A Preliminary Analysis of the Effects of Clicker Training and Verbal Instructions on the Acquisition of Relationship-Building Skills in Two Applied Behavior Analysis Practitioners
Tóm tắt
Recent research has emphasized the need for training and competency beyond the standard technical skills acquired by applied behavior analysis (ABA) practitioners, including essential relationship-building and compassionate care skills (Taylor et al., 2019). Clicker training is a well-established behavior-analytic method for improving performance via immediate feedback in the form of an audible “click.” The effectiveness of clicker training has not yet been evaluated as a technique for shaping complex clinical repertoires. This study evaluated the effects of verbal instructions, clicker training, and role-play on the acquisition of therapeutic relationship skills in ABA practitioners. Data were obtained as part of a training program conducted within an ABA agency, and the acquisition of target skills was evaluated using a multiple-baseline design across behaviors for two participants. During baseline, participants rarely demonstrated target skills. During training, the procedure resulted in increased engagement in all three target skills for both participants. Skill generalization with respect to untrained and novel scenarios was observed but at levels below mastery. Findings have potential implications for trainers and supervisors seeking efficient, nonintrusive, socially acceptable methods of improving practitioner performance.
Tài liệu tham khảo
Behavior Analyst Certification Board. (2020). BACB certificant data. https://www.bacb.com/bacb-certificant-data/
Belting, T., Joseph, J., Messersmith, M., & Nordone, L. (1998). Teaching an old polar bear new tricks. Soundings, 23, 20–22.
Brown, R. L., & Oriel, K. (1998). Teaching motivational interviewing to first-year students. Academic Medicine, 73, 589–590.
Callahan, K., Foxx, R. M., Swierczynski, A., Aerts, X., Mehta, S., McComb, M., Nichols, S. M., Segal, G., Donald, A., & Sharma, R. (2019). Behavioral artistry: Examining the relationship between the interpersonal skills and effective practice repertoires of applied behavior analysis practitioners. Journal of Autism and Developmental Disorders, 49(9), 3557–3570. https://doi.org/10.1007/s10803-019-04082-1.
Christopher, P. J., & Dougher, M. J. (2009). A behavior-analytic account of motivational interviewing. The Behavior Analyst, 32(1), 149–161. https://doi.org/10.1007/BF03392180.
Codding, R. S., Feinberg, A. B., Dunn, E., & Pace, G. M. (2005). Effects of immediate performance feedback on implementation of behavior support plans. Journal of Applied Behavior Analysis, 38, 205–219. https://doi.org/10.1901/jaba.2005.98-04.
Ducharme, J. M., & Feldman, M. A. (1992). Comparison of staff training strategies to promote generalized teaching skills. Journal of Applied Behavior Analysis, 25(1), 165–179. https://doi.org/10.1901/jaba.1992.25-165.
Ennett, T. M., Zonneveld, K. L. M., Thompson, K. M., Vause, T., & Ditor, D. (2020). Comparison of two TAGteach error-correction procedures to teach beginner yoga poses to adults. Journal of Applied Behavior Analysis, 53(1), 222–236. https://doi.org/10.1002/jaba.550.
Fjellanger, R., Andersen, E. K., & McLean, I. G. (2002). A training program for filter-search mine detection dogs. International Journal of Comparative Psychology, 15(4), 278–287. https://doi.org/10.1007/BF03392235.
Fogel, V. A., Miltenberger, R. G., Graves, R., & Koehler, S. (2010). The effects of exergaming on physical activity among inactive children in a physical education classroom. Journal of Applied Behavior Analysis, 43(4), 591–600.
Follette, W. C., Naugle, A. E., & Callaghan, G. M. (1996). A radical behavioral understanding of the therapeutic relationship in effecting change. Behavior Therapy, 27, 623–641. https://doi.org/10.1016/S0005-7894(96)80047-5.
Foxx, R. M. (1996). Twenty years of applied behavior analysis in treating the most severe problem behavior: Lessons learned. The Behavior Analyst, 19(2), 225–235. https://doi.org/10.1007/BF03393166.
Hayes, S., & Wilson. (2011). Acceptance and commitment therapy: The process and practice of mindful change. Guilford Press.
Herron, M. A., Lotfizadeh, A. D., & Poling, A. (2018). Using conditioned reinforcers to improve behavior-change skills: Clicker training for practitioners. Journal of Organizational Behavior Management, 38(2–3), 172–190. https://doi.org/10.1080/01608061.2018.1454874.
Hojat, M., Louis, D. Z., Markham, F. W., Wender, R., Rabinowitz, C., & Gonnella, J. S. (2011). Physicians’ empathy and clinical outcomes for diabetic patients. Academic Medicine, 86(3), 359–364. https://doi.org/10.1097/ACM.0b013e3182086fe1.
Kelley, J. M., Kraft-Todd, G., Schapira, L., Kossowsky, J., & Riess, H. (2014). The influence of the patient–clinician relationship on healthcare outcomes: A systematic review and meta-analysis of randomized controlled trials. PLOS ONE, 9(4), e94207. https://doi.org/10.1371/journal.pone.0094207.
Kerns, C. M., Collier, A., Lewin, A. B., & Storch, E. A. (2018). Therapeutic alliance in youth with autism spectrum disorder receiving cognitive-behavioral treatment for anxiety. Autism, 22(5), 636–640. https://doi.org/10.1177/1362361316685556.
Kim, S. S., Kaplowitz, S., & Johnston, M. V. (2004). The effects of physician empathy on patient satisfaction and compliance. Evaluation & the Health Professions, 27(3), 237–251. https://doi.org/10.1177/0163278704267037.
Kissel, R. C., Whitman, T. L., & Reid, D. H. (1983). An institutional staff training and self-management program for developing multiple self-care skills in severely/profoundly retarded individuals. Journal of Applied Behavior Analysis, 16(4), 395–415.
Langbein, J., Siebert, K., Nuernberg, G., & Manteuffel, G. (2007). The impact of acoustical secondary reinforcement during shape discrimination learning of dwarf goats. Applied Animal Behaviour Science, 103(1–2), 35–44. https://doi.org/10.1016/j.applanim.2006.04.019.
Lattal, K. A. (2010). Delayed reinforcement of operant behavior. Journal of the Experimental Analysis of Behavior, 93, 129–139. https://doi.org/10.1901/jeab.2010.93-129.
Leaf, J. B., Cihon, J. H., Ferguson, J. L., Milne, C. M., Leaf, R., & McEachin, J. (2020). Advances in our understanding of behavioral intervention: 1980 to 2020 for individuals diagnosed with autism spectrum disorder. Journal of Autism and Developmental Disorders. Advance online publication. https://doi.org/10.1007/s10803-020-04481-9.
Leaf, J. B., Leaf, R., McEachin, J., Taubman, M., Ala’i-Rosales, S., Ross, R. K., Smith, T., & Weiss, M. J. (2016). Applied behavior analysis is a science and, therefore, progressive. Journal of Autism and Developmental Disorders, 46(2), 720–731. https://doi.org/10.1007/s10803-015-2591-6
LeBlanc, L. A., Sellers, T. P., & Ala’i, S. (2020a). Building and sustaining meaningful and effective relationships as a supervisor and mentor. Sloan Publishing.
LeBlanc, L. A., Taylor, B. A., & Marchese, N. V. (2020b). The training experiences of behavior analysts: Compassionate care and therapeutic relationships with caregivers. Behavior Analysis in Practice, 13, 387–393. https://doi.org/10.1007/s40617-019-00368-z.
Lejuez, C. W., Hopko, D. R., Levine, S., Gholkar, R., & Collins, L. M. (2005). The therapeutic alliance in behavior therapy. Psychotherapy: Theory, Research, Practice, Training, 42(4), 456–468. https://doi.org/10.1037/0033-3204.42.4.456.
Levy, I. M., Pryor, K. W., & McKeon, T. R. (2016). Is teaching simple surgical skills using an operant learning program more effective than teaching by demonstration? Clinical Orthopedic Related Research, 474(4), 945–955. https://doi.org/10.1007/s11999-015-4555-8.
Lupu, A., Autumn, L., Stewart, & O’Neil, C. (2012). Instructional design and assessment: Comparison of active learning strategies for motivational interviewing skills, knowledge, and confidence in first-year pharmacy students. American Journal of Pharmaceutical Education, 76(2), 28.
Martin, D. J., Garske, J. P., & Davis, M. K. (2000). Relation of the therapeutic alliance with outcome and other variables: A meta-analytic review. Journal of Consulting and Clinical Psychology, 68(3), 438–450. https://doi.org/10.1037/0022-006X.68.3.438.
Martino, S., Haeseler, F., Belitsky, R., Pantalon, M., & Fortin IV, A. H. (2007). Teaching brief motivational interviewing to year three medical students. Medical Education, 41(2), 160–167. https://doi.org/10.1111/j.1365-2929.2006.02673.x.
McKay, K. M., Imel, Z. E., & Wampold, B. E. (2006). Psychiatrist effects in the psychopharmacological treatment of depression. Journal of Affective Disorders, 92(2–3), 287–290. https://doi.org/10.1016/j.jad.2006.01.020.
Mononen, K., Konttinen, N., Viitasalo, J., & Era, P. (2007). Relationships between postural balance, rifle stability and shooting accuracy among novice rifle shooters. Scandinavian Journal of Medical Science in Sports, 17(2), 180–185. https://doi.org/10.1111/j.1600-0838.2006.00549.x.
Neef, N. A., Lensbower, J., Hockersmith, I., DePalma, V., & Gray, K. (1990). In vivo versus simulation training: An interactional analysis of range and type of training exemplars. Journal of Applied Behavior Analysis, 23(4), 447–458. https://doi.org/10.1901/jaba.1990.23-447.
Nigro-Bruzzi, D., & Sturmey, P. (2010). The effects of behavioral skills training on mand training by staff and unprompted vocal mands by children. Journal of Applied Behavior Analysis, 43(4), 757–761. https://doi.org/10.1901/jaba.2010.43-757.
Parsons, M. B., Rollyson, J. H., & Reid, D. H. (2013). Teaching practitioners to conduct behavioral skills training: A pyramidal approach for training multiple human service staff. Behavior Analysis in Practice, 6(2), 4–16. https://doi.org/10.1007/BF03391798.
Persicke, A., Jackson, M., & Adams, A. N. (2014). Brief report: An evaluation of TAGteach components to decrease toe-walking in a 4-year-old child with autism. Journal of Autism and Developmental Disorders, 44(4), 965–968. https://doi.org/10.1007/s10803-013-1934-4.
Poirier, M. K., Clark, M. M., Cerhan, J. H., Pruthi, S., Geda, Y. E., & Dale, L. C. (2004). Teaching motivational interviewing to first-year medical students to improve counseling skills in health behavior change. Mayo Clinic Proceedings, 79, 327−331.
Pryor, K. (1999). Don’t shoot the dog: The new art of teaching and training (Rev. ed.). Bantam.
Quinn, M. J., Miltenberger, R. G., & Fogel, V. A. (2015). Using TAGteach to improve the proficiency of dance movements. Journal of Applied Behavior Analysis, 48(1), 11–24. https://doi.org/10.1002/jaba.191
Riess, H., Kelley, J. M., Bailey, R. W., Dunn, E. J., & Phillips, M. (2012). Empathy training for resident physicians: A randomized controlled trial of a neuroscience-informed curriculum. Journal of General Internal Medicine, 27(10), 1280–1286. https://doi.org/10.1007/s11606-012-2063-z.
Rollnick, S., Kinnersley, P., & Butler, C. (2002). Context-bound communication skills training: Development of a new method. Medical Education, 36(4), 377–383. https://doi.org/10.1046/j.1365-2923.2002.01174.x.
Romani, P. W., Alcorn, A. S., & Linares, J. (2018). Improving accuracy of data collection on a psychiatric unit for children diagnosed with intellectual and developmental disabilities. Behavior Analysis in Practice, 11(4), 307–314. https://doi.org/10.1007/s40617-018-00305-6.
Rosales, R., Stone, K., & Rehfeldt, R. A. (2009). The effects of behavioral skills training on implementation of the picture exchange communication system. Journal of Applied Behavior Analysis, 42(3), 541–549. https://doi.org/10.1901/jaba.2009.42-541.
Sarokoff, R. A., & Sturmey, P. (2004). The effects of behavioral skills training on staff implementation of discrete-trial teaching. Journal of Applied Behavior Analysis, 37(4), 535–538. https://doi.org/10.1901/jaba.2004.37-535.
Sellers, T. P., Alai-Rosales, S., & MacDonald, R. P. (2016). Taking full responsibility: The ethics of supervision in behavior analytic practice. Behavior Analysis in Practice, 9(4), 299–308. https://doi.org/10.1007/s40617-016-0144-x.
Stokes, J. V., Luiselli, J. K., & Reed, D. D. (2010). A behavioral intervention for teaching tackling skills to high school football athletes. Journal of Applied Behavior Analysis, 43(3), 509–512. https://doi.org/10.1901/jaba.2010.43-509.
Taylor, B. A., LeBlanc, L. A., & Nosik, M. R. (2019). Compassionate care in behavior analytic treatment: Can outcomes be enhanced by attending to relationships with caregivers? Behavior Analysis in Practice, 12(3), 654–666. https://doi.org/10.1007/s40617-018-00289-3.
Varelas, A., & Fields, L. (2017). Equivalence based instruction by group based clicker training and sorting tests. The Psychological Record, 67(1), 71–80. https://doi.org/10.1007/s40732-016-0208-x.
Vermeire, E., Hearnshaw, H., Van Royen, P., & Denekens, J. (2001). Patient adherence to treatment: Three decades of research. A comprehensive review. Journal of Clinical Pharmacy and Therapeutics, 26(5), 331–342. https://doi.org/10.1046/j.1365-2710.2001.00363.x.
Vorbeck, B., & Bördlein, C. (2020). Using auditory feedback in body weight training. Journal of Applied Behavior Analysis. Advance online publication. https://doi.org/10.1002/jaba.723.
Wampold, B. E., & Imel, Z. E. (2015). The great psychotherapy debate: The evidence for what makes psychotherapy work (2nd ed.) Routledge/Taylor & Francis Group.
Wertalik, J. L., & Kubina, R. M. (2018). Comparison of TAGteach and video modeling to teach daily living skills to adolescents with autism. Journal of Behavioral Education, 27(2), 279–300. https://doi.org/10.1007/s10864-017-9285-4.
Wilder, D. A., Ertel, H., Hodges, A. C., Thomas, R., & Luong, N. (2020). The use of auditory feedback and edible reinforcement to decrease toe walking among children with autism. Journal of Applied Behavior Analysis, 53, 554–562. https://doi.org/10.1002/jaba.607.
Wilson, K. G., & DuFrene, T. (2008). Mindfulness for two: An acceptance and commitment therapy approach to mindfulness in psychotherapy. New Harbinger Publications.
Wolf, M. M. (1978). Social validity: The case for subjective measurement or how applied behavior analysis is finding its heart. Journal of Applied Behavior Analysis, 11(2), 203–214. https://doi.org/10.1901/jaba.1978.11-203.