A Team Approach: How the LEND Program Can Provide Interdisciplinary Training for Behavior Analysts

Behavior analysis is the underclass of psychology. It is under-funded, under-taught, and underappreciated. A lot is happening that is positive, but just beneath the surface, there are grave dangers lurking that could significantly worsen our already poor status. I prefer to believe that most of these dangers are things we can control by our own behavior (itself a rather behavioral idea), and I offer this list of dangers in that spirit. As someone once said: if you always do what you always did, you'll always get what you always got. Behavior analysts need to appreciate the following six dangers and adapt to them. LOSS OF MISSION Behavior analysis was initially strategically committed to the field of animal learning, but from the beginning its ultimate purpose was an understanding of complex human behavior: importance of a science of behavior derives largely from the possibility of an eventual extension to human affairs (Skinner, Behavior of Organisms, 1938, p. 441). In the early decades that was merely a promise, but the arrival of applied behavior analysis turned it into a program. Over the years, however, both basic and applied behavior analysis have narrowed and that original vision is being lost. Applied behavior analysis is gradually becoming a subfield of developmental disabilities, as a glance at a recent issue of JABA will confirm. The depth of the risk this creates is covered over by methodological rigor and applied impact within that narrow domain. Basic behavior analysis clings largely to narrow and precise questions of self-stimulatory interest in the animal laboratory, even while animal laboratories are being closed one by one, and areas of research within behavior analysis are being opened up that require human research. The depth of the problem is covered over by the productivity of a few major behavioral laboratories and the emergence of a handful of international labs, where protection from political winds have allowed the old seeds to grow a few new sprouts. In some ways, all of the other dangers I list can be traced back to the following core concern. Behavior analysis was always a carom shot. Instead of approaching human complexity directly, it tried to develop conceptual tools based on simple behaviors in simple contexts with small non-human animals, and then to apply these to an analysis of virtually every form of complex human behavior. It was a bold and even slightly preposterous idea, and yet it was one that worked far beyond what anyone had a right to expect. Now, however, we seem to be on the verge of forgetting what the mission was in the first place. Many basic behavior analysts have begun to believe that basic behavior analysis is a subfield of animal learning or (perhaps worse) behavioral biology. Where are the experimental analyses of emotion, friendship, sexuality, health, reasoning, humor, intelligence, and so on? Interpretation is not enough--we need an experimental analysis of such behaviors. Without the basic account, applied behavior analysts either ignore these areas or build common sense approaches to them. TOOL POLISHING No field so enjoys principles as does behavior analysis. Principles of behavior are ways of speaking about the prediction and influence of the historically and currently situated actions of organisms that are precise, broadly applicable, and coherent in terms of the larger fabric of science. Principles are the intellectual tools of analysis. They are not, however, ends in themselves. Sometimes behavior analysts are like the watchmakers who decided to make a set of extremely fine tools before actually making some complicated new watches. Forgetting what the tools were for, the talented watchmakers did not build the watches and display them in a glass cabinet, but instead put the tools themselves in that cabinet, taking them out only to polish them and to show how they work. Basic behavior analysts are especially prone to this error. …

Across many countries in Europe, the last decade has seen a rapid increase in the number of early intervention programmes for children with autism based on applied behaviour analysis, and a related growth in demand for competent behaviour analyst practitioners. There has also been a rapid growth in university-based courses that are focused solely on behaviour analysis, and these have all aligned their curriculum with the Behavior Analyst Certification Board task list. We describe the context of these developments and discuss some of the ways courses have been developed and some of the future challenges to be faced in developing an international profession of behaviour analysis. These have been positive moves for behaviour analysis in Europe. Now there is a solid foundation to continue this work, and to ensure that behaviour analysts play a central role in helping those who need their expertise.

At its core, productive collaboration between speech-language pathologists and behavior analysts requires effective communication between both parties. Successful communication can be gained in par...

BackgroundGlobal Health is an inherently interdisciplinary field but overseas training in global health, particularly among health science institutions, has been an ‘individual’ or ‘individual discipline’ experience. Team-based training is an approach to global health education which is increasing in popularity; research on team-training demonstrates that teams are more productive than individuals. In 2015, the Johns Hopkins Center for Global Health (CGH) developed the Global Established Multidisciplinary Sites (GEMS) program, an interdisciplinary training program which was designed to establish a new norm in global health training by bringing interdisciplinary teams of faculty and students together to identify and solve complex global health challenges. This research aims to evaluate the program’s first year and contribute to the literature on interdisciplinary team training. We conducted 22 in-depth interviews with students, faculty, and local collaborators from 3 GEMS project sites. Findings were analyzed for themes through a framework approach.ResultsThe program exposed students, faculty, and collaborators to a wide range of disciplines in global health. Students’ desire to learn how other disciplines contribute to global health solutions was an important motivator for joining GEMS; many participants including faculty and collaborators valued exposure to multiple disciplines. Mentorship and communication were a challenge across all teams in part due to members having distinct “disciplinary languages”. Balancing disciplinary representation on teams and establishing work plans were also key challenges.ConclusionsBased on the data the CGH provides four recommendations for institutions developing global health interdisciplinary teams to optimize team functioning and address challenges in mentorship, language, and roles: 1) address interdisciplinary communication early, 2) develop work plans during group formation, 3) meet as a team prior to travel, and 4) establish regular check ins. This article provides first-hand reflections on interdisciplinary team experiences in a global context and provides a pathway for the development of innovative strategies in global health training.

Adapting interventions based on learner progress is paramount to the effectiveness of interventions in special education and applied behavior analysis. Although there is some research on effective methods for training practitioners to make general instructional decisions (e.g., modify an intervention) based on graphed performance data, research on training individuals to make specific decisions (e.g., how to modify an intervention) is more limited. Our purpose in this study was to evaluate the effects of a training package, consisting of a brief online training and a visual decision-making model, for increasing preservice teachers’ and behavior analysts’ accuracy in making specific instructional decisions based on graphed performance data. In a multiple baseline across participants design, all participants increased their decision-making accuracy on novel graphs during assessment sessions and maintained accuracy at 1-month follow-up. The implications of these findings for training and future research on data-based decision-making are discussed.

This paper presents the author's view of why the promise for education visualized by early behavioral researchers is as yet unrealized. It points out that behavior analysis has had an important impact on special education but has had much less influence on teaching practice in regular classrooms. This is not seen as the fault of educators who have failed to embrace procedures developed by behavior analysts. Rather, the author contends, behavior analysts have failed to develop procedures that fit the ecology of the regular classroom. Those developed often require too much additional effort thereby punishing those who attempt their use. Another factor hindering widespread adoption is that behavior analysts have failed to disseminate their procedures and have not participated widely in undergraduate training of teachers. The paper concludes by noting that our success in special education provides a model for behavior analysts interested in regular education. By developing procedures that result in increased academic performance for entire classrooms without punishing the teachers who implement them, by making those procedures available commercially and by publishing in journals teachers read, and finally by participating more widely in undergraduate training, the unfulfilled dream of what behavior analysis has to offer education can be achieved.

The emergence of positive behav-ior support (PBS) has presented somechallenges and opportunities for ap-plied behavior analysis. In a recentreview and critique of positive behav-ior support, Johnston, Foxx, Jacob-son, Green, and Mulick (2006) ac-knowledge that the success of PBS ingarnering support in schools, agen-cies that service individuals with de-velopmental disabilities, and stateand federal agencies, and suggestsome behaviors to be emulated byapplied behavior analysis in order togarner similar support. However,they recommend that PBS shouldnot be embraced by behavior analystsbecause it poses a threat to the fieldand is less effective than appliedbehavior analysis. Before this recom-mendation is embraced by behavioranalysts, it is important to considerthe ramifications of a split betweenPBS and behavior analysis, particu-larly given that PBS has its origins inbehavior analysis and is conceptual-ized by prominent adherents of thePBS model to be a type of orextension of applied behavior analy-sis (Dunlap, 2006; Horner, 2000). Ipropose that PBS should not bedismissed but should be viewed asan opportunity by the field of appliedbehavior analysis to reach its goal oflarge-scale adoption. A continuedstrong relation between PBS andbehavior analysis may actually ac-complish the broadest disseminationand adoption of effective behavioraltechnology. It will also benefit PBSby keeping it grounded in the con-ceptual system that fostered its de-velopment.PBS is clearly still in its formativestages; in fact the executive board ofthe Association for Positive BehaviorSupport currently is working to de-velop a comprehensive definition ofPBS and to define the roles for theorganization (C. Anderson, personalcommunication, November 2, 2006).As is true in any organization—eventhe Association for Behavior Analy-sis—different members may espousedifferent perspectives on issues suchas the relation between PBS andother perspectives, training models,and so on. This in itself has been thesource of many challenges, and per-haps misunderstandings, for those inthe behavior analysis community.For example, Johnston et al. (2006)emphasize the negative views of PBSresearchers toward behavior analysis.However, many leaders, trainers, andresearchers in PBS have a favorableview of behavior analysis, considerthemselves to be behavior analysts,and continue to publish in behavioraljournals such as the Journal ofApplied Behavior Analysis and TheBehavior Analyst. Thus, although thissituation has been viewed pessimisti-cally by Johnston et al., I believe thatthere are significant grounds forhaving an optimistic view about thefuture relation between PBS andapplied behavior analysis. BecausePBS is in its formative stages and isrooted in behavior analysis, the field

The purpose of this paper is to present to a community of behavior specialists, an overview of the subdiscipline of Organizational Behavior Management (OBM) in three aspects. First, OBM is a sub-branch of the larger field of Applied Behavior Analysis. It also has two other aspects: it can complement the traditional set of skills useful to behavior analysts or be one of the alternative careers for them. Behavior specialists predominantly, and especially in Poland, teach populations with special needs. Whether this is in special education, social assistance or select areas of health care, with young children with autism or adults with intellectual disability, this is where most behavior analysts work. At the same time, they often need to skillfully cooperate in teams, sometimes manage them or instruct people other than those with whom they are usually in contact, such as new team members, parents, and other specialists. OBM can be seen as a supplementary background that answers these needs. It is also a possible alternative career path, with a distinct client base and flagship journal, as well as specific procedures in behavior analysis, experts in the field and specialisms. Different client populations, variations in instruction techniques and knowledge of response generalization all point to that conclusion that traditional behavior analysts might be largely at a disadvantage in the area covered by OBM: that of a management and team leading and training typically developing clients. Behavior analysts require a background in OBM, otherwise they might "reinvent the OBM wheel" or - which is worse - apply their experiences one-to-one with special populations and bring with them harmful assumptions.

There is an old Chinese curse that says you live in exciting and we as clinical psychologists are certainly living in exciting times these days. Most of us are aware of the increasing pressure community-based clinical psychologists are experiencing, although we are not necessarily sensitive to the impact this pressure is having on those practitioners or on our field. In large part, many of the changes and challenges we are facing are byproducts of the increasing financial limitations and time restrictions being place on community-based clinical psychologists and it has become apparent that there are a number of changes ahead that will greatly impact the field as we know it. Clinical behavior analysis has much to contribute to the field. On a fundamental level, we have the strength of an empirically grounded theory and a lengthy history of research demonstrating effective clinical work. Additionally, our historical roots in pragmatism allow for the adaptation and integration of techniques from other branches of clinical psychology, not traditionally seen as behavioral. We will need to be aware of the current context, however, if we are to effectively participate in the transition clinical psychology is undergoing. In addition, there are number of obstacles which make it difficult for CBA to be a part of this process; some of the variables controlling these trends are in our hands. First there is our isolation from other branches of psychology. We need to spend more time talking to clinical psychologists from alternative theoretical orientations. This is true for both academic psychologists and clinical behavior analysts. I work in a department of anesthesiology, a somewhat unusual setting for a clinical psychologists, and my various roles in the medical school are such that I have a foot in the clinical camp and a foot in the ivory towers of academia. In trying to balance these contingencies, it has become apparent to me that there is a schism between what academic clinicians are doing and what community-based clinicians are doing. If that schism grows, we may find that community-based clinical psychologists will pay less and less attention to the research we produce. There is already a general attitude ex- pressed by many of the clinical psychologists I encounter that much of what we do as researchers is not relevant to what they do as clinicians. It is vital that we attend to this issue. On a more practical level, we as clinical behavior analysts need to participate in dialogues with other clinicians if we want to play a role in the changes psychology is already undergoing. As CBA is largely performed by academic psychologists at this point, we don't often consider our role in the economic marketplace. Since the marketplace is largely oriented toward cognitive-behavioral therapy, it is wise for us to plan specifically how CBA will fit into the future marketplace. This has implications for attracting future behavior analysts into the field. Although applied behavior analysis has been highly successful in our work with the developmentally disabled and in closed communities/hospital settings, many have been reluctant to move into settings in which our influence over the functional contingencies is more limited and relies heavily on verbal and rule-governed behavior. Despite pioneering early work in the outpatient arena by Kanfer and Saslow (1965, 1966), Ferster (1973), Krasner (1978, 1988), and Rachlin (1988), the role of functional analysis in the outpatient treatment session and a more molar view of a client's life were largely unexplored. The more traditional treatment areas for behavior analysts do not represent the typical setting in which most clinical psychologists practice and when these behavioral treatments appear, they are similar to cognitive treatments (e. …

Researchers and behavior analysts are interested in exploring the fusion between behavior analysis technology and emerging technological tools to augment meaningful learning and clinical outcomes. Tools such as virtual reality (VR) provide a means to augment learning opportunities within applied behavior analysis (ABA) clinical applications and practice. This chapter discusses using VR as a tool and medium for behavior analytic technology within ABA practice. Current research on VR simulations is reviewed, along with a historical review of how this research paved the way to modern, everyday uses within research and clinical practices. Concepts of psychological immersion, simulated environments, artificial intelligence use within VR platforms, and the ethics behind these technologies are discussed, including a series of suggestions and considerations for VR clinical implementation.

Chronic health conditions are predominant in the USA. Health coaching has demonstrated significant results in increasing health-promotion behaviors that impact the development or progression of chronic health conditions (Simmons & Wolever, 2011). Behavior analysis has also contributed to this body of research with effective behavior-change procedures (Allen & Hine, 2015). While often not cited, the methodology used in health coaching utilizes many principles that align with applied behavior analysis. The current paper serves several purposes: (1) introduces health coaching and the potential for application within a behavior analytic framework, (2) discusses commonalities and areas behavior analysis could impact, (3) suggests implications for future research and practice, and finally, (4) urges collaboration between behavior analysts, health coaches, physicians and other professionals practicing within fields that focus on improving individual health and healthcare.

Educating the public accurately about Applied Behavior Analysis (ABA) is an important undertaking, not least because misconceptions and myths about ABA abound. In this paper we argue that, unfortunately, the efforts of many dedicated professionals and parents to disseminate accurate information about the benefits of ABA for children diagnosed with autism spectrum disorder (ASD) are damaged by a few behavior analysts whose focus seems to be more on monetary gains than social responsibility. We cite examples of the resulting harm to the public image of behavior analysis from a number of European countries. We conclude by calling upon fellow scientists to unite in their opposition to unscrupulous abuses of free market forces for short-term monetary gains that damage the dissemination of the science of behavior analysis and thereby ultimately disadvantage those who should benefit primarily from our science, i.e., some of the most vulnerable citizens of society.

Applied behavior analysis is a widely used intervention for autistic youth, though its mental health impacts remain under-researched. This study aims to investigate the association between applied behavior analysis therapy and post-traumatic stress disorder, suicidality, mental health hospitalization rates, and length of mental health hospitalizations using a national database of privately insured youth under 18. We matched 17,120 autistic youth who received applied behavior analysis with a control group of autistic youth with no record of applied behavior analysis and clustered them into four applied behavior analysis dose groups using two-stage bisecting k-medians clustering. Then, we used negative binomial regression and logistic regression to compare outcomes for the applied behavior analysis and non-applied behavior analysis groups. Overall, applied behavior analysis receipt was associated with 30% higher odds of experiencing a mental health hospitalization (odds ratio = 1.30, p < 0.001) and a 32% higher incidence rate of these hospitalizations (incidence rate ratio = 1.32, p < 0.001). Our analysis found no relationship between applied behavior analysis dosing and the other tracked mental health outcomes. These results indicate the need for more quantitative analysis with more comprehensive records of applied behavior analysis receipt to fully investigate claims of ABA resulting in adverse adult mental health outcomes.Lay abstractAutistic youth often receive applied behavior analysis (ABA) therapy, but some autistic adults who had ABA as youth say it harmed their mental health as adults. We looked at the relationship between ABA and post-traumatic stress disorder (PTSD), suicidality, mental health hospitalization rates, and length of mental health hospitalizations among autistic youth. We used private health insurance claims data to look at how ABA receipt was related to those mental health outcomes. We divided autistic youth into groups based on how much ABA they received, so we could see if different amounts of ABA had different associations with mental health. There were 17,120 autistic youth in the group that did not receive ABA, and 17,120 autistic youth in the group that did receive ABA. In this sample, ABA therapy was associated with a greater use of acute mental health services; autistic youth in the ABA group had an overall risk that was 30% higher for mental health hospitalizations; and a 32% greater frequency of mental health hospitalizations. These results suggest that there may be a relationship between mental health hospitalizations and getting ABA. However, more work is needed to fully understand the impact of ABA therapy on mental health outcomes.

Chapter 8 - Quality measurement in applied behavior analysis

For thousands of years, societies actively practiced the oppression, persecution, and dehumanization of sexual and gender minority (SGM) people (e.g., lesbian, gay, bisexual, transgender, and queer individuals). Rekers and Lovaas'(1974) study is part of that history within behavior analysis. Following requests for retraction, the Society for the Experimental Analysis of Behavior and LeBlanc (2020) issued a formal Expression of Concern about the work. Continued conversation and debate have followed. First, we contextualize debate around retraction of Rekers and Lovaas and the history of behavior analysts' work on SGM issues. Second, we propose 5 steps that leaders in behavior analysis can take with relative immediacy, and we describe 5 research areas that individual behavior analysts could pursue. We conclude that behavior analysts can contribute much toward the liberation of SGM individuals if we begin to bring our science to bear on pressing, socially significant issues facing SGM communities.