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There has been a lot of talk about behavior analysis’s future. Some worry that we do not extend our reach far enough. Others worry that we have not done a good enough job refining our current practices. Some worry that we do not pursue enough interdisciplinary collaborations, while others worry inter-disciplinary collaborations will water down our science. These conversations (and many more like them), of course, are not new.

Now, I’m not saying anyone who has these (and other) worries is wrong for having them. Heck, that’s kind of the point of science: to constantly refine itself (which means it’s constantly in need of improvement). But I have a different type of worry to add to our growing list of concerns. For me, I worry that we’ve not done enough to celebrate what we have accomplished togeth-er. So instead of continuing to worry without any action, I want to eliminate my worry by creating a platform that helps us celebrate the thing we all love so very much. So here it is: Behavior Analysis Quarterly—A celebration of all things behavioral! Think of BAQ as a central place to document the won-derful things we’ve done, are doing, and will be doing together.

And in the spirit of celebration, I’d like the first bit of recognition to go to Joseph Wyatt. BAQ started out as Behavior Analysis Digest International, which in a prior life didn’t have the “International” attached to it. That di-gest was Dr. Wyatt’s creation. He kept it alive and in circulation for nearly 25 years. He took a gamble and handed the Digest over to me. After a year at the helm, the editorial board and I decided to take the publication to a larger platform and create a full-fledged magazine for the field. The format has changed, but we retain two things: 1) the Digest still exists in BAQ, and is now run by Julie Ackerlund Brandt, and 2) the spirit of celebration and recognition that Dr. Wyatt put into every issue is still here, and hopefully more accessible than ever.

We at BAQ are so thrilled to have you join us in this grand celebration we call “Behavior Analysis.”

FROM THE EDITOR’S DESK

Benjamin N. Witts, Ph.D., BCBAAssistant Professor - Behavior AnalysisDept of Community Psychology, Counseling, and Family TherapySt. Cloud State Universitybenjamin.witts@gmail.com

BAQ Staff

EDITOR-IN-CHIEF

Benjamin N. WittsSt. Cloud State University

COLUMNISTS

Todd A. WardUniversity of North Texas

Zach MorfordUniversity of Nevada, Reno

Daniel ReimerUniversity of Nevada, Reno

Chelsea WilhiteUniversity of Nevada, Reno

THE DIGEST EDITOR

Julie Ackerlund BrandtSt. Cloud State University

Mission

Behavior Analysis Quarterly has as its mission the

dissemination and celebration of all things behavior analysis.

Contact the editor at:benjamin.witts@gmail.com

Author Submissions Information: www.baquarterly.com

© 2015 Stimulus Press, LLC

BEHAVIORIST CROSSING

Behavior Analysis Goes to Medical School: The University of Nevada School of Medicine and the Behavior Analysis Program at University of Nevada, RenoDANIEL REIMER . . . . . . . . . . . . . . . . . . . . . . . . . 1

BEHAVIOR ANALYSIS AND WORLD EVENTS

Can a Science of Individual Behavior Prevent Terrorism?TODD WARD . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

LIVE IT!

Social InteractionsCHELSEA WILHITE . . . . . . . . . . . . . . . . . . . . . . . 6

FROM THE LAB

Blocking, Overshadowing, and the Difficulties in Teaching Impaired Learners to ReadBENJAMIN N. WITTS. . . . . . . . . . . . . . . . . . . . . . 7

OUR VERBAL BEHAVIOR

Why We Don’t Reinforce People!BENJAMIN N. WITTS. . . . . . . . . . . . . . . . . . . . .10

RECOGNITION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .12

COLUMNS

Give Choice a ChanceROCIO B. CUEVAS. . . . . . . . . . . . . . . . . . . . . . .24

The Overjustification Effect: Fact or Fiction?JEREMY W. DASHIELL. . . . . . . . . . . . . . . . . . . .24

Children with Disabilities Learn From Their PeersMORGAN DELUNA. . . . . . . . . . . . . . . . . . . . . . .25

Promising Tool Emerges Within Human Services FieldDAVID HUGHES. . . . . . . . . . . . . . . . . . . . . . . . .26

The Big Bang Theory Gets It RightMARTIN IVANCIC. . . . . . . . . . . . . . . . . . . . . . . .26

A Brighter Future for Clinical Behavior AnalystsTYLER LOY.. . . . . . . . . . . . . . . . . . . . . . . . . . . .27

Football and Domestic ViolenceQUINN MURRAY. . . . . . . . . . . . . . . . . . . . . . . . .28

Communication...I Want It And I Want It Now!MOLLY ANN REED. . . . . . . . . . . . . . . . . . . . . . .28

A Brief Review of Behavioral Interventions for Selective MutismMEGAN A. RHETT.. . . . . . . . . . . . . . . . . . . . . . .29

DIGEST

13Picky Eating: Treatment Options from Behavior Analysts and Speech PathologistsALEXIS C. WALDINJOY A. MCKENZIEBENJAMIN N. WITTS

17Behavioral Science Needed in Ebola OutbreakLAURA ADLINGTON

20Fear and Loathing of ABARANDALL BACHMAN

FEATURES

THINKSTOCK / BUMBASOR

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In 2009, the University of Nevada School of Medicine (UNSOM) had a site visit from the Liaison Committee for Medical Education (LCME), the accrediting entity for all medical school in the US, Cana-da and the Caribbean. The LCME strongly encouraged a curricular shift from traditional, subject-based courses (e.g. microbiology, anato-my) to a more integrated “block-based” curriculum focused on organ systems (e.g. circulatory, respirato-ry). This request represented an enormous change in both educational strategy as well as administration and infrastructure of the medical school.

“A huge shift was needed to accomplish the change,” says Gwen Shonkwiler, PhD, the interim Associate Dean of Medical Education at the time of the transition. “Med-ical schools are incredibly complex organizations, with all kinds of pressures that need to be considered.” One of the primary concerns was the effect a curriculum change would have on student performance.

A group of faculty, staff and admin-istrators created the Curriculum Evaluation Group (CEG). CEG’s main task was to develop a strategy to measure student performance before, during and after the curric-ular change. However, during their

first meeting it was decided that they needed another set of eyes on the problem.

Ramona Houmanfar, Ph.D., associ-ate professor in the UNR behavior analysis program was sought out by the group to act as an external member to the group, both in a consultant role for change manage-ment, as well as to provide expertise in evaluation and assessment. Hav-ing Dr. Houmanfar as an external

member also offered CEG an easy way to conduct research ethically, as the staff and administrators would have a conflict of interest when doing research on student perfor-mance.

Amber Candido, MA, a graduate student in the behavior analysis department currently working with CEG says, “Teaming up with

the faculty and administrators at UNSOM has been a rewarding and fulfilling experience. We have worked closely with them to devel-op a number of evaluation strategies for students. One of the difficulties that can come up in medical school evaluation is the operationalization of what students are being evaluat-ed on. How do you measure ‘profes-sionalism’ or being a ‘good listener?’ Behavior analysis can help create definitions for these things that are

observable and objective.”

The partnership was so successful that the role of the CEG was expanded to include the assessment and evaluation of other aspects of the change, such as the impact of the new curricu-lum on faculty. Faculty were an important group to study as they were the people implementing the change. Primarily, the CEG wanted to quantify the concerns fac-ulty had about the change. Interviews were conducted,

and faculty verbal behavior was coded to determine areas faculty identify as potentially problematic when rolling out the change. Re-sults of the interviews were present-ed to upper level administrators, with ideas about how to address these concerns. For example, one concern was financial compensation for block directors, which corre-sponded with the suggestion that

Behavior Analysis Goes to Medical School: The University of Nevada School of Medicine and the Behavior Analysis Program at University of Nevada, Reno

Daniel Reimer / University of Nevada, RenoBEHAVIORIST CROSSING

Behavioral Crossing: The field of behavior analysis is varied and diverse. The science can be useful to practically any profession, allowing us to work or contribute in many different settings. However, many of us are not aware of the unique and uncommon professional opportunities available to behavior analysts. This column strives to highlight the diverse areas in which behavior analyst’s work and to inspire all behavior analysts to pursue opportunities in areas not traditionally part of our repertoires.

The Mack Social Science building - home to UNR’s Behavior Analysis program

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their funds be contingent on block leadership.

There have also been opportunities for outreach and education. In or-der to better understand the system in which faculty and administrators were working, CEG requested a workshop on Behavioral Systems Analysis (BSA). Content included chapters from Dr. Maria Malott’s book Paradox of Organizational Change, as well as select publica-tions on BSA and the metacon-tingency. The two part workshop allowed the members of the CEG to ask questions and apply the new-ly learned concepts to the curricular change.

The administration of UNSOM has acknowledged the value of CEG, and the contribution of behavior analysis. Recently, the Dean, Executive Associate Dean of Academic Affairs, Associate Dean of Medical Education, and the Director of Evaluation and Assess-ment all attended the Summit on Leadership and Cultural Change, as well as ABAI 2014. They have given multiple presentations and are currently in the process of publish-ing a paper summarizing their work to-date in the Journal of Organiza-tional Behavior Management.

Additionally, the partnership has allowed for the creation of other

projects. “One exciting side project I have been working on is a com-pilation of leadership and leader-ship development literature,” says Candido. “The Dean [of UNSOM] created the Leadership Taskforce to develop a universal definition of the term “leadership,” and to create a

questionnaire pertaining to ob-servable leadership behaviors. The questionnaire will be used to help evaluation the leadership practic-es of UNSOM’s Dean, Associate Deans and Department Chairs.” The self-report measure can provide useful feedback to UNSOM leaders and will hopefully shape suitable leadership behavior in the future.

ConclusionMedical education is a large and influential field that is ripe for col-laboration with behavior analysts. Medical educators are in important positions, with great connections to other high-profile, prominent areas of medicine. Creating solid and long-lasting relationships, based off of collaboration and mutual explo-ration of modern problems facing medical science today, can be highly

beneficial for both fields.

The need for medical education to stay competitive in order to attract the top medical students can be used to a behavior analyst’s advan-tage. It makes medical education much more open to innovation and

increases the need for functional, useful technology which behavior analysts should be more than happy to provide. This is in contrast to some other areas of science which are more resistant to change. By building professional relationships in medical education, other areas of science can observe the benefits of cooperating with the field of behavior analysis, making medical education an ideal location to start improving the widespread adoption of a workable conception of human behavior. n

Authors Note: The author would like to thank Dr. Gwen Shonkwiler, Amber Candido and all the members of the CEG, past and present.

BEHAVIORIST CROSSING

How do you measure ‘professionalism’ or being a ‘good listener?’

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Terrorism defines the world stage of the 21st century. However, be-havior analysts, tasked with “saving the world” with their science, are virtually non-existent in this, and many other critical social issues (Mattaini & Luke, 2014). In the pages below, a brief overview of modern terrorism will be provided, followed by Biglan’s (2015) call for more research evaluating terrorism prevention efforts. It will be sug-gested that behavior analysts have a preliminary framework within which to contribute to the ame-lioration of terrorism. However, in order to make substantive contri-butions to the area, behavior analysts need to rethink the identity of their field from one of procedures to a “form-less” field of principles.

In the U.S. and allied nations, countless lives, dollars, and other resources have been de-voted to countering terrorism practices since 9/11. Yet, the Global Terrorism Database tells us that the annual rate of terrorist attacks has grown from approximately 2,000 in 2001 to 12,000 in 2013. In the years since 2013, the U.S. signifi-cantly drew down their presence in Iraq and the Islamic State of Iraq and Syria (ISIS) now controls vast swaths of territory in the region.

The processes involved in the in-crease aren’t certain, but at least two possibilities exist. The first, which I will tentatively call the “two-pro-cess” theory of terrorism, is that the

increase in terrorism is relatively in-dependent of the actions of govern-ments who are fighting against it. According to this view, the increase in terrorism was going to happen regardless of the policies of Western nations who are now engaged in extensive counterterrorism efforts. Another possibility is what I will call the “one-process” theory of terrorism. Another name for this is “blowback.” Blowback implies that the increase in terrorism is a direct reaction to the policies of govern-ments who are now fighting against it. Such actions include current counterterrorism efforts but also

historical alliances that had unin-tended consequences, such as the Mujahideen acquiring weapons and combat experience through U.S. efforts to fund Afghan fighters after the Soviet invasion of Afghanistan in the 1980s (Bergen & Reynolds, 2005).

As behavior analysts, historical influences on behavior are central to our analysis. However, from a

functional contextualist perspec-tive, bogging down in historical analyses of terrorism doesn’t really matter. Remember our analytic goals: the prediction and influence of behavior. An in-depth historical analysis of terrorism is analogous to a behavior analyst exploring the detailed histories of a client’s relationship with their parents as a psychoanalyst would do. Our anal-ysis of history emphasizes creating new histories as a function of our interventions aimed at predicting and influencing behavior, in this case predicting and influencing the reduction of terrorism. The be-

fore-cited data shows just the opposite is occurring. Thus, it is clear that more can be done.

Anthony Biglan (2015), a leader in large-scale appli-cations of behavior analysis to social issues, recently advocated for the use of Randomized Controlled Trials (RCTs) to evaluate counterterrorism efforts, primarily via prevention programs. He cites only

two existing studies in this area. In the first, hundreds of Afghan villages were randomly chosen to participate in an aid program. Those villages were later shown to have a decrease in security incidents, compared to villages that did not receive aid. The second study suc-cessfully demonstrated the effects of an information campaign to reduce pre-election violence in randomly selected Nigerian villages compared

Can a Science of Individual Behavior Prevent Terrorism?

Todd Ward / University of North TexasBEHAVIOR ANALYSIS AND WORLD EVENTS

Skinner’s vision for Radical Behaviorism had cultural analysis at its core. Today, behavior analysts working on cultural issues are few and far between. Behavior Analysis and World Events returns behavior analysts to their roots by addressing current events of the 21st century from a behavior analytic perspective.

ELL-R-BROWN / FLICKR

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to control villages.

To any behavior analyst reading this, they are immediately confront-ed with a problem—the RCTs don’t “look like” behavior analysis. No preference assess-ments, functional analyses, or rein-forcers are anywhere to be seen. Yet the majority of applied behavior analytic research today has one or more of the latter elements. Moreover, the RCTs target large groups rather than the behavior of individuals. In other words, no within-subjects data is to be found anywhere in these studies. Because all of our principles are centered on the behavior of individuals, a member of the social sciences might justifiably ask “how is behavior analysis relevant to social issues?”

The answer to that question strikes at the core of behavior analysis’ identity as the field progresses through, what many would say, an identity crisis brought on by the huge successes in developmental disabilities and autism. How-ever, if we keep ourselves firmly rooted in our pragmat-ic philosophy depicted in modern form through functional contextu-alism (Hayes, Barnes-Holmes, and Wilson, 2012), our path forward will be clear. Our analytic goals are the prediction and influence of behavior. Thus, the practice of behavior analysis is really a “form-less” practice in that our goals are not defined in terms of procedures.

Our procedures are only “true” to the extent that they contribute to our goals. Thus, any procedure that facilitates such goals can become a behavioral technique.

We are identified not so much by what we do, in terms of our actions, but in what we achieve in terms of the effects of our behavior on the behavior of those we serve. That doesn’t mean behavior analysis is a disorganized “bag of tricks.” Rather, the core of our identity is in our

principles of behavior change and in our subject matter. If the latter two are not precisely articulated then we lose our identity as a field and we lose our way in breaking new ground for the field.

Skinner (1981) gave us an initial conceptual framework for the analysis of cultural practices, to

which any procedure that enables the prediction and influence of behavior may be applied. He stated that cultural selection differs from operant selection in that the latter operates at the group level rather

than that of individ-ual behavior. Skin-ner was never very clear on what he meant by this, but revisiting his earlier

work, he tells us that practices are influenced primarily by controlling agencies, such as governmental in-stitutions or other regulating bodies (Skinner, 1953). Regulating bodies aren’t interested in the behavior of individuals. They are interested in what Biglan (1995) calls incidence

(the rate of a practice in a given population) and prevalence (the number of people engaged in a prac-tice in a given population). Take texting and driving as an example. A government doesn’t care who texts and drives, but they do care about the rate of the prac-tice (incidence) and how many people engage in the practice (prevalence).

Skinner (1953) was never so explicit as to say his analysis

of culture was an interdisciplinary concept, but he did acknowledge the potential benefits of collabo-rating with other social sciences. Incidence and prevalence measures mask the behavior of particular individuals. In fact, examining the behavior of particular individuals regarding social issues like terrorism would be counter-productive as the

BEHAVIOR ANALYSIS AND WORLD EVENTS

SOLDIERSMEDIACENTER / FLICKR

“RCTs don’t ‘look like’ behavior analysis”

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Bergen, P., & Reynolds, A. (2005). Blowback revisited. Foreign Affairs, December 2005. Retrieved on March 15, 2015 from http://www.foreignaffairs.com/arti-cles/61190/peter-bergen-and-alec-reynolds/blowback-revisited

Biglan, Anthony (1995). Changing cultural practices: A contextualist framework for intervention research. Reno, NV: Context Press.

Biglan, Anthony (2015). Where terrorism research goes wrong. The New York Times, March 6, 2015. Retrieved on March 15, 2015 from http://www.nytimes.com/2015/03/08/opinion/sunday/where-terrorism-research-went-wrong.html?smid=fb-share&_r=3

Hayes, S.C., Barnes-Holmes, D., Wilson, K.G. (2012). Contextual Behavioral Science: Creating a science more adequate to the challenge of the human condition. Journal of Contextual Behavioral Science, 1, 1-16.

Houmanfar, R., Rodrigues, N. J., & Ward, T.A. (2010). Emergence & metacontingency: Points of contact and departure. Behavior and Social Issues, 20, 122-146.

Mattaini, M.A. & Luke, M. (2014). Editorial: “Saving the world” with a matrix. Behavior and Social Issues, 23, 1-4.

Skinner, B.F. (1953). Science and human behavior. New York: Free Press.

Skinner, B.F. (1981). Selection by consequences. Science, 213, 501-504.

Ward, T.A. (2009). Piracy in Somalia: Interbehavioral assessment and intervention. Behavior and Social issues, 18, 136-154.

BEHAVIOR ANALYSIS AND WORLD EVENTS

behavior of particular individuals isn’t the problem so much as the practice as a whole. Certainly the behavior of individuals participates in practices, but an analysis of the incidence and prevalence of practic-es in relation to larger societal-level condi-tions is often times more useful.

As I stated in a pre-vious paper, the anal-ysis of societal-level relations allows us to do something that is a neces-sary prerequisite to predicting and influencing behavior—predicting an influencing the very contextual conditions that occasion behavior at the individual level, such as gov-ernmental policies and the influx of weapons into a country which then occasion the behavior of individual

terrorists (Ward, 2009). Reciprocal-ly, however, the analysis of individ-ual behavior can be beneficial if the analysis focuses on the behavior of influential leaders in a terror group and its effects on the group’s

operations (Houmanfar, Rodrigues, & Ward, 2010; Ward, 2009). In Skinner’s (1953; 1981) framework, a terror network may be thought of as a controlling agency which affects the incidence and prevalence of terror attacks to the extent that its leaders issue policies regulating such attacks.

In closing, many people are already working on terrorism and security issues and nearly all of them have never heard of behavior analysis. This is evidenced from a paper I presented at the International Stud-

ies Association con-ference on maritime piracy (see Ward, 2009). I was part of a group of 30 other researchers tackling the problem, yet the Association for Behavior Analysis

conference had zero people working on this or related issues. Stepping into these types of areas demands that we know who we are as behav-ior analysts, and I don’t think we do. n

“...if we keep ourselves firmly rooted in our pragmatic philosophy...our path

forward will be clear.”

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I am one of those behavior ana-lysts who drags my non-behavior analysis spouse to most of my work’s social functions (e.g., holi-day parties, the ABAI social, and the traditional graduation roasts). Though my husband is not a behav-ior analyst, he, fortunately for me, has always been quick to grasp the concepts and principles on which our field is founded. During the drive (or walk) home from social events with behavior analysts, we inevitably fall into discussion about how our conversations with peo-ple went throughout the evening. And while our interactions at these gatherings are overwhelmingly positive, those post-event talks got me thinking about how behavior analysts incorporate behavior ana-lytic techniques and principles into more difficult social settings. So, I talked with Dr. Scott Herbst about how he approaches social situations, specifically tense ones, from the perspective of a behavior analyst.

“If you approach what people say behavior analytically,” Herbst said, “there’s no good or bad in what they said, there’s just what they said.” I could reinterpret this as something along the lines of “it is difficult to remove one’s own emotion from a charged situation, but you can

acknowledge your own emotions without them ‘dictating’ your overt behavior.” Now, I know behavior analysts tend to shy away from the “E” word because covert behavior is difficult to study objectively. But in our everyday interactions, all that covert behavior we wrap up and label “emotion” exists. We might as well deal with it.

Herbst went on to explain that if you extend the concept, what anyone says is just a result of the contingencies under which s/he is operating. Of course, any behav-ior analyst, when asked the same question, would answer in a similar way, but many of us have trouble actually approaching our own social situations in this fashion. One reason I chose to discuss this topic with Herbst is I have observed him actually put this approach to work in very successful ways. And in full disclosure, Herbst was the offici-ant at my wedding and someone I consider a good friend.

“If you can set aside that what they said is personal to you – or means something good or bad about you – then you can get interested in what else is controlling their response.” If there is some level of excitement or upset in the interaction, one vari-

able to consider is emotion. “There’s probably some extinction or pun-ishment going on,” Herbst contin-ued. “If so, what was the reinforcer?” Often times in social interactions, the punisher or missing reinforcer is some sort of verbal stimulus. Herbst says if you can identify what they said, tact the emotion, guess the reinforcer, and acknowledge those three things, generally what hap-pens is the person is left with the feeling of being heard and, Herbst said, that is “probably the reinforcer for talking.”

What happens in the post-rein-forcement pause following the “being heard” feeling is the op-portunity for new verbal behavior. Sometimes, Herbst said, it is more verbal behavior regarding the initial topic or problem, but eventually something new can emerge. And this new verbal behavior provides opportunity for a more productive interaction.

By engaging in this behavior analytic approach to high-ten-sion social situations, Herbst is: 1) assessing the variables at play, 2) implementing a simple inter-vention, and 3) allowing for new behavior to be reinforced. In short, he is living it.

Social Interactions

Chelsea Wilhite / University of Nevada, RenoLIVE IT!

Behavior analysis’ leaders advocate using our science in solving the world’s problems. While we celebrate successes in some areas, limited mainstream acceptance is seen as failure to achieve the sweeping goals set by our pioneers. One definition of “success” could include engaging in behavior-analytically-informed behaviors as a consistent practice. I set out to find examples of behavior analysts engaging in behavior analytic practices outside of their occupations.

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I’m a new father to two wonder-ful children. As of this writing, they’ve just turned 4 months old. My twins, Lincoln and Lucy, prove to be a wonderful distraction from work (of which my wife says I do too much… but I digress). We sing songs, play peek-a-boo, bounce on daddy’s knee, and yes, we read a LOT of books. Well, I should clarify that we read a lot, though sometimes the books don’t rotate as frequently as I’d like. Each child clearly has a favorite book. Lincoln loves a black-and-white book with some simple statements about each picture, while Lucy enjoys being read a very repetitive book about saying hello to a bee who has ana-tomically impossible eyes.

It was somewhere around the 16th or 17th time of reading these books in the same day that I began to wonder about writing children’s books. My thought is children’s books are either simple to write, or they are deceptively simple (I’m guessing the latter). Cute pic-tures, word repetition, and a general poetic tempo to reading seem to re-main consistent across most of the books for infants that I read. In the more stripped-down books, a single picture is accompanied by one to three short words. For example, you might see on one page a blue dog and on the other page a green dog. The words “Blue dog” and “Green dog” are printed and correspond

with the appropriate picture. I suspect my kids have spent little to no time fixed on the words, opting instead to allocate their time to looking at the pictures.

But this makes me wonder: in terms of teaching reading skills, is there any benefit to putting words with the pictures when kids will likely attend to the pictures first? For most kids, I don’t think there’s too much of an issue, as reading tends to take hold relatively easy with some persistence. Review-

ing the behavioral literature on impaired learners, however, gives us a much different story for this particular population.

Picture Interference of ReadingAn early lesson in reading might start with learning sight words. Sight words are those words that are memorized without any neces-sary understanding of the rules of reading. For example, a child might

learn to say dog in the presence of the written stimulus “Dog.” Given the written stimulus “D,” the child would struggle to produce its sound, even though he or she is capable of saying dog to a stimulus that con-tains the “D.” So in learning sight words, the word is learned, but not necessarily its component parts.

I have to emphasize again that for typical learners, pairing pictures and sight words might not be an issue. The repetitive nature of children’s books, along with repeated readings,

is likely to help the child anticipate what word comes next. The continued pairing of words and the child say-ing the word, perhaps before the parent does, is likely to result in the word having some degree of stimulus control. The test is simple enough: present the word independent of the book at a later time and see if the child responds correctly.

A series of investigations were conducted on the influence pictures-as-prompts have on hin-dering impaired learner’s acquisi-tion of sight words. The most recent effort is an investigation aimed at decoding just what this influence is (Dittlinger & Lerman, 2011). I’ll unpack this study in a moment, but first a quick lesson on how pic-ture prompts might lead to slower learning.There are at least two identified

Blocking, Overshadowing, and the Difficulties in Teaching Impaired Learners to Read

Benjamin N. Witts / St. Cloud State UniversityFROM THE LAB Oftentimes the basic and applied domains seem as though a large

chasm separates the two. But each has something to inform the other. In From the Lab, we take work done in the basic domain and show how it applies to treatment, conceptualization, and everyday life.

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means by which antecedent stimuli can influence how impaired learners acquire sight words. Both come to us from the respondent literature (think: Pavlov). The first is blocking and the second is overshadowing.

BlockingBlocking is perhaps best explained with an example. I dislike most mints; peppermint especially. It’s odd, I know, and the winter hol-idays are nearly unbearable with peppermint everything sold at stores. You see, eating mint-flavored food tends to give me a stomach-ache. As you can guess, the smell of peppermint alone is enough to make me grimace. To get technical, the smell of peppermint was once neutral (an NS in respondent terms), but through being correlated with eventual stomachaches (uncondi-tioned response; UR) after ingesting foods containing the mint (unconditioned stimulus; US), it became a conditioned stimulus (CS) that elicits feelings of disgust (conditioned response; CR).

Now, let’s say it’s the winter holiday season and I’m at a faculty gathering where my department chair has prepared a series of desserts, all containing some form of pepper-mint. If I find myself in a situation where I must eat something as a sign of appreciation (or at least to avoid offending her), I would likely try to find some dessert that might compete with the peppermint. So I would reach for anything with really dark chocolate. I love dark chocolate; the bitter smell is so aro-matic. Therefore I grab a dark choc-

olate dessert, attempting to savor the bitter chocolate smell over the powerful whiffs of peppermint. I eat the dessert, and low and behold, 5 minutes later my stomach is killing me. So much for dessert.

But what about the dark chocolate smell? I LOVE dark chocolate, but wouldn’t we predict that the smell of dark chocolate paired with the smell of peppermint would lead me to find dark chocolate disgusting? In this case, the answer is, “no.” Be-cause the CS effect on peppermint was well established before being paired with dark chocolate, the peppermint smell blocks the ability of the dark chocolate smell to elicit similar conditioned responses in the

future. Thank goodness, too, because I wouldn’t know what I’d do if I couldn’t have the occasional hunk of dark chocolate with a strong port.

OvershadowingLet’s stick with holiday desserts to help shed light on overshadowing. This time I find myself at a family holiday party and I see my Aunt Mary’s bourbon balls. Oh man, those things are good! So I grab

one and take a big bite. But just before my teeth rip off a piece, the distinct smell of coconut and hazelnut hit my nose and I realize that she’s tried some other recipe. Much like with peppermint des-serts, I find my stomach in knots after a few minutes. Now, I don’t eat much coconut or hazelnut, and so these are distinct smells for me. What remains to be seen here is whether coconut, hazelnut, or both smells will come to elicit feelings of disgust on future occurrences. If one odor is particularly strong, it might overshadow the other. For exam-ple, if the coconut were especially strong, on some future occurrence coconut, but not hazelnut, would bring about some feelings of dis-

gust.

So what does this have to do with Reading Sight Words?Dittlinger and Lerman (2011) extended past research on the potential blocking effect that pictures might have on acquir-ing sight words. In their study, three young children receiving behavior-analyt-ic services were asked to learn 16 unfamiliar sight words. These 16 words were taught across one of four

conditions (4 words per condition): 1) the unfamiliar word presented without its corresponding unfamil-iar picture (i.e., the child did not know what the picture was), 2) the unfamiliar word presented without its corresponding familiar picture, 3) the unfamiliar word presented along with its unfamiliar picture, and 4) the unfamiliar word present-ed along with its familiar picture. Teaching consisted of asking the

FROM THE LAB

AMYLOVESYAH / FLICKR

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child to touch the correct card (containing the word or word+pic-ture) out of an array of 6 cards (target + 5 distractor cards). Each session included each target word being presented 5 times. There are additional details concerning each ses-sion and the exper-imental design, but I’ll try to stay focused on the take-home point here.

Dittlinger and Ler-man’s (2011) findings reveal some interesting patterns about teaching sight words with and without pic-tures. When pictures were includ-ed alongside the sight word, the picture interfered with sight word acquisition. This effect was seen regardless of the child’s familiarity

with the picture. Thus, a case for overshadowing was had.

Additionally, when words were presented alone, those words that did not correspond to a familiar

picture were acquired more quickly than their familiar-picture coun-terpart. In other words, if the child knew the picture but not the word, the sight word was more difficult to learn. This latter effect is evidence for blocking.

Of course, this doesn’t mean that pictures and words should not be presented together, or that count-less children’s books could never be used for young children with learning impairments. Indeed the

goal would be for any child to learn to read even with pictures, familiar or not, present. Instead, we might need dif-ferent instructional techniques, such as better emphasis

on the written words or additional prompts. There is much to be done in this area, for sure, but we have a better understanding today than we ever have, and it’s all thanks to a firm grasp on our basic research. n

Dittlinger, L. H., & Lerman, D. C. (2011). Further analysis of picture interference when teaching word recognition to children with autism. Journal of Applied Behavior Analysis, 44, 341-349.

FROM THE LAB

“We have a better understanding today...and it’s all thanks to a firm

grasp on our basic research.”

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“If she does a good job, be sure to reinforce her for it. We want to see that again.”

“I was going to reinforce him, but the trial was a bit sloppy. Maybe I should have, it would have prevent-ed the meltdown.”

These two quotes come from real conversations I had in the weeks preceding my writing of this col-umn. Both quotes come from BC-BAs. One even had a “D” attached to the end of that title. By the end of this article, you’ll know why both individuals were wrong for saying what they did.

Definitions of rein-forcement are not hard to find in the behavioral literature. The general defini-tional theme is some event follows some behavior and because of that rela-tion the behavior followed will be more likely to be produced in the future. Simply put, reinforcement makes behavior more likely.

To be sure, reinforcement doesn’t need labels like “good” or “bad.” Us-ing these terms might be fine when talking to a parent, teacher, or other community members, but they stand to muddy our science. Con-sider the drug user who must pro-duce many responses in getting and using the drug of choice (getting money, locating a drug dealer, buy-ing the drug, preparing parapher-nalia, etc.). The drug itself and the

escape or avoidance of withdrawal symptoms maintain all the respons-es that led to its use. In other words, the drug and its effects are types of reinforcement, and continued responding might be unhealthy or even deadly. In this light, we might be mistaken in saying that “rein-forcement is good.” On the flip side, the dealer’s behavior is maintained by reinforcement as well, and we might not be so quick to label this as “good” either. Of course, opinions on drug use and access differ, but the point is that “good” and “bad” are culturally-bound; what’s good or bad changes between cultures and within cultures over time.

When we speak of reinforcement, what we are concerned with is the initial change in frequency and whether that change main-tains. Of course, we can add other variables to the mix. Antecedent stimuli present before the behavior now take on new roles in evoking behavior, and current states of affair influence whether those anteced-ents even evoke behavior at all (we call these SDs and motivating operations, respectively).

But let’s get back to the central issue: to reinforce.

There are two major issues I see

with saying that you’ve reinforced someone. For example, if a col-league does a nice job with running session or you see a parent properly conducting an extinction procedure in a candy aisle, we might be quick to say, “Be sure and reinforce him/her for the good work!” much like my quoted colleagues did above.

Can you spot the issues?

First, when we say to reinforce someone we often mean to give him or her things that are liked. But giving “good” things for “good” behavior doesn’t mean it’s reinforce-ment. As we have seen, for some

people, “bad” things reinforce “bad” behavior (depend-ing on your point of view, that is). Often, we are not as concerned with the effect on behavior as

we are with pointing out a job well done. Reinforcement is an historical account, meaning we can only call it reinforcement after we see a change in responding.

Second, and perhaps more serious, the definition states that reinforce-ment increases the frequency of behavior that precedes it. Some speak of this as strengthening, mak-ing more probable, and so forth. The point is, you expect to see it more often. Let’s take an example with a definitional interpretation to illustrate the issue:

“Reinforce correct responding with

Why We Don’t Reinforce People!

Benjamin N. Witts / St. Cloud State UniversityOUR VERBAL BEHAVIOR Sometimes learning a scientific language can be just as difficult, if not

more so, than learning a foreign language. Our Verbal Behavior explores some of the intricacies of our scientific language with an emphasis on developing correct stimulus control over each term covered.

“...for some people, ‘bad’ things reinforce ‘bad’ behavior.”

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access to preferred activities”

Translation: Making access to preferred activities contingent on correct responding will increases the likelihood of correct responding in the future.

Now, let’s substitute behavior for a person:

“Reinforce him with access to preferred activities if he makes a correct response”

Translation: Making access to preferred activities contingent on correct responding will increase the likelihood of the client in the future.

WHAT??!!! Increase the likeli-hood of the client in the future? Yes. That’s what happens when you reinforce people. To be certain, the probability of you “occurring” is 100%. I cannot change that. No one can. You existed yesterday, you exist today, and if I’m playing the odds,

you’ll exist tomorrow.

Reinforcing people only works if either a) we can make more of you in the process, or b) you tend to pop in and out of existence. As neither of these is the case, I’ll stick to reinforcing behavior, which is the way it should be! Now the next time you hear a colleague talk about reinforcing someone, you can let them have it (the definition, that is). n

Benjamin N. Witts / St. Cloud State UniversityOUR VERBAL BEHAVIOR

High-Quality, Comprehensive, and Flexible!

• No. 1 ranked Board Certified Behavior Analyst passrates of any online ABA master’s program

• Ph.D.-level instructors in all courses• Conceptual and practical coursework• International collaboration• Publish, present and pursue your professional goals

all with close faculty support

For more information email: ccsaba@stcloudstate.edu http://scsu.mn/aba-grad

Applied Behavior Analysis

Aim High!

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From: Chelsea J. WilhiteRecognizing: Scott Herbst, PhD, Assist. Professor, The Chicago School

Thank you for your recent article on bSci21.org. Taking Responsibility for What We Don’t Know as Behavior Analysts is a reminder of why we must refrain from making claims or predictions not supported by empir-ical data. You also provide encouragement to continue pursuing investigations in areas traditionally beyond the scope of behavior analysis.

From: Chelsea J. WilhiteRecognizing: Behavior Analysts working on Nevada’s School Climate Transformation Project

Thank you for using the science of behavior to improve school environments for thousands of children and in the process helping disseminate our science to experts in other fields of science and education. The more people who see the results behavior analysis can bring about, the more impact we can have on our world.

From: Chelsea J. WilhiteRecognizing: Anthony Biglan, PhD, Oregon Research In-stitute Senior Scientist, Promise Neighborhood Research Consortium Co-Director

Thank you for your tireless push toward a better world. With the recent publication of The Nurture Effect, you demonstrated your dedication to improving human-kind. Furthermore, by targeting a lay-audience, you are making decades of research more accessible to the everyday person.

From: Benjamin N. WittsRecognizing: Joseph Cautilli

Thanks for taking 2 hours out of your day to talk to and inspire some unknown schmuck (i.e., me)

From: Benjamin N. Witts Recognizing: Kimberly A. Schulze Professor St. Cloud State University

Thank you for modeling dedication to students, staff, colleagues, and the program. And for not getting mad when I don’t know what the hell I’m doing…

From: Benjamin N. WittsRecognizing: Jerry Mertens, Professor St. Cloud StateUniversity

For inviting me into your work and your home. You’ve shaped this field, and you continue to help shape my behavior. If I achieve 1/10thof what you have and in-spire 1/100th as many as you have, I will have accom-plished more in this life than I ever imagined.

From: Julie Ackerlund BrandtRecognizing: Sarah Jenkins

Congratulations to Sarah Jenkins, a doctoral student from the University of Kansas. She is finishing up her dissertation and will be graduating this year! I’m so excited for you, Sarah, you have a wonderful and bright future ahead of you!

RECOGNITION

Submission Instructions:

• Limit your SR+ to 450 characters or less (including spaces) • Include your full name, the full name or title of the person, program, business, etc., you are SR+ing • Provide specifics what your SR+ is for, descriptive feedback is the most effective• Email Daniel Reimer to submit your SR+ at di.reimer@yahoo.com

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It’s common for children to have favorite foods. When a child’s fa-

vorite food is eaten to the exclusion of other foods, he or she might have a problem. This selective eating, or “picky eating,” affects approximately 50% of toddlers and infants (Car-ruth, Ziegler, Gordon, & Barr, 2004). Picky eating can involve an aversion to texture, temperature, flavor, color, or any food presentation (Twachtman-Reilly, Amaral, & Zebrowski, 2008). Picky eating is a serious concern as a picky eater’s diet might be nutritionally unbalanced, leading to health-related (e.g., malnutrition, failure to thrive) and developmental concerns (Bachmeyer, 2009).

We may not always know what led to a child’s picky eat-ing, but we have an arsenal of cross-disciplinary tools at our disposal. However, before jumping in to treatment, professionals must con-sult with a pediatrician to rule other possible medical issues (e.g., reflux, metabolic disorder, allergies) (Amer-ican Speech-Language-Hearing As-sociation [ASHA], 2014; Professional and Ethical Compliance Code for Behavior Analysts, 2014). Once you’re in the clear, it’s time to get to work!

Behavior analysts (BAs) and speech

and language pathologists (SLPs) have been effective in treating picky eating, though often through distinct means. The fact that each field has developed unique treatments means either a) one field has it right and the other is wrong, b) neither have it right, or c) both are right, and both could therefore benefit through collabora-

tion. Regardless of a, b, or c, working together can only improve how we deal with our picky eaters.

Behavior Analytic TreatmentsHere, BAs are concerned with the in-teraction between the picky eater and his/her environment (cf. Cooper, Her-on, & Heward, 2007). The BA looks toward antecedent and consequent events, and does so with consider-ation to motivational and contextual

Picky Eating: Treatment Options from Behavior Analysts and Speech Pathologists

ALEXIS C. WALDINJOY A. MCKENZIEBENJAMIN N. WITTS

ST. CLOUD STATE UNIVERSITY

variables. BAs have developed a host of treatments, including altering re-inforcement, punishment, and extinc-tion contingencies all in the pursuit of getting someone to eat more varieties of foods, and more often (e.g., Bach-meyer, 2009). Treatment variations include differential reinforcement of alternative behavior, non-contin-

gent reinforcement, stimulus fading, high probability-low probability, simultaneous pre-sentation, and escape extinc-tion (Bachmeyer, 2009).

Differential reinforcement of alternative behaviors (DRA) and non-contingent rein-forcement (NCR) are proce-dures selected when the child’s picky eating is presumed to be maintained by socially-me-diated positive reinforce-ment. DRA and NCR both deliver functionally-equiva-

lent stimuli (i.e., reinforcement), but each producing differing effects on behaviors. DRA is a procedure used to increase the future frequency of producing the desired behavior. DRA provides reinforcement contingent upon the individual producing the desired behavior (e.g., accepting food, picking up the presented cup) and withholding reinforcement (extinc-tion) for other non-acceptable types of behavior. NCR is a procedure used

ALEXIS C. WALDIN JOY A. MCKENZIE BENJAMIN N. WITTS

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to decrease the future frequency of the picky eating, and does so by delivering the maintaining reinforcement on a fixed-time schedule (i.e., independent, or regardless, of the behavior being produced). To help differentiate be-tween the two, let’s use an example of a child eating broccoli. With DRA, if the child eats the food they are given access to reinforcement, but if the food is refused, no reinforcement is deliv-ered. With NCR, regardless of if the broccoli is eaten, reinforcement will be delivered on some time schedule (e.g., every 3 minutes).

Stimulus fading (SF), high proba-bility-low probability (HP-LP) and simultaneous presentation (SP) are procedures to condition non-preferred foods/liquids as preferred foods/liq-uids. SF slowly increases the presen-tation of non-preferred foods while slowly reducing the presentation of preferred foods. For example, you might start off with a big glob of pudding and a single sliver of carrot, but before long, you’re eating whole carrots and nibbling on a smudge of pudding (see also Groff, Piazza, Zeleny, & Dempsey, 2011; Hagopian, Farrell, & Amari, 1996). HP-LP is a procedure that involves a series of food presentations for which compliance is likely, followed by a food presentation for which compliance is not likely. Essentially, the picky eater is given a running start before being asked to eat disliked foods. SP is a procedure in which a less preferred food/liquid and a more preferred food/liquid are presented at the same time. Such pre-sentations could include the foods/liquids on/in the same spoon or cup and/or on top of one another (e.g., Ahearn, 2003), or sequential presenta-tions (e.g., Piazza et al., 2002). Think of this like putting lots of veggies on a hot slice of pizza.

Escape extinction (EE) is a procedure in which escape from, or avoidance of, the demand of eating or drinking is withheld (Cooper et al., 2007). This procedure is used when a child’s picky eating is presumed to be maintained by escape and/or avoidance (i.e., negative reinforcement; Bachmeyer, 2009). Examples of EE include the non-removal of the presented food/liquid (e.g., Dawson et al., 2003) or physical guidance to consume the food/liquid (e.g., Freeman & Piazza, 1998). Parents might refer to this as “my way or the highway” approach to eating.

The behavior analytic approach to treating picky eating depends on op-erant contingencies surrounding the picky eating. Reinforcement is used to increase the future frequency of the desired behavior and extinction is used to decrease the future frequency of the undesired behavior. Used alone or combined, the behavioral treatment methods have demonstrated to be an effective method of treatment for picky eating.

Speech-Language Pathologists TreatmentsSLPs are often a pediatrician’s first stop when a medical etiology is ruled out (ASHA, n.d.), and their approach considers the strength and movement of the muscles in the mouth to be particularly important in picky eating. For example, the individual’s swal-lowing ability, tongue muscle and/or movement, cheek muscle, posture during speaking or eating, and man-dible muscle development could all be factors in determining what and when a picky eater eats (ASHA, 2001).

Much like BAs, SLPs review the in-dividual’s current regimen to observe preferred textures, flavors, foods/liq-uids, eating habits, and current nutri-

tional profile (ASHA, 2001). Toomey (2002) noted six prerequisite skills that must be achieved for an indi-vidual to be successful with eating. Five however, are pertinent to the eat-er: (a) postural stability to consume foods/liquids; (b) oral-motor skills to eat table foods and suck liquids; (c) jaw skills to suck, munch, and rotate chewing motion to break down varies textures of foods and liquids; (d) sen-sory skills to feel the food inside of the mouth; and (e) hand-to-mouth skills to self-feed. The sixth prerequisite skill is more specific to the parent’s contri-bution to their child’s eating habits.

Similarly, Bruns and Thompson (2010) noted that there is a progres-sion of milestones one typically fol-lows in the development of oral-motor and jaw skills. Bruns and Thompson indicated that it begins with a liquid diet (i.e., breast milk or formula), then semi-solid foods (e.g., baby food), then soft solids (e.g., bananas, cheese) and finally, foods that are hard and crunchy (e.g., meat, chips, crackers). This progression corresponds with the development of the oral-motor muscles central to the SLP approach (Toomey, 2002).

Before beginning a treatment, speech-language pathologists con-sider where their client stands within those five prerequisite skills and what types of foods/liquids they are cur-rently consuming. This consideration leads the speech-language pathol-ogist to determine if the treatment approach will be sensory-, motor-, behavior-based, or a combination of these approaches. Treatments that address the sensory, motor, and/or behavioral needs of the child include (a) sequential-oral-sensory approach ([SOS]; Toomey, 2002), (b) oral-mo-tor treatment based on hierarchical development, and (c) food chaining.

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The most prevalent technique is the SOS approach. SOS is a 12-week program based on the typical feed-ing progression (Toomey, 2007). SOS is primarily a desensitization program that encourages the individ-ual to explore, interact, and eventually consume new foods (Toomey). The six phases of SOS are: (1) tolerating the food/liquid being in front of the child, (2) interacting with the foods during play, (3) smelling the food and (4) touching the foods without the expectation to consume it. Once they are willing to touch, smell, and play with the food/liquid, they will be encouraged to (5) taste it and (6) to eat/drink it. (Toomey).

The second approach to addressing feeding skills for picky eaters involves the oral-motor system. This system’s

approach focuses on the child’s ability to consume various types and tex-tures of foods. This approach is used when a child is refusing food due to an inability to motorically manage the food in his/her oral cavity. In oth-er words, the individual just cannot chew or swallow the food (while the focus is on the motor component, one cannot completely separate sensory

from motor because both systems in-teract simultaneously). Foods that are hard, chewy, or have multiple textures require developed oral motor skills, disassociated tongue/jaw movement, tongue lateralization, and rotary chew movement to form a cohesive bolus safe to swallow. Typical treatment methods include external support to jaw and cheeks (e.g., Arvedson, 2010; Chapman, 2001), lip/cheek tapping (e.g., Manno, Fox, Eicher, & Ker-win, 2005), tongue stimulation, and jaw and tongue range of motion and strengthening (e.g., Beckman, 2009; Bruns & Thompson, 2012; Chapman, 2001; Groher & Crary, 2010).

The third technique is Food Chaining. Food Chaining is a method designed to expand the individual’s food reper-toire with sensory integration and be-

havior modification techniques (Frak-er, Fishbein, Cox, & Walbert, 2007). The technique expands the variety of foods/liquids in a child’s diet by using incremental steps to chain one food to another (Fishbein et al., 2006). The treatment begins by selecting foods the child readily consumes and food goal targets. Throughout treatment, the foods presented become more

aligned with the target food item. For example, if a child readily consumed french fries and the target food goal was chicken pot pie, the progression of food would follow a sequence similar to this: (1) french fries, (2) waffle fries, tator tots, hash browns, (3) potato wedges with cheese sauce/ranch dressing/ketchup, (4) baked po-tatoes with melted cheese/sour cream, (5) mashed potatoes with gravy, (6) mashed potatoes with ground meat and gravy, and finally (7) chicken pot pie (Fishbein et al., 2006). Fishbein et al. (2006) evaluated this procedure with 10 children referred to a feed-ing program for food aversion. The procedure was unanimously effective for all of the participants and their food repertoire continued to expand following completion of treatment procedures.

An SLP’s treatment methods empha-size the importance of desensitization and progression of food repertoires. The techniques and treatment con-siderations have been overall effective (ASHA, n.d.). Without the prerequi-site skills that SLPs account for, the individuals receiving the treatment could be at risk for choking, aspiration, or correlating feeding as an aversive condition.

Disciplinary SummaryBAs are involved when the behavior is believed to be maintained by operant contingencies. Such as, when a child is presented with a non-preferred food, they emit picky eating behav-ior (e.g., throwing, crying, whining) in an attempt to escape eating the non-preferred food. However, the non-preferred food could be aversive due to being correlated with a weak oral musculature. This could inciden-tally be overlooked by a BA as their specialty lies in behavior, not in the oral musculature development.

Figure 1. Differences and Commonalities between Behavior Analysts and Speech-Language Pathologists

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SLPs specialize in the oral-muscula-ture development and are not specifi-cally trained in addressing behavioral contingencies surrounding the picky eating. Therefore, although the child may initially have developed picky eating due to weak oral musculature, operant contingencies may have de-veloped because they were given access to preferred foods/liquids when they refused certain foods. Figure 1 shows the particulars of BAs and SLPs.

Proposed CollaborationOrientation and etiology aside, BAs and SLPs share the same goal; they both want to increase the amount and variety of food/liquid consumption. Both disciplines rule out medical etiologies first, use reinforcement to increase desired behavior, and try to remove the aversive condition of eating. This article is not looking to highlight the ideal technique or method, rather it is looking at the differing viewpoints and techniques to the treatment of picky eating in an attempt to emphasize the importance of an interdisciplinary collaboration. BAs should consider the prerequisite skills to consume various foods, and SLPs should consider the operant contingencies that might maintain picky eating. Through interdisciplin-ary collaborations, our clients can have the safest, most effective, and most efficient treatment possible. Thus, a collaboration between the two dis-ciplines is not only appropriate, it is essential. To accomplish this, we need to see that we each have a great deal to learn from one another. n

Ahearn, W. H. (2003). Using simultaneous presentation to increase vegetable consumption in a mildly selective child with autism. Journal of Applied Behavior Analysis, 36, 361-365.

American Speech-Language-Hearing Association. (2001). Roles of speech-language pathologists in swallowing and feeding disorders: Technical report. Retrieved from: http://www.asha.org/policy/TR2001-00150/. doi: 10.1044/policy.TR2001-00150.

American Speech-Language-Hearing Association. (n.d.). Feeding and swallowing disorders (dyspha-gia) in children. Retrieved from: http://www.asha.org/public/speech/swallowing/feeding-and-swallow-ing-disorders-in-children/.

Arvedson, J., Clark, H., Lazarus, C., Schooling, T., & Frymark, T. (2010). Evidence-based systematic review: Effects of oral motor interventions on feeding and swallowing in preterm infants. American Journal of Speech-Language Pathology, 19(4), 321-340.

Bachmeyer, M. H. (2009). Treatment of selective and inadequate food intake in children: A review and practical guide. Behavior Analysis in Practice, 2, 43-50.

Beckman, D. (2009). Beckman oral motor assessment and intervention. [Conference Notes]. Centra-Care Health Plaza, St. Cloud, MN.

Bruns, D. A. & Thompson, S. D. (2010). Feeding challenges in young children: Toward a best practice model. Infants & Young Children, 23, 93-102.

Bruns, D. A. & Thompson, S.D. (2012). Feeding challenges in young children: Strategies and special-ized interventions for success. Baltimore, MD: Paul H Brooks Publishing Co.

Carruth, B. R., Ziegler P. J., Gordon A., & Barr S. I. (2004). Prevalence of picky eaters among infants and toddlers and their caregivers’ decisions about offering a new food. Journal of American Dietetic Association, 104, 57-64.

Chapman Bahr, D. (2001). Oral motor assessment and treatment ages and stages. (pp. 125-128). Needham Heights: A Pearson Education Company.

Cooper, J. O., Heron, T. E., & Heward, W. L. (2007). Applied Behavior Analysis (2nd ed.). Upper Sad-dle River, NJ: Pearson Education, Inc.

Dawson, J. E., Piazza, C. C., Sevin, B. M., Gulotta, C. S., Lerman, D., & Kelley, M. L. (2003). Use of the high probability instructional sequence and escape extinction in a child with food refusal. Journal of Applied Behavior Analysis, 36, 105-108.

Fishbein, M., Cox, S., Swenny, C., Mogren, C., Walbert, L., & Fraker, C. (2006). Food chaining: A systematic approach for the treatment of children with feeding aversion. Nutrition in Clinical Practice, 21, 182-184.

Fraker, C., Fishbein, M., Cox, S., & Walbert, L. (2007). Food chaining: The proven 6-step plan to stop picky eating, solve feeding problems, and expand your child’s diet. New York: Marlowe & Co.Freeman, K. A. & Piazza, C. C. (1998). Combining stimulus fading, reinforcement, and extinction to treat food refusal. Journal of Applied Behavior Analysis, 31, 691-694.

Groff, R. A., Piazza, C. C., Zeleny, J. R., & Dempsey, J. R. (2011). Spoon-to-cup fading as treatment for cup drinking in a child with intestinal failure. Journal of Applied Behavior Analysis, 44, 949-954.

Groher, M. E. & Crary, M. A. (2010). Dysphagia: Clinical Management in Adults and Children. Mary-land Heights, Missouri: Mosby Elsevier.

Hagopian, L. P., Farrell, D. A., & Amari, A. (1996). Treating total liquid refusal with backward chaining and fading. Journal of Applied Behavior Analysis, 29, 573-575.

Manno, C., Fox, C., Eicher, P., & Kerwin, M. (2005). Early oral-motor interventions for pediatric feed-ing problems: what, when and how. The Journal of Early and Intensive Behavioral Intervention.

Piazza, C. C., Patel, M. R., Gulotta, C. S., Sevin, B. M., & Layer, S. A. (2002). On the relative contri-butions of positive reinforcement and escape extinction in the treatment of food refusal. Journal of Applied Behavior Analysis, 36, 309-324.

Professional and Ethical Compliance Code for Behavior Analysts. (2014). In Behavior Analyst Certification Board. Retrieved on October 29, 2014, from http://www.bacb.com/Downloadfiles/BACB_Compliance_Code.pdf

Toomey, K. (2002). Feeding strategies for older infants and toddlers. Pediatric Basics, 100, 2-11.

Toomey, K. (2007). An introduction to the SOS approach to feeding. Pediatric Feeding and Dysphagia Newsletter, 8, 2-10.

Twachtman-Reilly, J., Amaral, S. C., & Zebrowski, P. P. (2008). Addressing Feeding Disorders in Children on the Autism Spectrum in School-Based Settings: Physiological and Behavioral Issues. Language, Speech & Hearing Services In Schools, 39, 261-272.

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Ebola is a typically rare and deadly virus and is causing worldwide

concern during what is the largest Ebola epidemic in history. According to the Center for Disease Control and Prevention (CDC), 4,546 deaths have occurred in West Africa as a re-sult of the 2014 Ebola outbreak thus far. Worldwide concern has grown as cases have been diagnosed in Spain and the United States (where one death has already occurred). While transmission only occurs through contact with the blood or bodily flu-ids of a person who is sick or deceased from Ebola (CDC, 2014), the high death rate has caused widespread fear in people across the world. Presently, the Ebola epidemic has claimed the lives of 52% of those infected (CDC, 2014). With international travel an everyday occurrence, govern-ments, health ministries and hospitals worldwide have already started preparing for the inevitable spread of Ebola across the globe.

Just as is the case with any biological epidemic, the majority of resources deployed are centered on medical sci-ence. Medicine helps us understand incubation periods, spread of illness, best treatments and best practices for prevention. However, it does not pro-

vide all solutions to an epidemic that is much more complex. For example, when the cultural burial methods in West Africa consist of washing and kissing the dead, there is much more than knowledge of transmission need-ed to change practices that are deep seeded in the community’s beliefs and values. Behavioral science offers

a unique approach to this problem, in that we can analyze and manipulate stimuli to change or create healthier habits.

Commit and Act, a non-profit orga-nization, operates a clinic in Sierra Leone and is demonstrating that be-havioural science can have a measur-able impact on the spread of Ebola. Dr. Steven C. Hayes has drawn attention

Behavioral Science Needed in Ebola Outbreak

LAURA ADLINGTONST. CLOUD STATE UNIVERSITY

to Commit and Act’s progress in his blog on The Huffington Post. Com-mit and Act achieves success through use of Acceptance and Commitment Therapy (ACT). The clinic was started in 2010 by the non-profit organization Commit and Act. The clinic provides an example of collaboration with lo-cal health care workers on the use

of ACT in combination with evolutionary science. Since the clinic was already in operation when Ebola hit “an indige-nous resource was there, ready to make a difference” (Hayes, 2014). The local clinicians work with residents to un-derstand Ebola and to mod-ify traditional burial rituals. So far, the data is supporting their model. The Bo district fell from the fifth most in-fected district to the seventh, with the ninth lowest increase in cases of the eleven districts in Sierra Leone (Hayes, 2014).

Despite this living example of the importance of behavioural science, Dr. Hayes notes the lessons learned are not being fully utilized.

ACT is a psychological intervention based on behavioural science, namely Relational Frame Theory. According to the Association for Contextual Be-havioral Science, ACT makes use of acceptance, mindfulness, commitment

Bo, Sierra Leone – The current Ebola outbreak has been mainly viewed as a medical crisis. However, as the disease is spread through human contact (read: behavior), could behavioural science not offer valuable information in helping people take greater precautions?

Commit and Act group communicating the message that “Ebola if Real” in a way that the community can accept and understand.

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and behaviour change strategies to increase psychological flexibility. ACT targets the processes of language that are hypothesized to be involved in psychopathology, thus working toward achieving greater psychological flexi-bility. Through establishing increased psychological flexibility the individual is then better able to change or main-tain existing behaviours based on their values and what the situation affords. I reached out to Dr. Hayes for further information on the role of behaviour analysis in social issues, where as a field he thinks we can improve, and what lessons we need to note from the success of the clinic in Sierra Leone. He was kind enough to respond, and his answers are thought provoking (personal communication, October 9, 2014).

Addlington: Skinner describes behavior-ists as mainly talking to behaviorists.  Is this still accurate and how does this affect our ability to impact social issues such as the Ebola crisis?

Hayes: I think if we want to be careful as scientists we have to distinguish be-tween the different kinds of language that we’re using in different contexts and the purposes of those ways of speaking. Skinner viewed language es-sentially as a behavioral tool in which meaning was use and if that’s really what you believe it’s not very smart to try to use technical terms in all contexts. One of the things that the ACT and contextual behavioral sci-ence wing of behavior analysis have done that I think is important is that we’ve pretty carefully distinguished

between technical terms and what we call middle level terms which are ways of speaking that orient you to a do-main and help you know how to apply supersets of functional analyses to a given domain but are not themselves technical terms. Acceptance, defusion, values and so on are such things. It isn’t just a matter of translation. Often translational efforts feel very awkward and when you try to reinterpret com-mon sense language using behavior analytic language when talking to non behaviorists it can actually get in the way of communication. Instead, if you have multiple interrelated language games to play there’s no reason just to be talking to behaviorists anymore. We can be talking to behaviorists in technical ways when we want to work out how to think through different problem areas in behavioral terms but if the purpose of all that is to make a difference in peoples lives we have to find a way of speaking that is true to our purposes that is much more ac-cessible and common sense sounding to the average person or to opinion leaders. We’ve consciously done that in the CBS community and we received some heat for it from some who see these terms as mentalistic etc but I think it’s just an embrace of the radical functionalism of Skinnerian thought, bought forward into the present. Be-havior analysis has sort of managed to work its way into a ghetto and that makes no sense to me. This tradition is meant to be at the center of societal concerns. But we have to change to do that ... we need an analysis of language that works, first and foremost -- I think RFT gives us that -- and then we need the interest and flexibility to reach out, find friends, and get going.

A: You have participated in numerous media outlets to disseminate informa-tion on behavioral science and ACT (e.g. The Blog on the Huffington Post, www.

psychologytoday.com, Twitter, YouTube, published books and articles in peer re-viewed journals).  What changes would you recommend to those in the field for how we disseminate information to the general public?

H: I would add to that list starting Context Press; selling it to a major publisher; writing trade books; start-ing scientific societies; doing work-shops around the country; starting a training company; getting grants; helping to start a journal; and forming major alliances with non-behavioral intellectual leaders. I add to the list because it makes clear how many things we can do to be part of the larger conversation. If you want to change the world you need to be in the game. But it is not just me. The CBS culture has put dozens of folks in that position. So part of it is wanting to be reaching out ... looking outward more than inward. I did that from day 1 of my career. I was a political activist and environmentalist before I became a psychologist. I debated the mayor of San Diego; I disrupted Chamber of Commerce meetings; I learned that all you really needed to begin to make a difference was a clear voice and a strong heart. When I became a psychologist I swore I would never forget what I was there to do ... which was to make a difference in the lives of those we serve. But dissemination is the wrong way to think about this issue. Dissemination suggests that we have the answers and all we need to do is to get them in the hands of other people and make sure that they follow the information and guidance. In fact what we need to do is to lis-ten as well as speak and to work with others who have knowledge that we need. So for example our clinic in Sierra Leone is applying a method we developed, in combination with methods being studied at the Evo-

Steven C. Hayes, Ph.D.

Nevada Foundation Professor at the Department of Psychology at the University of Nevada

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lution Institute headed up by David Sloan Wilson that were originally developed by Elinor Ostrom, and in combination with the creativity and insights of indigenous therapists on the ground in Bo, Sierra Leone. That is not “dissemination” -- I frankly hate that word. It is arrogant and prideful. We need to work with colleagues to the help meet the needs of others. Focus on the good of others and you will not be content doing research that matters only to an in crowd; you will not be bouyed up by the grants and the promotions and the applause. You will want the real thing: making a difference. 99% of the science work we do as a field is ignored. The solu-tion isn’t to make people care ... the solution is for US to care and then to change the work we do in a way that reflects that change of focus.

A: In your Huffington Post blog Behav-ioral Science and Local Empowerment Are Needed to Help Solve the Ebola Cri-sis, you say we have a “living example on the ground in West Africa. It is time to learn the lessons it provides”.  What do you see as the most important lessons we need to learn and what barriers do you foresee in using this knowledge to make a difference in the Ebola crisis worldwide?

H: The specific lessons there are that you can use behavioral science to help people engage their values and make room for their fears, and then walk through the process of creating a social support process that will help people

manage their own affairs. That means our challenge in western Africa is sup-porting the people there in rising to the challenge of this disease. Western behavioral science is as relevant as medical science ... but we need to put knowledge into these countries in a way that comports with their local values. The other lesson is that the time to do that was years ago; and since time does not go backwards, we need to start now. In CBS we did that as a world community and because of things we did 4-5 years ago in de-veloping an intellectual and practical infrastructure in Sierra Leone, knowl-edge we’ve helped to produce is able to be of use now, in the ebola crisis. If we want to be ready for the next epidemic we need to be there now.

A: Finally, what contingencies need to be in place to change the value of behavioral sciences for health administrators and policy makers?

H: We are the problem, not them. Remember “the rat is always right”? Take that phrase to heart! This is a joke I heard many years ago -- how do you turn a behaviorist into a mentalist? Answer: ask him to explain why his work is ignored. Suddenly it’s “because they don’t understand behaviorism” yadda yadda. Oh please. If your science does not tell you how to be successful with people who disagree with you, and you are a behavioral scientist, doesn’t that mean your science is in-adequate? It is on you dude. Here is

my formula:

• Listen to others.

• Make friends with others.

• See the world through their eyes.

• Speak in ways that lead to understanding (reserve behavioralese for behaviorists)

• Reach people through their hearts first ... let their heads and hands  follow.

• Do research the way your audience wants it done (if they want RCTs, freakin do RCTs ... don’t quote Siman to them!)

• Make a difference and participate. Stay in the game. (And by the way that is what I’m doing now in responding to someone I do not know for a class project! I don’t care. You never know. 25-30 years ago  Dermot Barnes-Holmes wrote me a letter as an undergrad and I responded ... now he’s the backbone of RFT, and it is in part because of that response. I wrote a letter to Skinner as a beginning grad student ... he responded. And it cemented me as a behaviorist. So I hope you find this interview useful, Laura. I will look forward to seeing where you go with it. Maybe it will have some tiny role in furthering your thinking and your career. I hope so. n

Association for Contextual Behavioral Science. (NO DATE?). ACT. Retrieved October 21, 2014, from: http://contextualscience.org/act

Association for Contextual Behavioral Science. (NO DATE?). About ACT. Retrieved October 21, 2014, from: http://contextualscience.org/about_act

Center for Disease Control and Prevention. (2014). 2014 Ebola Outbreak in West Africa – Case Counts. Retrieved October 21, 2014, from: http://www.cdc.gov/vhf/ebola/outbreaks/2014-west-africa/case-counts.html

Center for Disease Control and Prevention. (2014). Transmission. Retrieved October 21, 2014, from: http://www.cdc.gov/vhf/ebola/transmission/index.html

Center for Disease Control and Prevention. (2014). Outbreaks Chronology: Ebola Virus Disease. Retrieved October 21, 2014, from: http://www.cdc.gov/vhf/ebola/outbreaks/history/chronology.html

Hayes, S. C. (2014, October 3). Behavioural science and local empowerment are needed to help solve the Ebola crisis. [Blog post]. Retrieved October 6, 2014 from http://www.huffingtonpost.com/the-blog/

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Years ago as a young whipper-snapper I worked as an early childhood con-sultant. While visiting a preschool, an older veteran teacher talked to me about Johnny. Johnny was hav-ing some behavior problems. Fresh out of college and eager to apply my book-learning, I developed an action plan based on rewards and a token economy. When presented to the teacher her reaction was: “This looks like behav-ior modification.” Well, yes, I replied, it is based on the principles of behavior mod-ification. Her reply: “I don’t believe in behavior modifi-cation.” Oh. Well.

While the teacher did not be-lieve in behavior modification, I am sure in her career she had plenty of experience in modifying behavior of young children. Maybe she was just playing me and wanted to take the college boy with a Master’s degree down a notch. Or maybe she truly thought behavior modification was some nefarious methodology that turned children into robots.

I posit four reasons for objections to behaviorism:

1. Belief in free will2. Belief in genetic determinism

3. Belief in the medical model4. Belief in eclecticism

Belief in free will: B.F. Skinner, the founder of “radical behaviorism” and one of the most influential and contro-versial psychologists of the twentieth century, believed that human free will was not a phenomenal reality, but the

results of how his or her behavior was shaped by its consequences. He wrote a book with the provocative title: Be-yond Freedom and Dignity. That sure gets attention. What could be beyond freedom and dignity?

His proposition flies in the face of those who believe that human actions are the result of inner forces that he or she controls. In other words, free will. It also flies in the face of those

Fear and Loathing of ABA(With apologies to the ghosts of Hunter S. Thompson and B.F. Skinner)

RANDALL BACHMAN

Randall W. Bachman is a licensed psychologist, the director of AXIS Healthcare, and Chairperson of the Autism Recovery Foundation. He can be reached at rbachman@axishealth.com

who believe that free will was given to humans by God. After all, if human behavior is merely the mechanistic re-sult of the organism’s reinforcements, then how can he or she be responsible for his or her behavior?

In defense of behaviorism, I don’t believe that behaviorists think that

human beings lack dignity, nor do I believe that they think irresponsible behavior should be excused. What I do think is they leave the fundamen-tal philosophical and religious questions about the purpose of humankind, inherent dig-nity and worth, the intent of the Creator, or even whether there is a Creator, the meaning of existence, original sin, and other lofty questions to the philosophers and theologians.

The principles of behavior-ism also upset those who believe that there is something called the mind that exists outside the physical brain. They would contend that the mind is something supernatural that exists outside the physical constructs and activities of the human brain. It is interesting to note the following on-line dictionary definition of the mind:

1. The human consciousness that originates in the brain and is

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manifested especially in thought, perception, emotion, will, memory, and imagination.

2. The collective conscious and unconscious processes in a sentient organism that direct and influence mental and physical behavior.

Note the origination in the brain that manifests all those valued aspects of thought, perception, emotion, will, memory and imagination. Also note the reference to collective conscious and unconscious processes. The funda-mental question is whether or not all of these processes we value, that make us human, can emanate from a me-chanical and electrical process in the brain, or if there must be something beyond the corporal body that exists.

Again, to behaviorists, the question of whether or not forces exists outside the physical realm is a philosophical and theological question, not an empirical one. The interest for behaviorists is applying scientific principles of observation, intervention, assessment, and learning to the process of shaping be-havior. While some may be offended by thinking that they are more than an organism that has been shaped by his or her environment, behaviorists would consider this belief to be irrelevant, and, like it or not, behavior is shaped by its con-sequences.

Belief in genetic determinism: Bil-lions of dollars have been spent re-searching the genetic determinants of disease. Some of this research has led to breakthroughs in diagnoses and treatments. To date, however, most of the breakthroughs have been where the discovery of a specific gene or mu-

tation leads to a specific trait or dis-ease. An individual’s genetic makeup may reveal whether he or she may be more prone to a specific cancer. How-ever, it is doubtful that an individual’s genetic profile will predict what make and model automobile he or she will purchase in the future.

The hope for some genetic break-through in diagnosing and treating complex behavioral conditions like autism motivates researchers. While this research may lead to insights that could lead to effective interventions, or even prevention, to date there has been no magic bullet found. Skeptics would hold there is no magic bullet, or bullets. Even if genetic pre-dispo-sitions can be discovered, the question remains, what then?

All this raises the age-old “nature

vs. nurture” controversy. Most would agree it is not either-or, but both and. Determinists would lean toward the nature side, and developmentalists would lean toward the nurture side. I believe behaviorists would basical-ly see the question as irrelevant. For them, the fundamental question is how does the organism respond to stimuli, what is the outcome of that response, and what can we learn by

applying reinforcement so that behav-ior is shaped in the desired direction? Whether the organism is genetically programmed to respond to certain stimuli, or does so as a cumulative result of environmental learning is immaterial.

That said, it is conceded that for some organisms it is easier to shape behavior in a direction that appears to be a “natural” behavior for it. For example, it is easier to get a dog to “sit” than to get him to walk on his front legs alone, although I imagine this too has been done. Certainly natural selection over millennia has created organisms that are “programmed” to do certain things. However, that programming does not necessarily prevent it from learning new things, although I con-cede that an amoeba may never be capable of learning calculus. (Some

of us who may be capable may never learn it, either.)

A frequent argument put forth by determinists goes some-thing like this: While behavior modification may be beneficial for X group or Y condition, it is less effective with A group or B condition. Indeed, it may be contra-indicated as harm-ful for Z condition. A behav-iorist would counter that we wouldn’t know unless we tried. Besides, fear of harm is over-blown, particularly in modern

ABA practice that discourages the use of aversive techniques.

Belief in the medical model: The term medical model is used widely, but may mean different things to dif-ferent people. For starters, here is the definition from the on-line dictionary:

“the traditional approach to the diagno-sis and treatment of illness as practiced

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by physicians in the Western world… The physician focuses on the defect, or dysfunction, within the patient, using a problem-solving approach. The med-ical history, physical examination, and diagnostic tests provide the basis for the identification and treatment of a specific illness. The medical model is thus focused on the physical and biologic aspects of specific diseases and conditions.”

Note the focus on diagnostic tests and deficits, which form the basis for treatment recommendations. While accurate diagnosis of a specific acute illness is an important step in de-veloping a treatment protocol, the medical model process is also applied beyond the scope of acute illness. For example, in the field of mental health, psychologists and psychiatrists assess historical and presenting conditions of the patient through standardized testing, gathering of historical information, and observation. From there a diagnosis based on that assessment is made, which usually leads to a label from the DSM or ICD-10. This leads to the completion of a profile on the five axes of the DSM, which purports to give a picture of a person’s mental and physical profile, leading to the development of a treatment plan. The field of social work has also been influenced by the medical model, as social workers are trained to assess, and develop service plans based on the assessment.

The medical model has penetrated several fields, and after all, seems like a straightforward, scientific approach. The medical model is also the para-digm for determining medical neces-sity, which is the standard by which treatment programs paid by third parties are authorized. So what are

the problems with the medical model?

First, with such focus on diagnos-tics and labeling, more time could be spent on admiring the problem than developing effective solutions. Diag-nostic assessments that ascribe labels are traditionally required before any treatment interventions are applied. While on the surface this protocol is meant to safeguard against the appli-cation of inappropriate treatments, in reality the process of getting an evalu-ation from a qualified professional can create bottlenecks and unfortunate delays to treatment. Also, even after a diagnosis is made and confirmed, in many cases the prescribed treatment is based more the practitioner’s ori-entation and training, than specifics directed by the assessment.

Second, ascribing a label can lead to

the implication that the condition is permanent and intractable. For exam-ple, if we diagnose some as “mentally retarded”, the implication is that this condition is not amenable to rehabil-itation and therefore it is a waste of time to try and improve functioning. Another example is someone diag-nosed with autism. The implication is that, as with “mental retardation”, the condition is intractable and ef-

forts at treatment towards recovery are idealistic and futile. In fact, people can and do recover from autism. How can that be?

Behaviorists do not discount the need for an assessment, but rather the fo-cus is on assessment of functioning versus assessment to categorize or label. Once a functional assessment is done, behavioral treatments are implemented with a constant evalu-ation of impact. This continual loop of assessment, treatment, and re-as-sessment is a scientific approach based on observable, empirical data. While a person may have an underlying med-ical or genetic condition that limits the progress of behavioral approaches, even with those conditions typically a behavioral approach will result in progress. The course of treatment may be labor intensive, but the applica-

tion of ABA has been shown to result in progress, and has been recognized as an effective treatment notwithstanding diagnostic categories.

Belief in eclecticism: When I was in graduate school de-cades ago we learned about various counseling theories grounded in different philo-sophical schools of thought. We learned about Client Centered Counseling, Ra-tional Emotive Therapy, Psy-choanalysis, Gestalt Therapy,

Behaviorism (not sure it was called ABA back then), and on and on. We studied Freud, Rogers, Perls, Ellis, Adler, and other giants from the pan-theon of human development. Later I learned about Transactional Analysis (I’m OK, You’re OK. OK), Neurol-iguistic Programming (NLP), and a variety of other new age approaches that blossomed in the 60s, 70s and 80s. I also took courses in early childhood

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development and monkeyed with the fascinating experiments of Jean Piaget. Earlier in my undergraduate course in psychology I got a rat to push a lever to get a food pellet using operant conditioning. Later in life I did a short-term stint as a part-time therapist after getting my license as a psychologist. When someone would ask me about my approach I would say something like: “I’ve studied many different approaches but like to tailor my approach to the individual. I try to take the best features from what I’ve learned and develop an individ-ualized plan. I guess you would call my approach eclectic.”

There may be an underlying assump-tion that individuals who seek out a therapist are looking for someone to help them change their behavior. While that would be a reasonable assumption, in my experience, many, if not most, are not looking for that. Many are just looking for the inti-macy of confidentially sharing their hang-ups and dilemmas with someone other than friends or family—who

likely would just give them advice they don’t want to hear anyway. Some are looking for justification. Some are looking for validation. Some are look-ing to see if they can pull one over on Mr. Smartypants who reminds them of their school principle they hated. There are valid reasons for not really wanting to change.

But if someone is looking to truly change behavior, then I know of two effective ways to do that: religious conversion (I include AA in that); or, see a behaviorist. I will not get onto the religious conversion path, because I’ve not seen Buddha on the side of the road yet. However, if behavior change is what you’re after, then it makes sense to see someone trained in behavioral principles, whatever brand.

So what does all this have to do with fear and loathing of ABA? While in academia there is a lofty principle that we should all seek the truth and use scientific principles in that pur-suit, there is also a counter-veiling force that creates an atmosphere of

acceptance for a whole grab-bag of philosophies and approaches. They hold a belief that no one approach can possibly have a corner on the truth, particularly when applied to the so-cial sciences. After all, we wouldn’t want to put all our eggs in one basket, or hurt anyone’s feelings, would we? People who fear ABA are reacting to the perceived arrogance of those who practice it.

Finally: ABA is not a philosophy of life, a religion, nor are its practitioners members of a cult. While acknowl-edging that much of human behavior is determined by his or her environ-ment, most would acknowledge that humans are born with certain inher-ited traits, inherent abilities and pre-dispositions. ABA is a methodology that can be applied to shape behav-ior notwithstanding those inherited traits, abilities or predispositions. It is a scientific approach, whose methods are constantly being evaluated and improved. If behavior change is the goal, then ABA is the method. n

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Give Choice a ChanceRocio B. Cuevas

Whether you are a practitioner or student, chances are you have come into contact with Discrete Trial Training (DTT) either as an instructor or as a learner. We are all too familiar with the consistent presentation of each step. Make sure you know your SDs, have an operationally-defined target behav-ior, know if, when, and at what level to prompt the behavior, and have the reinforcer, that you’ve carefully selected form a preference assess-ment, ready to be delivered. DTT is widely used to teach a plethora of skills. Now imagine adding the element of choice to your trials. While it may seem to contradict the rigid nature of DTT, allowing choice to be a component may in fact improve the effectiveness of this teaching strategy.

The act of choosing refers to how individuals allocate responding among concurrently available alternatives (Fisher & Mazur, 1997). Recent studies have sought to understand the value of choice and whether the act of choosing is reinforcing in and of itself (e.g., Fenerty & Tiger, 2010; Kern, Mantegna, Vorndran, Bailin, & Hilt 2001; Schmidt, Hanley, & Layer, 2009; Tiger, Hanley, & Hernan-dez, 2006;). Most of these studies presented identical reinforcers and measured whether participants

preferred to choose the reinforcer or have the reinforcer be selected by the experimenter. What they all found is that choice conditions are preferred over no-choice conditions.

The value of choice as a compo-nent within teaching strategies is that it goes beyond the fact that choice reinforces correct responses in DTT; choice, it seems, can even help to reduce problem behavior resulting from task presentations! For instance, allowing individuals to choose the sequence in which to complete assigned tasks has been found to successfully reduce problematic behavior and increase desirable ones (Kern, et al., 2001). Furthermore, choice of reinforce-ment conditions has been found to be more preferred than no-choice conditions, even when the choice conditions required more work from the participants (Tiger, et al., 2006).

Choice can be imbedded in nu-merous teaching approaches, DTT included. If your student loves to eat Skittles, consider allowing him/her to choose one from an array of identical Skittles before you reach for and select one yourself. If you have several tasks to get through, allow the child to select the order in which they will be presented. If you need the child to complete a worksheet, let him/her select which problem to work on first. n

Fenerty, K. & Tiger, J. (2010). Determining preschoolers’ preferences for choice-making opportunities: Choice of task versus choice of consequence. Journal of Applied Behavior Analy-sis, 43, 503–507

Fisher, W. & Mazur, J. (1997). Basic and applied research on choice responding. Journal of Applied Behavior Analysis, 30, 387–410

Kern, L., Mantegna, M., Vorndran, C., Bailin, D., & Hilt, A. (2001). Choice of Task Sequence to Reduce Problem Behaviors. Journal of Positive Behavior Interventions, 3, 3-10

Schmidt, A., Hanley, G., & Layer, S. (2009). A further analysis of the value of choice: Controlling for illusory discriminative stimuli and evaluating the effects of less preferred items. Journal of Applied Behavior Analysis, 42, 711–716

Tiger, J., Hanley, G., & Hernandez, E. (2006). An evaluation of the value of choice with preschool children. Journal of Applied Behavior Analysis, 39, 1–16

The OverjustificationEffect: Fact or Fiction?Jeremy W. DaShiellPennsylvania State University -Harrisburg

The overjustification effect (OJE) holds that a behavior will occur less frequently than it did before rein-forcement once reinforcement has been terminated. OJE researchers have asserted that extrinsic rewards (i.e., socially-mediated reinforce-ment) undermine initial interest in an activity (see Deci, 1971; Deci, 1972; Lepper, Greene, & Nisbett, 1973). Deci (1972) argues from a social/cognitive psychological perspective that “a person is in-trinsically motivated [has intrinsic motivation] if he performs an ac-tivity for no apparent reason except

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the activity itself ” (p. 113). Because of the power of reinforcement, people in positions that encourage productivity or learning employ the principle of reinforcement to increase behavior. However, if we are to believe the OJE, reinforce-ment programs could actually turn out to have a detrimental effect on desirable behaviors.

However, we can re-examine the OJE in behavioral terminology. En-gagement in an activity can be de-fined behaviorally as the duration or frequency of responding on a task. In behavioral terms, “extrinsic moti-vation” may be described as external (or socially-mediated) reinforce-ment for responding. Receiving an A would be an example of extrinsic motivation for studying hard for an exam. Intrinsic motivation can be defined as responding in the ab-sence of the external reinforcement (i.e., innate preference for a task). An example of intrinsic motivation would be someone playing a guitar simply because he or she enjoys playing guitar. We can evaluate levels of intrinsic motivation by measuring baseline responding on a task; if responding is high in the absence of external reinforcement, the client is likely intrinsically motivated, but if responding is low they are not intrinsically motivated to engage in that task. To evaluate the overjustification effect behavior-ally, one must examine responding first in the absence of socially-me-diated reinforcement (i.e., baseline), then during a period of social-ly-mediated reinforcement (i.e., reinforcement phase), and finally, again in the absence of socially-me-diated reinforcement (i.e., return to baseline). By examining behavior in this way, one can determine intrin-sic motivation or task preference during the initial baseline, how responding changes during rein-

forcement, and the effects rein-forcement has on behavior once it is discontinued (i.e., whether the OJE is evident) during the subsequent baseline. More research on OJE is highly warranted as research on the OJE is conflicting and employers and educators need a clearer demonstra-tion of when and how these pro-cedures pose possible detrimental side effects. It is possible that the OJE is more likely to occur when large or inappropriate amounts of reinforcement are used, and less likely if praise or intermittently reinforcement is used. Future re-search should employ single subject designs with repeated measures to allow for examination of individual responding and the trend of re-sponding over time, and to ensure that internal validity is achieved. Additionally, future research on OJE should include multiple fol-low-up assessments of responding, preferably weeks or months after the experimental sessions to enable investigation of the possible tran-sience of OJE. In conclusion, OJE has wide-reaching implications given the current use of incentive and grading programs in vocation-al and educational environments. Clearer results from research inves-tigating levels of responding during returns to baseline after periods of reinforcement will help resolve the controversy surrounding OJE and lend further insight to employers and educators around the world. nDeci, E. L. (1971). Effects of externally mediated rewards on intrinsic motivation. Journal of Person-ality and Social Psychology, 18, 105-115.

Deci, E. L. (1972). Intrinsic motivation, extrinsic reinforcement, and inequity. Journal of Personality and Social Psychology, 22, 113-120.

Greene, D., & Lepper, M. R. (1974). Effects of ex-trinsic rewards on children’s subsequent intrinsic interest. Child Development, 45, 1141-1145.

Children with Disabilities Learn From Their PeersMorgan deLunaUniversity of North Texas

Peer modeling is one way to teach response chains. Children with disabilities are often placed in special education classrooms where educational practices tend to be based on teacher instruction. Werts, Caldwell, & Wolery (1996) wanted to observe if children with disabili-ties could be taught response chains by their peers in general education classrooms.

Fifteen elementary school students, three of whom had disabilities, were chosen for this experiment. These three students were chosen because they had no inappropriate interac-tions with other students.

All three children were observed in general education classrooms. Charlie would sit at his desk, on the floor, or at the computer in the front of the room. James was strictly at his desk. Eleanor was on the floor in the front or a round table at the back.

The observers were measuring two different types of behavior (appro-priate and inappropriate), three different types of interactions (no interaction, instructional interac-tion, and social interaction), and the percentage of steps performed correctly. Baseline and training ses-sions were conducted in the same location. There were five different response chains (spelling last name with letter tiles, playing an audio-tape, using a calculator, sharpening a pencil, and sequencing number tiles) and three were assigned to each child. The students with dis-

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abilities were individually probed on their three response chains.

During the training phase, the peer modeled the response chain for the student with disabilities and described each step while perform-ing the task. Afterward, the student with disabilities was probed again on the same response chain.

The completion of tasks increased, but the social interactions stayed at a constant 4.9%. This indicated a change was demonstrated for the six different response chains, but not for social interactions between peers. The students completed the response chain tasks more effective-ly after the peer modeling. There was some generalization after these tasks were mastered. Some lim-itations included the adult coop-eration with the observations and the verbal explanations from peers while tasks were being completed.

For future research it would be ben-eficial if the peers were consistent over the days and that reinforce-ment contingencies might need to be in place. nWerts, M., Caldwell, N., & Wolery, M. (1996). Peer modeling of response chains: Observational learn-ing by students with disabilities. Journal of Applied Behavior Analysis, 39, 53-66.

Promising Tool Emerges Within Human Services FieldDavid HughesSt. Cloud State University

Auburn, AL – Anyone who is a manager in the human services industry can tell you about the overwhelming challenges inherent in his or her work. Demanding expectations, low pay, and minimal education requirements can turn staff performance management into

an ever-present balancing act. With these problems in mind, Dr. James Carr and a crack team of behavior analysts (2013) explored an existing method for improving job performance and redesigned it, tailor-fit to the human services industry. The PDC-HS (Perfor-mance Diagnostic Checklist-Hu-man Services) put a new spin on a pre-existing technology. Where former renditions of the PDC were used to pinpoint factors responsible for poor performance in job sectors ranging from coffee house baris-tas to department store clerks, the current checklist aimed to improve performance in the troubled human services sector.

The PDC-HS splits factors that bring down employee performance into four main categories: lack of training, materials and resources, clarity of tasks, and consequences for quality of work. After collecting and analyzing the data, consultants or administrators using the check-list can develop a clearer picture of where the problems lie and are supplied with a roadmap of where to go next.

Carr (2013) and his team tested the effectiveness of the checklist at an intensive treatment program for children with autism. Researchers were able to complete direct-care staff assessments through one-on-one interviews with administrative staff as well as thorough examining classroom conditions.

Results suggested poor employee performance was related to a lack of training for specific tasks. Addi-tionally, a dearth of clear and timely consequences for the quality of work may have influenced unsatis-factory performance. As a result, an intervention consisting of increased training and daily feedback for

completed tasks was implemented. Following the onset of intervention, performance among staff improved drastically and immediately.

The intervention’s improvement was significant enough that the school continued using the PDC-HS even after study’s completion. A staff member at the school commented that the checklist could help her as-sess how to best help her employees complete their job responsibilities in the future.

The findings of the checklist are promising. However, they are restricted to the setting of the small school. Eager researchers interested in replicating the study are encour-aged to explore implementation within larger organizations of 50 direct-care staff or more. Hopefully, in the future more organizations will adopt the functional methods of the PDC to safely and effectively increase employee performance in a scientifically proven manner. nCarr, J. E., Wilder, D. A., Majdalany, L., Mathisen, D., Strain, L. (2013). An assessment-based solu-tion to a human-service employee performance problem: An initial evaluation of the performance diagnostic checklist. Behavior Analysis in Practice, 6(1), 16-32.

The Big Bang Theory Gets it RightMartin Ivancic

On October 5, 2009 the CBS TV program The Big Bang Theo-ry made a misleading statement about negative reinforcement (“The Golthowtiz Deviation”), and many people complained about the inaccuracy. After consultation with the B.F. Skinner Foundation, they used behavior principles again in a new episode, “The Focus At-tenuation,” which aired Monday, October 13, and they not only got negative reinforcement exactly

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right (the removal of punishment), but they helped people make the discrimination by having Sheldon explain the non-example, positive punishment (the application of punishment). Positive punish-ment is what most people call neg-ative reinforcement. Sheldon also chided those who “get [negative reinforcement] wrong all the time” with a Ghostbusters clip that used negative reinforcement incorrectly. Based on how I hear undergrad-uate psychology students describe behavior principles, The Big Bang Theory did more for the understand-ing of behavior principles in 30 sec than many introductory college classes ever accomplish. In addition, their eventual application of these principles in the show was a cogent statement about typical behavior management. After showing that they understood what behavior principles were, they unwisely selected punishment (ripping duct tape off the hair on the back of their arms for infractions) to in-crease their attention to their work and demonstrated that punishment often elicits aggressive punishment and counter punishment until all responding breaks down. The incident reminded me of the plans many countries come up with for solving problems between them-selves. Sheldon may know what negative reinforcement and positive punishment are, but he isn’t ready for Secretary of State. n

A Brighter Future for Clinical BehaviorAnalysisTyler LoyImaculatta University

The term ‘clinical behavior analysis’ refers to the use, by some clinicians,

of radical behaviorism to explain how verbal interactions with clients help improve daily life. Clinical behavior analysis (CBA) has a checkered past with its closely re-lated field, applied behavior analysis (ABA), but seems to be returning to its behavioral roots. Because of its checkered past, CBA is often over-looked as a type of applied behavior analysis. This is understandable considering the boom of cognitive based approaches that gained much traction within the field of clinical psychology during the 70’s and 80’s. In the 60’s and early 70’s, however, it was commonplace for clinical psychologists to apply behavioral techniques in an outpatient setting. So what changed?

According to Kohlenberg, Bolling, Kanter, and Parker (2002), the reason for CBA’s abandonment was due to behavior therapists wanting to work with adults in a psychotherapy environment, the differences between problems being observed by typical adult clients and problems that applied behavior analysts typically dealt with, and the belief that operant techniques could not effect target behaviors outside of the therapeutic session. The “cognitive revolution” was received so well by many therapists because it was specifically created with the therapeutic environment in mind, whereas applied behavior analysis typically involved the natu-ral environment.

An important point in realigning with its behavioral roots was CBA’s realizing that behavior in a thera-peutic setting is not much different for a client than behavior outside of a therapeutic setting. Thus, it would make it possible for therapists to use operant conditioning during sessions through verbal behavior. Another discovery was that in-

structed behaviors, as compared to shaped behaviors, are less likely to be effective with programmed contingencies (e.g., Wulfert, 2002). This implies that telling a client how to behave will be less effective than shaping the client’s verbal behavior regarding the target re-sponse. Lastly, it was found through stimulus equivalences that when one is taught relations between stimuli that involve verbal events, additional relations can emerge spontaneously (Wulfert). From these and other discoveries, CBA was reborn. During the 90’s came some of the most notable approaches in the form of 1) Ac-ceptance and Commitment Therapy (ACT) created by Steve Hayes and 2) Bob Kohlenberg’s Functional Analytic Psychotherapy (FAP). These approaches are both based on verbal behavior being the driving force for change in therapy.

Advances like ACT and FAP mean clinical psychologists can use be-havioral-based treatments that are functional and empirically tested. Also, it has been found that using behavioral interventions with other forms of psychotherapy (Cognitive therapy) can improve the efficacy of treatment (Kohlenberg et al., 2002). Thus it is important that applied behavioral analysts work together with clinical behavioral analysts to further cultivate this return to behaviorism, and in moving for-ward there needs to be a dramatic increase in the practice and research of CBA. nKohlenberg, R. J., Bolling, M. Y., Kanter, J. W., & Parker, C. R. (2002). Clinical behavior analysis: Where it went wrong, how it was made good again, and why its future is so bright. The Behavior Analyst Today, 3, 248-253. doi:10.1037/h0099988

Wulfert, E. (2002). Can contextual therapies save clinical behavior analysis? The Behavior Analyst Today, 3, 254-258. doi:10.1037/h0099984

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Football and Domestic ViolenceQuinn MurraySt. Cloud State University

Minneapolis, MN – Ray Rice, Adrian Peterson, Greg Hardy, Ray Mcdonald. These names have two major themes in common: football and domestic violence.

Much attention has been given to the National Football League as of late due to the number of football players accused of domes-tic violence. The extensive number of news stories regarding football players and violence may lead one to wonder about a potential cor-relation between the two. Skinner (1953) discussed the prominence of behavior when there is a connection between emotional predisposition and a contingency of reinforcement. Skinner related this concept to the saying, “a man’s heart is in his work” referring to one’s work being reinforcing through one’s heart, or emotional predisposition. Skinner used the example of how one with an aggressive predisposition may access reinforcement through his/her work by engaging in work which allows this aggressive predis-position to be acted upon, such as through police or military work.

Perhaps many football players in the National Football League have this aggressive predisposition. Therefore, many players could po-tentially be accessing reinforcement playing football, which is a social-ly-acceptable means of behaving aggressively. This would suggest that aggressive behavior among these individuals may increase through playing football. This might shed light on the correlation between domestic violence and playing

football, as aggressive behavior may be maintained through continuous positive reinforcement. Is it fair to say that football could be consid-ered a causal factor for the ongo-ing domestic violence among its players? This is a controversy that will likely continue for decades to come, and completely accurate data on domestic violence rates between football players and the general public would certainly be difficult to come by. nSkinner, B. F. (1953). Science and Human Behav-ior. New York: MacMillan.

Communication... I Want It and I Want It Now!Molly Ann ReedUniversity of North Texas

What is communication?

Colloquially, communication is the use of words, signs, sounds, or behaviors to express or exchange information. Most of us learn to communicate fairly easily. But what happens when one is nonverbal or can’t vocally communicate? Specifi-cally, how do you evoke an effective form of communicative responding in children who are nonverbal?

Carbone and colleagues (2010) identified that previous research demonstrating the effectiveness of manual sign training, prompt delay, and vocal prompting all increased vocal responses, though never had all been used together. So the team decided to take it a step further.They asked the question: Does the use of manual sign mand training along with prompt delay and vocal prompting increase the production of vocal responses in non-vocal children with development disabil-

ities?Tony, Ralph, and Nick, ages 4-6 years old, all had some kind of a developmental disability, a limited repertoire of manual signs, and were nonverbal. The experiment-ers documented the occurrence of unprompted and prompted vocal responses (including speech sounds, word approximations or adult word forms) in each child’s classroom.

During baseline, if the participant declared motivation for an item and emitted the target manual sign mand request within 5 seconds of the item’s presentation, the instruc-tor delivered the item immediately while saying the item’s name. These items were selected based on a pre-experimental assessment for which each participant had shown motivation.

When the boys demonstrated motivation for the item and signed, the instructor did not immediately deliver the reinforcers; instead, they had a 5 second prompt delay. The instructor implemented a prompt sequence for the manual sign, and then paused if the child emitted a sound without the sign. If there was any vocal response the manded item was delivered immediately. If no vocal response occurred the items were presented two additional times with a 2 second delay before doing so.

The multiple baseline design across the three boys provided support of the effectiveness of the independent variable, with Tony showing the most increase of unprompted vocal responses and all boys increasing prompted responses.

Teaching vocal verbal skills to chil-dren with disabilities is highly valu-able. This will provide them with a sense of independence and give

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them the ability to communicate more efficiently without producing any negative behaviors because they cannot do so. nCarbone, V. J., Sweeney-Kerwin, E. J., Attana-sio, V., Kasper, T. (2010). Increasing the vocal responses of children with autism and develop-mental disabilites using manual sign mand training and prompt delay. Journal of Applied Behavior Analysis, 43, 705-709.

A Brief Review of Behavioral Interventions for Selective MutismMegan A. Rhett

Individuals with selective mutism only engage in social interactions in certain settings, and only with cer-tain people. It is most common for the mutism to occur outside one’s home, in public or social settings, such as school. Selective mutism has been determined to be rather difficult to treat, possibly due to the negative reinforcement provided for the behavior (Kolvin & Fun-

dudis, 1981). For example, parents and peers often speak for the mute individual. Although difficult to treat, behavioral interventions such as contingency management, extinction, shaping, self-modeling, or treatment packages that encom-pass several interventions have been shown effective at increasing vocal behavior for this population.

Contingency management can be combined with extinction where non-vocal gestures, such as head movements, are placed on extinc-tion and reinforcement is imple-mented contingent on vocal-verbal behavior, which might need to be shaped (e.g., Piersel & Kra-tochwill, 1981. Another treatment for selective mutism is parent and peer training. As previously stated, parents and peers often reinforce the lack of speaking by speaking for the mute individual, or by accepting non-vocal responses when vocal responses would be more appro-priate. Teaching parents and peers the importance of having the mute

individual speak for him/herself loud enough for others to hear increases the success and progress of the interventions.

Incorporating multiple components produces the greatest increases in vocalizations. Placing non-vocal behavior on extinction and rein-forcing audible vocalizations along with using prompts such as “are you telling a secret?” as a self-monitor-ing or regulation tool can create an effective intervention package as well. nKehle, T. J., & Owen, S. V. (1990). The use of self-modeling as an intervention in school psy-chology: A case study of an elective mute. School Psychology Review, 19, 115-121.

Kolvin, I., & Fundudis, T. (1981). Elective mute children: Psychological development and back-ground factors. Journal of Child Psychology and Psychiatry, 22, 219-232.

Piersel, W., & Kratochwill, T. (1981). A teacher-im-plemented contingency management package to assess and treat selective mutism. Behavior Assessment, 3, 371-382.

Rye, M. S., & Ullman, D. (1999). The successful treatment of long-term selective mutism: A case study. Journal of Behavior Therapy and Experi-mental Psychiatry, 30, 313-323.

The digest accepts reviews of journal articles of interest to behavior analysts. Review articles should be written in the active voice and be understood by non-behavioral readers. Typically, digest articles are written in the “newspaper style” with catchy titles, location of the story, and frequent use of action words and phrases.

- Limit all digest articles to 500 words or fewer - Do not include graphical reprints from the journal article - Articles must be published in the last 5 years- Include full reference in APA style- No more than 3 references per article

Submit your Digest article to the digest editor at jaackerlundbrandt@stcloudstate.eduBy submitting your article for consideration to BAQ, you agree to BAQ’s right to alter your article’s text, primarily grammar, to fit its current needs.

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