Study guide · Area H

Selecting and Implementing Interventions

20 of the exam's 175 scored questions (11%) · 8 tasks

This area covers the decisions that turn assessment into an effective plan and keep it effective: writing measurable goals, choosing interventions, selecting replacement behaviors, planning for side effects and relapse, judging procedural integrity, deciding from data whether to change the plan, and working with other people. Questions describe a plan in progress and ask what to do next; the best answers check integrity before changing the plan, choose function-based and socially valid options, and make decisions from data.

A study feature written by ExamDragon, not part of the real exam. Each heading is one of the BACB's tasks for this content area (8 of them), in the BACB's words.

H.1Develop intervention goals in observable and measurable terms.

Intervention goals describe the target behavior in observable, measurable terms, using the operational definition.
A complete goal states the learner, the behavior, the conditions (when, where, with what materials or prompts) and the criterion (the level of performance and how long it must be maintained).
Criteria should be meaningful in the natural environment (such as how a typical peer performs), not arbitrary percentages, and include generalization and maintenance where relevant.
Goals are stated positively where possible (what the learner will do), with reduction goals paired with replacement behavior goals.
Goals are written so that progress can be measured with the chosen measurement system, and they are agreed with the client and stakeholders.

In practice: Instead of Sam will improve social skills, the behavior analyst writes: during recess, Sam will initiate play with a peer by asking to join or offering a toy, at least three times per 20-minute recess, for 5 consecutive school days, across two different peers.

Where questions turn: Goals that use labels (improve, understand, be appropriate) or lack conditions and criteria cannot be measured, however important they are.

Practise H.1

H.2Identify and recommend interventions based on assessment results, scientific evidence, client preferences, and contextual fit (e.g., expertise required for implementation, cultural variables, environmental resources).

Interventions are selected based on assessment results, especially the function of problem behavior and the learner's skills, so the procedure addresses why the behavior occurs.
Scientific evidence: choose procedures supported by peer-reviewed research for similar behaviors, people and settings, and weigh the quality of that evidence.
Client preferences: involve the client and stakeholders, consider their values and the acceptability of procedures (social validity), and respect the right to choose among effective options.
Contextual fit: consider the expertise needed to implement it, the people available and their training, cultural variables, environmental resources (time, materials, money) and the routines of the setting.
Choose the least restrictive effective procedure, with reinforcement-based procedures first, and plan for training implementers and measuring integrity.
Recommendations should be explained to stakeholders, with the reasons, and revised as data come in.

In practice: An FA shows a child's aggression at home is maintained by escape from homework. The behavior analyst recommends functional communication for breaks with demand fading, which has strong research support, fits the parents' preference for no punishment, and can be implemented by them after brief training.

Where questions turn: An effective intervention from the literature can still be the wrong choice if the family cannot implement it or it does not fit the function of the behavior.

Practise H.2

H.3Select socially valid alternative behavior to be established or increased when a target behavior is to be decreased.

When a behavior is to be decreased, an alternative behavior should be taught or strengthened that produces the same reinforcer (function-matched), so the person still meets their needs.
A good replacement behavior is socially valid (acceptable and useful in the person's community), efficient (less effort, faster and more reliable reinforcement than the problem behavior) and likely to be reinforced naturally.
Prefer behaviors already in the person's repertoire or easy to learn, so the alternative contacts reinforcement quickly.
Common examples: functional communication responses (requesting a break, attention or an item), tolerance responses (waiting, accepting no) and self-management or coping responses.
The alternative must be reinforced more than the problem behavior (often with extinction for the problem behavior), or the person will continue with the problem behavior.
The fair pair rule: for every behavior to be decreased, select a behavior to increase.

In practice: A teenager screams to escape crowded hallways. Rather than teach him to sit quietly in class (unrelated to the function), the team teaches him to show a pass card that lets him leave class two minutes early to walk alone, a socially acceptable way to avoid crowds.

Where questions turn: An alternative behavior that does not produce the same reinforcer as the problem behavior is unlikely to replace it, however appropriate it looks.

Practise H.3

H.4Plan for and attempt to mitigate possible unwanted effects when using reinforcement, extinction, and punishment procedures.

Reinforcement procedures: plan for satiation (vary reinforcers, use small amounts), dependence on contrived reinforcers (fade to natural ones), and for reinforcing problem behavior inadvertently (deliver reinforcers contingently).
Extinction: plan for the extinction burst, aggression and emotional responses, and spontaneous recovery; prepare caregivers, ensure safety, combine with reinforcement of alternatives and NCR, and avoid extinction when the burst could be dangerous and cannot be managed.
Punishment: plan for emotional and aggressive responses, avoidance and escape, conditioned aversiveness of the implementer or setting, overuse by implementers, and suppression only in the punishment context; always combine with reinforcement of alternatives.
General steps: inform stakeholders of possible effects, obtain consent, set data-based criteria to stop or modify the procedure, monitor side effects as well as the target behavior, and train implementers to respond consistently.
Protect the client's dignity and safety throughout; prepare a crisis plan when severe behavior may escalate.

In practice: Before starting extinction for a child's attention-maintained screaming in class, the behavior analyst warns the teacher that screaming will probably get worse before improving, plans attention every few minutes for working quietly, and arranges a safe space if the child becomes aggressive.

Where questions turn: Unwanted effects are not only a problem of punishment; extinction and even reinforcement procedures have side effects that should be planned for.

Practise H.4

H.5Plan for and attempt to mitigate possible relapse of the target behavior.

Relapse is the return of a reduced behavior after successful treatment; forms include resurgence (the problem behavior returns when an alternative behavior is extinguished or its reinforcement weakened), renewal (return when the context changes from treatment to another setting), reinstatement (return after noncontingent presentation of the old reinforcer) and spontaneous recovery.
Mitigation for resurgence: maintain reinforcement for the alternative behavior, thin schedules gradually, teach multiple alternatives, and use signals (multiple schedules) for when reinforcement is and is not available.
Mitigation for renewal: conduct treatment in multiple settings and with multiple people, including the natural settings where the behavior occurs, and include stimuli from those settings.
Teach caregivers to respond consistently and to avoid reinforcing the problem behavior when it reappears.
Plan follow-up and booster sessions, and monitor for early signs of relapse with periodic data.

In practice: After functional communication training reduces a child's aggression, the school is closed for a week and staff are unavailable to respond to requests. When aggression returns, the team re-establishes reinforcement for requests quickly and plans for substitute staff who can honor requests in future absences.

Where questions turn: Relapse is predictable when the reinforcement for the alternative is reduced or the context changes; plan for it before treatment ends rather than treating it as a new problem.

Practise H.5

H.6Make data-based decisions about procedural integrity.

Before concluding that an intervention does not work, check procedural integrity: an intervention that is not being implemented as planned has not been tested.
Use integrity data to decide: if integrity is low, the first step is to address implementation (retrain, simplify, clarify), not to change the intervention.
Identify the specific components with low integrity and the type of error (omission or commission), and look at causes: lack of skill, unclear instructions, too much effort, competing demands or lack of reinforcement for implementers.
Remedies include behavioral skills training, performance feedback, simplified protocols, prompts (checklists, visual cues), goal setting and reinforcement for implementers.
Set integrity criteria in advance (for example, the percentage of components correct across sessions) and continue to monitor after improvement.
If integrity is high and the intervention is still ineffective, then the intervention itself is reconsidered.

In practice: Data show that a student's problem behavior is not decreasing. Integrity checks reveal that the teacher delivers reinforcement for appropriate requests in only 40 percent of opportunities. The behavior analyst provides feedback and rehearsal, integrity rises above 90 percent, and problem behavior begins to decrease.

Where questions turn: Changing an intervention that has not been implemented with integrity confuses implementation problems with the intervention's effectiveness.

Practise H.6

H.7Make data-based decisions about the effectiveness of the intervention and the need for modification.

Decisions are based on graphed data reviewed often: level, trend and variability compared with baseline and with the goal.
Continue when data show progress toward the goal at an acceptable rate; modify when progress is absent, too slow, or the behavior is worsening; consider discontinuing or fading when goals are met and maintained.
Set decision rules in advance (such as a change after a set number of sessions with no improvement, or when the trend line does not reach the aim line).
Before modifying, check integrity, measurement accuracy, the reinforcers' value, motivating operations, and whether the learner has the prerequisite skills.
Modifications may include changing prompts, reinforcement, instructional procedures, the size of steps, or the intervention itself; change one variable at a time when possible so the effect of the change can be seen.
Share data and decisions with stakeholders, and document the reasons for each change.

In practice: After three weeks, a learner's correct responding to a new set of tacts remains at 30 percent with no trend. Integrity is high. The behavior analyst changes from least-to-most to most-to-least prompting with a delay, and correct responding increases within a week.

Where questions turn: Modifying a plan should follow data and predefined decision rules, not impressions, and only after integrity and measurement have been checked.

Practise H.7

H.8Collaborate with others to support and enhance client services.

Clients often receive services from several professionals (teachers, speech-language pathologists, occupational therapists, physicians, psychologists); collaboration improves consistency and outcomes.
Collaborate by sharing goals and data, learning the other professionals' perspectives and expertise, agreeing on shared targets and consistent procedures, and resolving conflicts with the client's interest first.
Obtain the client's or guardian's consent before sharing information, and communicate only what is needed.
Stay within one's scope of competence; refer to and consult other professionals for issues outside it, such as medical, speech or psychiatric concerns.
Respectful communication avoids jargon, acknowledges other approaches, and focuses on the client's outcomes; when an approach lacks evidence or may harm the client, the behavior analyst raises concerns respectfully with data.
Collaboration also includes caregivers as partners, involving them in decisions and training.

In practice: A child's speech-language pathologist uses a picture exchange system, while the behavior analyst plans to teach vocal mands. They meet with the parents, agree to use the picture system as the main communication mode while pairing it with vocal models, and share data each month.

Where questions turn: Collaboration means coordinating goals and procedures with others while staying within one's scope, not adopting every approach others use nor ignoring their expertise.

Practise H.8

Key terms

Behavioral objective: A goal stating the learner, behavior, conditions and criterion in measurable terms.
Contextual fit: The match between an intervention and the values, skills, resources and routines of the people and setting.
Social validity: The acceptability and importance of goals, procedures and outcomes to those affected.
Least restrictive effective procedure: The procedure that achieves the goal with the least intrusion on the client's freedom and dignity.
Replacement behavior: An alternative behavior that serves the same function as the problem behavior.
Fair pair rule: For every behavior to be decreased, a behavior to be increased is selected.
Resurgence: The return of a previously reinforced behavior when reinforcement for an alternative is reduced or stopped.
Renewal: The return of an extinguished behavior when the context changes.
Reinstatement: The return of an extinguished behavior after noncontingent delivery of the former reinforcer.
Decision rule: A predefined criterion for continuing, modifying or ending an intervention based on data.
Aim line: A line on a graph from current performance to the goal showing the expected rate of progress.

After this guide: Given a plan in progress, you should be able to write measurable goals, choose function-based and socially valid interventions and alternatives, anticipate side effects and relapse, and decide from integrity and outcome data whether to continue, modify or change it, working with others in the process.

Practise area H