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Running head: ACCEPTABILITY OF APPLIED BEHAVIOUR ANALYSIS 1

Acceptability of and Resistance to Applied Behaviour Analysis and other Behaviour Techniques

Rachele M. Arseneau

BHSC 1001

Communications in Behaviour Science

Assignment #1

Gina Varelas-Stapper

Tuesday, September 25, 2017

Turnitin Score: 12%


ACCEPTABILITY OF APPLIED BEHAVIOUR ANALYSIS 2

Acceptability of and Resistance to Applied Behaviour Analysis and other Behaviour Techniques

Applied Behaviour Analysis (ABA) and behaviour modification techniques have

shown to be effective in reducing problem behaviours in children and adults with a variety of

developmental needs. Many research studies have shown the effectiveness that function based

intervention strategies have in reducing challenging behaviour, promoting desired behaviour

(ONeill, Bundock, Kladis & Hawken, 2015) and improving self-determination and quality of

life. When institutions were highly used, people with challenging behaviours were treated using

negative, detrimental procedures that decreased their ability to join their community, decreased

quality of life and did not teach socially acceptable ways of communicating their needs. Due to

conflicting views, behaviour professionals are often met with resistance when presenting ABA

techniques to school professionals and to parents. This begs the question, what cause resistance

to the use of behavioural treatments and how can behaviour professionals teach or demonstrate to

others the effectiveness and fairness of these programs.

Research has shown that with more education and experience, parents, teachers and

other professionals working with individuals with challenging behaviours will be more

acceptable of ABA and behavioural modification techniques. Professionals and parents with

exposure to the use of behavioural treatments are more likely to accept the methods than

professionals and teachers that have less exposure, education and experience.

The history of behaviour treatments and ABA will be discussed, along with some of

the reasons why teachers and parents resists ABA, some research that has proven ABA

effectiveness, an intrusiveness study of ABA and ways to encourage teachers to cooperate with

ABA.
ACCEPTABILITY OF APPLIED BEHAVIOUR ANALYSIS 3

History of ABA

Applies Behaviour Analysis is defined as a scientific approach devoted to

understanding and improving human behaviour by objectively defining behaviours of social

significance. ABA discovers environmental variables that reliably influence behaviour and

develop a technology that practically uses those discoveries (Cooper, Heron, Heward, 2007).

Prior to positive behaviour supports and other forms of ABA, individuals with

disabilities with challenging behaviours who were receiving support were vulnerable to abuse,

neglect and restrictive procedures (Baker & Allen, 2012), some in attempts to reduce or contain

their dangerous and/or destructive behaviours. Some of the resistance to behavioural treatment

stems from the historical uses of punishment and reinforcement systems. People with

maladaptive behaviours who lived in institutions were treated poorly and were stripped of their

rights and abused. Although the professionals at the time were using positive and negative

reinforcement, they were not following ethical or moral guidelines to how people with

disabilities should be treated.

Positive Behaviour Supports

Positive behaviour supports (PBS) were developed to reduce the use of aversive

procedures such as punishment (Baker et al., 2012). The changes that PBS demonstrated helped

to illustrate that individuals with intellectual disabilities were able to make changes to

maladaptive behaviour (Baker et el., 2012). It showed that the poor environments of institutions

created learned behaviours, and that they can be unlearned and exchanged for more socially

acceptable and life enhancing behaviours.

Baker and Allen explained that services for people with disabilities began a push towards

peoples human rights as they moved away from institutions into community settings (2012).
ACCEPTABILITY OF APPLIED BEHAVIOUR ANALYSIS 4

This time, however, also showed an increase in the use of punishment procedures such as

restraints, electric shocks and removal of possessions (2012) in order to redirect a persons

problem behaviour.

The possibility remains that there were worse aversive procedures occuring prior to PBS,

but were not being well documented. Once researchers had a reason to document treatments and

behaviours, it created a visible correlation between using behaviour programs and the increase in

punishment behaviours.

Reasons for Resistance.

Behaviour Analysts (BAs) have 3 decades of data that prove the effectiveness of ABA

and behavioural treatments. Many BAs are now working in schools, group homes, hospitals,

correctional facilities, retirement homes and other location. BAs are often met with different

types of resistance when introducing, teaching and collecting data for behaviour modification

programs. Some teachers and support staff will tell you what they dont like about the program.

Other support staff will simply not follow the program or collect data, which could be more

detrimental as it is hard to see that this is happening.

Schreck and Mazue (2008) conducted a survey with behaviour analysts where results

indicated they were using a practice not supported by scientific evidence and endorsed some

interventions despite indicating difficulty with implementations, problems of cost effectiveness

and lack of support of interventions in research literature (Mayton et al., 2014) Research such as

this would assist to explain where some resistance to ABA and behaviour modification comes

from.

Studies have shown that teachers and education assistance can successfully implement

FBA procedures and function-based interviews (O, Neill, et al., 2015). Due to some resistance in
ACCEPTABILITY OF APPLIED BEHAVIOUR ANALYSIS 5

the use and effectiveness of FBA, questions still remain about the validity, reliability, and

treatment integrity of FBA procedures occurring at this level (ONeill, Bundock, Kladis &

Hawken, 2015).

Some support staff have a lack of interest and willingness to participate in the program.

This will also jeopardize the reliability of the treatment process (Butler et al., 2002). If someone

is happy with how their work life is going, are resistant to change in general or dont want to

make extra work for themselves, they may be unwilling to participate in the program. This will

create more issues for the individual and other people involved.

Behavioural Consultants (BCs) are often asking teachers and other professionals to

change their behaviour in order to create change in the student (Butler et al., 2002). Teachers

often take home a lot of their work and spend a lot of their time and money on their classrooms.

Also, sometimes, it is not the teacher who has requested the support, but rather another

professional in the school that has recommended the student for behavioural therapy. Teachers

feel pressure to accept ABA when their views may not coincide with ABA techniques.

Another reason why some parents and professionals are avoiding behavioural treatments

is that they view the individual with intellectual disabilities as their mental age, rather than their

biological age. The individual might be being coddled and the support network doesnt want

anything bad to happen to this individual. This happens in schools by EAs and teachers, in

group homes by Direct Support Professionals, at home by parents and in other institutions where

behaviors are occurring. Some also say that behaviour treatments only work for children and

adults who have less severe intellectual disabilities (Baker et al., 2002). Some people have even

used less technical and more general interventions that do not require the understanding of the

function of behaviour (Johnston et el., 2006)


ACCEPTABILITY OF APPLIED BEHAVIOUR ANALYSIS 6

Detrimental Effects of Resistance

As Tingstrom and Edwards stated, even the most useful and effective interventions will

be left useless if they are not being implemented (Butler, Weaver, Doggett & Watson, 2002). This

means that even when a behavioural consultant has made an easy to follow, potentially effective

support plan, if the support staff are not following through with the guidelines, it will become

ineffective and may actually increase the behaviour as a way for the individual to resist the

program.

Skinner and Hales (1992) wrote that prior to exposure to ABA training, teachers

would observe classroom behaviour as being based on developmental stage or the childs age.

After in-service and pre-service teachers were exposed to new information on ABA, data

collection and training methods, their views changed more towards being attributed to behaviour.

Elvin et al. (2001) reviewed 100 published articles regarding FBA procedures. Only 2%

reported any type of social validity, acceptability of assessment or intervention procedures

(ONeill, 2015). The studies that do note these items have indicated that FBA procedures are

acceptable and useful. They also reported widely varying levels of use and significant concerns

about knowledge, skills, and use by educators and other clinicians. Teachers, special educators

and psychologists results on acceptability can be varied based on education, experience and

amount of time they spend in the classroom.

Acceptability of ABA and Functional Behavioural Analysis in Research

Behavioural professionals view behavioural that is observable, measurable and

describable. Teachers have been taught to view behaviours as coming from within the child.

They are taught to view behavioural as being either developmental, physiological,

psychoanalytical and behavioural last. (Skinner & Hales, 1992).


ACCEPTABILITY OF APPLIED BEHAVIOUR ANALYSIS 7

Pre-service and in-service teachers who were taking a classroom management course

were asked which factors they thought affected a classroom students behaviour the most. The

factors to choose from were developmental, physiological, psychoanalytical, and two types of

behaviour. The survey was completed before and after the course for comparative results. The

results of the survey indicated a major change in the pre-service teachers away from the cause

being psychoanalytical and physiological and towards behavioural, and a major change for in-

service teachers in their views on development, more towards behavioural (Skinner et al., 1992)

Langthorne and McGill (2012) wrote an article on a study assessing the social

acceptability of functional analysis procedures among 10 parents and 3 teachers of children who

had recently received functional analysis. The study used a 9-item questionnaire. Findings

indicated several respondents acknowledged some degree of discomfort or their child. All other

indications of the functional analyses were positive. The majority of the respondents reported FA

to be an acceptable means of assessing problem behaviours. Problem with this study was that the

participants had already participated in FAs prior to the study, so it becomes somewhat biased

on previous experience.

Langthorne and McGill (2012) in a separate study also noted that the social acceptability

of ABA of two teachers changed after receiving training on how to implement functional

analyses. This study shows that with more education on ABA and behavioural treatment

strategies, more teachers and professional may be more inclined to accept and use ABA, rather

than dealing with the behaviour once in a crisis moment.

ONeill et al. (2015) wrote an article about a survey that was conducted assessing the

acceptability of a variety of FBA procedures. 123 special educators and 140 school psychologists

were surveyed, including information about their teaching location, grades taught, highest level
ACCEPTABILITY OF APPLIED BEHAVIOUR ANALYSIS 8

of education and number of years teaching. The participants showed generally positive

perceptions regarding willingness to participate and their thoughts on appropriateness, usefulness

and feasibility of FBA procedures (O, Neill, 2015).

Elliot (1988), Reimer & Wacker, and Tobin & Sugai (1993) suggested that there is

some judgement of research acceptability influenced by the severity of behaviour, effectiveness

of intervention, intrusiveness and aversiveness of interventions and the time and effort involved

in carrying out these procedures (O Neill, 2015).

Michelle Kelly and Dermot Barnes-Holmes discussed the research around the Implicit

Relational Assessment Procedure (IRAP). IRAP measures treatment acceptability of

reinforcement and punishment interventions when dealing with different behaviours (Kelly &

Holmes, 2014). 15 teachers trained in ABA (ABAT) and working with children with

developmental disabilities and 15 teachers trained and working in mainstream primary education

(MT) participated in the study. Results showed that ABAT teachers were pro reinforcement for

all behaviours, while MT teachers were pro reinforcement for good behaviours and pro

punishment for bad behaviours.

In order to measure acceptability, researchers developed the Treatment Acceptability

Rating Form- Revised (TARF_R, Reimers et al., 1992), and Behaviour Intervention Rating Scale

(BIRS; Von Brock and Elliot, 1987) and others systems to measure the acceptability of

interventions for challenging behaviours (Kelly et al., 2014)

Eckert and Hintae (2002) stated that interventions that are developed to increase

behaviour are more acceptable than interventions developed to decrease behaviour (Kelly et al.,

2014). Kazdin (1980) and Hastings et al., (2004) indicated that clinical staff rated reinforcement

based interventions more acceptable than approaches based on punishment. (Kelly et al., 2014).
ACCEPTABILITY OF APPLIED BEHAVIOUR ANALYSIS 9

These statements assist researchers to understand the acceptability of ABA and to present it in a

way that other professionals will accept.

The severity of a behaviour has shown an increase in the acceptability of interventions.

Characterisitcs of the rater also affect acceptability including knowledge and experience (Kelly

et al., 2014). These correlations made the study lean towards assessing attitudes and opinions

that account for treatment acceptability. IRAP has a good base for assessing acceptability of

interventions but still needs more time to be studied.

Cultural Differences

Some factors in acceptability of ABA are in regards to cultural differences. Some parents

who are not originally from Canada themselves, have a language barrier or different parenting

styles, or all of the above, may not be very accepting of the behaviour consultant in general or of

the methods that ABA delivers.

Janet Mah and Charlotte Johnston sampled 117 Euro- Canadian and Chinese

immigrant mothers of boys aged 4 to 8 years old. The survey found that Chinese immigrant

mothers were more acceptable of punishment techniques like spanking or overcorrection than

Euro- Canadians who were more authoritarian (Mah & Johnston, 2012) Rewards were regarded

the same as well as withdrawal of positive reinforcements.

The goal of the survey was to increase the cultural sensitivity of mental health

services for the underserved population of Chinese-Immigrant families (Mah et al., 2012). Yeh

et al. (2003) indicated that Asian North-American families are under referred to support services.

They recognized that these families show less therapeutic involvement in mental health services

when compared to nonminority families (Mah et al., 2012)


ACCEPTABILITY OF APPLIED BEHAVIOUR ANALYSIS 10

Other programs such as Behavioural Parent Training programs tend to fail due to parents

not actively participating fully in office or at home. Ethnic families are less likely to enroll in

BPT, which is being regarded as due to cultural sensitivity.

Ethical Implications to ABA

An early study by Julian C. Leslie (1997) indicated a couple of social factors that have

surfaced that bring attention to ethical issues for behaviour analysts and other behaviour

professionals.

Misconceptions are making behaviour modifications to be seen as coercive (Leslie,

1997). Skinners use of the word control in his description of the science of behaviour portrays

behaviour analysis as things being done to the individual rather than to benefit their quality of

life. Another factor is that some people view a link to SR psychology (stimulus-response). SR

implies that all behaviour is being forced out or coerced from individual especially with the

contingencies or reinforcement (Leslie, 1997). Behaviour analysts would argue this. A third

factor is media misrepresentation. The media covers news that is exciting and grabs viewers

attention. They are telling stories of failure in ABA rather than the success stories.

Intrusiveness of ABA and behavioural treatments

Mayton, Carter and Wheeler (2014) wrote an article about the intrusiveness of behavioural

treatments for individuals with developmental disabilities. Their study aimed to determine the

restrictiveness of an intervention and if the intrusiveness altered relevant aspects of the

individuals functioning or environment.

The study used Base Line Intrusiveness Procedures (BLIP) and Modified Level

Intrusiveness Procedures (MLIP) to determine the amount of intrusiveness used in the behaviour

treatments. BLIP included physical prompting and attempting to minimize or eliminate problem
ACCEPTABILITY OF APPLIED BEHAVIOUR ANALYSIS 11

behaviour as factors. It also included factors such as increasing the effort required to engage in

problem behaviour and restricting access to activities. The latter are looked at as potentially

negatively effecting an already vulnerable person with an intellectual disability and affecting

their quality of life. Mayton et al. also stated that some level of intrusiveness is required, even

desired, to use FBA.

Some intrusiveness level factors that Mayton et al., (2014) indicated to consider were

individual level of physical discomfort, reliance on peer/professional influence, opportunities to

resist or compromise and increased level or use of intrusiveness including time-out, drug-use or

electric shock. They explained how some procedures could result in a situation where someone

becomes isolated or given unnecessary or overtly burdensome tasks (Mayton, 2014).

There are some treatment components that increase intrusiveness but may or may not be

necessary for producing the desired effect on behaviour. These include involving peers and other

professionals, requiring the individual to participate and involving parents and other caregivers

in the treatment of the behaviour ( Mayton et el., 2014).

Carter et el., (2002) said there is limited guidance in determining the level of

intrusiveness or intrusiveness reducing portions to these procedures (Mayton et al., 2014) It was

noted that when you factor in intrusiveness-reducing factors such as access to reinforcers,

individuals preferences in reinforcement, the overall intrusive picture of MLIP and BLIP appear

much lower. When BLIP is observed individually, the intrusiveness factors are more evident.

Finding positive alternative to physical restraint

Mark Brend and Dave Jackson wrote an article about a 18-year-old boy who was

having many documented reports of physical restraints. This study came after the death of a 15-

year-old boy who died while being restrained by 3 adults.


ACCEPTABILITY OF APPLIED BEHAVIOUR ANALYSIS 12

The report on 18-year-old Richard indicated that he was in the process of leaving

child services and gaining services from Choice Support. There were many factors and elements

changing in his life at this time, including transitioning into adulthood (Brend & Jackson, 2006).

In the first 7 months of 2003, there were 42 incidents where some sort of injury occurred to

Richard or a staff member. There were records that before Choice support became involved,

there were 180 documented episodes of restraint used. His behaviour was deemed as

unpredictable and out of control with no known triggers. Dave Jackson knew that you must

understand the function and meaning of behaviour, and began working on a plan with Choice

Support and Richards parents. He figured that the used of physical restraints was provoking even

more violent behaviour. Jackson began with changes to environmental strategies, teaching

functionally equivalent skills, reactive strategies and staff training (Brend & Jackson, 2006).

With these services in place, there was a quick reduction in incidents of restraints, a reduction in

staffing, a reduction in the annual cost of service and different types of staff training that did not

include the use of physical restraints (Brend et al., 2006). Brend and Jackson have demonstrated

how the systematic application of positive behavioural support methods have dramatically

increased Richards quality of life, and have completed eliminated the use of physical restraints.

Ways to encourage cooperation

Butler et al. (2002) suggest that it is essential to create a positive relationship between the

BC and the classroom teacher or other working professionals. It is important that the teacher

trusts the BC and that they are willing to cooperate in the early stages of intervention (Butler et

al., 2002).
ACCEPTABILITY OF APPLIED BEHAVIOUR ANALYSIS 13

In light of behavioural consultants being faced with resistance from teachers,

professionals and parents, individuals from the Mississippi State University created a list of

professional responses that can be utilized to answer some teachers statements and concerns.

It is worth noting some of these examples as they may be very helpful to have ready

when dealing with resistance to behavioural intervention. They noted that a teachers response to

behavioural interventions might be the it is not fair to the rest of the class that one students gets

rewards. A way to respond to this might be that you could give the reward in private and create

on to one attention. Since the childs behaviour is disruptive, the other children would probably

appreciate and understand the intervention. Another common teacher response is that they dont

have time to deliver the reinforcers or pay attention when the child is behaving appropriately. A

way to respond to this might be that rather than the teacher spending their time correcting,

redirecting, punishing or explaining to parents the situation, they can use the time to reinforce the

child during critical learning opportunities (Butler et al., 2002). The teacher can also develop

some ways to provide brief frequent bursts of attention using a small amount of time such as

allowing the student to hand out papers, run errands or have a turn to be the line leader (Butler et

al., 2002).

Conclusion

There are a variety of reasons why some teachers, other professionals and parents resist

ABA and behaviour modification techniques. Historically, improper behaviour modifications

treated people with developmental disabilities poorly. Applied behaviour Analysis (ABA) and

behaviour modification techniques have shown to be effective in reducing problem behaviours in

children and adults with a variety of developmental needs.


ACCEPTABILITY OF APPLIED BEHAVIOUR ANALYSIS 14

Prior to positive behaviour supports and other forms of ABA, individuals with

disabilities with challenging behaviours who were receiving support were vulnerable to abuse,

neglect and restrictive procedures (Baker & Allen, 2012). Positive behavior supports were later

being used to encourage positive desirable behaviours and reduce negative behaviours, but some

people were still skeptical of PBS. Today, behavior professionals are met with resistance from

parents, teachers and other professionals when trying to teach and demonstrate new ABA

programs. Some of the reasons for resistance are a lack of experience and education with ABA,

historical implications and cultural difference. Studies have shown that with more education,

experience and exposure, parents and teacher are starting to accept behavior techniques for the

social validity. Professionals and parents with exposure to the use of behavioural treatments are

more likely to accept the methods than professionals and teachers that have less exposure,

education and experience. There are still come ethical implications with ABA such as isolation

and overcorrection. However, research has shown the effectiveness of ABA at reducing problem

behaviors and increasing quality of life for the individuals with challenging behaviours. With

more research, practice, education and experience, there will be a community of professionals

that share and understand the validity of ABA and behavior modification programs.
ACCEPTABILITY OF APPLIED BEHAVIOUR ANALYSIS 15

References :

Baker, P., Allen, D. (2012). Use of positive behaviour support to tackle challenging

behaviour. Learning Disability Practice, 15(1), 18-20.

Brend, M., Jackson, D. (2006). Finding Positive Alternatives to Physical Restraint.

Learning Disability Practice, 9(10), 32-38.

Butler, T. S., Weaver, A. D., Doggett, A., Steuart Watson, T. (2002). Countering Teacher

Resistance in Behavioural Consultation: Recommendations for the School -Based Consultant.

The Behaviour Analyst Today, 3(3), 282-288.

Cooper, J. O., Heron, T. E., Heward, W. L. (2007) APpled Behavior Analysis (2nd ed.).

Upper Saddle River, N.J.; Pearson Merrill Prentice Hall.

Kelly, M. E., Barnes-Holmes, D. (2014). Measuring Implicit and Explicit Acceptability of

Reinforcement Versus Punishment Interventions with Teachers working in ABA versus

Mainstream Schools. Psychol Rec, 65, 251-265. Doi: 10.1007/s40732-014-0101-4.

Langthorne, P., McGill, P. (2011). Assessing the Social Acceptability of the Functional

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Leslie, J. C. (1997). Ethical Implications of Behavior Modification: Historical and

Current Issues. The Psychological Record; Fall 1997; 47, 4; ProQuest Central. 637.

Mah, J. W. T. , Johnston, C. (2011). Cultural Variations in Mothers Acceptance of and

Intent to Use Behaviour Child Management Skills. J Child Fam Stud, 21, 486-479. Doi:

10.1007/s10826-011-9502-z.
ACCEPTABILITY OF APPLIED BEHAVIOUR ANALYSIS 16

Mayton, M., R., Carter, S., L., Wheeler, J., J. (2014) Intrusiveness of Behavioural

Treatments for Adults with Developmental Disabilities. Research in Developmental Disabilities,

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O Neill, R. E., Bundock, K., Kladis, K., Hawken, L. S. (2015). Acceptability of

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