering), Becky Haynes (Vanderbilt University Medical Center- TRIAD), Pablo Juárez (Vanderbilt University Medical Center)|
|Abstract: Behavior analysts striving to efficiently make decisions while conducting functional analyses can benefit from accessing graphed data and structured analysis outcomes in real time to determine when their analysis has achieved functional control over behaviors of interest. Knowing the precise moment when a strong level of control over dangerous behavior has been demonstrated within an analysis can reduce unnecessary additional assessment time and exposure to risk, as well as expediting the introduction of an individualized function-based treatment. We have developed the Problem Behavior Multilevel Interpreter (PB.MI) computer application to (a) allow for on-going visual analysis of data displayed in real-time and (b) support visual analysis with a computerized interpretation of functional control within a functional analysis. In this presentation we describe the program’s functioning abilities and how we validated those abilities through experimentation that included calculating agreement between trained research assistants and the program’s graphing and interpretation of 200 simulated functional analyses. In addition, we discuss the PB.MI program’s practical utility. This presentation will demonstrate that this program is able to immediately and accurately graph and analyze data entered during functional analysis sessions.|
Effect of Computer-Based Instruction on Skill-Based Treatment Integrity of Board Certified Behavior Analysts
|JOHANNA STAUBITZ (Vanderbilt University), Marney Squires Pollack (Vanderbilt University), Katherine McMahon (Vanderbilt University), Bernanda Guzman (Vanderbilt University), Gina Richig (Vanderbilt University), Angela Gialanella (Vanderbilt University), Taylor Crawford (Vanderbilt University ), Jacob Frier (Vanderbilt University)|
Asynchronous skill training programs can produce results comparable to those of in-person behavioral skills training (Geiger et al., 2018), yet have many practical advantages, including on-demand accessibility and independence from a live trainer. When complex skills are addressed asynchronously, computer-based instruction (CBI) including multiple components (e.g., instruction, video models, interactive activities, feedback) may be most likely to support mastery (Gerencser et al., 2021). We conducted an underpowered randomized control trial to evaluate the effects of CBI on Board Certified Behavior Analysts’ mastery of and adherence to a skill-based treatment protocol adapted from Rajaraman and colleagues (2021). We measured treatment integrity at two time points for 17 participants, eight of whom were randomly selected to complete the CBI. The CBI had a significant and strong effect on level of mastery attained (p = .002, Cohen’s d = 2.08). Mean improvement in treatment integrity was greater in the training versus control group on all five domain scores and a composite variable, though between-group differences were not significant at an alpha value of p = .01. Limitations and future directions relate to assessing generalization and maintenance of skills, effect of trainee characteristics on response to CBI, and training component analysis.
An Extension of "Balance": A Parent-Implemented Problem Behavior Prevention Program Implemented via Telehealth
|KARA LACROIX (TACT, LLC), Gregory P. Hanley (FTF Behavioral Consulting), Alexandra Beckwith (FTF Behavioral Consulting), Shana Rodriguez (FTF Behavioral Consulting), Kelsey Ruppel (FTF Behavioral Consulting)|
The American Academy of Pediatrics (2014) recommends individuals with a diagnosis of autism spectrum disorder (ASD) receive applied behavior analysis (ABA) services as soon as they are diagnosed. Ruppel et al. (2021) demonstrated that a parent-implemented problem behavior prevention program, Balance, was effective in reducing problem behavior and increasing social, communication, and cooperation skills in all four participants under the age of six. Access to effective intervention, like Balance, is critical, but waitlists for early intervention services can be long or the individual may reside in an area where ABA services are not readily available (Antezana et al., 2017). In these instances, the use of telehealth may be useful for supporting caregivers as they implement behavior-change programs. This study evaluated the effects of Balance implemented via telehealth using a multiple baseline design nested within a randomized control trial with children aged three and six years. Preliminary results indicate that emerging problem behavior remined high and skills were not acquired for the children randomly assigned to the control group (i.e., delayed intervention). By contrast, children in the test group who received immediate intervention engaged in zero to low levels of problem behavior and social and communication skills were high. Strategies for supporting caregivers attempting to prevent the development of problem behavior via telehealth will be discussed.
Emphasizing Safety During Telehealth Delivery of Skill-Based Treatments for Dangerous Behavior
|ADITHYAN RAJARAMAN (University of Maryland, Baltimore County), Holly Gover (IvyMount), Joshua Jessel (Queens College, City University of New York), Jennifer L. Austin (University of South Wales)|
Ensuring safety and trust when providing therapeutic services is a core commitment of trauma-informed care. This commitment has implications for the assessment and treatment of dangerous behavior in that different approaches to intervening upon problem behavior may be associated with differential levels of experienced safety and perceived trust. One example of a potential violation of perceived trust pertains to the physical management of individuals exhibiting dangerous behavior, and these concerns are ostensibly exacerbated when services are delivered remotely via telehealth. During this presentation, after providing a behavior-analytic conceptualization of the constructs of safety and trust, we share findings from a survey regarding practitioner experiences and opinions on the use of physical management procedures in ABA practice. Findings suggest that there are varied opinions regarding the safety and feasibility of such procedures, with a majority advocating for reduced use in everyday practice. We connect these findings to an evaluation of a systematic replication of the enhanced choice model of skill-based treatment—initially described by Rajaraman et al. (2021)—that importantly avoids the use of physical management, and that was delivered via telehealth consultation. Survey and single-subject data are discussed in the context of exploring trauma-informed approaches to addressing dangerous behavior.