Applied Behavioral Analysis Practice Flashcards

Registered Behavior Technician (RBT) Role and Job Requirements

  • Professional Title and Scope: Ari's First Big Girl J-O-B refers to beginning a role as a behavior technician (BT). This role involves providing therapy and support to clients with Spectrum Disorder (ASD).

  • ASD Characteristics: Autism Spectrum Disorder is identified as being different for everyone. It is categorized as ASD 1 in some instances. The focus is on understanding how a child learns and applying scientific methods to support them.

  • Team Structure: Behavior Technicians work closely with a client and a Board Certified Behavior Analyst (BCBA) supervisor. Technicians are responsible for writing clinical reports.

  • Onboarding and Timeline:

    • Start Date: April 1st.

    • Onboarding Checklist: Managed through the Workday email system.

    • Maryland ePREP: A required component of preparation/onboarding.

    • Training Duration: The 40-hour training course typically takes 1 week, but may take up to 2.

    • Certification Deadline: There is an 8-week window to complete the training. Start Date: April 1st; End Date: May 27th.

  • Professional Growth Path:

    • Initial role: Registered Behavior Technician (RBT).

    • Performance reviews occur every 6 months. After 6 months, a technician can become a Lead BT.

    • After holding the Lead BT position for 1 year, the individual can become a Senior BT.

  • Financial and Rewards Programs:

    • RBT Completion: A $1.00 benefit is noted upon completing the certification process.

    • Super Stars Rewards Program: Available for use by employees.

    • Referral Bonuses: $100 for referring a non-RBT certified person; $250 for referring an RBT certified person.

  • Administrative Tasks:

    • Keep track of notes, time worked, and contact with the supervisor.

    • Provide copies of HS or college transcripts.

Applied Behavior Analysis (ABA) Foundations

  • Definition of ABA: Applied Behavior Analysis is a scientific and evidence-based approach that applies the principles of learning and behavior to understand and improve human behavior. It is described as "Science + Heart."

  • Core Components:

    • Applied: Focusing on socially significant behaviors.

    • Behavior: Anything that can be measured or observed, ranging from a small action to a complex skill.

    • Analysis: Systematically approaching work, analyzing data, and making adjustments to best help the client.

  • The Seven Dimensions of ABA (BATCAGE):

    • Behavioral: Target behaviors are observable and measurable.

    • Analytic: Data analysis tracks improvement and effectiveness.

    • Technological: Protocols are described clearly so they can be replicated exactly.

    • Conceptually Systematic: Every strategy connects to established principles of human behavior (e.g., reinforcers).

    • Applied: Focuses on behaviors that are socially significant and impactful for the client.

    • Generality: The learned behavior lasts over time and occurs in different environments.

    • Effective: Improvements are seen and are impactful for the client.

  • Three-Term Contingency (ABC Sequence):

    • Antecedent (A): An environmental event or stimulus that occurs immediately before the behavior.

    • Behavior (B): The specific response or action taken by the client.

    • Consequence (C): A stimulus or event occurring immediately after the behavior.

    • Example: A worker sees a customer (Stimulus/Antecedent) $\rightarrow$ Greets them (Response/Behavior) $\rightarrow$ They share a positive interaction (Consequence).

Clinical Documentation and Data Collection

  • Session Note Protocol:

    • Notes must include exact start and end times.

    • Write and verify notes during the last 15 minutes of scheduled therapy sessions.

    • For in-home services, obtain caregiver signatures on the note right before the session ends.

    • It is prohibited to write and verify notes for sessions that did not occur or for inaccurate times.

  • Graphing and Visual Analysis:

    • Line graphs are the standard for ABA. They use points connected by lines to show trends over time.

    • X-axis: Represents time (sessions, days, or weeks).

    • Y-axis: Represents the measure of behavior (rate, percentage, duration, or count). Labels must match the data source (e.g., "Percent Correct").

    • Condition Line: A solid vertical line marking a change in overall treatment condition (e.g., switching from baseline to intervention).

    • Phase Change Line: A dashed vertical line marking a smaller change within a condition (e.g., fading prompts).

    • Visual Inspection Criteria:

    • Level: The general height/position of the data on the y-axis.

    • Trend: The overall direction (Increasing/Ascending, Decreasing/Descending, or Flat/Stable).

    • Variability: The degree of fluctuation between data points (High variability vs. Low variability/Stability).

    • Immediacy of Change: How quickly the behavior shifts after a condition change. Immediate shifts show stronger evidence of treatment effect.

    • Overlap: How much data from one phase falls into the range of another. Low overlap indicates a stronger treatment effect.

  • Charting Logic:

    • Baseline: Provides the comparison point for intervention.

    • Steady State Strategy: Collecting data until behavior is stable before changing conditions.

    • Withdrawal/Reversal Designs: Alternating between baseline and intervention phases.

Assessment Procedures

  • Types of Assessments:

    • Preference Assessment: Identifies items/activities the client likes/dislikes (e.g., choosing between different toys). It determines what stimuli function as reinforcers.

    • Skill Assessment: Structured evaluation of a client's abilities in communication, daily living, motor skills, and academics. Commonly used tools include VB-MAPP, ABLLS-R, and AFLS.

    • Functional Assessment: Identifying the purpose or "function" of a behavior (Social Attention, Escape, Tangibles, or Sensory/Automatic).

  • Preference Assessment Methodologies:

    • Free Operant: Unrestricted access; observer records time spent with each item.

    • Single Stimulus: Presenting one item at a time and recording engagement.

    • Paired Stimulus: Presenting two items and having the learner select one; shows a clear rank order.

    • Multiple Stimulus (MSW): With replacement; chosen item goes back in the array.

    • Multiple Stimulus (MSWO): Without replacement; chosen item is removed after being selected.

  • Functional Assessment Methodologies:

    • Indirect: Interviews, checklists (FAST, QABF, MAS).

    • Descriptive (ABC Recording): Direction observation of Antecedents, Behaviors, and Consequences in the natural environment.

    • Functional Analysis (FA): Highly controlled experimental test manipulating conditions (Attention, Escape, Tangible, Alone) to identify behavior causes.

  • Probes: A brief, structured skill check without prompts or reinforcement to see what a client can do.

Reinforcement Principles

  • Reinforcement Definition: Presenting a consequence immediately after a behavior that results in an increase in that behavior in the future.

  • Positive vs. Negative:

    • Positive (+): Adding a stimulus results in increased behavior.

    • Negative (-): Removing an aversive stimulus results in increased behavior.

  • Factors Affecting Reinforcer Effectiveness:

    • Immediacy: Delivery within 1-2 seconds.

    • Quality: Higher value/preference items work better.

    • Magnitude: Size or intensity of the reinforcer.

    • Satiation: Reduction in effectiveness if a reinforcer is delivered too often.

    • Establishing Operations (EO): Factors that make something more reinforcing at a particular moment (e.g., hunger makes food more reinforcing).

    • Response Effort: As effort increases, behavior likelihood decreases.

  • Schedules of Reinforcement:

    • Continuous (CRF): Reinforcement follows every correct response (used for new skills).

    • Intermittent: Some but not all responses are reinforced (used for maintenance).

    • Fixed Ratio (FRFR): Set number of responses (e.g., FR2FR2 reinforces every second response).

    • Variable Ratio (VRVR): Average number of responses (e.g., VR4VR4 reinforces around an average of every 4th response).

    • Fixed Interval (FIFI): First response after a set amount of time (e.g., FI5FI5 minutes).

    • Variable Interval (VIVI): First response after an average amount of time (e.g., VI10VI10 minutes).

    • Note: FRFR schedules often produce a post-reinforcement pause.

Skill Acquisition Methodologies

  • Discrete Trial Teaching (DTT): A structured format with five parts: 1. Discriminative Stimulus (SDS^D), 2. Prompt (if needed), 3. Response, 4. Consequence, 5. Inter-Trial Interval (ITIITI).

  • Natural Environment Teaching (NET): Skills are embedded into everyday life and child-led activities. It uses natural reinforcers.

  • Incidental Teaching: Using a learner's initiation to prompt a response and expand learning.

  • Shaping: Reinforcing successive approximations toward a final target behavior.

  • Chaining: Teaching a sequence of linked behaviors.

    • Forward Chaining: Teaching the first step first.

    • Backward Chaining: Teaching the last step first (provides immediate terminal reinforcement).

    • Total Task Chaining: Teaching every step during each trial.

  • Prompting: Assistance given to increase the likelihood of a correct response.

    • Response Prompts: Physical (hand-over-hand), Model, Verbal.

    • Stimulus Prompts: Positional, Movement, Redundancy (color, size, shape).

    • Prompt Fading: Gradually reducing prompts to foster independence (e.g., Time Delay, Proximity Fading).

    • Hierarchy: Most-to-Least or Least-to-Most intrusive.

  • Generalization: Behavior occurring across different people, stimuli, and settings.

  • Maintenance: The persistence of a skill after intervention has been removed. Checked via Maintenance Probes.

Behavior Reduction and Crisis Management

  • Functions of Behavior (SEAT):

    • Sensory (Automatic Reinforcement).

    • Escape (Social Negative Reinforcement).

    • Attention (Social Positive Reinforcement).

    • Tangibles (Social Positive Reinforcement).

  • Extinction: Discontinuing reinforcement for a previously reinforced behavior.

    • Extinction Burst: A temporary increase in rate, intensity, or duration of the behavior.

    • Spontaneous Recovery: Reoccurrence of behavior after it was extinguished.

  • Differential Reinforcement:

    • DRO: Reinforcing Other behavior (absence of the target).

    • DRA: Reinforcing Alternative behavior (serves the same function).

    • DRI: Reinforcing Incompatible behavior (cannot occur simultaneously with target).

    • DRL/DRH: Reinforcing Low/High rates of behavior.

  • Punishment: Consequence that decreases the future probability of a behavior.

    • Positive Punishment: Reprimands, Overcorrection (Restitutional or Positive Practice), Response Blocking.

    • Negative Punishment: Time-out (Exclusionary vs. Non-exclusionary), Response Cost.

  • Crisis Management:

    • Escalation Cycle: Baseline/Calm $\rightarrow$ Trigger $\rightarrow$ Agitation $\rightarrow$ Acceleration $\rightarrow$ Peak $\rightarrow$ De-escalation $\rightarrow$ Recovery.

    • Protocol: Stay calm, maintain safety, follow written crisis plan, call for assistance, document/debrief.

    • Environmental Blocking: Arranging the environment to prevent danger without touching the client.

    • Prohibitions: No takedowns, holds, or seclusion without authorized training. Do not improvise physical procedures.

Ethics and Professional Standards

  • Confidentiality and Privacy:

    • Follow HIPAA and FERPA regulations.

    • Protect Protected Health Information (PHI): names, photos, voice recordings, locations.

    • Use initials only in documentation. Never take pictures of children or post them on social media.

  • Professional Boundaries:

    • No social relationships with families outside of the job.

    • Gift limit: Can accept gifts worth up to $10.00; higher amounts are considered bribery.

    • Do not answer clinical questions; refer caregivers to the supervisor.

  • Mandated Reporting: RBTs are legally required to report suspected abuse or neglect (of children, elderly, or animals) based on reasonable suspicion.

  • Supervision Requirements:

    • At least $5\%$ of monthly hours providing behavior-analytic services must be supervised.

    • Example: $40$ hours of service = $2$ hours of supervision; $80$ hours = $4$ hours.

    • Supervisor must be an active BCBA/BCaBA and cannot be a relative or employee.

    • At least 2 face-to-face contacts per month, with at least one individual session. Contacts must be at least 30 minutes.

  • Interobserver Agreement (IOA): Consistency between two observers collecting data.

  • Procedural Fidelity Formula: Correct StepsTotal Applicable Steps×100\frac{\text{Correct Steps}}{\text{Total Applicable Steps}} \times 100. Aim for at least $80\%$.

  • RBT Certification Maintenance: Recertify annually (12 PDUs required). Inactive status incurs a $25$ fee; exam costs $65$.

Questions & Discussion

  • Parent Concerns regarding Attention Span: If a parent reports a poor attention span, the RBT should ask for specific, detailed examples of the struggle to track observable behaviors and measure them.

  • Treatment Plan Conflicts: If a supervisor has a plan, the RBT cannot alter it. If inconsistencies are noticed, it must be reported to the supervisor for retraining or adjustment.

  • Ethics of Data: Do not alter scales or omit data to favor results; this is unethical. All data must be included in graphs.

  • Multiple Relationships: If a supervisor invites an RBT to personal outings (e.g., drinks/dinner), it constitutes a multiple relationship risk and should be reported to HR or a higher-up if it persists.