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Behavior analysis is the scientific study of behavior. Radical behaviorism is the worldview of behavior analysts and this perspective drives how we think about behavior, assess the influences on behavior, and develop strategies to change behavior. There is evidence that some behavior analysts are using interventions that are not conceptually consistent with foundational principles, which results in using treatments not based on strong scientific evidence of effectiveness, and thus, are less effective and potentially harming the client. The reasons for this drift (from radical behaviorism) could be due to inadequate training in our philosophy, poor supervision, persuasion, and financial contingencies, among others. To maximize positive impact on the consumer, and to stay true to scientific roots, behavior analysts must adhere to the worldview of behavior analysis and radical behaviorism. By doing so, one’s work will be based on science, and thus will protect our science and, more importantly, the consumer.

The provision of applied behavior analytic (ABA) services is a highly efficacious intervention approach most often used to improve the lives of individuals with autism spectrum disorder (ASD)/Autistics. Given the advancement of the field, more nuanced skill sets of behavior analysts, such as compassionate care skills, are emerging as the focus of intervention as measurable, observable, and essential. As the field progresses, the identification, refinement, and assessment of more nuanced skills become crucial to the success of our interventions. Leading with a compassionate approach that balances habilitation with client happiness, assent, and engagement is of the utmost importance. This paper discusses the current trend in existing compassionate care literature and how those evaluations may potentially be extended to direct interventionists and Registered Behavior Technicians. In this paper, we argue that a behavioral framework should be used to conceptualize, train, and evaluate the demonstration of these skills in front line ABA practitioners.

The science of behavior began in the laboratory setting, focusing on the direct measurement of behavior-environment relations. The field of applied behavior analysis (ABA) is relatively new with the first publications in the flagship journal, The Journal of Applied Behavior Analysis, appearing in 1968. Soon the application of the science was applied to the treatment of autism and, due to its tremendous success, the number of professionals claiming to use behavioral procedures increased exponentially. It became obvious that some sort of systemic oversight needed to be created to protect both consumers and practitioners, and difficult questions had to be raised concerning licensure, certification, which was more advantageous to pursue, and with what consequences. The purpose of this paper is to explore the historical roots of behavior analysis and provide commentary and context to the movement of certification up to the current day. Current challenges within the field of ABA will also be reviewed, along with recommendations to ensure that ABA-based intervention in the future is high in quality.

Recent events have highlighted the need for behavior analysis to address issues of diversity, equity, and inclusion (DEI) in service provision and in higher education. There has been a call to action issued, noting the need for cultural humility and cultural responsiveness. An opportunity exists within training programs to ensure that students of behavior analysis are instructed in ways that promote cultural responsiveness and that equip them to serve diverse populations. Additionally, more needs to be done to engineer environments where students of behavior analysis are treated with respect and compassion, and to ensure that educational environments promote the comfort and success of all students. This article outlines the initiatives of an applied behavior analysis department to gather information about DEI on the local level, identify goals, implement change, and evaluate progress toward these goals.

Recent behavior analytic research has demonstrated that the provision of applied behavior analytic services via direct telehealth can be an effective teaching modality for some learners with autism spectrum disorder (ASD). Historically, teaching procedures based on applied behavior analysis (ABA), including discrete trial teaching (DTT), have been provided and evaluated via in-person delivery. This study sought to compare the implementation of DTT via direct telehealth to DTT implemented in-person within and across participants. Specifically, this study evaluated the two delivery modalities in terms of skill acquisition, maintenance, efficiency, and learner responding during teaching sessions. Results of an adapted alternating treatments design nested into a multiple baseline design demonstrated that all three participants diagnosed with ASD met the mastery criteria for the expressive labels taught. Areas of future research, participant prerequisite skills, and clinical implications will be discussed in the context of these results.

Socially valid practices are at the heart of applied behavior analysis and can influence how interventions are experienced by families. However, the training of practitioners of applied behavior analysis is primarily focused on the implementation of technical procedures with little focus on therapeutic approaches. Empathy and therapeutic rapport have been associated with improved outcomes in allied professions (Beach et al.

In recent years, there has been discussion of the need for training behavior analysts in collaboration skills. There is some consensus that these skills are needed to improve outcomes with clients and with colleagues. Specifically, students of behavior analysis and behavior-analytic practitioners need to learn the skills associated with functioning effectively in interdisciplinary teams. At Melmark, a model of training in this skill set has been developed and integrated into supervision modules for those seeking Board Certified Behavior Analyst certification. In this model, supervisees are exposed to information about the expertise and value of the allied professions of speech-language pathology, occupational therapy, physical therapy, and developmental pediatrics. Rotations are done within these fields to expose trainees to the expertise of these fields and to build skills in collaboration with members of those professions. Trainees are also assigned tasks that require them to identify the contributions of other professions and display appropriate collaborative behavior. Future directions for the model are discussed, including extending it across the organization and developing performance-based assessments and social validity measures.

As the field of behavior analysis expands, our need to develop ourselves as more effective collaborators, particularly with families who may be the primary consumers of our science, becomes paramount. As scientists, our training lies primarily in the behavior analytic technologies that we study and apply. But our ability to disseminate our science, collaborate with non-behavior analysts, and ultimately grow our field hinges on our ability to navigate interpersonal situations in a way that puts forth compassion and humanity. We have the opportunity and capability to use our empirical procedures to implement and assess the effectiveness of interventions that target the soft skills of our field. The current article discusses the benefits of empathic and collaborative approaches in fields related to behavior analysis and provides suggestions for current behavior analysts to incorporate compassionate care into their practices. We provide a checklist for compassionate interactions accompanied by possibilities for its use as a tool for self-evaluation, procedural fidelity, and comprehensive training in the area of collaboration with families. Finally, we discuss areas for future research with respect to assessing and improving behavior analysts' compassionate approaches to treatment.

This qualitative study aimed to elicit the perspectives of individuals with food insecurity (FI) who were enrolled in a Fresh Food Prescription (FFRx) delivery program through a collaboration between an academic medical center and multiple community partners in the southeastern United States. Semi-structured interviews and open-ended survey responses explored the experiences of participants enrolled in a FFRx delivery program during the COVID-19 pandemic. The interviews probed the shopping habits, food security, experience, and impact of the program on nutrition, health, and well-being; the surveys explored the perceptions of and satisfaction with the program. A coding scheme was developed inductively, and a thematic analysis was conducted on raw narrative data using Atlas.ti 8.4 to sort and manage the data. The themes included that the program promoted healthy dietary habits, improved access to high-quality foods, improved well-being, enhanced financial well-being, and alleviated logistical barriers to accessing food and cooking. Participants provided suggestions for FFRx improvement. Future studies may facilitate improved clinical–community partnerships to address FI.

Research addressing food selectivity has involved intrusive techniques such as escape extinction. It is possible that observational learning methods employed in previous studies could provide the desired results with respect to food selectivity without the need for invasive physical interventions. The purpose of this study was to evaluate the effectiveness of an observational learning procedure on the selection of food items of three children diagnosed with autism spectrum disorder. Baseline consisted of a simple task after which a choice was presented between high- and low-preferred foods. The intervention consisted of observing an adult engage in the same task and selecting the low-preferred food while making favorable comments and engaging with the food in novel ways. The results of a reversal design demonstrated that selection of the low-preferred food only occurred following the introduction of the intervention, and all three participants engaged in flexible responding as a result of the intervention.

Infant siblings of children with an autism spectrum disorder (ASD) diagnosis (i.e., infants at risk of ASD) are excellent candidates for early interventions based on the principles of applied behavior analysis. This study replicates and extends behavioral research using contingent social reinforcement procedures (i.e., vocal imitation and motherese speech) to increase both vocalizations and echoics among 3 infants at risk of ASD with their mothers in the natural environment. Results confirmed earlier findings that contingent reinforcement, specifically vocal imitation, reliably produces high rates of vocalizations, echoic approximations, and emerging pure echoic repertoires in at risk infants. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s40617-020-00413-2) contains supplementary material, which is available to authorized users.

Identifying the maintaining contingencies of problem behavior can lead to effective treatment that reduces the occurrence of problem behavior and increases the potential for the occurrence of alternative behaviors. Many studies use descriptive assessments, but results vary in effectiveness and validity. Comparative research further supports the superior utility of analog functional analyses over descriptive assessments, but clinicians continue to report the consistent use of descriptive assessments in practice. Direct training on the recording of descriptive assessments as well as the process for interpreting the results are limited. The absence of research-based guidance leaves clinicians to interpret the results as they see fit rather than following best practice guidelines for this critical activity. This study examined the potential impact of direct training on several components of descriptive assessment: the recording of narrative antecedent-behavior-consequence data, interpretation of the data, and the selection of a function-based treatment. Implications for training and practice are reviewed.

Behavior analytic supervisees need to master technical and conceptual skills in their fieldwork and training. Recently, the profession has recognized the need for cultural responsiveness to be emphasized and woven throughout clinical practice and supervision. However, findings from research within applied behavior analysis (ABA) yield limited information on specific methods to increase one’s cultural responsiveness, as well as few tools to identify areas of development. This paper highlights challenges BCBA®s face in providing culturally responsive supervision. The authors also make recommendations for specific areas of focus in the pursuit of culturally responsive training and skill development through the introduction of the Culturally Responsive Supervision Self-Assessment (CRSS) tool. Cultural constructs that could be addressed using the CRSS tool include, but are not limited to, race, religion, gender conformity, and intersectional paradigms of culture. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s40617-022-00688-7.

We report a case with a 7-year-old girl with autism spectrum disorder and anxiety disorder who had severe restrictive eating leading to various medical concerns raised by her pediatrician. Following medical consultation and a descriptive functional assessment, a therapist implemented behavioral intervention consisting of a visual cue, choice, and differential reinforcement of alternative behaviors. The intervention was focused on both in-home meals and telehealth consultation during mealtimes, as the COVID-19 pandemic necessitated moving to remote consultation for continued treatment. The success of this study has long-standing implications for the benefits of positive feeding interventions and telehealth as well as parental training strategies.

In an effort to provide clarity about the unique contributions of several professions within the context of multidisciplinary treatment, we reviewed the definitions, philosophical underpinnings, and national requirements pertaining to both scopes of practice (i.e., model licensing acts, legislation, and regulatory boards) and training (i.e., task lists, accreditation standards and course requirements, and exam blueprints) of 4 behavioral health professions. The professions we selected (behavior analysis, psychology, speech-language pathology, and occupational therapy) are likely to provide treatment alongside one another and often to the same clients. In a review of documents pertaining to scopes of practice and training for each profession, we found overlapping content. However, the similarities between professions diminished when we reviewed more specific guidelines such as learning objectives, educational requirements (i.e., coursework), supervised clinical experience (e.g., internships), and national examinations. This was especially true when considering each profession’s underlying approach to treatment (i.e., philosophical underpinnings) and, hence, service activities. We discuss our findings in light of service overlap and make a call for greater collaboration between professions, as related to the separate content knowledge and expertise of professionals in each field and the impact on client outcomes.

Interdisciplinary collaboration is challenging, but necessary, to meet the needs of individuals with autism spectrum disorder. Among the dyadic interactions in interdisciplinary teams, the relationships between occupational therapy practitioners and board certified behavior analysts are uniquely challenging. The disciplines define evidence-based practice differently and approach intervention from different angles. Furthermore, there are fundamental differences in worldview between the disciplines. Both disciplines offer necessary treatment, and successful collaboration between these disciplines is essential for maximizing outcomes. Hence, finding ways to help bridge the gap between these professions, in particular, is essential. Common barriers to developing collaborative alliances include misperceptions of the other discipline, differences in terminology, and unprofessional behavior. This article reviews the history and foundational concepts of both disciplines, and the common approaches associated with each. In addition, models of collaboration are discussed, with suggestions for enhancing interdisciplinary communication and treatment. Successful collaborative treatment is predicated on an understanding of the value and expertise offered by different disciplines, and requires mutual respect and professional dialogue.

In recent years, there has been discussion of the need for training behavior analysts in collaboration skills. There is some consensus that these skills are needed to improve outcomes with clients and with colleagues. Specifically, students of behavior analysis and behavior-analytic practitioners need to learn the skills associated with functioning effectively in interdisciplinary teams. At Melmark, a model of training in this skill set has been developed and integrated into supervision modules for those seeking Board Certified Behavior Analyst certification. In this model, supervisees are exposed to information about the expertise and value of the allied professions of speech-language pathology, occupational therapy, physical therapy, and developmental pediatrics. Rotations are done within these fields to expose trainees to the expertise of these fields and to build skills in collaboration with members of those professions. Trainees are also assigned tasks that require them to identify the contributions of other professions and display appropriate collaborative behavior. Future directions for the model are discussed, including extending it across the organization and developing performance-based assessments and social validity measures.

Children with autism spectrum disorder (ASD) often display repetitive and restrictive patterns of behavior, which can be seen in food selectivity and other feeding problems. Feeding problems in children with ASD not only lead to medical complications for the child but also can lead to increased caregiver stress. In order for behavior analysts to ensure adherence to the Professional and Ethical Compliance Code for Behavior Analysts, many factors need to be addressed prior to and during feeding assessments and interventions. The need for interdisciplinary collaboration and ethical situations that may arise are reviewed. The purpose of this article is to assist the behavior analyst in determining best practices for feeding assessments and interventions while maintaining ethical compliance.

Interprofessional collaboration has become an essential component in the treatment of individuals with autism spectrum disorder, as practitioners from a range of disciplines are often necessary to address the core features and co-occurring conditions. Theoretically, such cross-disciplinary collaboration results in superior client care and maximal outcomes by capitalizing on the unique expertise of each collaborating team member. However, conflict in collaborative practice is not uncommon given that the treatment providers come from varying educational backgrounds and may have opposing core values, fundamental goals, and overall approaches. Although the overarching interest of each of these professionals is to improve client outcomes and quality of life, they may be unequipped to effectively navigate the barriers to collaboration. This article reviews the potential benefits and misconceptions surrounding interprofessional collaboration and highlights common sources of conflict. As a proposed solution to many of the identified issues, we offer a set of standards for effective collaborative practice in the interprofessional treatment of autism spectrum disorder. These standards prioritize client care and value each discipline’s education and unique contributions. They are intended to function as core standards for all treatment team members, promote unity, prevent conflict, and ultimately help practitioners achieve the most integrated collaborative practice among professionals of varying disciplines.