|Shifting Organizational Intervention Philosophy: Integrating Skills Based Training Into Organizational Practices
|Saturday, May 28, 2022
|3:00 PM–4:50 PM
|Meeting Level 2; Room 258A
|Area: AUT/DDA; Domain: Service Delivery
|Chair: Sara White (Sendan Center)
|Discussant: Sara White (Sendan Center)
|CE Instructor: Sara White, Ph.D.
|Abstract: In October 2019 several of the Behavior Analysts from Sendan Center attended a training on Skills Based Treatment. Following that presentation and through significant management team discussion, the decision was made to begin company wide implementation of this methodology starting with a small number of clients under the supervision of each Behavior Analyst. Over the course of the year Sendan has shifted to using Skills Based Treatment as our primary means of intervention for all clients with severe behavior issues, including several within local school districts. This symposium will cover several case studies, including that of the first client within our organization to shift to Skills Based Treatment and one for whom we have implemented a blended program with some more structured programming integrated with specific Skills Based Treatment work periods. Presentations will also include an analysis of company wide data on the reduction of holds, restraints and isolation and perspectives from school district partners on the value of implementation of Skills Based Treatment in the school setting.
|Instruction Level: Advanced
|Keyword(s): ethical treatment, organizational change, SBT
|Target Audience: Intermediate - familiarity with basic principles and the process of implementation of Skills Based Treatment
|Learning Objectives: At the conclusion of the presentation, participants will be able to:
1. Describe advantages of implementation of Skills Based Treatment
2. Describe institutional benefits in organizational implementation of Skills Based Treatment
3. Describe potential barriers to organizational implementation of Skills Based Treatment
Client Zero: The Success Story That Sparked an Organizational Shift
|HILLARY LANEY (Centria)
Shifting organizational practice to be more comprehensive, compassionate, and effective is a necessary undertaking that requires grit, determination, passion, and convincing data. The literature supporting the use of Practical Functional Analysis and Skills-Based Treatment (PFA/SBT) to treat severe problem behavior shows it can be effective and generalizable. Client Zero was the first client within our region and agency to access the efficacy of PFA/SBT. His outcomes sparked the initiatives which fundamentally shifted our organization and therefore our region. Client Zero began his treatment in October 2019 in his school placement and November 2019 in his home environment. The utilization of the SBT process opened pathways previously thought to be inaccessible to this client due to the severity and complexity of his behavioral profile. We will demonstrate the overall outcomes from his treatment plus maintenance and generalization data spanning 18 months across multiple contexts and people who support him. The demonstrated outcomes influenced agency-wide implementation as well as the consultation models utilized to support local school districts. This model of behavioral intervention has increased successful outcomes across a vast array of contexts and implementers in our region. Client Zero paved the way for this shift to occur regionally.
|How Teaching from Joy is Igniting Revolutionary Outcomes: Changing Student Trajectories in Public Schools
|BETH NELSON (Bellingham School District)
|Abstract: Inspired by one teacher who said “I need your help. We need to do something different.” The search for “something different” led us to Practical Functional Assessment (PFA) and Skills-Based Treatment (SBT). Inspired by one, we are now on a path to shift the long-term outcomes for an increasing number of students with severe problem behavior. The shift to implementation of SBT is resulting in socially valid, measurable gains for an increasing number of students. Functional outcomes include decreases in contextually inappropriate behaviors and, as a result, decreases in the use of restraint and isolation to maintain safety as well as decreases in staff injuries and the need to teach in isolated settings for staff and student safety. Multiple case studies document increased engagement in instructional activities, increased participation in group settings, increased attendance, and increased time in general education. The session will include a review of the barriers to implementation and the activities and structures that resulted in successful implementation over a 2-year period. Case studies include several different applications of school-based implementation with successful outcomes, including partial and full-day implementation spanning grade levels and examples of differentiation based on environmental context and student performance.
Reduction of The Use of Holds, Restraints and Isolations Through Implementation of Skills Based Treatment
|SARA WHITE (Sendan Center), Aneesa Shaikh (Sendan Center)
Maintaining client and staff safety when working with clients who exhibit severe problem behavior has remained a paramount concern in the field of Applied Behavior Analysis. Literature has identified that the Practical Functional Assessment and Skills Based Treatment (PFA/SBT) approaches are effective in significantly reducing rates of problem behavior. This presentation sought to evaluate the relative frequency of aggression toward staff, restraint, and isolation before and after implementing Skills Based Treatment on an organizational level where clinically indicated. A review of company-wide Critical Incident Report data was conducted to determine the frequency of these incidents during the year prior to the organizational shift to SBT, as well as in the year following the shift to SBT. The presenters hypothesized that there would be a considerable decrease in the frequency of aggression, restraint, and isolation following the implementation of SBT with clients exhibiting severe problem behaviors. Preliminary data analysis supported this hypothesis.
What if Skills Based Treatment Isn't Exactly Working: Evolution of a Hybrid Applied Behavior Analysis Programming for a Client That Includes a Structured Schedule and Skills-Based Treatment
|HAILEY BABIN (Sendan Center)
This case study will examine a client who's services began approximately one year into the organization implementation of Skills Based Treatment. Given the severity of his behavioral profile and his lack compliance with virtually all adult directions his program initially consisted of full sessions of Skills Based Treatment. However, the client continued to have frequent episodes of extended non-compliance and tantrums. During a session in which the client was completing an assessment it was observed that his behavior appeared be decreased when he had increased periods of structure. As such, it was hypothesized that increasing periods of structure would contribute to the client's ability to remain happy, relaxed and engaged. A shift was then made in his programming to intersperse structured activities with periods of Skills Based Treatment trials. In doing so, not only did progress improve for the Skills Based Treatment branches that were implemented, but there was also a significant decrease in problematic behaviors.