Playing Nicely in the Sandbox
Graduate school can be a wonderful time; a cohort of like-minded students studying behavior analysis and preparing to change the world, one consumer at a time. In this academic environment, students and teachers love to discuss and philosophize the powers and technical prowess of functional analyses, behavior interventions, and socially meaningful behavior change procedures. Heated debates on hot-button issues are a thrill in the graduate school setting and can inspire tremendous learning and growth for students in the field; however, it can leave students empty handed when they enter into a collaborative setting as a newly certified clinician.
All too often, new behavior analysts leave their graduate programs not fully equipped to answer difficult questions and are unable to hold the uncomfortable conversations that greet them, head on, after leaving the safety of their graduate school bubbles. Whether it is families receiving ABA services, an IEP team, or professionals from different disciplines, ABA consumers alike may recount their former negative experiences with ABA therapy. This can be difficult for newly minted BCBA holders who may be joining a team of interdisciplinary professionals for the first time. Often, new BCBAs lack the art of interprofessional collaboration. Without this invaluable skill, it is nearly impossible for a behavior analyst to have the desired effect in a collaborative environment, and unfortunately, rolling up your sleeves at the IEP table and proclaiming, “the data show ABA is effective,” just doesn’t cut it.
As a behavior analyst, it is a top priority to recommend the most effective treatment options. Sometimes, especially while working with professionals from outside the behavior-analytic field, the most effective treatment option isn’t always the option that will work the fastest. Instead, the most effective treatment option fits the current environmental construct and accommodates the contingencies under which other professionals operate.
Consider the following example: Tim is a new BCBA working with an interdisciplinary team in a school setting to support Jamie, a six-year-old first-grade student with autism. Jamie frequently leaves his desk and walks around the room during math instruction. The occupational therapist suggests using a sensory bin to support Jamie’s sensory diet during the math lesson. Jamie’s parents, teacher, and principal like the occupational therapist’s suggestion.
Tim is aware of the limited empirical research regarding the efficacy of sensory bins. Tim also knows the most effective treatment recommendation likely includes a highly systematic and dense schedule of reinforcement for attending during math instruction. However, it may not be a practical expectation for the teachers and paraprofessionals at Jamie’s school to provide a high level of contingent reinforcement for just one student in a classroom of 25 students. Instead of trying to convince the group of professionals to make an exception and modify entire lesson plans and classroom structure for one student, here are some approaches Tim could use to maintain his ethical practices, while also working collaboratively with the team:
- Acknowledge that using the sensory bin is motivating for Jamie and suggest it can be used before and after math instruction as a reward
- Use items in the sensory bin as manipulatives to teach addition and subtraction
- Interrupt the use of the sensory box to complete math instruction, gradually increasing instruction over time (i.e. demand facing, non-contingent reinforcement)
- Allow Jamie to make choices regarding math tasks (e.g., addition or subtraction first) in addition to use of the sensory box
- Allow Jamie to use the sensory box, then allow access to the sensory box after appropriate requests during math instruction
All of the treatment recommendations above balance Tim’s ethical responsibility to recommend effective behavioral strategies with the environmental constructs of Jamie’s school and other professionals supporting Jamie.
If you’re a new behavior analyst, try to treat new professional relationships the same way you’d treat new client relationships. Start with rapport-building. Bring cookies to the IEP meeting or make a well-timed joke during the meeting. Let the other professionals know you are there to help and support their student in any way possible. Ask questions about disciplines with which you’re unfamiliar.
While developing rapport, find the function of behavior for other professionals. What contingencies are they working under? How have they found success with other clients? What’s been effective with the clients you with whom you jointly work? What are their ethical contingencies you might be overlooking when it comes to treatment?
Finally, and most importantly, use the information you get from other professionals. Accommodate your treatment recommendations for the client’s environment. Work in conjunction with the client’s interdisciplinary team to ensure your recommendations are devoid of potential problems for other professionals, and really take their suggestions into consideration. Learn something new!
We thrive on feedback, so ask for feedback from the client’s treatment team. Soliciting feedback from the team will establish your presence as a discriminative stimulus (SD) for the client’s treatment team members and help get more buy-in from other professionals. Additionally, the feedback will help shape future treatment recommendations and save copious amounts of time on recommendation revisions.
Our zeal for treatment is part of the reason ABA is such an excellent treatment option for our clients. As a field, we can seem elitist if we are unable to work effectively, and within the professional standards of an interdisciplinary team. Remember to stay professional, respectful, and open to collaboration. You’ve got this!
