ABA Inside Track – Episode 333: Risk Assessment with Dr. Stephanie Peterson, Dr. Rebecca Eldridge, & Dr. Neil Deochand

Recording Date: January 21, 2026

Episode Overview

This episode centers on risk assessment within behavior analysis, particularly regarding conducting functional analyses (FA) for severe problem behavior. Hosts Rob, Jackie, and Diana are joined by Dr. Stephanie Peterson, Dr. Becky Eldridge, and Dr. Neil Deochand, the researchers behind the Functional Analysis Risk Assessment Decision Tool (FARAD/FARAT/“the tool”). They discuss the impetus behind creating the tool, challenges practitioners face in performing risk assessments, development and utility of their tool, and insights for advancing ethical, competence-based decision-making in ABA.

Key Discussion Points & Insights

1. How the Project Began and the Problem in the Field

• Origin Story ([02:52]):

  • Dr. Peterson recalls Becky and Neil approaching her with questions about risk assessment, sparking a series of research projects.
  • The collaboration was driven by practical needs: both students experienced hesitation in the field about conducting FAs, largely because of perceived (and real) risks and the lack of standardization or clear tools.

• Cross-Lab Culture ([04:09]):

  • Becky describes the supportive, collaborative environment at Western Michigan University, facilitating projects beyond individual dissertations.
  • Real-world “clinical decision making” felt unstandardized, challenging to teach, and difficult to consistently apply.

• Need for Knowledge Translation ([06:18]):

  • Neil refers to their attempts to extract and quantify the clinical expertise that resides with senior practitioners, so newer BCBAs could benefit even without access to top-tier mentorship.
  • Points out the peculiar lack of formal, quantifiable risk reporting in FA literature, despite detailed reporting of trivial session parameters.

Quote:
"We were literally horcruxing Stephanie... just getting as much information from Stephanie and her access to other experts..." — Neil ([06:18])

2. The Gaps in Practice and Literature

• Risk Assessment Not Well Defined ([08:29]):

  • Despite early papers mentioning risk or cost-benefit analyses, practical, operational definitions were lacking.
  • Limited formal survey or quantitative risk tools existed prior to their efforts.

• Barriers in Real-World Settings ([09:48]):

  • Schools and agencies often outright refused FAs, citing risk, leading to ineffective intervention and practitioner frustration.

Quote:
"It wasn't that we were solely worried that people were doing FAs when they shouldn't be... but like, both ends of that we saw as issues." — Dr. Peterson ([09:48])

3. Articles Under Discussion ([11:00])

• The team based their tool and discussion on several key articles:
  • Wiskirchen, Deochand & Peterson (2017): On the need for clinical decision support tools.
  • Deochand, Eldridge & Peterson (2020): The original FARAT tool paper.
  • Schroeder, Peterson, Binti Mahabab & Dresh (2024): Pilot evaluation of expert and novice use of the tool.

4. Development of the FARAT Tool

• Initial Design Considerations ([12:19]):
  • Inspired by decision aids published by Geiger et al (for treatment choice post-FA) and LeBlanc (for measurement procedure selection), but quickly found risk assessment was less linear.
  • Many variables interact (e.g., severity of behavior, practitioner experience, setting, staff support).

Quote:
"My gut reaction was, I don't think that's going to work because I don't think it's a linear decision making process..." — Dr. Peterson ([12:54])

• Variables and Weighting ([14:01], [17:04]):
  • Tool accounts for: behavioral severity/intensity, experience, environment, staff support.
  • Not a simple arithmetic sum—variables interact multiplicatively and contextually.
  • Rarity and variety of actual risk assessment tools in practitioners' hands was confirmed in their own survey.

Quote:
"When we got down to it, no one actually had a formal or at least quantifiable way to look at risk." — Neil ([17:04])

• Excel-Based, Open-Source Design ([22:06]):

  • Tool is freely available as an Excel workbook in supplementary online materials to increase accessibility.

• Analogies: The Radio Mixer ([23:56]):

  • The tool works like tuning different dials (risk domains) to reach an overall “output” (risk level); change in one area affects the whole.

5. Iterative Testing and Language Nuance

• Language Choices for Risk Levels ([30:49]):
  • Extensive expert consultation on how to describe levels ("slight risk," "substantial risk," etc.). Decided against a "no risk" level—there is always some risk.
  • Language selected had to be general enough to fit many topographies and settings.

Quote:
"Our experts were very firm that the lowest level still needed to indicate there is risk. There is no such thing as, like, no risk in these analyses." — Dr. Peterson ([31:31])

6. Comprehensiveness and Next Steps

• Beyond Assessment: Resources and Adaptations ([35:56]):

  • The tool embeds resources, modifications, and references for adapting procedures for specific risk situations (e.g., pica, staff limitations).
  • Encourages continuing the process after initial risk determination: “If there’s substantial risk, here’s what to consider, here are readings, here are modifications.”

• Combating "FA Mysticism" ([38:10]):

  • The tool aims to demystify FAs, making them accessible procedural options rather than daunting last resorts.

• Extending to Training and Teaching ([41:26], [42:03]):

  • Viewed as a teaching and supervision tool for graduates and new BCBAs as much as a clinical one.
  • Urges educators to incorporate it into their curricula.

7. Cautions and Limitations

• Not a Substitute for Clinical Judgment ([46:17]):

  • Dr. Peterson underscores that the tool’s output isn’t “the green light”—it’s guidance. Clinical judgment is still required.
  • Differences in interpretation may arise with practitioners from different training backgrounds.

• Evolving Tool & Limitations ([50:12], [57:52]):

  • Anticipate ongoing evolution, including possible transition to a web-based/app platform.
  • Ideally, could integrate reevaluation steps, video scenarios, increased community input, and more nuanced treatment risk assessment in the future.

Quote:
"We're advocating here is an instructional resource and we believe it can help you in your process of navigating what can be a vague decision making process." — Neil ([39:15])

8. Larger Context: Training, Competence, and the Field

• Systemic Issues in Training ([50:31]):
  • Becky notes the explosion of new certificates means many new BCBAs lack rich, experience-based learning.
  • Tool focuses on encouraging curiosity, critical thinking, consultation—not just “if-then” rule following.

Quote:
"So much of the people that we work with, it's such a greater context... The reason why [the tool] is so robust is we kept thinking, like, it's not just this is how you're going to minimize risk, but also if you do this you might reduce the validity of the assessment." — Becky ([53:06])

• Promotion of Networking & Consultation ([64:48]):
  • Explicit encouragement to seek support—“no shame in that.”
  • Many pioneers in the field are accessible, willing to help or provide papers.

9. Looking Forward

• Potential Improvements ([57:52], [60:25]):

  • Considerations around adapting the tool for different types of FA (e.g., latency, trial-based) and for treatment risk.
  • Improved user experience features (before/after snapshots, built-in encouragement to reevaluate).

• Final Reflections ([67:46]):

  • Deep gratitude expressed to expert reviewers and participants—labor-intensive research that advances the science.

Notable Quotes & Memorable Moments

• "We were literally horcruxing Stephanie..." – Neil ([06:18])
• "Our experts were very firm that the lowest level still needed to indicate there is risk. There is no such thing as, like, no risk in these analyses." – Dr. Peterson ([31:31])
• "So much of the people that we work with, it's such a greater context... And so part of the tool and the reason why it's so robust is that we kept thinking like, well, it's not just this is how you're going to minimize risk, but also if you do this, you might reduce the validity of the assessment." – Becky ([53:06])
• "I'm hoping that some ABA graduate professors are listening to this as well, because what a wonderful resource for graduate students, right?" – Jackie ([41:26])
• "No shame in seeking out consultation. These are just humans." – Becky ([64:48])

Timestamps for Key Segments

• Background & Project Origin: [02:52] – [06:18]
• Article Framework: [11:00] – [11:52]
• Tool Variables and Development: [12:19] – [17:04]
• Expert Review & Language Nuance: [30:49] – [33:21]
• Resource Integration & Training Utility: [35:56] – [42:03]
• Tool Limitations and Training Implications: [46:17] – [50:31]
• Looking Ahead/Future Tool Development: [57:52] – [63:42]
• Consultation & Accessibility: [64:48] – [66:57]
• Gratitude for Participants/Experts: [67:46] – [69:22]

Further Resources Mentioned

• Past ABA Inside Track Episodes:

  • Ep. 7 (Trial-based FAs)
  • Ep. 66 (Latency-based FAs)
  • Ep. 110 (ISA)
  • Ep. 166 (History/Evolution of FA)
  • Ep. 208 (FBAs and schools)
  • Ep. 234 (Idiosyncratic FAs)
  • Ep. 200 (Ethical Decision Making)
  • Ep. 261 (Geiger et al. 2010: Escape Behavior)
  • Ep. 271 (Social Justice Research)

• FARAT Tool & Key Papers:
  Available via Behavior Analysis in Practice (2020) as supplemental material.

Summary Takeaways

• The FARAT tool fills a critical gap by providing a structured, accessible means for practitioners to assess and manage risk when considering FAs for severe problem behavior.
• It is not a simple checklist, but a nuanced, interactive support for clinical decision-making, training, and ethical practice.
• The goal is not to replace judgment but to inform it—prompting critical reflection, reevaluation, and consultation where necessary.
• Ongoing feedback and iterative improvement—especially as technology and the field evolve—will keep the tool relevant and effective.
• Emphasis throughout is on benefiting clients, supporting practitioner competence, and advancing the science of behavior analysis ethically.

For practitioner use, research, or training in behavior analysis, the FARAT tool is highly recommended and freely accessible. The episode encourages widespread adoption, ongoing improvement, and, most of all, curiosity and humility in clinical practice.