PSY 4600

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PSY 4600

• Unit 8
• Credentialing in Behavior Analysis
• Ethics

Schedule Tuesday and Thursday Lecture Tuesday
Exam
Special thanks to Dr. R. Wayne Fuqua for his
contributions to this material
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End of semester schedule

• Thursday, 12/10
• Return of E8
• Special grade sheet
• Can you benefit from taking ME2?
• If so, how many points do you need for the next
  highest grade?
• ME2 study objectives
• No lecture Good day to do course evaluations
  during class time
• Thursday, 12/17 Make-up Exam 2, 1230-230
• Units 5-8
• Room 1728
• Be here at 1230
• Remember you cannot start the exam after a
  student has left the room with the answers you
  will receive a zero

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Unit materials

• Credentialing in behavior analysis
• Dickinson article (2015)
• Ethics
• Martin Pear (2015), Chapter 30, Ethics
• Van Houten et al. (1988), Right to effective
  behavioral treatment
• Skinner (1978), The ethics of helping people
• Hanley et al. (2005), On the effectiveness of and
  preference for punishment and extinction
  components of function-based interventions
• OPTIONAL Wolf, Risley, Mees (1964),
  Application of operant conditioning procedures to
  the behavior problems of an autistic child

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Credentialing in BA, intro

• Purpose of Credentialing
• Protect the public from individuals representing
  themselves as competent in a field, when they are
  not
• Two Types of Credentialing in Behavior Analysis
• Certification
• Licensing
• Who is covered by certification and licensing
• Applied behavior analysts who work with at-risk
  populations
• If you work in human services, you need to be
  certified and, if relevant for the state you work
  in, licensed
• In a few states, all behavior analysts who work
  in applied settings with humans are required to
  be licensed

(at this point in time, 20 states have license
laws, in a moment, laws do vary from state to
state not EAB regardless of whether your work
involves humans or nonhumans)
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SO1 Two differences Certification vs. Licensing

• Organizations that oversee credentialing
• Certification Behavior Analysis Certification
  Board (BACB)
• Nonprofit international organization (separate
  from ABAI)
• Licensing Individual states
• Two differences between certification and
  licensing
• Certification is voluntary, licensing is legally
  required
• Requirements for certification are the same from
  state to state and globally, requirements for
  licensing vary from state to state

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Requirements for certification and licensing are
similar why?

• Certification predated licensing
• National certification began 1998, licensing
  began 2009
• BACB anticipated licensing and developed and
  posted a model license law on its web site to
  assist states
• States why re-invent the wheel when a
  professional organization had already developed
  standards and an exam?
• Certified behavior analysts were typically the
  ones who advocated for license laws and
  spearheaded their adoption, thus brought the
  model license law to the attention of the
  legislators

(In almost all states, the requirements for
licensing are the same or similar to requirements
for certification some states, identical in a
few you must be certified to be licensed any
event, similar. )
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Four levels of Certification

• Registered Behavior Technician (new 2014)
• Front-line staff who implement behavior plans
• Because it is new, most human service agencies do
  not yet require staff to be certified
• I anticipate that in the future, they may require
  staff to become certified, probably within a
  certain time period after hire
• Board Certified Assistant Behavior Analyst BCaBA
• Board Certified Behavior Analyst BCBA
• Board Certified Behavior Analyst-Doctoral BCBA-D

(most relevant to you at this point, BCaBA and
BCBA)
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SO2 Four categories of requirements for BCaBA
BCBA

• Educational degree from an accredited university
• Specific number of course hours in behavior
  analysis
• Specific number of supervised hours by a BCBA
• Passage of the relevant certification exam

(details change rather frequently as BACB
upgrades requirements so no details, visit web
site)
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SO3 Educational Requirements for BCABA and BCBA

• BCaBA
• Bachelors degree from an accredited university
• Does not have to be in behavior analysis or
  psychology
• BCBA
• Masters degree from an accredited university (a)
  in behavior analysis, psychology, or education,
  or (b) from a program with an approved BACB
  course sequence

(move onto licensing)
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Why license laws?

• To legally protect at risk-individuals seeking
  behavior analytic clinical services
• To accompany autism insurance laws that have
  recently been passed, specifying and regulating
  the individuals who could receive insurance
  reimbursement
• Some behavior analysts believe that we will not
  achieve the same status as other professionals
  (doctors, licensed clinical psychologists) unless
  we are licensed
• Some behavior analysts believe license laws
  should protect all consumers, not just at-risk
  individuals (also protecting the field in
  general)

(certification is voluntary licensing rqd
first two are the main ones some states use
certification as standard Employees, athletes,
college students, etc.because of these differing
views, two broad category of laws)
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SO4 Two types of laws

• Restrictive laws
• Only behavior analysts who provide clinical
  services to individuals need to be licensed, for
  example
• Those who work with children diagnosed with
  autism
• Those who work with individuals with
  developmental and intellectual disabilities
• Those who work with seniors with dementia
• Broad title and practice laws
• You cannot call yourself a behavior analyst
  (title) or practice behavior analysis (practice)
  unless you are licensed

(in general, two types of laws, although one
state has a title law first type relates to
the first 2 reasons on the previous slide, the
last type relates to all four reasons last two
most laws include mental health parity for other
relevant professionals who are credentialed in
their specialization see the article)
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States that have each type (according to Dr. D)

• Restrictive laws 15 states
• Alabama, Alaska, Kansas, Louisiana, Maryland,
  Nevada, New York, North Dakota, Oklahoma, Oregon,
  Pennsylvania, Rhode Island, Tennessee, Utah, and
  Virginia
• Michigan has a restrictive law pending (it is in
  the legislature)
• Broad title and practice laws 5 states
• Arizona, Kentucky, Massachusetts, Missouri,
  Wisconsin
• Eleven laws were passed last year all were
  restrictive
• Due to revision of the BACB model license law in
  2012, including wording for the potential
  exclusion of applied behavior analysts who
  provide non-clinical services, and explicitly OBM
  practitioners and applied animal trainers
• Seems to be the trend (although again I could be
  wrong)

(I could very well be wrong it is hard to
interpret the laws talk more about this in the
article)
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Implications for you

• If you are planning on a career in human services
• You need to be certified
• You need to be licensed in states that have
  license laws
• If you are planning on a career in other applied
  behavior analysis areas
• You do not need to be certified
• If you work/move to a state that has broad title
  and practice law, you need to check with the
  licensing board in that state to determine if you
  need to be licensed

(Questions?)
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Two Assumptions of systematic applications of
behavioral principles

• Behavior can be controlled
• Science of behavior can be used to help humanity
• Science of behavior can be used to harm humanity
• It is desirable to control behavior to achieve
  certain objectives

(Martin Pears chapter on ethics why we need
ethical guidelines and monitoring of the use of
this very powerful science and technology of
behavior)
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SO7 Define ethics from a behavioral perspective

• Certain standards of behavior that a culture
  develops to promote the survival of that culture
• Example
• Respect for the possessions of others is
  reinforced
• Stealing is punished
• In prehistoric cultures, stealing may have
  resulted in so much in-fighting, members of a
  culture became vulnerable to invasions by other
  cultures
• Members may have killed each other off or
  defected to other groups so that the culture did
  not survive.
• On the other hand, cultures that reinforced
  respect for the possessions of others survived.

(Skinner, 1953, 1971, Science Human Behavior
Beyond Freedom and Dignity sometimes
codified Into legal contingencies, sometimes
religious principles, back up a bit and explain)
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NFE Behavior analysis Is it relevant to ethics?

• Many sciences claim no expertise on ethical/moral
  issues about use of their science and related
  technology
• Today genetic engineering

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NFE Behavior analysis - Is it relevant to ethics?

• Ethics are about values (what is reinforcing,
  Skinner, Beyond Freedom and Dignity) and behavior
• Behavior Analysis has contributed to our
  understanding of how we acquire new behavior and
  motivate already acquired behavior
• No reason why ethics should be excluded

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NFE Development of Ethics and Values

• Ethics and values statements of what is good in
  a culture
• Beneficence and non-maleficence (not doing harm
  or evil)
• Integrity
• Fidelity and responsibility
• Justice
• Respect for persons
• Commitment of excellence
• Obviously stimuli associated with these are
  acquired reinforcers, not unconditioned
  reinforcers
• Are these arbitrary cultural inventions?
• Why do so many of these values cut across so many
  cultures?

(not arbitrary from a behavioral perspective)
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NFE cultural selection of ethics and values

• Variation and natural selection operate at three
  levels
• Shaping of operant behavior
• Biological evolution morphological features and
  innate behavioral tendencies
• Selection of cultural practicessome increase (or
  decrease) the survival of that culture and are
  transmitted culturally
• Ethics and values

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NFE How are Ethics and values acquired?

• Direct instruction (parents, schools), modeling
  (media), religious and secular rules and laws

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RELigious codification

• Jewish and Christian, Ten Commandments
• Thou shalt not kill
• Thou shalt not commit adultery
• Thou shalt not steal
• Thou shalt not bear false witness
• Thou shalt not covet neighbors wife, house,
  animals, etc.
• Buddhism, Five Precepts (basic morality)
• Refrain from taking life
• Refrain from taking that which is not given (not
  stealing)
• Refrain from sensual (including sexual)
  misconduct
• Refrain from lying
• Refrain from intoxicants which lead to loss of
  mindfulness

(not a coincidence that many of these resemble
each other no matter what the culture,
violation leads to problems in the culture/group
that can decrease its survival cultural
anthropology Marvin Harris)
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SO8 Is all control unethical?

• It is sometimes argued that all control is
  unethical. Why, upon a little reflection, doesnt
  this argument make sense?
• The goal of any helping professional can only be
  achieved by exerting control over behavior
• Teachers can only teach children to read by
  changing their behavior
• Drug addiction counselors can only get addicts
  clean by changing their behavior
• Behavior analysts can only get autistic children
  to successfully interact with the world and learn
  new skills by changing their behavior
• Sports psychologists can only get athletes to
  improve their skills by changing their behavior
• OBM practitioners can only get mangers to be
  better managers by changing their behavior

(go on to make the point that control is
ubiquitous, and when left to chance
sometimes things go horribly wrong look at all
the problems in our society, even with our legal
system)
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SO10 Countercontrol

• From a behavioral perspective, countercontrol is
  the most fundamental and effective safeguard to
  ensure individuals and groups are treated
  ethically.
• Countercontrol is the reciprocal of control
  influence the controllee has on the controller by
  having access to suitable reinforcers (and
  punishers)
• Citizens vote politicians out of office
• Workers unionize
• A client stops seeing a therapist

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SO10 Countercontrol

• When individuals lack meaningful forms of
  countercontrol, the culture/group creates
  safeguards (arranges contingencies) to ensure
  ethical treatment
• Ethical guidelines for behavior analysts working
  with at-risk individuals (monitored by the BACB
  and profession)
• Loss/suspension of certification
• Loss/suspension of license
• Ombudsman and Office of Student Conduct at WMU
• Students can complain to the ombudsman about a
  faculty member without retaliation
• Students can only be charged with academic
  dishonesty after a hearing with an unbiased panel
  overseen by the OSC

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NFE When Effective counterconrol doesnt exist
options
Manage by decreasing reinforcement and increase
response effort and risk of detection and
punishment
Increase by providing clear guidelines/rules and
supplemental social contingencies
(on to Van Houten article any questions?)
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SO13 Right to effective treatment and
restrictiveness

• An individual is entitled to effective and
  scientifically validated treatment
• Selection of treatment should be consistent with
  the philosophy of the least restrictive but
  effective treatment (both italicized terms are
  critical)
• It is unacceptable to expose an individual to a
  restrictive procedure unless it can be shown that
  such a procedure is necessary to produce safe and
  clinically significant behavior
• It is equally unacceptable to expose an
  individual to a nonrestrictive procedure if
  assessment results or research indicate that
  other procedures would be more effective

(one of the first set of ethical guidelines for
behavior analysts generated by controversy
surrounding the use of punishment one of the
most important things in this article, statement
with respect to what determines the overall
restrictiveness of a procedure)
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Slow-acting nonrestrictive procedures

• Slow-acting nonrestrictive procedures could be
  considered highly restrictive if prolonged
  treatment
• Increases risk
• An autistic childs head banging can lead to very
  serious injury
• A child with pica can swallow a life-threatening
  object/liquid
• A child that bites can hurt himself, his
  siblings, his parents

For samples of severe self-injurious behaviors,
see youtube.com The videos are very disturbing
and emotionally distressing.
(may not have thought about this, but you must
consider all of the effects of alternatives SR
may Be more restrictive than SP he ethicalnature
of a decision/treatment cannot be judged in
isolation increased physical risk is the one
that people think of most often, but there are
othersnext slide)
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Slow-acting nonrestrictive procedures

• Slow-acting nonrestrictive procedures could be
  considered highly restrictive if prolonged
  treatment not only increases risks, but
• Inhibits or prevents participation in needed
  training programs (aggressive behaviors toward
  others)
• Delays entry into a more optimal social or living
  environment (hospitalization vs. a group home or
  living at home)
• Leads to a adaptation to the treatment and
  eventual use of a more restrictive procedure

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SO14 What determines overall restrictiveness?

• Absolute level of restrictiveness
• Antecedents vs. consequences, reinforcement vs.
  extinction vs. punishment, restraints, medication
• Amount of time required to produce an acceptable
  outcome
• Consequences associated with interventions that
  have delayed effects

(to summarize questions, comments, on to Skinner)
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SO16 Ethics

• Give a man a fish and you feed him for the day.
  Teach a man to fish and you feed him for a
  lifetime.
• By giving too much help, we postpone the
  acquisition of effective behavior and perpetuate
  the need for help.

(Not Chinese proverb, if you give a man a fish he
is hungry again in an hour. If you teach him to
catch a fish you do him a good turn. Anne Ritchie
(1885) Skinners basic point and deprive him
of reinforcement, which defines/is responsible
for quality of life)
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So 17 18 Very important

• Three reasons why the behavior of some
  individuals is not sufficiently reinforced
• Others do things for them
• They have not learned to do things for themselves
• They are given things their behavior would
  otherwise be reinforced by
• When we refer to people as lacking initiative,
  having weak wills, suffering from apathy and
  boredom, what are they actually suffering from?
• A world in which their behavior is not positively
  reinforced

(animated slide)
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Hanley et al. Intro

• I included this article because of what it
  indicates about (a) restrictiveness of
  interventions and (b) that the selection of
  treatments should not be based on personal
  conviction about what is good or bad
• We should not be using the Golden Rule to select
  treatments, but the Platinum Rule
• Golden Rule Treat others as we would like to be
  treated
• Platinum Rule Treat others as they would like to
  be treated

(I am quoting Van Houten et al. here again)
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Hanley et al. summary

• Participants Two children
• Jay
• 5 years old, moderate retardation, autism,
  seizure disorder
• Self-injurious behaviors hitting and slapping
  head with hands, hitting head with objects,
  biting arms, and eye poking
• Aggression hitting, kicking, pushing, pinching,
  hair pulling, scratching, and head butting
• Disruption throwing objects, breaking objects,
  and knocking objects to the floor
• Betty
• 8 years old, mild to moderate retardation, ADD,
  and oppositional defiant disorder
• Aggression hitting, kicking, pinching,
  scratching, biting, pulling hair, and throwing
  objects at people (behavior targets in the study)
• Pica and self-injury (not treated in the current
  study due to the fact that these were controlled
  by different variables than her aggression)

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Hanley et al. summary

• IV
• Functional communication with extinction
• Functional communication with punishment
• Punishment only for inappropriate behavior
  (control)
• Functional Communication Training First
• Taught children to emit appropriate responses
  that would result in adult attention
  (inappropriate behaviors were being reinforced
  with that attention)
• Jay Handing a yellow card that had the word
  play written on it to the therapist
• Betty Taught her to say attention, please and
  excuse me

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Hanley et al. summary

• IV
• Functional communication with extinction (FCT
  only)
• FCT Jay if he handed the card to the therapist,
  20 seconds of praise/interaction with the
  therapist
• FCT Betty if she said, attention, please or
  excuse me, 20 seconds of praise/interaction
  with the therapist
• Extinction for inappropriate behavior
• Functional communication with punishment
• FCT same as the above for Jay and Betty
• Punishment for inappropriate behavior Jay 30
  seconds hand-down procedure (therapist stood
  behind him and held his hands to his sides)
• Punishment for inappropriate behavior Betty 30
  seconds hand-down procedure plus vision screen
  (therapist stood behind Betty, and placed one arm
  around Bettys arms while placing the other hand
  over Bettys eyes.
• Punishment only for inappropriate behavior
  (control)
• Punishment only, same as above

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Hanley et al. summary

• DV Selection of treatment by Jay and Betty
• Pressed one of three different-colored switches,
  each of which was paired with one of the
  treatment conditions
• After they pressed the switch, they were
• Immediately praised by the E regardless of which
  switch they pressed
• Were exposed to the corresponding treatment for 2
  minutes

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Hanley et al. summarySO 31 33

• Results
• Both children strongly preferred functional
  communication with punishment, rather than
  functional communication with extinction
• Possible reason
• Functional communication with punishment was more
  effective in decreasing their inappropriate
  behaviors
• Because of that, a higher percentage of their
  responses were reinforced
• They preferred the condition in which they
  received the highest rate of reinforcement

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Hanley et al. summarySO 31 33

• Back to Skinner and Van Houten et al.
• Skinner
• What they are suffering from is a world in which
  their behavior is not positively reinforced
• The good life is not a world in which they have
  what they need it is one in which the things
  they need figure as reinforcers in effective
  contingencies
• Van Houten et al.
• A procedures overall level of restrictiveness is
  a combined function of its absolute level of
  restrictiveness, the amount of time required to
  produce a clinically acceptable outcome, and the
  consequences associated with delayed outcomes
• Selection of a specific treatment is not based on
  personal conviction. Techniques are not
  considered either good or bad according to
  whether they involve the use of antecedent rather
  than consequent stimuli or reinforcement versus
  punishment.

(Onto Dicky)
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DickyWolf, Risley Mees

• One of the most famous articles in behavior
  analysis
• First written account of behavior analysts
  working with an autistic child, 1964
• First use of time out

(Before I talk about this, I want to just briefly
review some earlier material so that will be
fresh)
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SO 21 Skinner, Behavior analysis vs. traditional
views of helping others, the conflict

• Why was it inevitable that there would be a
  conflict between behavior modification and the
  traditional views of helping others, particularly
  those in institutional care?
• In order to help individuals with complex
  behavioral problems and provide a reinforcing
  environment, we need to implement effective
  contingencies of reinforcement.
• The arrangement of effective contingencies of
  reinforcement involves depriving individuals to
  some extent of powerful reinforcers things that
  have been traditionally viewed as guaranteed
  rights and withholding them until the
  habilitative behavior occurs.

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Van Houten et al.
One of the individuals rights stated in that
article
An individual has the right to the most effective
treatment procedures available.
Their conclusion re restrictiveness of a procedure
In some cases, a clients right to effective
treatment may dictate the immediate use of
quicker acting, but temporarily more restrictive
procedures.
(How do we decide? How restrictive?, asked you in
abstract, is it OK to deprive Dicky I am going
to spend quite a bit of time on this because I do
believe it is important, even though I dont have
any sos over it a lot of benefit of the class
thinking about and considering this issue I am
not going to ask/require you to take a
particular viewpoint, but I do want you to think
about this)
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DickyWolf, Risley Mees

• Dicky was 3.5 years old
• Progressed normally until he was 9 months
• Cataracts were discovered in both eyes
• Severe temper tantrums and sleeping problems
  developed
• When two years old, he had a series of eye
  operations which made wearing glasses necessary
  if he didnt wear them it would result in
  permanent loss of macular vision (central as
  opposed to peripheral vision)
• He was seen by a variety of specialists who
  diagnosed him as
• Mentally retarded, diffuse and locally
  brain-damaged, psychotic (among other things)
• It was recommended that he be placed in an
  institution for the retarded because his
  prognosis was so poor

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DickyWolf, Risley Mees

• Behavioral problems
• Did not eat normally, lacked social and verbal
  repertoires, and engaged in self-injurious
  behaviors such as head-banging, face-slapping,
  hair-pulling, and face-scratching
• Would not sleep at night, forcing one or both
  parents to remain by his bed
• His mom said that after a severe tantrum
• he was a mess, all black and blue and bleeding.
• Sedatives, tranquilizers, and restraints were
  tried, without success

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DickyWolf, Risley Mees

• At three, he was admitted to a childrens
  hospital with the diagnosis of schizophrenia
  (subsequently released)
• Wolf, Risley, Mees brought into consult
• They did readmit him to the hospital temporarily
  until they could change his disruptive behaviors
• They dealt with
• His temper tantrums (using time out), bedtime
  problems, wearing his glasses, throwing his
  glasses (which he began to do after he started
  wearing them), verbal behavior, and eating
  problems

(so thats where we start how many would like
this case? I am going to focus on his glasses
getting back to the ethical consideration raised
by Skinner the necessity to deprive individuals
of powerful reinforcers and conflicts with
traditional views of helping and the rights of
individuals.)
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DickyWolf, Risley Mees

• At three, he was admitted to a childrens
  hospital with the diagnosis of schizophrenia
• Wolf, Risley, Mees brought into consult
• They did readmit him to the hospital temporarily
  until they could change his disruptive behaviors
• They dealt with
• His temper tantrums (using time out), bedtime
  problems, wearing his glasses, throwing his
  glasses (which he began to do after he started
  wearing them), verbal behavior, and eating
  problems

(so thats where we start how many would like
this case? I am going to focus on his glasses
getting back to the ethical consideration raised
by Skinner the necessity to deprive individuals
of powerful reinforcers and conflicts with
traditional views of helping and the rights of
individuals.)
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DickyWolf, Risley Mees

• They conducted a session at breakfast, using food
  as the reinforcer that didnt work
• They conducted a session at lunch, using food as
  the reinforcer that didnt work
• They conducted a session at 200 that afternoon

Dicky had received very little to eat all day,
just a few pieces of dry cereal, and was most
interested in the ice cream we brought to the
session. At the beginning of the session it was
quite obvious that our reinforcers were much
powerful than earlier in the day.After this,
progress was rapid and he was soon wearing his
glasses continuously during the meal sessions in
his room.
Started with fruit candy modified the glasses
a number of times more wearable, less easy to
take off (they were not having much success
getting him to wear the glasses 5 weeks shaping
so the authors decided to get directly
involved. Quote from the article.., remember
permanent loss of vision one more slide on this)
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DickyWolf, Risley Mees
After wearing the glasses was established in
these sessions, it could be maintained with
other, less manipulable reinforcers. For
example, the attendant would tell Dicky, Put
your glasses on and lets go for a walk. Dicky
was usually required to wear the glasses (during
meals, snacks, automobile rides, walks, outdoor
play, etc.). If he removed the glasses, the
activity was terminated.
Fast forward a bit Dicky was released from the
hospital and according to his mom, six months
later Dicky had continued to wear his his
glasses, did not have any tantrums, had no
sleeping problems, was becoming increasingly
verbal, and was a new source of joy to the
members of his family.
(one more slide)
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DickyWolf, Risley Mees

• So, essentially, the authors
• Food deprived a 3.5 year-old autistic child for,
  give or take, 7-8 hours (not counting overnight)
  so food would function as an effective reinforcer
  and
• Punished him for removing his glasses by taking
  away food and activities he enjoyed

Question
Were these procedures and interventions ethical
or were Dickys rights violated?
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Questions/Comments/discussion

• Exam Tuesday, 12/08
• Instructional assistance hours 12/07, 630-800
  pm
• Jessica will be there