Focus on the Treatment Team: Applied Behavior Analysis

Kristina Gasiewski, MEd, MOTR/L, BCBA and Kate McKenna, MEd, MSEd, MS, BCBA
Association for Science in Autism Treatment

History

Multidisciplinary Applied Behavior Analysis

Photographed by Mikhail Nilov (pexels.com)

Behavior analysis is the science founded on the belief that behavior should be the primary focus of scientific study (Cooper et al., 2020). It is both a discipline and a practice. The philosophy on which the science of behavior analysis rests is radical behaviorism, the supposition that all human behavior including thoughts and feelings can be studied and understood. The experimental analysis of behavior, associated with B.F. Skinner, emphasizes scientifically studying the relationship between behavior and the variables in the environment that control it.

Applied behavior analysis (ABA), as the name implies, is the application of behavioral principles to real-world problems with the goal of effecting lasting and positive change in socially important behavior (Baer et al., 1968; Fennell & Dillenburger, 2014). At the heart of applied behavior analysis is the belief that behavior can be studied and understood, and that this understanding can guide how teachers and clinicians respond or intervene. Since behavior is shaped by the individual’s interactions with people, objects, and events in the environment, we can arrange the environment to affect the change we want to see. In other words, by studying the antecedents (what happens before a behavior occurs) and consequences (the response from the environment after the behavior occurs), it is possible to ascertain the purpose or function of behavior (the reason the behavior happened). That information allows us to arrange the environment to result in behavior that is beneficial to the individual engaging in the behavior and the broader society, and that will respond effectively to social problems faced by a community (Cooper, 2020).

Although ABA is often used as a catch-all descriptor of current techniques used in the treatment of autism, it has a history unrelated to autism treatment dating back to the turn of the 20^th century. Classical conditioning of behavior was described by Ivan Pavlov in his famous set of experiments with dogs. Learning theory developed by Edward Thorndike held that learning results in the consequences of our behavior. John Watson is known as the “father of behaviorism.” He posited that behavior is the result of observable and recordable environmental events. This was a sea change in the investigation of learning and the science of behavior. At that time psychology studied mental processes, the conscious, and the unconscious. Introspection was used as the method of investigating the purpose of behavior. In contrast, Watson suggested direct observation of environmental stimuli and the responses that result.

In the 1920s B.F. Skinner advanced the idea that understanding our behavior is essential to understanding ourselves. He wrote extensively on the application of behavioral principles to social issues such as education, the law, economics, and self-control. Skinner thought it possible to create living environments that benefit all individuals and societies. He believed that all behavior, including thinking and feeling emotions, which he called “private events,” could be described and observed. Skinner called this radical behaviorism.

The seven dimensions of ABA were first outlined in a seminal article published in the Journal of Applied Behavior Analysis (Baer et al, 1968). ABA is applied in that it focuses on creating socially significant change that is meaningful for those involved. ABA is behavioral in that it objectively defines and measures target behavior in such a way that it is possible for anyone to observe and record instances of the behavior. The dimension of being analytic refers to the ability to predict and control a target behavior. This functional relationship allows the clinician or teacher to create environmental conditions in which a target behavior is more or less likely to occur. In meeting this dimension, in both research and clinical practice, BCBAs are guided by their professional code of ethics to ensure that target behavior and goals are truly beneficial to the learner.

Any description of scientific research, treatment plan, or educational program must be written with sufficient clarity and detail so that another researcher can replicate the study to substantiate reported results or that a clinician unfamiliar with the student can step in based on the information provided. This is the definition of technological. Related to this dimension is the call that ABA-based interventions and research be conceptually systematic, that is that it be grounded in the principles and tenets of applied behavioral analysis. The final two dimensions of ABA, effectiveness and generality, speak to the goal of lasting significant change that benefits all stakeholders. Target behavior, interventions, and research must be socially valid and matched to the individual’s skills, needs, and their interactions in their environment. For an intervention to be effective it must fit within the daily lives of the people involved. Methods used to support change should be practical, not overly costly, and designed to be as convenient as possible to those who will live with them long term. Interventions should be generally applicable. That is, they should be functional in a variety of environments, apply to a range of behaviors, and have sustainable and maintainable effects. The ability to generalize newly acquired knowledge and skills in new environments, with similar but not identical materials, and with a variety of people is critical to the success of ABA-based interventions.

The principles of ABA have been found beneficial in the fields of addiction and substance abuse (Silverman et al., 2011), gambling (Weatherly & Flannery, 2008), eating disorders (Peterson et al, 2022), forensic analysis (Ruben, 2019), gerontology (Burgio & Burgio, 1986), and other mental health specialties (Harvey et al., 2009). These broad applications speak to the strength of ABA-based interventions in addressing many diverse challenges.

As with any scientific field, new discoveries and knowledge prompt discussion and influence how principles are put into practice. Standards of ethical and effective practice have evolved since the 1960’s. The concepts of assent and consent are at the heart of the effective practice of ABA. Assent is agreeing or approving of something after considering it carefully. Consent involves granting permission for something to happen or agreeing to do something. Both assent and consent are important in the interactions during teaching sessions between the providers and learners as well as the balance in the relationships between providers, individuals, and family members. One key aspect of learning is genuine engagement in the activity and with the materials. The goal is for the individual to be “happy, relaxed, and engaged,” willingly participating with no visible signs of discomfort (Hanley, 2021; Parenti & Rothman, 2023).

Education

Behavior analytic professionals include Board Certified Behavior Analysts (BCBA®), Board Certified Assistant Behavior Analysts (BCaBA®), and Registered Behavior Technicians (RBT®). Certification programs are accredited by the National Commission for Certifying Agencies (NCCA), the accreditation body of the Institute for Credentialing Excellence (ICE). While there are BCBAs across the world, as of January 1, 2023, the BACB made changes to their international focus and currently accepts certification applications from individuals who reside in the United States (US), Canada, Australia, and the United Kingdom (UK). The International Behavior Analysis Organization (IBAO) certifies applied behavior analysts worldwide and offers two certifications, the International Behavior Analyst (IBA) and the International Behavior Therapist (IBT).

A BCBA is a graduate-level certification in behavior analysis. BCBA practitioners can practice with either a Master’s or Doctoral Degree. The Board-Certified Behavior Analyst-Doctoral (BCBA-D ®) is a BCBA with a doctorate degree. It is not a separate certification, and functions within the same capacity as a BCBA.

There are different pathways to sit for the Behavior Analyst Certification Board (BACB) exam. First, behavior-analytic coursework can be attained through either an Association for Behavior Analysis International (ABAI) accredited or recognized behavior analysis degree program, or a Verified Course Sequence. Master’s or higher behavior analysis degree programs that have been accredited or recognized by ABAI have met these standards for the curriculum, faculty, and resources, among others. Accredited programs may be found on ABAI’s Accredited Programs web page. A Verified Course Sequence is a set of courses that have been verified by ABAI as having met the BACB’s behavior-analytic coursework requirements. Verified Course Sequences may be located using ABAI’s Verified Course Sequence Directory. Some typical courses of study include the study of ethics for behavioral practice, functional behavioral assessment and analysis, experimental analysis of behavior, experimental design and research, evidence-based instructional methods, methodologies of behavior change, science and philosophy of ABA, verbal behavior, collaboration, and supervision.

Once coursework has been started, candidates can begin to accrue fieldwork hours. There are two means of satisfying hours including supervised fieldwork (2,000 hours) or concentrated supervised fieldwork (1,500 hours). Trainees may accrue hours in a single category or may combine the two types, supervised and concentrated, to meet the fieldwork requirements. Hours accumulated each month must be at least 20 hours but cannot exceed 130 hours. Additionally, fieldwork hours include independent hours (supervisor not present) and supervised hours (supervisor present). There are specific requirements for each type of fieldwork that specify the number of required contacts with the supervisor, observations, and percentages for supervision per supervisory period, individual supervision, and unrestricted activities.

Once the above requirements are met, a candidate may take the BCBA examination, which is composed of 185 multiple-choice questions. Once certified, a BCBA is to obtain 32 continuing education units (CEUs) within each 2-year recertification cycle including 4 CEUs in ethics and 3 CEUs in supervision (for supervisors). For specifics and the most up-to-date information on obtaining the BCBA credential, please refer to the BCBA handbook.

BCaBAs have an undergraduate-level certification in behavior analysis and must be supervised by BCBAs. Like the BCBA, there are different eligibility pathways. Each pathway requires a degree, behavior-analytic content, supervised fieldwork (1,300 Supervised fieldwork or 1,000 concentrated supervised fieldwork) and passing the BCaBA certification examination. The BCaBA examination comprises 160 multiple-choice questions. Once certified, BCaBAs must obtain 20 CEUs per 2-year recertification cycle including 4 CEUs in ethics and 3 CEUs in supervision (for supervisors). For specifics and the most up-to-date information on obtaining the BCaBA credential, please refer to the BCaBA handbook.

RBTs are paraprofessionals certified in behavior analysis. They assist in delivering behavior-analytic services and practice under close supervision from a BCBA. RBTs have a high school-level education or equivalent. Once a candidate completes a 40-hour training and Competency Assessment, and has a supervisor on record with the BACB, they are eligible to sit for the RBT certification exam. The RBT examination comprises 85 multiple-choice questions. Renewal of this certification is every year and includes an RBT Renewal Competency Assessment. For specifics and the most up-to-date information on obtaining the RBT credential, please refer to the RBT handbook.

Standards of Practice and Guiding Documents

Knowledge requirements, ethical standards, and disciplinary procedures in the practice of behavior analysis are established and monitored by the Behavior Analyst Certification Board, Inc.^® (BACB^®). The BCBA Task List (5^th ed.) outlines the minimum knowledge and skills necessary for effective practice and serves as the foundation for the questions on the BCBA examination for prospective BCBAs and BCaBAs. The Ethics Code for Behavior Analysts guides the professional activities of BCBAs and BCaBAs by outlining core principles involved in ethical decision-making that apply to behavior analysts’ professional activities during in person service delivery, in written reports, and in interactions via phone, email, text message, and video conferencing. Core principles, which guide all aspects of the work of behavior analysts and form the basis of ethical decision-making, are to benefit others; treat others with compassion, dignity, and respect; behave with integrity; and ensure our own competence (practice only within our scope of competence). Separate documents cover ethical behavior and scope of practice limitations for RBTs.

Professional Organizations

Established in 1998, the Behavior Analyst Certification Board, Inc.^® (BACB^®) is the professional organization that certifies BCBAs, BCaBAs, and RBTs. The BACB’s stated mission is to “protect consumers of behavior-analytic services by systematically establishing, promoting, and disseminating professional standards of practice.” The BACB establishes practice standards, develops certification examinations, and oversees continuing education of certificants. It has also created ethics requirements and a system of oversight for each of the three certification options and for those in a supervisory role in their practice.

The Association for Behavior Analysis International (ABAI), established in 1974, is the primary professional organization for behavior analysts. Through its special interest groups, affiliated chapters, international conferences and journals, ABAI fulfills its mission of supporting and educating professionals interested in the philosophy, science, application, and teaching of behavior analysis. ABAI has 40 special interest groups which speaks to the breadth of application ABA has to society. ABAI publishes six peer-reviewed journals. Perspectives on Behavior Science is the official publication of ABAI and publishes articles on theoretical, experimental, and applied topics in behavior analysis. Since 1937, The Psychological Record has published empirical and conceptual articles related to behavior analysis, behavior science, and behavior theory. Behavior Analysis in Practice provides information on best practices on topics relevant to service delivery to service providers, school personnel, and supervisors. Education and the Treatment of Children presents articles written in a practitioner-friendly style for individuals working with children and youth at risk for or experiencing emotional and behavior challenges, and who are practicing in schools or treatment centers. The stated mission of The Analysis of Verbal Behavior is to “support the dissemination of innovative empirical research, theoretical conceptualizations, and real-world applications of the behavioral science of language.” Affiliated with the Behaviorists for Social Responsibility special interest group, Behavior and Social Issues is an interdisciplinary journal that publishes articles that analyze the social behavior of people to better understand and address significant social problems.

The Society for the Experimental Analysis of Behavior (SEAB) was founded in 1957 to promote the advancement of the science of experimental analysis of behavior and to disseminate information about behavior analysis. To that end, the Society publishes the Journal of the Experimental Analysis of Behavior and the Journal of Applied Behavior Analysis. The Journal of the Experimental Analysis of Behavior publishes articles primarily related to research on individual organisms. The Journal of Applied Behavior Analysis, first published in 1968, publishes research on the use of behavior analytic principles to issues and problems of social importance.

Scope of Practice and Approach to Intervention

Applied Behavior Analysis is a scientific approach for identifying environmental factors that reliably influence socially significant behavior. Socially significant behaviors are those that enhance and improve people’s lives. These behaviors can include social, language, academic, daily living, self-care, vocational, and/or recreation and leisure behaviors. The overarching goal is to change behavior, either by increasing or decreasing the occurrence, and is achieved through various principles of behavior (e.g., reinforcement, punishment, stimulus control, environmental contingencies; Cooper, et al., 2020). BCBA’s use ABA-based programs and strategies in a variety of other fields, such as gerontology, brain injury rehabilitation, addiction, both general and special education, organization behavior management, public health, and sports psychology.

BCBAs are guided by ABA principles. Behavioral methods are utilized to measure behavior, teach functional skills, and evaluate progress. Common services may include but are not limited to, conducting behavioral assessments, analyzing data, writing behavior-analytic treatment plans, training others to implement components of treatment plans, and direct implementation of treatment plans (Cooper, et al., 2020). Data are reviewed on a regular and systematic basis including visual graphs. In summary, the analysis of data drives changes to interventions. (Cooper, et al., 2020; BACB, 2020).

It is a common misconception that ABA itself is an autism intervention. ABA is not the teaching strategy in and of itself. ABA is the science behind how research is conducted, and educational and behavioral services are provided. There are many autism interventions based on the principles of ABA that have been demonstrated to increase learning and decrease challenging behavior in individuals with autism. These interventions are backed by decades of rigorous scientific research carried out by hundreds of individuals that demonstrate the efficacy of interventions based on the principles of ABA (Cooper et al., 2020). For a more detailed description of an ABA-based treatment program for autism, please click here. In treatment for autistic individuals and those with developmental disabilities, ABA has proven to be effective in supporting people across the lifespan in reaching goals to improve communication, social, and life skills that lead to greater independence and self-determination.

In autism treatment, ABA-based interventions and teaching techniques include, but are not limited to, breaking tasks into smaller components (task analysis, chaining), the use of antecedent interventions, modeling (both in real time and video), visual supports, and positive reinforcement. A particular focus in autism treatment is responding to challenging behavior that interferes with learning. The ultimate goal of a treatment program is to support the individual in acquiring new skills related to academics, language, communication, and social interactions to increase agency and independence to the fullest possible extent.

References:

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Citation for this article:

Gasiewski, K., & McKenna, K. (2023). Focus on the treatment team: Applied behavior analysis. Science in Autism Treatment, 20(12).

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