I recently presented on an ABA ethics panel at the ABAI conference in San Diego, so today
I'm going to get on a soapbox regarding one of the most common ethical issues I've seen
in the past two decades in the autism world.
Hi, I'm Dr. Mary Barbera, autism mom, board certified behavior analyst, and best selling
author.
Each week, I provide you with some of my ideas about turning autism around, so if you haven't
subscribed to my YouTube channel, you can do that now.
If you are a board-certified behavior analyst, you probably are aware that you need to follow
the BACB compliance code, and you need 4 hours of Type II BACB ethics CEUs every two years,
to recertify as a BCBA.
I don't know about you, but I've been to some pretty dull ethics workshops since 2003, when
I was first certified, so I recently put together a four-part ethics interview series, with
four Type II BACB Ethics CEUs, but before I tell you more about this series, I want
to tell you about one of the most common ethical issues I see, which you're probably not aware
of and probably never considered as an ethical issue before.
Let me tell you about a 200-pound teen I'll call Billy.
Billy was in a private ABA school, and the district that was funding him to go there
wanted an independent educational evaluation and an FBA, a functional behavior assessment,
which I agreed to do, because the school was concerned that the private ABA school was
asking to increase from two-to-one, two staff on Billy, to three-to-one staff, three staff
for just Billy.
I think he was about 15 years old, and he was still an early learner, not speaking at
all, and his problem behaviors included aggression and property destruction.
He also eloped from the home a few times.
I went to the home first, to evaluate Billy, and found a very distraught mother.
Billy towered over her, and they also had a younger brother who was not home at the
time.
But Mom really was frightened of Billy, and to be honest, I was kind of frightened of
Billy too, when I was in the home, because without large staff to control Billy's behavior,
it was very unpredictable what he was going to do.
I then went to his school, and what I found there was a very elaborate restraint over-correction
protocol that required a two-to-one ratio, but now it was going to require a three-to-one
ratio.
And worst of all, the data showed that this protocol appeared to be reinforcing, so the
problem behaviors were going up instead of down.
There was just a general lack of concern for what was happening at home, where it was just
Mom trying to control Billy with a younger sibling at home.
There was a failure to pair, and mand, and to conduct a verbal behavior assessment, which
I would have recommended.
And I was particularly concerned that there was no response to the current data, which
was clear, that the restraint procedure was actually leading to more problem behaviors.
Billy ended up in a residential treatment facility, and I doubt he ever lived at home
again.
And I have, unfortunately, dozens of stories like Billy's, where well-meaning professionals
and BCBAs develop protocols that are either not individualized or not created looking
at the whole child in terms of providing programming and treatments that will work in all settings,
and there's a failure to work together with families to ensure optimal treatment.
As BCBAs, we're required to work with families and other team members to thoroughly assess
and program for each child and to make data based decisions on the progress or lack of
progress for each client.
If you're using one-size-fits-all protocols or have protocols in place that aren't working
to increase or decrease behaviors, I think you should look at this as an ethical situation
and evaluate some ways to change your own behavior as a BCBA.
As I talked about a few minutes ago, I've recently created a four-part ethical interview
series, and up until now, this ethical series has only been available as part of my verbal
behavior bundle course membership, which includes all 32 BCBA CEUs.
In the ethical series, four BCBAs with ethical expertise give their advice.
Dr. Eileen Schwartz created an ethical decision-making matrix, and covers this matrix in interview
number one of the series.
So, let's talk about the matrix and how it would relate to a child like Billy.
Part of Dr. Schwartz's ethical matrix involves asking myself why Billy's situation triggers
my ethical radar.
This is triggered because Billy's safety, and the safety of his mom, brother, and staff
members, are all at risk.
It's also an ethical issue to me because of Billy's dignity, the impact of escalating
problem behaviors on his relationships, and his overall outcome.
One of the most profound things Dr. Schwartz said during her interview was that BCBAs are
spending way too much time focusing on the little things, like, "Can I accept a cup of
coffee from a client”, or “Is that a gift I must decline?"
instead of looking at larger ethical issues, like ensuring that ABA treatment leads to
dignity and quality of life for our clients.
The other three individuals I interviewed included Rosemarie Griffin, who's an SLP and
BCBA, and Drs. Megan Miller and Amanda Kelly.
For more information about the ethical series, please visit http://www.marybarbera.com/ethics
and if you want to learn more about the verbal behavior bundle, which covers assessment and
programming for early and intermediate learners, sign up for a free online workshop at http://www.marybarbera.com/bundle-ws.
Leave me a comment, give me a thumbs up, and share this video to help me get the word out,
and I will see you next week.