Quigley, S. P, Ross, R. K., Field, S., & Conway, A. A. (2018). Towards an understanding of the essential components of behavior analytic service plans. Behavior Analysis in Practice, 11, 436-444.
Reviewed by: David Celiberti, PhD, BCBA-D and Karrie Lindeman, EdD, BCBA-D
Association for Science in Autism Treatment
Why research this topic?
There are seven characteristics that define applied behavior analysis (ABA). One of these is that behavior analysts have a longstanding commitment to ensuring that interventions are sufficiently “technological.” That is, procedural components are defined and specified in such a way to allow accurate and consistent implementation across people, settings, and situations. This is particularly important as behavior plans are often carried out by para-professionals, parents, and other caregivers. The authors argue that there is a lack a consensus of the “essential components of a written skill acquisition/behavior reduction plan” and limited literature to guide behavior analysts in adequately meeting the technological standard. Without successfully fulfilling this standard, providers may not be implementing interventions effectively and reliably, and may have difficulty training others (e.g., registered behavior technicians). By fulfilling the technological requirement, behavior analysts may be better positioned to provide quality care for recipients of services.
What did the researcher do?
The researchers reviewed the existing intervention literature and highlighted key articles that described critical components of behavior reduction plans. This information was used to form the basis of a 56-item survey that was administered to behavior analysts, specifically BCBAs and BCBA-Ds. The initial six questions of the survey were demographic in nature. The remaining items of the survey featured components that appear in behavior reduction plans, and had participants rate their need through a rating scale of 1-5 (1 indicated “not necessary to include” and 5 indicated “must be included”). These ratings of essentialness (i.e., relative importance) represented the dependent variable in the study. The survey also invited participants to write in other areas not specified and to rate them accordingly. The researchers surveyed a total of 54 participants. Of these, 9 were BCBA-Ds and 45 were BCBAs.
What did the researchers find?
Following completion of the surveys, components with scores above 3.0 were deemed essential, while scores under 2.99 were viewed as non-essential. BCBA and BCBA-D scores were computed separately to see if there were any differences in ratings between the credential groups. The researchers found that client information questions were rated as essential for including name and age, but not for including personal and family history. This was consistent across both BCBAs and BCBA-Ds. Treatment component questions were rated primarily as essential by both groups. These included prevention procedures, skill-building procedures, reactive procedures, crisis management, data procedures, data sheets, criteria for measurement, and procedures for training others how to implement the plan. The four areas that were not considered essential were treatment fidelity for both behavior reduction and skill building, who conducts fidelity checks, and who trains staff. For consent questions, agreement on essentialness was high for two items: including a line upon which the behavior plan’s author would sign and addressing benefits/risks to client. Statements of legal compliance and consent for the Functional Behavior Assessment (FBA) did not meet essential standards. BCBAs and BCBA-Ds disagreed on the need for signature lines for the guardian and client, with the latter group rating these components as less essential.
What are the strengths and limitations of the study?
One noteworthy strength of this article involved the detailed description of various frameworks for conceptualizing behavior plans (e.g., Horner, Brinkman, Kroger, Phillips, Browning-Wright, and Tarbox). This particular study further contributes to our understanding of essential components and the findings echo guidelines put forth in the literature up to 25 years prior. As is the case with all survey research, small sample sizes may limit the extent to which findings are representative of the larger population. In this case, the total number of board certified behavior analysts has surpassed 16,000 with only 54 completing the survey. This is a very small fraction of behavior analysts overall. Future research in this area could involve a larger number of participants.
What do the results mean?
The results suggest a continued need to evaluate the essential items required in behavior reduction plans to ensure a high standard of care is met. To adhere to the technological dimension of behavior, a more stringent outline for professionals to follow seems warranted. Although a small population was sampled, the results appear to indicate the need to further develop this line of research by exploring both a larger scale survey and studies incorporating more clearly aligned experimental design to further assess variables. Although it was surprising that fidelity and training procedures were viewed as non-essential, the authors pointed out that these results do not mean that steps to address these areas would be omitted even if mention was excluded from a written plan. This leads to a potentially important area of future inquiry; that is, does inclusion of fidelity evaluations actually lead to better implementation? This can be explored using an experimental design and further discussion and understanding (e.g., Lerman, Leblanc, & Valentino, 2015).
With continued research in this area, a standard level of treatment delivery for practitioners to guide their efforts is underway. It is important to note that the goal of identifying essential components is to help standardize what is put into a plan, not to take away from the individualized content of the behavior plan. By tackling this area of study, we can further ensure the technological dimension is met, while continuing to enhance training and best clinical outcomes for our clients.
References
Lerman, D. C., LeBlanc, L. A., & Valentino, A. L. (2015). Evidence-based application of staff and care-providers training procedures. In H. S., Roane, J. E. Ringdahl, & T. S. Falcomata (Eds.), Clinical and organizational applications of applied behavior analysis (pp 321-352). New York, NY: Elsevier, Inc.
Citation for this article:
Celiberti, D. A., & Lindeman, K. (2019). Research synopsis: Towards an understanding of the essential components of behavior analytic service plans. Science in Autism Treatment, 16(5).
