- Define what is meant by “program book”
- Discuss general components within a learner’s ABA program book
- Discuss each component and give possible examples
What is a program book?
A program book contains all the information a therapist/RBT needs to effectively run each therapy session.
It includes specific information about the learner’s:
- Skill acquisition tasks – what they are learning
- Challenging behavior’s being targeted – Behavior Intervention Plans (BIPs)
- Collected data – Data Sheets/Summaries
Essentially the program books contain the information needed by the therapist to know what to target within a session and exactly how to do so. And in today’s environment, many of these “books” are now in electronic online database formats. (Though this is an argument in and of itself within the field as to whether or not tablets and devices recording data are indeed a blessing or a curse)
Ideally, before starting a therapy session the therapist reviews the program book to identify:
- Challenging behaviors being targeted within the BIP
- Any new behaviors that the therapist should be aware of (and any potential suggestions from the BCBA on how to handle those new behaviors)
- Anything at all noted that would effect the current session
- What lessons need to be presented
- How to present each lesson
While a learner’s ABA program book will vary greatly across providers, there are some general components that most program books will contain:
Session notes: An overall view of how the learner is doing within their therapy session and what occurred within the session. It is generally located in front of the program book so that it can be reviewed at the onset of a therapy session. These session notes serve as means to maintain open communication across the entire therapy team. Document and share any information needed by the team to effectively run therapy sessions. Session notes should remain objective and not relay subjective information.
- Session notes may include other variables that might effect the learner’s treatment such as: Medication, increased stereotypy, sick or injured, changes to the environment, relocation of therapy,
- Session notes may be on a form or they may simply be on lined paper
BIP: Which is detailed appropriately to manage a learner’s challenging behaviors from an analytic perspective. It is an individualized plan for the client that details how any challenging behaviors should be addressed by the therapists/RBT. This is typically located in the beginning of the book, and generally only one page in length per behavior and should at once glance give the reader a picture of what they may need to observe in a session. These BIPs have been developed by the BCBAs however, it is the therapists who are responsible for implementing the BIPs within regular therapy sessions.
- While formats will vary, a well designed BIP will include the following:
- Defined Target Behavior: a clear description of what the behavior is,
- Maintaining function: what is the function of behavior?
- Antecedent Modifications : or in other words what are we going to do to manipulate the antecedent to prevent the behavior from happening in the first place.
- Replacement behavior: what is the learner going to be taught that will replace the challenging behavior?
- Consequence Manipulations: What we are going to do after the behavior occurs, to handle it appropriately, and to make sure that we are not reinforcing it
- Type of Data to be Recorded: What exactly are we going to be measuring?
Essentially this section in the program book is a short description of everything the RBT will need to know within a session to manage challenging behaviors.
Skill Acquisition Plan: Their lesson plans, what are the specific targets or learning tasks that are being implemented. It is similar to the BIP, however, instead of challenging behaviors it is the lesson targets for the learner. Each sheet provides all of the information that a therapist needs to implement a particular acquisition task. Skill acquisition plans will vary greatly in presentation from provider to provider, while necessary components will remain the same:
- Discriminative Stimulus (SD) or Motivating Operation (MO): What is the antecedent. What is the first part of that learning sequence. Are we giving an instruction. Are we contriving a situation. All of our learning plans follow the three term contingency (ABC) A) The Antecedent, what happens in the environment immediately prior to the behavior (and how do we manipulate this to elicit a desired response from the learner), B) The Behavior, what is the actual response that they are going to give? and C) The Consequence, what is going to happen as a result of that behavior? So we use this three term contingency within our ABA lessons. So for that first part, the Antecedent, it could consist of a Discriminative Stimulus or SD or the instruction that we give to the learner.
Remember that an SD is…
An antecedent stimulus correlated with the availability of reinforcement for a particular response class.
And what that means in English is that the SD or the instruction acts as a signal to the learner that a particular reinforcement is available if they respond a particular way.
Why is it important that we indicate the SD on the skill acquisition plan?
First and foremost it ensures consistency across the therapy team, everyone on the team knows exactly what the BCBA wants presented to the learner. It will also be indicated if there is any flexibility in the SD or if it should only be presented in one format. So in other words can the therapist say only, “put with same” or can they also say, “where does this go?” and “match”. It will also indicate the exact condition in which the response was learned, in other words was it a very specific instruction or was it a varied, and more generalized instruction?
This will also indicate if any additional modifications or prompts have been added to the SD for the particular learner or task, as some learners may require additional or multiple prompts. Especially in the beginning stages of acquisition. The BCBA will specify this.
Remember that an MO is…
An antecedent condition which makes certain reinforcement more or less desired and certain behavior (associated with that reinforcement) more or less likely to occur.
And what that means in English is that the MO is a state of motivation. And that means that there are certain lessons or skills that are well suited to the learner when they are in a naturally motivated state to do so, such as being hungry, cold, tired, hot, etc. Versus being given an instruction or SD.
A Motivating Operation is a critical antecedent when teaching manding (requesting) skills. We want the learner to learn how to request for things when they want them, when they need them, when they are in a state of motivation.
Why is it important that we indicate the MO on the skill acquisition plan?
First and foremost it ensures consistency across the therapy team, everyone on the team knows exactly what the BCBA wants and how the “scene should be prepared”. It is critical that all therapists capture the appropriate motivation when teaching these types of skills. Otherwise, rote learning will occur. This will indicate the exact conditions in which a response was learned, so in other words, was the desired object in view or out of view? Was tempting required?
- The Expected Correct Response: In addition to the specific SD or MO, the skill acquisition plan should indicate what correct response is expected of the learner. Inclusion of the expected correct response ensures consistency across the therapy team, everyone on the team knows exactly what the BCBA wants. It is also important for data collection, what is correct? What is incorrect? Without this knowledge it would be impossible to collect accurate or meaningful data and assess the child’s progress.
- Specific Target /Exemplar: The specific target or exemplar should be clearly indicated. For example, if the student is being taught to identify objects, all of the exemplars will be included, meaning a list of targets such as cup, shoe, ball, boy, etc. and if the student was being taught prepositions the list of targets or exemplars would something like under, on top, next to, and so on and so forth.
The exemplars or targets listed provide a guide to the therapy team as to the acquisition targets the BCBA has identified as appropriate for that particular learner.
- Introduction Date & Mastered Date: These two components work together and with the exemplars. Each target has an introduction date once it is introduced to the learner and a mastered date once that target has been mastered according to the criteria predetermined by the BCBA. Extremely important information for the therapist team, the BCBA, the program book and ultimately the continued success and development of the student.
Why is this important information?
This data gives us the rate of acquisition. How fast is our student learning? Is it days? Weeks? Is the learning pace increasing over time? Is the pace decreasing? Is the learner learning so fast that multiple targets can be introduced at once? This information will show patterns in the students learning that can lead to modifications in the students skill acquisition program.
Preparing for Therapy Sessions Following the Skill Acquisition Plan
- The skill acquisition plans, along with the collected data, will guide the therapy team
- Before starting the lesson the therapist should review the skill acquisition plan to confirm the current SD on acquisition, the correct response required, and the current exemplar on acquisition
- If during a treatment session an exemplar is introduced or mastered the therapist will record the data in the appropriate place on the skill acquisition plan
Data: The ongoing continuous data for the learner which shows progress or lack of progress as they move through their program. All data is kept in a learner’s program book. Including:
- Behavior Management Data
- Skill Acquisition Data:
- Discrete Trial Training
- Natural Environment Training
- Task Analysis
- First Trial
- Graphs (could be reflecting behavior rates, skill acquisition rates across lesson areas)
BCBA Updates/Notes: Any updates on the learner, especially when the BCBA updates or makes any changes to the Skill Acquisition Plan or BIP.
- RBTs work under the supervision of a qualified and trained BCBA and are not responsible for the development of a treatment program
- BCBAs should have regular oversight on all cases
- Team meetings / planning meetings
- Observations / overlaps
- When reviewing the learner’s treatment progress the BCBA may document updates and/or instructions for all skill acquisition tasks as well as behavior reduction targets
- Each lesson placed within the learner’s program book should also be accompanied by the BCBAs notes
- The notes guide the therapy team as the client progresses through the acquisition tasks
- We have reviewed what is meant by program book
- We have discussed general components within a learner’s ABA program book
- We have discussed each of those components and given possible examples