This month’s response comes from Dr. Bryan J. Blair. The original discussion questions can be found in last week’s post. Don’t forget to let us know your thoughts on our Facebook page!
One of my early applied behavior analysis (ABA) supervisors used to say that the hardest part of his job was changing direct care staff behavior so that the staff would comply with administrative policies and to ensure the consistent implementation of treatment plans. He certainly did not mean to imply that developing effective interventions for severely challenging and dangerous behavior, such as aggression and self-injury, was easy or formulaic. But he rightly noted how challenging it can be to train and supervise staff using the same behavior analytic principles that we use directly with clients in clinical settings. The article for the ABA Journal Club, An Assessment-Based Solution to a Human-Service Employee Performance Problem (Carr, Wilder, Majdalany, Mathisen, & Strain, 2013), tackles this supremely relevant issue by providing us with an empirical analysis of a tool that can be used in the process of improving staff performance.
One of the defining features of interventions based on applied behavior analysis is that the procedures and protocols rely on objective operational definitions of the world around us and that the natural world is continually empirically analyzed to ensure that treatments are relevant and effective. As ABA practitioners, we have realized great success in this approach for developing and implementing treatments and interventions for a vast array of skill deficits and challenging behaviors. However, far too often we fail to use these same guiding and controlling principles when training and supervising the professionals who directly implement ABA technologies. As Dr. Blanco noted, the vast majority of trained Board Certified Behavior Analysts (BCBAs) have received little formal training in the management and supervision of direct care professionals, so it is ultimately not overly surprising that many BCBAs struggle with using the principles of ABA to develop staff skillsets.
However, that will soon change! As of January 2022, the Behavior Analyst Certification Board’s (BACB) 5th Edition Task List (BACB, 2017b) and Verified Course Sequence Coursework Requirements (BACB, 2017b) will include content related to staff supervision and training. Graduate programs will be required to develop academic content that targets supervisory skills and strategies associated with training direct care professionals and BCBA supervisors will need to address these areas in supervised fieldwork settings. This is certainly a welcome development and I am optimistic that these new requirements will lead to practicing behavior analysts who are better equipped with skills that can be applied to staff supervision and performance management.
Early in my career, along with several colleagues, I developed a new direct staff observation and feedback protocol using a partial-interval observation and data collection system that allowed for empirical analysis of the performance of an individual staff person over time. Prior to the development of the system, we relied on more subjective and anecdotal observational strategies that limited our ability to provide meaningful, timely, accurate, valid, and relevant feedback to staff in order to develop their clinical and administrative skills. The new tool allowed us to graph staff performance data over time and visually analyze the data to determine objective performance levels across a variety of defined skills, and this visual presentation of behavior was shared with the staff themselves so that they could see their own behavioral changes over time as well. The summarized data were included in staff evaluations and referenced during supervision and mentoring meetings. The PDC-HS provides behavior analysts with an opportunity to screen for deficits in strategic and systemic supervision practices (as opposed to more tactical procedures such as directly observing the implementation of a discrete trial training protocol) and I feel that such a tool is essential when developing staff observation and feedback systems. Had we used such a tool in conjunction with our more direct observation tool, we may have identified agency-level holes in training, mentoring, and supervisory practices that resulted in staff performance that didn’t meet the expected clinical standards. In essence, by using the PDC-HS, we might have identified other contributing factors to poor performance that might not have been easily identified by direct in-vivo observations.
In addition, the PDC-HS provides behavior analysts who supervise staff with directly applicable empirical references that can be used to further support the development of staff supervision and feedback systems. BCBAs are well aware of the fact that we must always use evidence-based interventions for clients of ABA interventions and services (BACB, 2014); however, given the fact that many practicing behavior analysts have received little formal training on staff supervision, it is imperative to provide the field of ABA with tools to help facilitate the process of staff performance management.
Coincidentally (or perhaps because of the pervasiveness of this skill deficit), when I supervised a team of ABA therapists who shared an office space, I too needed to address cleanliness and orderliness of the shared space with a simple behavior analytic intervention (i.e., a gamified group reinforcement system). Again, however, had I used the PDC-HS tool, the intervention would most likely have better reflected the setting events, training and supervision deficits, and functions of the skill deficit (or motivative deficit). Given the rapid expansion of direct ABA therapy in a variety of unstructured settings where supervision from a BCBA might occur less frequently than in a clinic (e.g., in a general education classroom or in the client’s home), I agree that systematic replications can and should address the fidelity of the implementation of teaching protocols and behavioral interventions. Such replications would provide supervisors with much-needed clarification regarding the conditions and systems that control certain behaviors that interfere with the effective implementation of behavior analytic interventions.
As Dr. Blanco noted in her remarks about the article and the PDC-HS, BCBAs must be well-versed in effective and individualized staff supervision and performance management strategies and tactics. BCBAs are highly encouraged to develop their own tools to facilitate the consistent application of principles of ABA to such supervision, and tools like the PDC-HS can be used to help frame staff skill and performance deficits that might otherwise be difficult to analyze.
References
Behavior Analyst Certification Board. (2017a). BCBA/BCaBA coursework requirements based on the BCBA/BCaBA Task List (5th ed.). Retrieved from: https://www.bacb.com/wp-content/uploads/2017/09/170113-BCBA-BCaBA-coursework-requirements-5th-ed.pdf
Behavior Analyst Certification Board. (2017b). BCBA/BCaBA task list (5th ed.). Littleton, CO: Author. Retrieved from: https://www.bacb.com/wp-content/uploads/2017/09/170113-BCBA-BCaBA-task-list-5th-ed-.pdf
Behavior Analyst Certification Board. (2014). Professional and ethical compliance code for behavior analysts. Littleton, CO: Author. Retrieved from: https://www.bacb.com/wp-content/uploads/BACB-Compliance-Code-english_190318.pdf
Carr, J. E., Wilder, D. A., Majdalany, L., Mathisen, D., & Strain,
L. A. (2013). An assessment-based solution to a human-service employee
performance problem. Behavior Analysis in
Practice, 6(1), 16-32. doi:
10.1007/BF03391789
About The Author
Dr. Bryan J. Blair is a licensed behavior analyst (MA), Board Certified Behavior Analyst, and is currently an Assistant Professor at Long Island University – Brooklyn where he is also the coordinator of the Applied Behavior Analysis graduate certificate and supervised fieldwork programs. He has worked with children and adults with developmental disabilities and other clinical disorders for over 15 years in a variety of settings. For more information or to contact Dr. Blair please see his website: https://ww.bryanjblair.com.