(REC) Addressing the Behavior Cusp Skills of Tolerating Routines Related to health and safety and environmental aversives: prioritizing assent while staying healthy and expanding reinforcers

People with Intellectual and Developmental Disabilities (IDD) are at risk for a high rate of medical problems and regular trauma from daily care to prevent and treat health and safety issues. Those who need the highest level of care often have the least access to it and face challenges with communication with medical providers and toleration of preventative and reactive care. Additionally, they face social isolation and the loss of additional skills with a narrow range of reinforcing activities, which often grows narrower the older they get if these tolerating skills are not addressed proactively.

After a thorough discussion of the ethics involved, we present a practical, evidence-based ethical decision-making process for selecting and designing curriculum for desensitization targets depending on the type of social significance for the learner including skills necessary for current and future health and safety as well as skills necessary to expand leisure activities and increase community access and involvement.

Discussion topics include the process of designing an assessment that determines social significance with client assent is the first step, and subsequent curriculum design including treatment packages such as Calm Counts, Skills Based Treatment and Essential for Living.

Learning Objectives:

• Attendees will identify ethical issues regarding selection and process for teaching these skills.
• Attendees will learn to assess what skills would be behavior cusps for a specific learner based on their health needs and family culture.
• Attendees will learn how to determine the most effective and ethical treatment procedure for health and safety routines, given their client’s profile and needs. 
• Attendees will become familiar with current forms of procedural technology and guidance on how to combine those within a desensitization program.
• Attendees will plan for care coordination with caregivers and providers.

Presenter Bio

Emily (she/her) has worked in the field of ABA field 1999 using evidence-based practices with children and their families in homes, schools and the community. She received her master’s degree in special education from Sonoma State University in 2008, focusing on using ABA to increase prelinguistic communication among young children with atypical language development. Her current professional passions involve instructional design using a component/composite analysis to help learners get the most out of learning time with generative learning; designing teaching contexts based on client assent with a foundation of rapport; and teaching practitioners to make in-the-moment clinical adjustments and use shaping and the teaching context as the reinforcer. She is currently delving into Non-Linear Contingency Analysis. Emily enjoys working with the “newly minted BCBA” to support others in analyze behavior from a comprehensive lens and program accordingly.