Ethics for Behavior Analysts Ch 1 How We Got Here

1. Ethics for Behavior AnalystsCh 1 How We Got Here Presenter Kenneth F. Reeve, Ph.D, BCBA-D Caldwell College

2. Recent Events In spring 2010, the BACB undertook a review of the Guidelines Expert panel consisting of certificants Jon Bailey (chair), Jose Martinez-Diaz, Wayne Fuqua, Ellie Kazemi, Sharon Reeve, and Jerry Shook (chief executive officer of the board) was created. The panel recommended rather minor changes to the Guidelines overall but did include some new procedures including risk�benefit analysis.

3. What Led to Ethics Code? Abhorrent when individuals who are developmentally disabled are victims of abuse. Especially disturbing when abuse come at the hands of your chosen profession. Is exactly what happened in Florida (and elsewhere) in the early 1970s. Abuses changed course of history for behavior analysis and treatment of people with disabilities.

4. State of ABA Circa 1960s �Behavior Modification� was all the rage. (Yeah, baby!) ABA only started in the mid-1960s (Krasner & Ullmann, 1965; Neuringer & Michael, 1970; Ullmann & Krasner, 1965) Behavior modification�s early promoters promised dramatic, quick changes in behavior Aversives used with abandon for self-injurious, destructive, and inappropriate behavior ABA said to be easy to produce changes and could be carried out by almost anyone Could become competent with an attendance certificate from a day-long �behavior mod� workshop!!

5. State of ABA Circa 1960s �You don�t have to know why a behavior occurs, only that it was learned. You need to know only how to manipulate consequences.� No consideration given to �causes� of behavior or that there might be a connection between a likely cause and an effective treatment. Food very commonly used as primary reinforcers. No thought was given to possible side effects of using food (e.g., food allergies, weight gain) or how the food, often candy, might be handled.

6. State of ABA Circa 1960s Much of the work of the early behavior analysts was in severe behavior units in institutions This was a residential facility for developmentally disabled individuals, severe mental retardation, physical disabilities, and non-functional behaviors Hospital housing 300 to 1,500 �patients.� http://www.youtube.com/watch?v=BjvckUFcNmM&feature=related http://www.youtube.com/watch?v=k_sYn8DnlH4 http://sproutflix.org/content/willowbrook-last-great-disgrace

7. State of ABA Circa 1960s ABA staff members� pockets were usually loaded with hot pepper sauces, lemon juice, and M&Ms Custodial care was the norm until �behavior mod� came along and offered dramatic treatment for severe behavior problems. So�we were the first hope for these individuals, BUT� With no guidelines and minimal restrictions, �treatment� often turned into abuse.

8. Sunland Miami Scandal Sunland Training Center in Miami became �ground zero� for abuse investigation in Florida in 1972. Center had high turnover rates resulting in frequent understaffing and low-quality training. Majority of �cottage parents� were college students In 1969, superintendent resigned after �allegations of resident abuse� in which confined two residents in a �cell improvised from a large trailer� (McAllister, 1972).

9. Sunland Miami Scandal In 1971, Florida Division of Mental Retardation and the Dade County investigated resident abuse that had allegedly occurred with the apparent knowledge and approval of top administrators! 7 individuals were suspended, including the superintendent, the director of Cottage Life, the staff psychologist, three cottage supervisors, and a cottage parent. Each was charged with �misfeasance, malfeasance, negligence, and contributing to the abuse of residents�

10. Sunland Miami Scandal Resulted in formation of 9-member Blue Ribbon Panel �Resident Abuse Investigating Committee� Had experts in MR, an attorney, social worker, client advocate, and two behavior analysts (Dr. Jack May, Jr., and Dr. Todd Risley). Panel interviewed more than 70 individuals, including current staff members, former employees, residents, and relatives of residents Committee also examined original logs, internal memoranda, a personal diary, and personnel records. One resident had died from dehydration, and another drowned in a canal in escape attempt

11. Sunland Miami Scandal Panel uncovered that Dr. E., a staff psychologist who called himself an expert in behavior mod had established a �treatment� program that consisted of: forced public masturbation forced public homosexual acts forced washing of the mouth with soap beatings with wooden paddle excessive use of restraints forced to sit in a bathtub for 2 days Isolation Forced wearing of embarrassing signs or clothing Forced sleeping in urine-soaked sheets

12. Sunland Miami Scandal In Dr. E�s �Achievement Division,� these procedures were systematically applied, condoned by supervisors and professional staff, and recorded in daily living unit logs! Procedures were not only were used openly but also were, at least initially, well researched. A token program, for example, had been modeled after one first developed in Parsons, Kansas, by Dr. James Lent BUT�procedural fidelity was not carried out (poorly trained staff were left to their own devices to implement interventions) �Behavior drift� on part of the staff is not uncommon in residential treatment facilities

13. Sunland Miami Scandal Written policies at Sunland Miami clearly prohibited abusive practices but administration saw them as behavior modification procedures Investigative committee, however, completely disagreed Committee also found that Dr. E had exaggerated his credentials and really had little training in ABA principles

14. Blue Ribbon Panel Recommendations Statewide advocacy program: staff members allowed unannounced visits to residential institutions and to collect information from personnel, residents, parents, staff, and concerned citizens. professional peer review of behavior programs to assure treatment is derived from research literature and that no procedures would be used that were considered �experimental� (unproven) �Experimental� programs would come under standard review for human experimentation in Division of Retardation Prohibition of bizarre punishment Abandoning seclusion in favor of positive and appropriate �time out� techniques

15. What Followed? After Sunland scandal, Florida Association for Retarded Children (now Association for Retarded Citizens of Florida) took up the cause of humane treatment They endorsed data-based behavioral treatment, strict guidelines, and close supervision by properly trained professionals. The Division of Retardation set up both statewide and local peer review committees for behavior modification programming in Florida

16. What Followed? Statewide Peer Review Committee for Behavior Modification (PRC) established guidelines for use of behavioral procedures (later adopted by the National Association for Retarded Citizens and by Florida Division of Retardation By 1980, PRC encouraged institutions, group homes, and smaller residential facilities to begin networking with one another PRC urged bringing �professionalism� to behavior analysis in Florida and held 2-day conference in 1980 1st annual conference of the Florida Association for Behavior Analysis (FABA) was held in 1981, with B. F. Skinner as keynote

17. What Followed? Although common today, FABA conference was a game changer in that leaders in the field were routinely being brought to a state conference to present latest applied behavioral research Practitioners now had an opportunity to see firsthand what others were doing in other parts of the country for behavior problems Administrators from state government and private facilities could see that behavior analysis was not just some local phenomenon but rather was a treatment approach that was legitimate, effective, and humane.

18. What Followed? The PRC, in conjunction with FABA, began the process of certifying behavior analysts via a testing program sponsored by the Division of Retardation. In 1988, FABA membership adopted the FABA Code of Ethics, the first state association of ABAI to do so.

19. Legacy of Abuses Abuses by early �behavior modifiers� often led to total banning of ABA altogether (a recommendation still espoused by many today!) In case of Sunland, panel was convinced by the behavior analysts (Risley and May) that was better to establish strict guidelines for treatment and� to set up an infrastructure for oversight involving community citizens who would bring values, common sense, and good judgment to evaluate behavioral treatment strategies on an ongoing basis (public appraisal of behavior analysis!)