 back to another CalPy. This time we're going to be talking about behavioral assessment or assessment. In general, of course, we're behavioral analysts. We're talking about behavioral assessment, which leads me to the first slide, the various issues associated with assessment with behavioral assessment. So first off, we've got to know what's this assessment thing, right? So assessment is a process that you use to go through with regard to discovering information about behavior that you want to know, that you need to know. How often it occurs? What behavior? Under what context? How severe is it? So on and so forth, blah, blah, blah, blah, blah, all these different things. We're going to conduct these things called behavioral assessments, right? Behavioral assessments are pretty cool. All we're going to do is focus on the data of the behavior that's being produced, right? So this obviously leads to some observation stuff and some recording stuff and some definitional stuff and a few other things. But anyway, I digress. So we're going to focus on the data. We're not just going to focus on suspicions. We're not going to focus on what we think happened. We're not going to focus on what we think will happen. We're not going to focus on what we think did happen. We're not going to focus on what we think someone else said about what they think would happen under certain contexts. We're going to focus on the behavior we see. There's lots of different kinds of behaviors that we can observe. Most of them directly, we hope. Some of them indirectly. Not so nice, but we'll come back to that. So again, we're going to focus only on data. If we capture quality data, we'll be able to design quality interventions, right? This criteria, this criteria of using behavioral assessment, focusing on particular data, is the criteria, is one of the criteria that makes behavior analysis so darn effective. We gather evidence, then we treat solely based on that evidence. It's that simple. We're not going to gather evidence and then go, yeah, whatever, we're going to do something else. Or we're not going to gather evidence and go, oh, it's worthless. I'm going to treat something that I didn't measure. That sounds stupid, but it happens, right? So what are the phases? Wow, I jumped ahead there. So anyway, back to the point, kind of sum it up a little bit. The whole issue here is that we are empirical. We are going to focus on direct observation when we can. Then we're going to design our interventions based on the information we have, not the guesses that we want to make. We may have been doing this for so long that we just know that everything is controlled through escape, or we just know that everything is attention maintained. No, you don't just know anything. You better observe it. You better record it, better have quality data. Otherwise, you're being unethical when you design your interventions, because your interventions are going to be targeted at the behavioral problems that you've observed. Okay, so let's break this down into a few more pieces with regard to the types of assessment or the phases of assessment. Here we go. Alright, so the first phase, the one that we always do first where we're not really doing anything other than figuring things out and getting some information from our clients. This is the intake phase. And you know, is the person being treated in the right location? I don't know. Well, it depends on the question that they have or the problem that they have. If they come knocking on your door. Hello, how are you? You say, I'm fine. How are you? They say very good. I would like to learn how to fly an airplane. Like, yeah, wrong place. Go to the airport place. Thank you very much. Have a good day. Bye. What? That sounds kind of dumb, right? How about this one? Hello, how are you? Very good. What do you need today? I am trying to lose some weight and I'd really like to have you work with me on some self management skills. Interesting. Well, I'm a behavior analyst, I may not know much about self management skills. So I might want to do some things. So we'll come back to that. So here we go. Hello. Yes, how are you? I need some help with some anxiety issues that I've been having lately. Oh, wonderful. I'm an expert in working with clients with anxiety. I think I can help you out. See what I'm doing there? Right? Oh, let's try another one. Hello. Yes, I have cancer. Can I help you? Can you help me? No, I cannot stop smoking. Well, maybe I did help you. No, go to a doctor. Go get your cancer treated. You get the point here, folks. It's really simple. If you don't have the expertise to help the person in front of you, then stop trying to help them. You should refer that person to another agency. For example, the person with cancer, you should probably refer to a doctor or an oncologist or something specific, right? But maybe the person with the self management stuff. Well, you know what? Maybe you don't have the skills, but somebody else in your organization does. So find another practitioner. Maybe somebody you work with, right? Maybe you know of a particular practitioner that specializes in self management. You get the idea. The point being that in order to be ethical, you can only do work in the area that you have an expertise in, right? And well, people go, well, how do I get new expertise? You work with someone else who does, right? So if you may not have expertise in self management, but one of your colleagues might so you work with them and learn a bit about self management study, come up with reviews and study the literature and grab a couple of books and see if you can learn something about it, then maybe under supervision with some supervision, you could do some work in the self management area. Now suddenly, you become the person to work with on self management issues. You get the idea, right? All right. So that's that kind of first step of are you here? Or can we help you? And are we willing to take that on because it matches our expertise? So the second point being that inform the client about the program that policies the procedures. Yeah, right. This is a huge step, folks. That's like, I don't know, a week between part one and part two. I don't know. The point I'm getting at is that in a slide like this, it makes it look like it's really fast. So just get done with the first part, you move on to the second part. It doesn't really work that way. It takes a lot more time. Anyway, so you're going to inform the client about the program that you're going to be working on them with. You're going to give them all the details of the program that you might be that you're helping them on all the different reinforcement procedures you're going to use all the context you're going to do the work in all the people that are going to work with your kiddos and all that fun stuff. Then the policies of the organization, what do you have to do? The procedures, the very specific detailed stuff that's going to happen to the client, how it's going to work. What types of reinforcers are you going to use? Of course, you would have had to do an reinforcement assessment in order to figure that out. You get the idea, right? I'm just kind of glossing over stuff here. Make your clients informed. This is another one of those things that if you don't do, you're just being a bad person. Not only that, you're being unethical and you might even be violating all sorts of international agreements and I'm not joking. Informed consent is an important piece. Consent is one thing. Informed consent is something entirely different. If I say, hey, can I treat you for your smoking behavior? They say, sure. Was that informed consent? Or was that just consent? It's just consent. You didn't tell them anything about what you're going to do. Because, for example, I might beat you with a stick every time I see you pick up the cigarette and now you're like, no, no, whoa, whoa, I don't want part of that one. That is not me. Not going to do that. Sorry, I'm going to go to a different clinic. Right, makes some sense. But if you say, hey, here's the deal. We're going to look at smoking as an interaction between biological cravings the drug that you're consuming and the behavior itself of smoking the cigarette. So we're going to understand that cravings themselves are responses. So we're going to try to put those responses on extinction. And how we're going to do that is by making sure that when you have a craving, you record it, but you're not going to follow that craving with a cigarette as best of your ability. And we're going to work on tools that you can use to do that. Do you feel like something that you could do? We're not going to be doing any punishment. We're not going to hit you with anything. We're going to use this particular procedure. I'm going to have you grab some of your responses and then I'm going to have you reinforce yourself when you engage in appropriate behavior for certain amounts of time. And we're going to record that. You're going to come back in here. We're going to report it. We're going to work together on this stuff, blah, blah, blah, blah. Would you like to participate in that program? Do you think that's going to meet your needs? Or is there anything that you might want to tweak with that? Or is there anything that makes you uncomfortable? Wow, folks, do you see the difference here? One's informed, one's not. Like, not at all. Anyway, so informed consent is the key. The other thing is there a crisis going on, right? Somebody's getting beat up. Somebody's getting hurt physically. They're hurting themselves or hurting other people. There's abuse. Somebody's threatening suicide. Somebody's got a plan. Somebody's got all this stuff going on that you need to be aware of that you're finding out during the intake phase. Why? Because if there is a crisis, get them help now. The dollars that you're going to make through your organization and your work have nothing, have no weight compared to helping someone through a crisis. Get them the support they need and get it immediately. If that means calling a suicide hotline, you call the hotline for them. Maybe, maybe not, right? You get the client the help they need. So this is not something you say, oh, well, we're going to have to do a little bit of paperwork here and come back and see you in a week. In the meantime, why don't you just rip your nose off your face, right? Self-injurious behavior can be really difficult for people. So you need to get attention for that right away, right? And suicide and all of the different things that may be out there that qualify as a crisis. Immediate treatment, right? We're just going to jump the line. That's the key. Hopefully, you won't have to send them to another practitioner, but you better if you don't have expertise in the area. Again, go back to point one. All right. Making some DSM diagnosis, right? You're not going to be qualified to do that. Send them to the right people. But why is it required? Well, sometimes you have to have a diagnosis in order to access treatment. Why is that? Because insurance may need a diagnosis in order for them to pay for the treatment that they're seeking through, through you. So you might have to collaborate with other people in order to get that diagnosis. This is a really common thing. Oftentimes we're collaborating with medical doctors. You're collaborating with a neuro developmental psychologist, psychopathology type stuff, all sorts of all sorts of folks and experts in the field that you're going to have to to collaborate with in order to get the diagnosis you need to help the clients get the get the treatment that they need. This is one of those things that really I didn't think about insurance when I was just getting into behavior analysis. Well, you better be because that's who pays the bills. Right. A lot of times, not always. All right. Are there any indicators going on? Is something indicates something else? Are you seeing, you know, maybe indicators for drug use? Are you seeing indicators for other neurological issues that may be popping up? Are you seeing some other things that may need other professionals to help to come in and help out? Are people just talking about things that indicate problems? Well, if so, maybe you need to get them to be a bit more specific. This indicators question is kind of a well, you know, there's goods and bads about indicators. But I like to think of them as indirect sort of things that help you direct your focus into areas that will help the client. But oftentimes, again, you just need to be sensitive to see, are you actually going to be able to provide the support you need? And there's a whole bunch of other stuff to the intake with regard to what types of assessments you do, what types of questions you have. And it would take, I don't know, the rest of the YouTube time of all of it in order to explain all those because each client is drastically different. Each problem is different. You're going to have to take different methods of assessment. If you're working with autism, then you are working with self-management issues. Or if you're working with marriage and family issues, or you're working with parenting issues, everything's got a different little layer to it. But remember, you're trying to observe the behaviors and question that the client has come to you to try to address. Okay, that's really what we're going to focus on. There's a couple other phases here. So let's take a look at the baseline. In behavior analysis, we're like awesome, right? Because we do everything database. And that's the most horrific line ever, I apologize. But the point is, is that we're going to capture a baseline, we're going to see where you're at. How many cigarettes are you smoking today? How many verbal outbursts are you having in classrooms? How many times did you bang on a wall? How many times did you, I don't know, pick your nose? Whatever it is, how many times did you in flip a fidget spinner around today? Whatever, right? So the baseline is the phase where we're going to figure out where you're currently at with something. What value is that? It's an awesome value because it allows you to then make comparisons on the effectiveness of your treatment. Okay, so we're going to look at the target behavior, we're going to be specific and we're going to define it really well. We'll come back and look at that later. Okay, stability is the criteria. Now notice this line is like up and down, up and down, up and down. It's actually stable. Why? Because I tell you it's stable. Sorry. Stability is hard to tell. You have to have some criteria for it. Usually it has to do with predictability. Are you reasonably predicting? Can you reasonably predict where that next data point is going to be? If so, you're probably stable. So steady state is another way to kind of think of this is this behavior steady enough in order to transition into another phase to see if we could change it. And I would say yes, this one is sure there's some variability because there's always going to be, but it should be okay. Treatment. Alright, so this is the phase in which you're engaging in the treatment. So we got this kid that's picking his nose at such a level. Now we're going to engage in an, I don't know, an extinction procedure, a DRA procedure and we're going to get the kid to do something else instead of picking his nose, but we're still going to track picking his nose. So we're going to see that behavior decrease with any luck and look, the graph, it shows it the intervention is happening. And we're actually going to find out did our intervention have an effect? Right. Constant observation. And there's a lot of different ways to do that, which we will get into shortly. And in the follow up, did, did the baby maintain at a low level or did nose picking come right back? In this case, it seems like it came back ish, right, a little bit, but way lower than it was during baseline. Look at that beautiful design. Look at that thing. It may not be experimental. It's basically an AB design with a follow up. But wow, holy cow. You'd start a way up there. You went through an intervention, which reduced the behavior, then boom, it stayed, it generalized, it maintained. How awesome is that? All right. So where do we get data from? We got indirect assessments. No, I hate indirect assessments, but they're not that bad, but they are, but they're out, but they're okay, but they're not, but they're awful, but they're good, but they're, oh my gosh. I'm torn as a behavior analyst. I love data. I want data. I want it from everywhere because it helps me draw conclusions. It helps me inform what I'm going to be doing. But it may not be valid if it comes from other people. It may not even be valid if the data comes from what the client is saying about their own behavior. I'll say that again. It may not even be valid if the client, if it's coming from the client about what they're saying about their own behavior. Hmm. Why is that? Because we're really bad observers of our own behavior. Right? We are. We don't do a good job of monitoring our own responses. That's a skill that you need to develop in people. And that's part of the self management stuff. Anyway, so we're going to do interviews with people with the client and with people close to them to find out what's the problem under what conditions is it happening? How often is it happening? Is there a certain time of day? Are there certain types of medicines that you are taking when it occurs? Is there a certain type of medications that you're taking when it doesn't occur? Are there certain people present when your behavior happens? Are there certain people when you're not present when you pick your nose? Do you only pick your nose in front of your grandma? Do you only pick your nose in front of your grandpa? Do you get the idea, right? We're going to interview everybody and we're going to get all the information we possibly can. We're going to give out questionnaires, right? How often did you engage in the behavior that you're, you know, so questionnaires, how often? Intensity of the response. Whatever it may be. So we can do it on paper, right? There's some issues here. There's self-report. Self-report sucks for a lot of reasons, but basically, like I said earlier, people don't track their own behavior well. Subsequently, when you're engaging in self-report, the accuracy drops. Again, indirect. Life history, okay? That might be pretty obvious there. Behavioral checklists. Did you do this? Did you do this? Did you do this? Did you do this? Did you do this? Did you do this? Did you do this? Did you do this? Just a list of behaviors that you check off. Yes, I've done that. No, I haven't done that. Yes, I've done that. No, I haven't done that. Yes, I have, yes, I have, yes, I have, yes, I have. You get the idea. Okay. Role playing, if you can't directly observe the context, if you can't set up a situation. Oh, I used to study a bunch of condom use stuff, and we did a ton of role-playing, right? Why? Because you can't really go to someone's house the moment they're about ready to have sex and say, Oh, I need to observe your, your, your, your self management skills and make sure that you're able to be assertive about your desire to use condoms. Right? So what we did, we brought in the class, sorry, I'm just having a moment there. So we bring into the classroom, we'd say, All right, Bob, and whoever and you guys are about your all heated and everything's going. Now one of you needs to bring up the fact that you need to have a you should probably be using condoms. Okay, so it's role playing, you're setting up the scenario as if it's real, it isn't real, which makes it indirect, but it's useful when you can't observe the person in the real situation. Right? It's still an as if, right, because people usually know what they're going to do, you know, that they're kind of planning what they're going to do, and it may not be accurate, because in those role plays with the condoms, of course, I'm going to whip out a condom out of my pocket. Here it is. It's a blank blank, because I'm not going to do brand placement, right? It's a blank blank. And oh my gosh, it's the best fitting ever. I love it. And you get into the real world. And you're like, Hmm, God, God, God, God, God, God, God, God, God, God. It's an awkward topic. I'm just going to be quiet and not say anything and hope the other party. I hope my partner said something about it. Yeah, you see the difference. All right. So the role playing is okay, but it still produces some problems. Self monitoring. And why is this indirect? Because why? Because you're trusting what someone else says about their own behavior. Now you can teach someone to do effective self monitoring and you can reinforce them for being accurate if you happen to know if they're accurate or not. However, we won't know that. So self monitoring is really just an indirect thing. The tracking their own behavior is accurate or not, right? More sources of information assessment stuff, direct assessment. Yeah, we love this one direct observation. It is the most preferred method of behavior analysis. We want to see it happen. We want to count it. We want to see how often under what context and all that stuff we are going to watch. That's the big eye. We are empirical, right? We are seeing things. We're going to measure it directly. We're going to, we're going to be scientific as possible. This is one of those things that sets us apart from the other areas of psychology. We could do a functional analysis, right? We could actually do a functional assessment too, which is probably what I was referring to with regard to direct assessment, but see a later lecture on functional analysis assessment, you'll understand. Alright, so functional analysis. Here we go. So functional analysis is something really cool. I often call this FB, big A, or all FBA, all big letters, right? Versus the FBA. So functional assessment is a little bit smaller. Functional analysis is this highly controlled experiment where you find what is actually controlling the behavior. Get it? You do a darn experiment. You put a reversal procedure in place and or a withdrawal procedure in place and you actually determine what is the function of this response, what reinforcers are maintaining it and under what context. There is zero guesswork with an FB, big A. Functional behavior analysis, a functional behavior assessments, a little bit of a smaller thing. It involves less of this high degrees of control. So you're basically never going to do a functional analysis, but you need to know that if somebody says, I did a functional analysis and they're like, yeah, it took you like 15 minutes. No, you didn't. If you didn't bring it into the lab to adjourn, sorry, you're not bringing it to the lab, but if you didn't do a genuine AB, AB design, then you didn't do a functional analysis. If you didn't do all certainly there's all the types of designs that you could use, but AB, AB would probably be the most popular. If you didn't prove basically experimentally that the behavior is functioning for a particular reason, then you didn't do an FB, big A. Anyway, I think that's enough for now. I'm way farther into this than it should be. Bye. See you.