Realigning DDS Clinical-Behavioral Supports Better

Transcript:Realigning DDS Clinical-Behavioral Supports Better:
Realigning DDS Clinical-Behavioral Supports Better Understanding PBS and ABA Peter Tolisano, Psy.D. ABPP Board Certified in Clinical Psychology Director of Psychological Services Connecticut Department of Developmental Services Vincent Covino, Ph.D. Director of Clinical Services, North Region Connecticut Department of Developmental Services Realigning Clinical-Behavioral Supports Goals of Training: 1. Identify the similarities and differences that exist between the Positive Behavior Support and Applied Behavior Analysis. 2. Grasp the limitations of a Medical Model and coercive methods. 3. Appreciate the individual and systemic benefits of a Positive Behavior Support approach. 4. Better understand the key components of a comprehensive Positive Behavior Support plan. 5. Learn the updated DDS qualifying requirements and process for PBS versus ABA providers. 3 Realigning Clinical-Behavioral Supports In general, Positive Behavior Support (PBS) constitutes a distinct discipline and a different service delivery model from Applied Behavioral Analysis (ABA) While the science of behavior underlies both PBS and ABA (e.g., functional assessment as a cornerstone), ABA is primarily guided by the behavioral research literature. PBS, in addition to guidance from various research literatures, places an emphasis on cultural and social values, as well as supports the movement toward deinstitutionalization, normalization, and inclusion for individuals with developmental disabilities. The attributes of PBS are consistent with the mission of the Department of Developmental Services (DDS) that aspires to partner with the individuals we support and their families, to support lifelong planning and to join with others to create and promote meaningful opportunities for individuals to fully participate as valued members of their communities. 4 The Traditions of Applied Behavioral Analysis An ABA program analyzes the interaction between purposeful behavior and a changeable environment, especially operant conditioning. The strength of ABA is focusing a narrow lens on intervening and modifying a specific behavior through prescriptive techniques that are data-driven. That is, concentrating on what occurs directly before, during, and after a maladaptive behavior in order to form a functional hypothesis as to why the individual is behaving in a certain way. ABA is developed by Board Certified Behavioral Analysts. This approach has been demonstrated as very effective for individuals diagnosed with an autism spectrum disorder. Agencies and families should appreciate the strengths and limitations of ABA, especially the potential for over-applying the model in cases with more complex behavioral challenges. 5 Why not rely on a Medical Model? Maladaptive behaviors are conceptualized as a sign of an underlying disease or reflective of