An Interview with Drs. Carl Sundberg and Genae Hall

Conducted by David Celiberti, ASAT Executive Director

As part of this issue’s dedication to the Behavior Analysis Center for Autism (BACA), I had the opportunity to interview some of the leaders of this program of excellence: Carl Sundberg (President and Chief Clinician) and Genae Hall (Director of Research).

Q: Dr. Sundberg, Josh Pritchard had the good fortune of interviewing you last year (see Interview with BABC President, Carl Sundberg, PhD, BCBA-D) so I wanted to take this opportunity to delve further into your role at BACA. What is a typical day like for you? Do you actually have a “typical” day?

A: Most of my day is spent working with the kids and their team. During these periods, I am looking at the student, the Behavior Technician, and the BCBA. I am looking at specifics that will help the student learn and specifics to help the Behavior Technician teach and the BCBA to attain that next level of analysis that is necessary for teaching our students. Some of the day is spent in team meetings with staff and some of the day is spent in meetings with the parents regarding specific client progress. Another part of the day is spent working on systems development and in administrative meetings. There are always special projects in the works such as developing a video training system, or preparing for a workshop or other presentation. Sometimes a day is devoted to appealing a denied insurance authorization or meeting with a lobby group to ensure that ABA services are available for everyone (this, of course, is a monumental battle). No two days look the same, so really there is no typical day. My favorite days are those when I can spend the whole day working with the kids and teaching the staff.

Q: Carl, it sounds like your day-to-day experiences are quite diverse but that you are able to spend considerable time engaging directly with the students and the staff charged with their programming. I see that BACA’s commitment to the promotion of generalization is front and center in the organization’s official belief statements. Can you briefly share with our readers how this is achieved at your center?

A: We feel that various dimensions of generalization are critical. Perhaps the most obvious is that a skill that is taught in one setting is evoked in another setting, with different people, and occurs under appropriate circumstances. That is, the behavior analyst or technician taught a skill in a training session that is useful in the real world. This requires careful programming. The behavior analyst must train components of a skill individually and then arrange circumstances in order for the skill to occur in the natural setting. For example, if we are trying to teach an older student to independently make a purchase at a store, we would first teach the necessary component skills, such as money exchange, making a list, etc. We would then put these skills together and practice in a mock setting. The next step would be to take the student to the store and assist if needed. Finally the behavior technician would wait outside the store, and so on. The skill is less likely to transfer if you cannot closely replicate the environment of the real world. Often this involves doing training in the setting where the skill is targeted to occur.

I liken this to a basketball analogy. In order to play in a game, you must have the component skills. It would be difficult to learn how to dribble and shoot in the game situation (not enough trials, too much punishment, and no chance for prompting, fading, and practicing). These skills need to be taught in isolation with intense teaching. Once these skills are mastered, it may still be difficult to jump right into the game situation. In basketball you would have various levels of scrimmage, a chance to put the skills together while teaching can still occur. You can stop a scrimmage and try the play again after giving the players instruction. You can’t stop the game. The game is still a valuable opportunity for teaching. The coach can observe what needs work and bring it back to the practice court. This should all be happening when teaching people with autism the skills they need to function in the real world. With the store example, the intense training (dribbling, passing, shooting, etc.) is done in isolation (math, money exchange, social exchanges needed, etc.). The scrimmage is done on two levels: first, in the mock store that is set up and then in the real store. Going into the real store with the student is close to the game situation but prompts and help can still be provided in this context.

Q: Carl, clearly parent and caregiver training is the soil in which generalization can take root. Can you tell us a bit about your approach to parent training and education?

A: We view parent training as essential. Upon entering our program, we tell parents that we only have the kids for 15-40 hours a week (some cases less). That leaves about 60-80 waking hours per week where we are not working with them. Furthermore, all of the skills that we are targeting are done so for the purpose of occurring somewhere else. Training in the natural environment is critical (the scrimmage and game situation). Typical children are constantly learning from their environment. It is more difficult for children with autism. Behavior analysts must conduct the training where the skill is used.

We strongly encourage our parents to avail themselves of opportunities to learn the principles and procedures of ABA and how they’re implemented in their child’s program. We provide training in their home on how to teach their child in their environment and take everyday situations and turn them into teachable moments. For example, the mother may give the child French fries and then pour ketchup on the plate. We would take the opportunity to show the mother that that is a valuable opportunity for a mand and show her other ways to contrive such motivation.

Parents are encouraged to view therapy live and through video, and learn why we are teaching what we are and what they can work on at home. Through communication with their child’s team, they are taught as much as they are willing to learn and apply regarding their child’s program. BACA offers periodic parent training seminars on ABA and Natural Environment Teaching. We also provide direction to other reading and training resources, such as websites, workshops, and books.

Q: Carl, what qualities do you look for when hiring clinical staff?

A: When hiring a Behavior Technician, we require a bachelor’s degree, preferably in a related field. We are, of course, partial to those who have a bachelor’s degree in behavior analysis. Because of the recent increase in demand for services and the success of ABA, the demand for clinical staff is much higher than the supply of experienced behavior analysts. Therefore, we often have to look at other factors when hiring. First and foremost, we look for people who like to work with kids, people who like to teach and receive reinforcement from seeing progress made in their client. We need people who are patient and can tolerate slow progress, behavior problems, toileting accidents, meltdowns, etc. It is hard work so we want staff members who keep their eye on the big picture. We look for people who are eager to learn, who are willing to take more classes, who are excited about going to trainings and workshops, and who are excited about the prospect of becoming a behavior analyst.

When we hire for an advanced position we do require a BCBA. When selecting a BCBA, we look at education in behavior analysis, professional affiliations, presentations, publications, etc. We look hard at where someone received their training, who supervised them, and for how long. We enjoy bringing in people with new experiences and learning from them, but we also have developed a prestigious career path and many of our advanced positions are coveted from within. We need people who will fit in our culture.

Q: That sounds wonderful. I want to refer our readers to the job recruitment ad on page 9. Carl, what suggestions do you have for retaining high quality staff?

A: We believe the best way to retain high quality staff is to treat them well and recognize their importance. While the pay incentives can help keep a person at a job, we feel that job satisfaction is more important. Those who have been with BACA for many years understand how important their job is. They are excited when other Ph.D.s come to BACA to consult. They want to learn more. They want to advance their career in behavior analysis. They are excited when they are selected to go to ABAI, or any other conference or workshop. They realize that behavior analysis is something special and they are proud to be part of it. They are driven to become better behavior analysts and learn all they can from the people at BACA (other staff and the many visiting PhD consultants). It turns out to be sort of Darwinian. Those who have those traits are the best employees and the ones we really want to stay. Those who have those traits are the ones who tend to stay because of the environment we have created.

Q: How can behavior analysts best collaborate with speech pathologists?

A: We employ speech pathologists at BACA. Our speech pathologists focus on the mechanics of speech, articulation, developmental progression of phonemes, feeding issues, etc. This works well in our system. Our behavior analysts and technicians create and oversee the language and learning programs while our speech pathologists will evaluate for speech and provide recommendations for speech but not general language acquisition. For example, our speech pathologists would not design a program to teach mands, tacts, intraverbals and listener responding. They would design a program to work on development of speech, echoics and improved articulation, volume, prosody, next appropriate speech target, etc. We also rely on our speech pathologists for input as to the possibility of speech development. That is, whether it is likely for a non-vocal child, or one with very limited vocals, to make enough progress with vocals where vocalization could be a functional response form. We work well together because we’ve defined our roles and responsibilities clearly.

Q: Carl, one more question! Before we shift over to your colleague, Dr. Genae Hall, can you tell us what led to your decision to develop a research program at BACA?

A: Behavior analysis is a science founded on research. Behavior analysts use evidence-based treatments. This goes well beyond procedures, however. Our basic principles were established in the laboratory by B.F. Skinner and outlined in The Behavior of Organisms in 19381. Anytime a behavior analyst talks about reinforcement, extinction, shaping, chaining, generalization, punishment, discrimination training etc., we are talking about principles and procedures that were discovered and proven by Skinner a long time ago.

Our whole method for teaching language and other skills to people with autism is based on research. The first school for the treatment of children with autism using ABA was at the University of Washington and was directed by Sid Bijou, with his main staff members: Mont Wolf, Don Baer, and Todd Risley. Ivar Lovaas later joined them. The first published study on the behavioral autism treatment was Wolf, Risley, & Mees, (1964), later called DTT/ABA. Since that time the behavioral research has grown steadily and the behavioral journals are now replete with research demonstrating the effectiveness of behavioral techniques to teach people with autism and other developmental disabilities.

In the 1970s approximately 50 verbal behavior research projects were conducted at the Kalamazoo Valley Multihandicap Center (KVMC) under the direction of Jack Michael, Mark Sundberg, and Jerry Shook. Most of these projects were Western Michigan University Masters theses and Doctoral dissertations. Many of these studies were published in The Analysis of Verbal Behavior and form the foundation for what today is often called the Verbal Behavior Approach.

I always wanted to try to replicate that atmosphere of Western Michigan University in the 1970s. I think it is important for BACA to contribute to the research base. Genae Hall was one of the students who was doing the research at KVMC in the 1970s. Her master’s thesis was the first study to demonstrate the functional indpendence between the mand and the tact, supporting Skinner’s position of separate verbal operants. I was thrilled to find that she was interested in coming to BACA to head up our research department. She has been with us now for over a year and we have several studies operating at this time. Our goal is to get 2-3 publications per year moving forward. BACA is a great place for behavior analysts who want to work in both the applied and research settings.

Q: Dr. Hall, I would like to hear specifically about your research program at BACA, but can you first tell us about your career path and how you became involved in the field of behavior analysis?

A: My interests in behavior analysis, autism, and research began when I was an undergraduate psychology major at University of California Santa Barbara (UCSB). Although the UCSB psychology department was eclectic, I had the opportunity to work as a research assistant and take courses from Drs. Robert Koegel and Robert Sherman, two behaviorally oriented faculty, and Dr. David Premack, who conducted language research with primates. Later, while enrolled in an ABA Masters program at Western Michigan University (WMU), I studied ABA research under Dr. Brian Iwata, B. F. Skinner’s analysis of verbal behavior under Dr. Jack Michael, and conducted verbal behavior research while working at the Kalamazoo Valley Multihandicap Center. At that time, Mark Sundberg and a large number of other WMU graduate students were working at the center and conducting many ABA and verbal behavior studies.

After WMU, I worked as a behavior programming specialist at the May Institute for Autistic Children in Chatham, MA, and then entered a Ph.D. program in behavior analysis (experimental analysis of behavior) at West Virginia University (WVU). While at WVU, I worked with Drs. Philip Chase and Andy Lattal, continued to study and write about Skinner’s analysis of verbal behavior, acquired new interests in conceptual learning, stimulus equivalence, behavioral economics, and other basic topics, and conducted research on behavioral economics. After finishing my Ph.D., I moved to Northern California and coordinated behavioral services for individuals with developmental disabilities for a large agency in the San Francisco East Bay, provided behavioral consultation to families and group homes for children and adults with autism and other developmental disabilities, and co-directed a behavioral consulting group. During this time, I continued writing about Skinner’s analysis of verbal behavior, presenting at regional and international behavioral conferences, and doing editorial work for behavioral journals.

Q: Dr. Hall, how did you first get involved with BACA?

A: In May 2012, while attending the Association for Behavior Analysis International (ABAI) conference in Seattle, I learned that BACA was starting a research department and looking for a research director. This sounded very interesting, as it could provide an opportunity to pursue some of my own research interests, increase meaningful research in the area of verbal behavior (thus contributing to the literature in that area) and expand the evidence base for ABA treatment for children with autism. I contacted BACA and eventually visited the center for an interview. After being hired, I assisted BACA in recruiting and hiring a research assistant, and we began building a research department.

Q: Can you tell our readers a bit about what is involved in starting up a research department?

A: Immediate priorities in starting a research department (after the director and research assistant were hired) included creating a research ethics committee to review research proposals, identifying potential participants for each study, obtaining informed consent for each participant, identifying space for research to be conducted, obtaining furniture, purchasing or creating re-search materials needed for each study, and developing a system to create and store session videotapes securely. These tasks have been accomplished, although we continue to work on improving and expanding the videotaping system.

Q: Can you tell us a bit about your current research foci at BACA?

A: Regarding research topics, we are currently conducting studies on functional independence versus transfer between tacts and mands in early learners, comparing the effectiveness of two types of prompting in establishing listener behavior in early learners, establishing unprompted mands to peers and responding to the mands of peers in more advanced learners, and evaluating overall program effectiveness.

Q: Dr. Hall, what are your future plans for research at BACA?

A: We would like to enhance systems within BACA to facilitate research, coordinate with the Florida Institute of Technology (FIT) program at BACA and when this begins, initiate new research studies, expand existing lines of research, and develop new lines of research.

Regarding systems, we would like to enhance the existing communication system to contact and receive feedback from team supervisors, assistants, or therapists conducting research sessions at each BACA program site, so that feedback can be acted on very quickly. We would also like to develop a system whereby therapists teach certain prerequisite skills for research (such as completing simple and enjoyable chains of behavior) to children for whom research would be appropriate, so that studies can be conducted more quickly. Speeding up the studies would seem to be desirable to reduce participant attrition as a result of sudden changes in placement due to insurance coverage or other issues.

We are looking forward to working with the FIT program at BACA when it begins. FIT students who need to conduct Master’s theses (along with their faculty advisor) will be responsible for these research projects and can coordinate them through the BACA research department. We would like to expand existing lines of research by assessing functional independence versus transfer between various verbal operants (including, but not limited to, tacts and mands), comparing the effectiveness of different prompt-ing procedures in establishing verbal or other functional skills, establishing unprompted verbal and social behaviors, of various types, in learners with more advanced verbal skills, and introducing additional controls in future studies of program effectiveness.

The research department can propose new lines of verbal behavior and/or ABA research, or students in the FIT program or BACA employees with particular interests can propose them. The number of people available to take primary responsibility for studies limits the number that can be implemented. We would like to conduct research with older as well as younger learners.

Q: What advice do you have for other behavior analytic center-based programs that are trying to develop an applied research program?

A: Here are some initial suggestions:

The program should establish a research ethics committee or collaborate with a university with an Internal Review Board (IRB) to review proposals that are submitted.

The program should hire a qualified person with the desired research background and interests to direct and coordinate the research program, along with a research assistant. The director and assistant should establish systems to support research, propose and carry out some studies themselves, with staff assistance, and provide consultation to others in the program who are primarily responsible for specific studies.

Program administration should inform program staff that research is part of their jobs, and replace some of their current tasks with research activities. If staff are asked to add research activities to a full schedule, such demands may be ignored or tasks not carried out consistently or well.

To conduct more than a few studies, individuals other than the research director and assistant will need to take primary responsibility for some studies. This may occur if people working in the program are students at a collaborating university and research is required for their thesis or dissertation. Or, a staff person with interest and expertise in a particular area could propose and take primary responsibility for a study, with input and support from the research department.

There should be frequent opportunities for those conducting research to meet with knowledgeable people to “bounce ideas” off one another. Collaborating with a university and having graduate students working in the program may provide such opportunities.

The program should schedule periodic in-house trainings by the research department on general requirements of conducting research, progress on ongoing studies, and topics related to these studies. Staff should also receive training on the importance of evidence-based practice and making contact with the relevant research literature while designing studies, along with strategies for accessing the literature.

References:

Wolf, M. M., Risely T. R., & Mees H. (1964). Applications of operant conditioning procedures to the behavior problems of an autistic child. Behavior Research and Therapy, 1, 305-312.

Skinner, B. F. (1938). The behavior of organisms. New York: Appleton-Century-Crofts.

Citation for this article:

Celiberti, D. (2014). An interview with Drs. Carl Sundberg and Genae Hall. Science in Autism Treatment, 11(2), 4-10.

 

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