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Teaching Graduate Students to Translate Nonbehavioral Treatments Into Behavioral Principles

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Abstract

Behavior analytic translations of nonbehavioral treatments were recommended by Brodhead in Behavior Analysis in Practice, 8(1), 70–78 (2015) as part of a decision-making framework for practitioners working on interprofessional treatment teams. Professionals from different disciplines often have overlapping scopes of practice and competence, yet each recommends interventions according to their discipline-specific worldview and training. Nonbehavioral treatment recommendations may be especially challenging for behavior analytic practitioners who are committed to the science of human behavior and who are also ethically obligated to work cooperatively and in the best interest of the client. Learning to translate nonbehavioral treatments into behavior analytic principles and procedures may function as a valuable means of improving professional judgment, thereby promoting evidence-based practice and effective collaboration. Behavioral translations may expose procedures that are, in fact, conceptually systematic, creating more opportunities for behavior analysts to partner in interprofessional care. Using a behavioral skills training package, graduate students of applied behavior analysis were taught to translate nonbehavioral treatments into behavior analytic principles and procedures. All students produced more comprehensive translations following training.

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Correspondence to Kristin S. Bowman.

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Appendices

Appendix A

Sample Case Scenario: Model Scenario 1 (Modified From Bailey & Burch, 2016, p. 247)

You are a BCBA working in a public-school setting. You have been invited to join the treatment team for Cassie, a kindergarten client with autism. Although Cassie is approaching 6 years of age, her expressive language is very limited, with only a few vocal approximations to request her favorite items such as “cookie,” “juice,” “Muffy” (favorite doll), “up” (to be picked up and carried by an adult), and “Pocoyo” (favorite cartoon). She is ambulatory, but her motor problems have resulted in an unusual gait, tripping easily, and dropping things. She avoids activities other children her age enjoy, such as running, climbing, dancing, etc., and instead prefers more sedentary activities such as playing alone indoors on the floor with favorite toys or watching her favorite cartoons on her tablet. At school she usually avoids other children during free-play time and sits on the bench next to her teacher at recess.

Cassie’s teachers have expressed concerns regarding Cassie’s tantrum behaviors. When upset, she screams, drops to the floor, curls into a ball, and cries. Your functional behavior assessment indicates these behaviors are maintained by escape from difficult or aversive demands and unwanted activities.

During a treatment team meeting, Debbie, the occupational therapist states that sensory integration therapy is the best course of treatment. Debbie says, “Cassie’s scores on the Sensory Processing Measure indicate a praxis and proprioceptive dysfunction. Her hypersensitivity to environmental stimuli is causing an overreaction. Cassie needs to engage in more sensory activities so she can learn to make sense of her environment. You can see she gets on the floor in the fetal position because we are not properly challenging her senses. Whenever she is having a tantrum, we’ll need to have her participate in appropriate exercises such as rolling and bouncing on the exercise ball, playing games like tug-of-war, and jumping on the mini trampoline or accepting deep pressure stimulation such as having an exercise ball rolled over her while lying down or lying under a weighted blanket. These exercises will help her brain develop and improve her behavior. I’ll make a list of appropriate sensory activities that she can participate in whenever her tantrums start and train the classroom staff to select from the list and help her engage in these exercises.”

Appendix B

Sample Translation of Scenario Depicted in Appendix A

The overall goal of the intervention is to decrease Cassie’s tantrum behavior at school. As described, the tantrum behaviors comprise a functional response class of overt responses resulting in escape from unwanted demands and activities. These tantrum behaviors may be operationally defined as follows: an episode of crying, whining, and/or screaming following demand from adult or presentation of unwanted activity. May also include sudden drop to the floor, lying on the floor, rolling on the floor, flailing body movements, kicking, or hitting or throwing nearby objects. Does not include responses that follow painful stimuli, illness, or injury or those that may be part of a classroom activity.

The results of the functional behavior assessment indicate the tantrum behaviors are escape maintained and typically follow difficult demands and the presentation of unwanted activities. The occupational therapist has proposed an intervention that will include various sensory activities such as jumping on the trampoline, rolling, bouncing on the exercise ball, playing tug of war, etc., and deep pressure stimulation such as placing a weighted blanket over Cassie or rolling the therapy ball over her body while she’s lying down. The overt responses necessary to engage in many of these sensory activities (i.e., jumping, bouncing) are likely aversive given Cassie’s motor difficulties and preference for more sedentary activities and seem indirectly related to the goal of decreasing escape-maintained tantrum behavior.

Current antecedent stimuli, which evoke the tantrum behaviors, include difficult or aversive demands and unwanted activities. The intervention proposed by the occupational therapist does not include any changes to these aversive antecedent stimuli. These antecedent stimuli are establishing operations that increase the effectiveness or value of escape as a reinforcer and the frequency of tantrum behaviors which have been reinforced by the removal of the aversive demands/activities. Under the occupational therapist’s proposed intervention, these antecedent stimuli will be removed contingent on the tantrum behavior to allow for presentation of the sensory activities. Because the tantrum behaviors are escape maintained, this contingent removal maintains the contingency of negative reinforcement and will therefore continue to increase or maintain the tantrum behaviors. Stimulus and response prompts were not included in the description of the treatment.

The sensory activities are consequent stimuli to be presented at the occurrence of the tantrum behavior. The contingency described in the treatment procedure is as follows:

Aversive demand/activity (antecedent)—tantrum behaviors (behavior)—sensory exercises or deep pressure (consequence)

Because the sensory activities are likely aversive and contingent on the tantrum behavior, they may have a punishing effect. The school staff, teachers, and therapists implementing these procedures may be paired with these aversive activities resulting in conditioned punishers and unwanted effects of stimulus–stimulus pairing. Cassie’s preference for the more passive, deep pressure stimulation activities is unknown and the effect of these stimulus changes cannot be predicted. However, should Cassie perceive the deep pressure stimulation as pleasant it may potentially function as an additional reinforcer to strengthen the tantrum behavior.

Appendix C

Sample Block From the Worksheet

Block 1—Targeted Behavior(s)

1. What is the desired functional outcome of the proposed treatment? Is the goal of the proposed intervention a behavior or the result of certain behaviors (e.g., weight loss, having friends, earning an “A” in class)? If the goal is a behavior, is it targeted for increase, decrease, acquisition, maintenance, elimination, etc.?

2. What is the function of the behavior to be addressed by the proposed intervention? If it has not been assessed, can it be reasonably postulated based on observation or report?

3. Are there specific responses targeted for instruction with the proposed intervention? Are these responses targeted for increase, decrease, acquisition, maintenance, elimination, etc.?

4. How are the behaviors targeted for instruction related to the goal of the intervention?

     a. Do the targeted behaviors represent the actual goal of the intervention (e.g., kicking a football at gradually increasing ranges with the goal to improve distance and accuracy of field goal kicks)?

     b. Or are the targeted behaviors necessary for achieving the goal (e.g., increasing exercise to lose weight)?

     c. Or are the targeted behaviors necessary prerequisites for another, more complex functional behavior (e.g., targeting sound–letter associations to teach reading)?

     d. Or are the targeted behaviors only indirectly related to the goal? Are the targeted behaviors necessary to obtain the true goal of the intervention?

5. Does the proposed treatment recommendation target covert or overt responses? Or both?

6. Provide an operational definition for the targeted behavior(s). Can the behavior(s) be clearly and objectively defined? (Free of hypothetical constructs, explanatory fictions, assumptions, etc.)

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Bowman, K.S., Weiss, M.J. Teaching Graduate Students to Translate Nonbehavioral Treatments Into Behavioral Principles. Behav Analysis Practice 16, 530–546 (2023). https://doi.org/10.1007/s40617-022-00736-2

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