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ABA Inside Track
Episode 333 - Risk Assessment w. Dr. Stephanie Peterson, Dr. Rebecca Eldridge, + Dr. Neil Deochand
01:15:15
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- [00:00]
A
Foreign.
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B
Hey, everybody. Welcome to ABA Inside Track, the podcast that's like reading in your car, but safer. I'm your host, Robert Perry Cruz, and with me, as always, are my fabulous co hosts.
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C
Hey there, Rob. It's me, Jackie, not Perry Cruise McDonald.
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B
So your. Your legal middle name. I can't believe your parents thought so far ahead.
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C
I changed it, actually, in adulthood.
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B
Oh, okay. It's your professional name. That's good.
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A
And it's me. Hello, it's Diana Perry Cruz.
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B
Oh, boy. Well, everyone, usually I do a little joke, but I'm not in a joking mood today. I just want to get into a talk about behavior analysis and behavior analytic research, which we do every week on this podcast related to some topic and some research. But I was, the other day was thinking about a topic and so I was reading a paper and they mentioned, hey, you should be doing a risk assessment. And I said, yeah, yeah, I know what a risk assessment is. And then I thought about, I said, but do I really know what a risk assessment is? And then I thought to myself, how many papers have talked about cost benefit analysis, cost benefit analysis and risk assessment? And then they sort of like dot, dot that they trail off. And I think nobody knows what they're talking about when they talk about doing a risk assessment. So I did what I like to do, which is I looked at, at some research. And fortunately we had some listeners who said, I want to hear more about that research. And we got super lucky in that there A, is research on the topic and B, there are three people who want to talk about that research and tell me if I just should have learned what a risk assessment is better or whether it is something that hasn't been defined as well as it should have been all these years. And thankfully they're going to put a stop to that problem. So we're talking all about risk assessments. Specifically, we're going to talk about the. We'll have to talk about how to pronounce this, but the far, the farad, the far dart, the farat, the farat assessment. And you know, acronym aside, we've got three great guests on who are going to talk all about this. We have Dr. Stephanie Peterson, we have Dr. Becky Eldridge, and we have Dr. Neil Dushan, all here to talk about risk assessment. Thanks to our listeners and then thanks to them for being here. So thank you all so much for coming here and pointing me in the right direction.
- [02:26]
D
Yes, yes, exactly.
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B
Now, the challenge, we have a lot of guests is everyone has to talk about who they are and sort of where they came from, a little quick, Quick brief bio and how they came into studying risk assessment. It's something of interest to them. But there's three of you, so don't. Can't go too long. But that's okay. Just, you know, you're. You have the. You have the mic. How did y' all get to this topic, to this point in time?
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D
Well, I'll start. This is Stephanie. And we got to this topic, I think, because I was sitting in my office one day, and Becky and Neil said, hey, we're taking this class. You guys will have to help me. Was it Dr. Fuquay's class or something? Yeah, I don't know. Yeah, they were taking a class and had to write a paper on a topic, and they got on this topic about risk assessment and came to see me because they were like, we want to talk about this with you and what we're thinking about writing. And from that evolved, like, three or four research questions. And we just batted some things around a little bit, and then we ended up having lots of meetings. Right. To, like, refine those. But. And I think we were. Originally, when you guys came into my office, the question you came in with was actually, like, the third question. And we had to be like, yeah, but to get to that, we have to do this, and we also have to do that first. And so it eventually evolved into two or three papers, and it was really. So it was really their brainchild, and I got to tag along for the ride with them. So, like, I guess you guys can talk more about how you came up with that.
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E
How lucky, right?
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C
How lucky are you all that you got multiple papers after one initial meeting.
- [04:09]
E
Yeah, I think this is. Becky. I think that the cool thing about Western Michigan University and the culture that was there when Neil and I were students was really collaborative across labs, and Neil was a Dr. Fuquay student and I was a Dr. Peterson student, but we were regularly in each other's labs, you know, discussing practicum work that we were doing and issues we were having. And Neil was working with severe problem behavior out at Great Lakes, and I was working in Portage Public Schools on it. And we just, you know, had a lot of these experiences where we wanted to do functional analyses, but it was. It felt risky. We had the feeling inside we shouldn't proceed, but. But our science was telling us, yes, go ahead and proceed. And so that whole, you know, dilemma of ethical decision making and really going to that. And I think one thing that's so cool about just. I'll toot Stephanie's horn. A little bit of being a student of Stephanie's is she has so much experience in dealing with problem behavior, both in hospital settings, but also in school settings that we get this really cool knowledge and experience that we can tap into. And so there is a lot of questions that I think that Neil and I were thinking about. We learned clinically like that clinical decision making. And I'm doing air quotes. People listening can't see me. But how do we define what clinical decision making is in order to teach it to a standard? And so that's really where a lot of this came from. And Neil was like, you meet with Stephanie every week, right? And kind of tagged on to one of my, you know, regular student meetings with her and quickly became this, you know, project that evolved into like a for fun project. It wasn't either Neil or I's, you know, dissertations or requirements. It was just something that we were running into in practice and wanted to really capture all of the articles and experience from Stephanie's brain and put them into a tool that others could use who maybe weren't a student of Stephanie's.
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F
We made the joke that we were literally horcruxing Stephanie because we were. We were worried about the level of expertise that that's in the field and then the newly certified individuals and how do we make sure that know, Western Michigan's a great university, but how do we get access to, like, those experts? And, you know, Speccy had worked even longer in the field than I had. And Stephanie conducts functionalities, like, all the time. And it was funny when we would go to those meetings, we would write down a set of references and would ask the same question. And we'll get a whole set of new references because depending on the mood and how the brain works, the we were just basically getting as much information from Stephanie and her access to other experts too, which, you know, we can talk about because like you mentioned, it's a lot of people, a lot of papers before us, like, there was a Weeden polling paper, and they quote Carl Sagan saying there was an absence of evidence of safety precautions in FA papers. And, you know, behavior analysis papers, they tell you the room size. It was 2ft by 16ft. And they'll tell you the papers 3 inches. 3 inches. And we use italic Roman times, numerous font or, you know, very specific. And then for some reason, the safety precautions, which in the original OADA paper are heavily specified. And there are even people that were not given an FA because of how pernicious the self Interest behavior was. And since that 2010 paper, we hadn't seen anything. Maybe the Bailey and Birch book had an anecdotal kind of fill in and they noted in, I guess it was a third edition, there'd only been one attempt to quantify risk in a mathematical way. And that was. I think it was in the 70s or 80s or so that that was done. And then, no, no more work on it. So we. We basically just hung with Stephanie all the time and we had lots and lots of meetings. And Becca, Becca was the gate gateway. Becky was the gateway to getting to Stephanie.
- [08:29]
B
Now, why do you think that that is? You know, looking at kind of the dates of the papers, we've got sort of the initial paper, and then there's a span of time before we're sort of talking about the FAA risk assessment tool.
- [08:42]
F
But.
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B
And then before that, like 2010 and maybe a couple of pieces here, like, did it come up? It's like, why is this something that, like, were you nervous when you were publishing? Like, are we publishing a paper that like somebody. There's like 50 of these and we just totally missed that Journal of Risk assess something. It does feel like one of those topics about that.
- [09:01]
F
I think we were like, we've hit the nail on the head not to be like blowhorns or like braggadocious about this. Like, we saw that there was new people coming to the field and that they probably aren't even practicing functionalities when they probably needed to. And that's anecdote. We don't know for sure because we can't see everyone in practice. We weren't worried that people were running FAS when they weren't supposed to. We're more so worried that they don't have a way to know when they should be using it when there's very minimal risk. But it also applies in both directions as the field grows. And, you know, people with less experience overestimate their capabilities. It could go either direction. So we saw a dialectical approach to fixing a real world problem.
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D
Yeah. And I think what you said there is really important, Neil. It wasn't that we were solely worried that people were doing FAS when they shouldn't be. But like, Becky and I had a lot of experience in the public schools where teachers, principals, and others special ed directors would say, we don't do those. Like, those are way too dangerous or it's not appropriate for this setting. And that was really frustrating when you're out in the schools, like consulting on difficult cases with them and you're Wanting to do a functional analysis, like in the classroom and having people, like, tell you, no, that's like, not appropriate or too dangerous here really limits our ability to do our work well. So, like, both ends of that we saw as issues.
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B
Now just kind of take it back to the bigger level. When we talk about the idea of like a risk assessment, what typically would be included? Oh, Diana is reminding me that we haven't even talked about what articles we'll be discussing today.
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A
We just went right into the deep end.
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B
We just got right into it. So before we do that, let's talk.
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A
About what articles tell everyone who's listening. What articles are informing our discussion today. They include Functional Analysis and Need for Clinical Decision Support Tools to Weigh Risks and. And Benefits by Wiskirchen, Dioshand and Peterson. And that was in Behavior Analysis research and practice 2017. Also toward the development of a functional analysis Risk assessment decision tool. That's the farat that we just referenced. That was by Dushan, Eldridge and Peterson, all. All present. That was in Behavior analysis and practice 2020. And finally, a pilot evaluation of expert and novice use of the Functional Analysis Risk Assessment Decision tool by Schroeder, Peterson, Binti Mahabab and Dresh. And that was in Behavior analysis and practice 2024.
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B
Right. Now check your Internet browser.
- [11:55]
E
It's there.
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A
All right, proceed.
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B
Okay, so when you were kind of thinking about risk assessments, I mean, I. I assume you started with a general sense of like, what is it we want to know about risk assessments? So were you looking at other fields as to what are the risk assessments tools? Whether they're tools or just protocols that exist? Was it more you just started looking at it in the context of the faa?
- [12:20]
D
Well, I think, and you guys correct me, I think if I'm wrong here, but I think when we first started, you know, that it was. It was kind of coming on the heels with some other decision tools that had been published in the not too distant past. Like the Geiger et al PA on like if. If FA comes out as the kid engaging in problem behavior because due to escape, like, here's some different treatment options. How do I decide which treatment option to use?
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A
I love that paper.
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C
It's one of our. It's the. One of the podcast. Favorite. Favorite. We did a whole episode just on that paper alone.
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D
Yeah. So, yeah, so there was that tool and I think there. Maybe Linda LeBlanc has one on deciding what measurement procedure to use. And so we were starting to really talk about is it kind of a flowchart like those. And 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. And we very quickly got into that. There's a lot of variables to consider and that like one variable, how one might evaluate that variable is going to really impact another variable. Right. And so these things were sort of dependent on each other a little bit. They were not independent of each other. Anyway, so we quickly got into that discussion and like, I had no idea how to make that work. So I was really glad Neil did or was willing to figure it out. But yeah, so then we started just talking about what are the variables like that we have to think about in.
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E
That and kind of what guided the variable conversation. There are two papers that came out super close to each other, the Oliver Pratt and Normand and the Roscoe et al. And that was really getting at, you know, Stephanie and Neil's earlier point of people not doing FAS because of a variety of reasons. And when we think about a risk benefit analysis, I think a lot of times people just do the risk assessment, but they forget to think, what's the risk of not doing an fa? And part of that is like, we're going to be in ineffective treatment for years or we're going to be just trial and erroring things over and over and over and over. And when we think about the risk to, you know, a client who's receiving ineffective services, possibly reinforcement for, you know, higher levels of challenging behavior as the years go on, that is huge. Not to mention the risk of, you know, that practitioner feeling defeated over and over and over again, possibly leaving the field. Like, there's a ton of risk involved with not doing an FA when we aren't having, you know, effects, good effects with our treatments. And so I think that when we were looking at that those two articles had come out like. And that also kind of led Neil and I down a rabbit hole. Cause we were reading those articles and we were like, you know, this was when we were in graduate school. And so this was like, we were primed for that and just thinking, like, why aren't people doing this? And so some of the variables that we ended up putting in the risk assessment tool came directly from the Oliver Pratt and Normand and the Roscoe et al studies. And then a lot like Neil said earlier, came from, you know, Stephanie's Horcrux, like, what was her experience and like, which factors would make it too risky to conduct an fa. And then I might be jumping the Gun here. But could those factors be mediated or could those risks be lowered in any way? Or was there a different assessment that could get at those things in order to ascertain function with the goal of coming up with an effective function based intervention.
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D
Yeah.
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A
And that Oliver study, as I recall, it had a really high percentage of folks who had not run an FA who are practicing behavior analysts.
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F
I don't remember them.
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A
Yeah, it was like 60 or something. It was a lot. Yeah.
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D
Yeah.
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B
I mean, I was. I was very shocked when I went into. Because I worked at public schools for a very long time, but I started in a private school, like a high research base, high clinical base. So I'd done an fa, you know, a couple before, you know, I went into public schools and. And just meeting BCBAs, you're like, nope, never done that. Never. I don't even know what that would be. And sort of being in the position of, I guess I have to teach you how to do this. Like, am I the person who should be showing you this? Like, do I have enough experience? And I'm guessing that's a lot of stories of a lot of BCBAs who all their training was in a setting and it wasn't one that does a lot of FAs.
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F
One of the interesting things of the surveys is they pointed about the support of, like, the schools and the institutions for conducting phases. One of the barriers. But when we conducted our survey, we were looking at, do they actually have the support of something that guides them to whether they should conduct an fa? And we never. I don't think we ever answered what were the domains. So in Becky's paper, we kind of posited that there was behavioral severity as one of the primary interpol behavior intensity as one of the primary factors, clinical experience, the location where the FA would take place, the environment, and then the support stuff. But in that paper, we said that they probably won't tie in in a arithmetic way, so it wouldn't be like +1 for each of them. The way they tie together, have these multipliers where. And this is where Stephanie mentions, like, the hard work of like making the tool do what. What we wanted it to do. Because, you know, the way that a case can display just the way it's written can be very confusing where risk would lay. So we ended up making a tool that has kind of six widget points for experience. And when we first started it, we had it based on the number of fas that someone had conducted. And then we quickly realized, like, Stephanie, do you know how many FAs, you've conducted a million? No, I don't have an exact number. So then we started, you know, some of it was intuitive, like we weren't like initially sampling everyone, like how would we create this tool? We made what we thought could work. And then we started to explore getting expert opinions. And then what Stephanie did with her students piloting out, does it actually influence decision making? And that's one of the big problems in behavior analysis right now is we don't actually have access to in practice data. Are people writing behavior plans correctly? Are they doing it to the guidelines? Are they doing a functional analysis and are they conducting it at the right times? Are they avoiding it at all costs? And so we did a survey and 35 out of 598 reported that they used some tool. When asked to provide that tool, only 19 responded. And of those 19, one of them, a couple of them were like the Bailey and Birch chapter on the risk assessment in the third edition. And then some of them talked about Hanley's open ended functional assessment interview, which is in his seminal paper, the Dispelling myths paper. The 2012 paper is very good, but it's still just an open ended question. And then others mentioned that it was their institution's assessment. And so when we got down to it, no one actually had a formal or least quantifiable way to look at risk. And at least where our concern was how do we train folks to make this not necessarily a standardized procedure, but like some way of conceptualizing the risk where they have some benchmark and it doesn't override clinical decision making, but gives them some considerations. But while we were doing that and scouring the literature, we were finding out we have validity concerns, we have medication concerns. And so we reached out to some of the authors of the other risk tools that are out there or other like the measurement system by LeBlanc, the other tables, Schlichemeyer idiosyncratic function table. And we got permission from those folks to include them in the tool so that there's a one shot stop for references as well as ways to mitigate risk and potentially validity. Because if you have to rerun an fa, it's a problem. And if you think the FA is the only option, it's a problem. And so even in the tool we're saying, look, you've got a structural analysis that could be done if it's more academic based, you have modified choice assessments, you have the opportunity of not to run the fa. We have to consider that. And so the hard Part was putting it all together in a way that helps people potentially rerun the same decision tree, which in our case I think it was 1296 outcomes that could be out of it, which doesn't fit in a simple decision tree. And that's a big tree.
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B
Yeah, you gotta make it in canva, make it look real nice, you know, all thousand.
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F
It'll be a California red.
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C
But it's like the whole book.
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F
There might be an avatar tree, you know, one of the ones that are. Yeah, I don't think it works in our gravitational pull for that level of branching.
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E
I think one thing that was really cool about the way that Neil created this in so just so listeners know this is a freely available decision tool, we publish the paper in behavior analysis in practice for that specific reason. If you go down to the. They're called like supplemental materials, but it's esm. It's like electronic supplemental materials.
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D
I don't know what the E stands.
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E
For, but you scroll down on the website to the bottom of that and you can download. It's an Excel workbook that has everything that you need in it from the time that it was published. There have been additional papers since then, but, you know, I'm like, I think in analogies a lot. And so when we sat down and we're like trying to figure out this isn't going to be like a, you know, unilateral decision tree. This, these, you know, like experience would interact with severity of behavior. If I have, you know, zero experience and the behavior is super severe, we're going to say, no, like, this is high risk turnaround, go back down the tree. But if it's high risk behavior or, you know, high intensity behavior, and I've got 20 years experience working with this population, maybe it's less of a risk because I know how to write really good termination criteria or I know how to reinforce, you know, less significant behavior. So as I was, as we were all thinking about this, we had a piece of paper on Stephanie's desk. We were like drawing it out. I kept thinking of a radio and I kept thinking of like, okay, you have your treble, your bass, your volume, and depending how you turn those buttons, you get different outputs. So if the treble is really high and your volume's really high, it's going to be really grainy and icky sounding. But if you turn your treble down a little bit and maybe your bass up a little bit, the volume might not be so bad. And so when we were thinking about this really like that Was like the analogy or the image in my head of how I wanted the tool to be, that different risk levels would be a different sound output. And so Neil is a magician when it comes to Excel and he did this all on Excel using. I don't know what the programming mechanism is.
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F
It'd just be nested if formulas and a couple macros. It's actually not that complicated. But like, if you meet someone that's.
- [24:05]
D
Actually good at Excel, it sounds complicated.
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F
It's not that like, I'm an embarrassment to really in Excel. I'm just good in ABA and Excel.
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B
They're way better people.
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E
We didn't want it to be like an. One of the things Neil's super intuitive about is like thinking forward. And if we made it an application on a phone, we'd have to like, re up that every time phones got updated. And you know, and so we were like, Excel's probably the easiest to do across platforms. Maybe people have to purchase it, but they probably have access to some device that has Excel already. And so that was kind of the decision for that. And then Neil kind of just made it all work in there. And yeah, I don't. We'll probably get into too much technicality.
- [24:50]
D
About that one day. And we'd, we'd play with clicking some of the, like, well, what if risk. What if the problem behavior is this severe and. And we click this for the person's training and the environment and so forth, and we'd see kind of where it lands and we'd go, ah, that. That doesn't feel like it's landing risky enough or that's landing really risky. And I think that should be lower. And he'd go, okay. And he'd walk away and go home and tweak some of his formulas and bring it back next week. And he'd be like, yeah, that's better. How'd you do? So he's, he is a magician with that.
- [25:24]
F
There's kind of like they like, it's all the knowledge of the FAs. Like, we're locked in by Stephanie and Becky. Like, I, I run like a couple at the Great Lakes and you know, I, I like the experimental analysis of behavior, but like the, the breadth of knowledge that they brought with and the number of papers. Like, it was always we. It was a reading list that far outweighed any class. And I think, like, like I think the new kind of new students, like that, if they aren't having these little projects, they're kind of missing out on like that real fun experience where it's like, I'm not doing this for a grade. I'm doing this because I truly believe this is valuable and I learned so much just hanging out. I miss it. I wish actually the things I miss are like those moments. Those cold winter moments. I won't go back to the cold, but I'll be. I would love to hang out and do it all over again.
- [26:31]
C
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- [26:36]
A
Sure. We all do.
- [26:38]
C
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- [26:44]
A
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- [26:47]
C
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A
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C
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A
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A
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C
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A
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- [27:29]
C
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- [27:48]
F
Hey everyone.
- [27:48]
B
I'm so sorry to stop this awesome conversation with our special guest, but I just want to take this moment to remind all our listeners that ABA insidetrack is ACE and KWABA approved. And by listening to this episode, you're able to earn one Ethics CE all. Thanks again to our fabulous guests, their fabulous research, and of course our great, great listeners on patreon.com who voted for this topic. You're going to need to do a couple things though if you want that ethics ce number one, listen to the whole episode. Number two go to our website abainsidetrack.com you can click the link in your Podcast Player Notes section to go directly to the page. Put in some key information about yourself as well as some information related to some code words that we got from our special guests. I'm going to give you the first of those code words now that you will need to write down or remember what it is. Yes, because I got rid of that window so I don't remember what it was.
- [28:39]
A
The first code word is Buster. B U S T E R Buster.
- [28:46]
B
Everyone's favorite character from Arrested Developments.
- [28:49]
A
Yeah. Or you wear your Buster Browns.
- [28:52]
B
You could. You could wear your Buster Brown saddle shoes.
- [28:54]
F
Yeah.
- [28:55]
B
Yep.
- [28:55]
A
Buster.
- [28:56]
B
Buster. All right, let's get back to our discussion about the functional analysis Risk assessment tool. Now, in terms of the tool, I'm trying to remember because I found the. Well, I didn't find it. It was given to me or it was at a presentation. I'm trying to remember what year it was. I think it was a little bit before. It was around the time of the publication of the second paper. So I'd been playing around with it and I've actually used the tool myself a few times and I really did appreciate that interactivity piece, that sense of. It's not just. I think Neil, you or maybe Zubek mentioned, it's not just like, well, I click these four boxes and that makes a four. That's too risky. But if I click three boxes, it's a three. So it's kind of risky. There really is that interactivity piece of. I've been doing this forever, but I've never done it with this challenging, this, this topography of intensity behavior. But I got a lot of other staff with me and I can do it in a super safe space is going to be a very different outcome than. I have a lot of experience and I've done a little with this type of, you know, problem behavior, but my space isn't quite as safe and I have to do it all by myself, you know, is going to give you such a different outcome, which I think even for folks that have done a lot of fascinating sometimes I'm not going to say that I do this, but, you know, assume that I can, you know, write some checks about how good I am at fa is that perhaps, you know, my, my butt can't cash. So being able to kind of go back and review all of these other factors in this very like, quantifiable and visually very clear, you know, sort of arrow of, you know, from slight risk, not no risk, slight risk to intense risk was just kind of a really great review too. So, you know, excellent job with the. With the conceptualizing of the tool, with the programming of the tool so that it's just super easy to use and very accessible. So again, kudos, kudos to the crew for that. That was excellent.
- [30:50]
F
You don't know how long it took for us to choose slight risk as it works. I was just going to say because I don't know.
- [30:57]
B
You mentioned it in the paper.
- [30:58]
E
Yeah, yeah, Minimal. We admit we had so many like.
- [31:03]
F
And And I think, you know, the new paper talks about it quite well. Just language is so important. Just like how it. Because we wrote it generally so that maybe you could, you know, understand pica with it. Understand like, hey, how can I have a. Have a way where like, things are stuck on the board so that they, you know, from Cody's papers in Stephanie's lab as well, so that there is a lowered risk of pica actually occurring that we can measure attempts. And then we have all the types of FAS as recommendations or have you considered latency, trial based, peer wise, blah, blah, blah. Yeah. Stephanie, how long. We went through a lot of different words.
- [31:41]
D
Yeah, I was thinking, as you were describing it, we had some experts and we defined experts as people who've published papers on functional analysis where we asked them, I think we. I don't remember if we gave them scenarios or just asked them to, like, take it and consider some situations that they've been in and, and like, play around with it. But I think we gave them some specific scenarios too. And we would have them, like, click the things and then look at the outcome and say, what do you think? Like, what. How does that match your gut with how risky this situation is? And so they, they would tell us if it seemed about right or it was, you know, it was a little too high or a little too low for. But we got a lot of feedback on the language in those earlier drafts of like, what we were calling the different levels of risk. Like, and I think we had minimal risk. And I don't remember what. We went through so many iterations, I don't remember. But our experts were very firm that the lowest level still needed to indicate that there is risk. There is no such thing as, like, no risk in these analyses. There is always risk. And then there was also conversation about what those upper levels should be labeled. Labeled as too. And I remember, I remember pulling up at thesaurus and really looking at all kinds of words that mean slight and minimal and like batting those around. And we would sometimes send them out to our experts and be like. A modicum of risk, a teensy bit of risk.
- [33:16]
B
Teensy risk.
- [33:18]
D
Like, yeah, we went through all kinds of words.
- [33:22]
E
And I think we also, you know, Neil mentioned Cody Morris's paper on pica. So that was. Came out of a client that we were working with who would eat his bedsheets in the hospital. And what could we, what kind of stimuli that was edible could we use to match the sheet, you know, and. Or the he would eat. I'm forgetting some of the other things that this client would eat. But all of that to say, like, initially, if you were. Even if you were, you know, somewhat experienced in fa, you might go into that setting and be like, I can't do one because I can't let him eat the sheets or, you know, the bottle of medication that he shouldn't eat or whatever the case may be, I can't let him do that. So I can't. And there's no precursors. So. So we're not going to do the fa. And, you know, Stephanie was such a good resource for being like, thinking about the modifications of, like, well, could we use, you know, a match stimuli that is edible, that is safe to eat? And would. Would we get similar results? You know, like, would we see that? And we would be like, oh, we never thought about that. And she'd be like, oh, check out this article. And Neil and I are like, writing down like, oh, yeah, she knew this article. And so there's so much. And one of the things we mentioned, I can't remember if it's in the first paper or the second paper, but one of the things we mention is that the resources for all of these modifications that we talk about, because it's not just there's risk, don't do it, it's there's risk. How are you going to figure out the function? What are your next steps? Is it a different assessment? Is it concurrent operants, or is it a choice? It's not just don't do the fa, continue collecting ABC data. Like, that's not the only alternative, which is in practice, what I see is the alternative. And so thinking through some of those things, what could we do to reduce risk? Or what could we do to, you know, contrive or simulate an environment that would be safe and still get the analysis completed was something that was so powerful. But those articles that Stephanie had in her head were in like 21 different journals. They're not all in Java. And I don't know about you, but I don't read Jabba every time it comes out from COVID to cover. I certainly don't read in the bathroom.
- [35:57]
A
You don't?
- [35:58]
E
I don't read 21 different journals from COVID to cover to keep myself current. And. And I'm guessing others don't either. And so how that was the other kind of thought of this is, how do we get these resources into people's hands? You know, Neil's talking about a reading list and it was kind of like this massive project of where are all these safety Modifications listed. Where are all the different types of fas, because there's an innumerable number of ways you could conduct an fa. And so just trying to get that also into the hands of practitioners in a usable way where maybe they don't have to read all 21 journals, but if they do this risk assessment, the next page is considerations to reduce risk. Go read this article and points them right in that direction.
- [36:52]
B
And it's still color coded, correct? I can't remember which edition. I'm pretty sure in the edition. It's not just, here's a list of a thousand things. I don't know, pick one. It's, hey, these are the risks you put into the tool. Here are the resources you want to be looking at so that you can decrease those. I have always loved that about this tool, that, that sense of that activity, because I similar, I think, to all of us, you know, talking here today. That sense of like, 60% of us being like, FA is not, for me, not going to do it is so disappointing. So the fact that the tool doesn't just let people off the hook of like, yeah, it's moderate risk. Oh, well, yeah, like you said, Becky, back to ABC data for all time and back to 70 iterations of my token system until I find something that works. It's like, no. Now here's the next thing to do, which I think, especially for young students, is so important to sort of push them of. It's not a matter of you have the answer or you don't have the answer. It's you have an answer, and here's how you're going to get more answers, more information to continue improving your ability to help your clients, to help your students. Right. So just excellent. And the color coding, you can't miss it. It's right there.
- [38:00]
A
Folks love it. It's bright red. So many resources in, like, embedded within this tool. So it's not just like the Cos. Cosmo quiz. It's much more complicated than that.
- [38:10]
B
Which type of FA are you?
- [38:12]
A
But then there are also, like, pages and pages of additional, like, considerations and resources and varying things that you should be thinking about. It's really comprehensive. So it's very impressive to see all of that, you know, collected in one place. And I agree with you, Rob. It's like in. In some places, functional analysis, I think, has like a, like a mysticism around it, in a sense. And people are scared to do it if they didn't get that training initially. And that's something, to me that. That shouldn't be considered to be outside of one scope of competence if you are a behavior analyst, right. Like that's something that you should be able to do because it's kind of the center of how we think about the world. So if folks are feeling like they didn't get that past history experience, this is a great place to learn a lot of different variables that could go into the decision making process. And it's all about problem solving. Right? Like that's what I. That's like my favorite thing to do as a behavior analyst is solve problems. So this helps you like really identify what some of those variables are going to be.
- [39:16]
F
Treatment itself, I'm sorry, Stephanie, just treatment itself is to a degree in its experimental design. And the recommendations here, even if you don't run an fa, are useful for safety precautions you can implement for general treatment. And then the other thing we don't know from like the data, even from the surveys that are out there, that the proportion of FAs are just going in the hands of a select few that have lots of experience. And maybe this serves as a tool for those individuals to help kind of share the pass the baton and give that learning experience in a controlled way. And I understand there's a lot of burnout in the field and the ratio of supervisors to newly certified are more challenging. We saw this as an opportunity to get the information out there, provide it in a way. And we were very careful that we're not advocating do this under all circumstances. We're advocating here is an instructional resource and we believe like it can help you in your process of navigating what is a vague decision making can be a vague decision making process. And we talked about how do we unwrap clinical decision making. Like there are experts out that do group contingencies in the school system and you know, how, how is interdependent or dependent or you know, whichever one recommended. It's to some degree based on a lot of time in the field. And if you don't do a talkout allowed procedure, we don't know how these experts are making this decisions. And so that's why we sent it to the experts. And, and for some, I think in the Ali Schroeder's paper there was a signal detection for the ones that were in the middle that, that the moderate risk area kind of being the one where there was the most variability. So we can agree on what's high and what's low. But that middle ground and heavily dependent potentially on language is where we might have some differences. And just vignettes is something. And maybe the videos is the next step. How do we get to what happens in the real world? And if we don't get there as behavior analysts, it's a reckoning for the field in its quality outputs.
- [41:26]
C
I'm hoping that some ABA graduate professors are listening to this as well, because what a wonderful resource for graduate students, right? Because maybe they haven't done an FA yet, maybe they don't get to do one in their program, but maybe they're required to do one when they're out. Right. And without supervision or support. And so I'm hoping that everyone is listening and those professors put those in their behavior assessment class or their FA class that they have to, you know, they have to run that class. And this seems like a wheelhouse of, you're like, here's everything, right. I just love that.
- [42:04]
D
Well, and I think, you know, being somebody who's taught those classes before, it's a real challenge to be teaching a class of say 15, 20 graduate students and asking them to go practice something like this. That's kind of risky. Like, could be pretty risky depending on the situation. And so sometimes you'll see people say, well, so we're going to practice in the least risky scenario we can. And we're going to have you choose a target behavior, for example, like off task behavior. That's pretty, you know, it's not, it's not a very high risk behavior. And so, you know, if people do have experience coming out of their graduate experience, that may be what the experience is. So, so then they get a kid who's highly aggressive or something and you're going to now try to go do that FA under a different circumstance. And it so like, I totally get it where that's kind of intimidating for people. And as a professor who's tried to teach them, I'm like, yeah, and I'm not going to put you in those kind of situations right out of the gate or certainly if, if I'm trying to oversee all these projects people are doing and I, and I can't be there with you as you conduct each one. I don't want to put you or the child into a risky situation. So it's very easy for me to understand why people are reporting. I don't feel like competent enough to do this. And so one of the things we have in the tool though is for the quadrant on like your own skill level is seek consultation and help. Like, it may not be about modifying the actual analysis, but rather you having the support of somebody else who can help you. And I don't think people should feel ashamed or bad or nervous about asking for help. Like, I do it all the time, even now. Like, I have cases that come through and I've called up Wayne Fisher and said, I've got a case and I don't know what to do. You know, like, can you help me? Or we've got a kid right now who we're doing several analyses and we're just having a really hard time finding any differentiation or getting like, any control over this behavior. And so my colleague and I sit there and go over the data together and talk about ideas because there's tough cases out there and I don't think you should expect yourself to know everything about all those contexts. Right, Right.
- [44:28]
B
I do want to talk a little bit about the recent the Schroeder paper, the vignettes for the novice and the experts. So just kind of a brief overview for the listeners. If you haven't had a chance to look at it, it's just kind of, you know, the next iteration. Continuing on with the far out far. I got to risk assessment tool, you know, working on we just call it the tool Just use the tool. Got to use that tool. You had the variety of vignettes at the different levels or slight, moderate, substantial and intense is the highest one. And giving it to novices, giving it to experts to sort of see did they use the tool and come up with the same assessment, risk assessment that they would have done on their own. And you know, I don't think it probably was that big a surprise for for everyone that the novices found it much more useful to have something like this present. The experts, you know, they overall liked it. You know, do we really need this tool? Perhaps was what some of them were responding. But they did see a value in it for the novices, though. I did love there was a comment in the discussion I'd love to sort of talk about kind of as we start talking about kind of what's next for disseminating the tool, using the tool, the idea of just because you are an expert in the sense of you have had this many years and I know it's not phrased this way, you know, in the tool, it's just how many years. But this, this differentiation between I have done this job for a long time versus I have ethically done this job for a long time, did some of those kind of factors when you sort of think about either updates or areas, was there ever a concern that some of the Terms would sort of be taken out of the wrong context and therefore skew the results a bit. Or those hours with the thesaurus, you think you nailed kind of what everything's supposed to be.
- [46:18]
D
That's a good question. I will say I, I had a lot of consternation about if we publish this tool and somebody uses it and it says this is a low risk situation or slight risk and I move forward and somebody gets hurt, that they're like, yeah, well, the tool told me, and liability issues, I had those concerns for sure. So we were very careful to say in the paper that anything that that tool puts out does not, is not like the green light.
- [46:49]
E
Right.
- [46:50]
D
You still have to use your clinical judgments about what you know about the situation and you have to use your behavior analytic skills. Like, this is not a rule governed thing that we do. Right. So I really appreciated your earlier comments about like, you have to be an analyst, you have to really think about and do some critical thinking about variables here. So the same goes for some of the language in there and even for those four quadrants where we have like, here's things to think about as you're rating those. Like, there's other things you might want to think about too. And the way we worded it might mean something different. I think that's one thing we found out every time we did stuff with experts was what. Because of where I trained, certain things meant certain things to me. But if, but it meant something completely different to somebody else or they used a different word or language for that. So I recognize that. And I think people have to recognize those descriptors are examples and guideposts, but not like a straight path, that this is the answer.
- [48:01]
A
Right.
- [48:03]
F
It was a really good example in that paper. And I read it, even though I had to keep up to date because it's hard to keep up with all these new papers. But it was 95% of blocking. Response blocking. Is it more severe because response blocking is required or is it, oh, you can block 95% of them. And I think the experts went either direction and just a vignette may be insufficient. Although I need more information and that is in most cases, being an analyst is not just relying on written documents of an informal assessment or knowing that this is what has failed in the past when they were in a psychiatric facility. Some of the cases I've worked with, you've had to make decisions on the fly. Or they're so smart, they're like, I knew I was under an FA and I'm like, well, we shifted the function of what we're going to measure to heavy breathing. We still have our results, you know, so like we, we know that there are some issues with the FA in certain cases and like, you know, and there's a lot of debate which ones to use, when to use it. That debate's going on right now whether it's a standardized or, you know, I'm an opinion that you tailor your assessments to your, your clients and it continues in that way as it should do. And there might, there isn't one solve for everything. There's no salva for application or panseer for anything. I think it's a constantly evolving framework and I think this tool itself is potentially something that will change and it won't stay in the same language that it is. And that's going to be based on new findings from the field. So we probably need to start moving to a web based application for the future to get consumer support feedback because that's the big thing I think is missing for data informed research that comes to the university setting. It gets to private equity, it gets made into this like wrap that everyone's using and then it doesn't get changed because people are already making money hand over fist. So bringing it to can you make behavior change? Can you do it ethically? Can you make something that funds itself but for the purpose of like a nonprofit in the truest sense of a nonprofit, like it serves the people for the people. That was a bit of a soap.
- [50:13]
D
Opera box, but it's a big ask.
- [50:18]
C
It's a really big ask, I think, but I think it's really important and I think that might be hard to do, but I think how useful would it be? Like a little golden nugget.
- [50:31]
E
I feel like this goes into a larger conversation beyond just risk assessment, but in our field, you know, the BACB just came out with the most recent, you know, numbers. We have over 300,000 certificates. So that's RBTS, BCABAs and BCBAs. That is a lot of human behavior that we are trying to train up to a level. And I think that we have shifted as a field from trying to figure out how to word this diplomatically. We've shifted from, you know, these really rich experience based programs that are sometimes really inaccessible to a large population of people to making behavior analysis as a science more accessible to people. But we have lost that richness of experience and clinical decision making along the way. And, and not only has, you know, many of us work in the field of autism, that has become an industry I hear autism industry all the time and I just, just get a little cringy because I'm like, no, no, no, these are people that need help. Like, it's not an industry. These are humans. But behavior analysis has become an industry and you know, there's so many, so much money invested in it. And how can we get these students graduated the quickest so that they can start billing, so they can get licensed, so they can get all this stuff? And it's like, wait a minute, maybe the quickest way isn't the most effective or ethical because just, you know, these new practitioners are coming out with all of these rule governed behaviors and they have no contingency shaped behaviors. And so much of what I learned in graduate school was from messing up and something shaped my behavior and oh, don't go this way, go this way. Like, and, and so I think like that, that experience piece of it. And I know there's a lot of people talking in the field right now about, you know, doing some sort of, you know, required internship beyond the 2000 hours or putting, you know, more parameters around the 2000 hours. So it's not just quantity, it's also quantity. But I think with the tool specifically, we were trying to get away from role governed. None of the things say, if this happens, do this. It says if this happens, consider, ask, think about. We're trying to give people the questions to ask, to stay curious about. You know, maybe we're missing something. And I think so much of the time when I'm working with novice behavior analysts, I am a mentor for new behavior analysts. That's like my big passion. They just wanted an if, then they want an answer, they want a rule, they want to, you know, which I get. I'm a black and white alpha female. Like, I want rules and answers and structure too. But so much of the people that we work with, it's such a greater context and this child is coming in or this adult is coming in with a huge history of reinforcement. And we're trying to just figure it out in an hour. And there's 18 years of history that we really need to analyze. 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. And then you also want to consider this thing like. And so we were just trying to more, get people to be asking more questions and staying curious a little bit. Longer before jumping into yay or nay, like, this should be a discussion. And the thing that I've used the tool a lot with, you know, Stephanie and Neil at conferences with students, with consultation cases, is teaching people about functional behavior assessments. And it's really. We've used it a lot as a teaching tool of, you know, I, I have, you know, maybe a semester with you. I can't impart, you know, 20 years of experience in a semester, but I can teach you the questions to ask, like, things to be thinking about. And so I think. I know I just went on a huge tangent, but it's more than just like risk assessment. It's also how do we stay skeptical and humble as behavior analysts and really know what we're trying to do?
- [54:52]
F
Oh, that was a. That was beautiful, by the way. I really. It was great. Well, that was, There was a large tangent because that was.
- [54:59]
E
I'm just, I see all the debates online and I'm like, it's not one answer. Like, there's not a one size fits all. It's not, you know, this is going to work for everyone. It's what questions should you be asking?
- [55:13]
B
Right, Becky? I loved all that, Neil. I mean, everything you've kind of been saying. I know everyone feels like they got too soapboxy, but I think it's perfect. The only thing I wish I had done before you said that is brought us into the section of the show, the dissemination station, where we do get on our soapboxes and do some. So we're going to do a little bit behind. We're doing backwards. A little backwards.
- [55:31]
A
Back the train up.
- [55:32]
B
We're going to back the train up and then say all that again.
- [55:35]
D
No, I don't actually know what a.
- [55:38]
C
Back would train backwards.
- [55:39]
A
Okay, just do it forward.
- [55:40]
B
Just do it forward then. They were there.
- [55:44]
C
So, yeah, I haven't heard a backward train yet.
- [55:48]
D
So that's something that I'm going to.
- [55:49]
C
Have to do some research on later this evening.
- [55:51]
B
So I think.
- [55:52]
D
And that makes me think of Ferris Bueller, what you just did.
- [55:59]
B
So ethically, we need students. We need novice BCBAs, we need expert BCBAs, whoever you are, as a BCBA, we need people using functional behavior assessment methodology. We need it to not be rule governed. We need it to be based on meaningful contingencies for the client. We need people to be able to feel comfortable asking for resources. If you think I'm lying, check your code, man. 2.13, 2.14, 2.15. We got minimize risk and we got to actually Implement assessments. Hey, if you don't want to remember numbers, I like the core principles because I only have to remember four of them. We have to benefit others in our work. And a thousand variations on your DRA program isn't really that beneficial to anybody. Maybe you, if you're billing by the hour, I guess, but not to, not your clients. And then we need to be able to feel competent. And I think, you know, a lot of the strengths of the, of the far far the tool is the utility of those questions related to competence, related to setting, related to if you as the BCBA feel like the risk is slight, but your setting doesn't think it's slight. Using this tool also as an educational one for individuals who wouldn't actually use this tool because they're not behavior analysts, they're not doing the behavior assessment. So I think you've made a beautiful case for all of the reasons. This is something that should be included within our problem solving models as one of the things, one of the tools that we can use to sort of weigh our abilities, weigh resources, look at other resources and supports. But looking into the future, kind of, kind of looking into what's coming up next, are there any areas in the, in the tool that, you know, other than maybe making it web based or. Oh, do we do, do we really need an app? You know? Yeah. What are the pieces that still need to get out there to either get this message out or that you think will be added to the tool to make it even stronger?
- [57:53]
E
I have a couple ideas.
- [57:54]
D
Yeah. So I loved Neil's thinking about like getting user input. Also I think with respect to the tool, I think in hindsight one of the things that I wish maybe we had done differently, although I'm not really sure, you know, when we designed it, it was kind of like assuming that you're talking about a standard. And I'm using air quotes around that because I don't think there is such a thing as a standard fa. But I think we all, when I say that, I think people know what I mean, which is like the Awada style. I'm going to do a free play, escape, attention, maybe tangible, maybe alone. I'm going to run those conditions in some counterbalanced fashion until I see, you know, trends and stability. And so I get a lot of questions sometimes about, yeah, but what if I'm planning to do a trial based fa? How do I factor that into my risk assessment? And we, you know, we really didn't design it that way. Right. It was really thinking about that standard and then we have the things in the table that are here's how you can adapt it and that could lower risk. But I don't think I really thought about now how if I was going to go back to that tool and say, okay, so I'm going to do a trial based or I'm going to do a latency based instead of that, like how, how would that factor into a re evaluation of risk? So I think that's something we could possibly work on more with that tool. And then I guess I would also say this isn't directly related to the tool itself, but if you don't use the results of your FA to design a function based intervention that's evidence based and matches the function and takes into like lots of other things into account, then the data are useless anyway. So how you translate everything into like what about risk for treatment and are we really thinking about how risky this treatment is or alternatively, or maybe part of it is how restrictive or intrusive is that treatment in terms of like ascent and consent and all of that. Like I think there's so many applications that you could be thinking about on that end too that we don't even touch on with ours. Right. It's not even in the same room as those other questions.
- [60:25]
B
Make your treatment the treatment assessment tool about risk.
- [60:28]
D
The tariff.
- [60:32]
F
We do recommend like the latency and some other ones as a when it highlights. But we do not have any kind of reevaluative component. But I think, you know, if you want to do videos because you know, with, if you get to, away from the language you say, hey, this is the severity and you show this is the highest and you have an act to do it. You know, you know, and then you do this, this is the behavior with response blocks and you kind of fill in those details that the experts in Ali's paper were saying. Hey, I didn't know what the 95% blocking meant in terms of severity. I think that would be a really cool paper. And then like the tool itself has another. There's a third tab, the considerations tab. Because we just, we didn't know what. There were some things we didn't know if they fit into validity or whatever. And like we'll have, we have Mariana Valdevino's, Maria's psychotropic medications. And it's like, you know, if someone's having titrated medications or changes in medications it could necessitate, maybe we do the FA just after this. Is there a change in tangibles as well or like edibles because of amphetamines, you know, being prescribed. So I think there's a lot more that can go in. I think we just had enough of it at the time. We were like, this rabbit hole goes, deep analysis done, going. You know, the caterpillars block the path.
- [61:48]
E
It's so interesting to me that you both mentioned the reevaluation, because when I train the tool, I train people to go back after they've fixed the considerations. So, like, if they're doing it, you know, they're worried about reinforcing several instances of problem behavior and they decide to do the latency fa, then that changes the results. Or if they're worried about, you know, staff, and they ended up getting more staff. The trial base is a little bit harder because you're thinking like, okay, I'm training up a teacher perhaps to do this or a para to implement this. But I just. I always train when I'm training it, and I don't. It's. It's just interesting that we all, like, have this idea. And I'm like, well, I already ran with it. Oops. Like, I didn't realize that we weren't doing that.
- [62:38]
F
I think that's the way it's meant. When I'm thinking about it, I'm thinking that we provide both the before and after in the bars.
- [62:47]
D
Yes.
- [62:48]
E
Yeah.
- [62:48]
F
Yeah. Because like, right now, when you click it, it just gives you a new reading and you have to, I guess, screenshot it. So it's like, hey, look at where you were. And this is the new bar. This is the different color shaded one. And so that way it's not a constantly changing picture. It's a where we were, where we are now. And can we get lower on increased safety? But yeah, I imagine doing it the same way that you're. You're teaching folks back, Becky, because it's same.
- [63:16]
D
Same here. And I've just been surprised, I guess, that it doesn't seem like that's intuitive for folks to do that. And I wonder, like, I think what you just described, Neil, would be one way to make it more intuitive. Like, what could we do with the tool to make that more, like, sort of apparent that once you decide things are going to change, you can come back here and reevaluate and see.
- [63:43]
E
Whether.
- [63:43]
D
The risk has been lowered or not or to the extent to which it's been lowered. Is it now an acceptable level? Right.
- [63:51]
B
Oh, boy. Well, I, for one, am very excited to see future iterations, even small tweaks like the before and after anything to keep people using our science and using this technology rather than just feeling stuck and then giving up and saying, well, I'll just do something. Which is never the right answer. So if you're someone who says that's your answer, don't worry. We've got a tool for you. We'll have it linked in the show notes. Go click it. We'll link right to the article. You can link right to the tool, Download it.
- [64:21]
A
I feel like the phrase people do well when they can applies. This gives people so much more. It can be really daunting and intimidating to embark on an FA if you don't have that much experience. So this can really help you like break down. Like what is the part of this that I'm worried about? Maybe there is some, some hidden risk in here that I hadn't haven't been able to articulate.
- [64:43]
F
Right.
- [64:44]
A
And that can help you identify what that is and then work to mitigate that through additional supports.
- [64:49]
E
I think the other thing that I would say that I always say when I like talk on this tool is something that Stephanie mentioned is like seeking out consultation. And there's no shame in that.
- [65:00]
A
Yeah.
- [65:00]
E
So many times I think we're nervous because some of the papers that we cite in the, you know, in the tool are big names and you're like, oh. But I think one thing that Stephanie always like drilled in our heads was people are people are people. Like these are just humans. And you know, some of them are nice, some of them are not nice. But like if you run into, you go through the tool and you decide, I want to do this type of FA and I've never heard of it, I'm going to reach out to the authors. Many of these authors are faculty who have open research studies happening and they may have a research study on training people how to do trial based. I don't know. But like, it never hurts to just like reach out. And the worst thing that can happen is they say no and you're in the same spot you were before. But you know, and I just, I think that's something that is also lost a little bit with some of the, you know, get these people trained quickly and is part of the networking and the connection and this, the human nature of our field. And that even though we have 300,000 certificates, you know, across all levels, it's still fairly small and people want to help. And most people that are, I say most because it's not all. Most people that are in this field got in it because they knew someone they Had a loved one. They, you know, were impacted some way in their life, that they wanted to make it better for someone. And so I just think, like, that's a big thing to remember, too. Like, that that consultation piece isn't, you should have learned this, or, you know, you're not a good behavior analyst because you don't know this. It's like, just go reach out to that person. They might have a study, and they might be like, yes, we need more participants. Join us.
- [66:43]
D
Yeah.
- [66:44]
A
And they'll send you the copy of their paper, too.
- [66:46]
D
Yep, for sure.
- [66:49]
A
We're actually all just waiting by the computer for someone to email us to ask us for a publication. That's true. It's so true.
- [66:58]
E
It is.
- [67:00]
B
Well, Dr. Neil Dioshan, Dr. Becky Eldridge, Dr. Stephanie Peterson, thank you so much for coming on the show. Thank you so much for developing this tool and writing so eloquently about its utility and then talking about it with us. Again, if you have not downloaded this, even if you are someone who thinks that your FAS are the best, and there's never been a risk ever, you know, it never hurts to double check against and leave us your name so.
- [67:22]
F
We can give that name to the bacb.
- [67:25]
B
You're gonna be getting some vignettes pretty soon if you don't watch out. You know.
- [67:32]
A
Go check it out.
- [67:33]
C
It's very cool.
- [67:33]
B
Yeah, it is very, very cool. And again, we'll have the link so you can play around with it. You can do. What I did when I first got it, which is actually what was in the study, is like, I'm gonna click all the boxes and see what colors show up and what citations I get. That was a lot of fun.
- [67:46]
D
Well, and if I can tag on one thing to the end of that, first of all, I would like to express gratitude to all the, like, experts that helped us and took time out of their busy schedules to review this. Like, there was nothing in it for them.
- [67:59]
A
Right.
- [68:00]
D
They just said, okay, we'll help you, and they gave us their time. And for participants who participated in any of our studies, there was not very much in it for them. Some of them may have gotten paid, but, like, this stuff on decision making is really labor intensive research. It's labor intensive for the researchers, and it's labor intensive for the participants because, like, we have to know what you're thinking about, which means, like, you have to sit down and narrate what you're thinking about. And that takes a lot more time than clicking through a survey. It takes a lot more time to analyze those data. So I express gratitude to the participants, to the experts that participated in all of our studies, and just want to encourage people when they see all those emails come through asking for people to participate. Like, just keep in mind that you're helping to advance the science and it's really important work. And I know like for Becky's dissertation, it was stuff that required quite a bit of effort on the participants, and it was hard to get enough participants to hang in there for it. But I think you learn something through that participation, or I hope you do. And, you know, just know that it's really important work and we can't create these kinds of things without people's assistance with that. So I'll just like sort of hang that out there for folks to think about too.
- [69:23]
B
Once again, we want to say a great big thanks to our special guests, Dr. Stephanie Peterson, Dr. Becky Eldridge, and Dr. Neil Dioshan. I. I know we were talking a little bit after the show just how great it was. It felt like we were in those initial meetings and talking about the tool from way back in the grad and doctoral level days. So it's just a real treat to have all of them join us for this episode. And we hope you all got to enjoy that, that kind of, that energy as well. But before we wrap up, we do have one more section of the show. Diana, take it away.
- [69:54]
A
All right, it's time for pairings. Pairings is the part of the show where I tell you about past episodes in our library that you might want to ch if you found this one of interest. We have talked about functional analysis several different times, so I'm going to tell you what those times are right now. Episode 7, trial based FAS episode 66, latency based FAS with Dr. Joshua Jessel. Episode 110, the ISA with Dr. Aditio Rajaraman. Episode 166, history and evolution of functional analysis with Dr. Jessica Slayton, episode 208, FBAS and schools, and episode 234, idiosyncratic functional analyses. There are also a few other episodes I thought would be good in conjunction with this one, which include episode 200 where he talked about Ethical Decision Making with Sir Matthew Brodhead. Episode 261, Strategies for Escape Maintain Behavior. That's that Geiger et al. 2010 article that we referenced a few times here. And Then finally, episode 271, Social Justice Research Practices with Dr. Malaika Pritchett. I also like to recommend a snack to go with the episode. The snack Today is pizza rolls.
- [71:10]
F
Do you remember those, Diana?
- [71:12]
B
I do remember pizza rolls. I feel like we've done pizza rolls or maybe we done bagel bites.
- [71:17]
A
I don't care if you think that I've already done pizza rolls. It's irrelevant. But pizza rolls are. They were really popular in the 90s. They're like little pillows of, you know, crust on the outside and then molten hot tomato sauce and cheese on the inside. So you would pop those in the oven or the microwave, and then when you took them out, you had to make a risk assessment.
- [71:42]
B
It was never slight whether on whether.
- [71:45]
A
It was you were going to be safe to bite into that thing because.
- [71:49]
B
Substantial or intense, it just was one end of that tool.
- [71:53]
F
Right.
- [71:53]
A
Because you bite into that and that molten hot substance inside would strip down your chin or burn your mouth or your.
- [72:01]
B
It doesn't care about your experience. It doesn't. It's intensity. And do you have medical staff on hand? That's it.
- [72:07]
A
Yeah, yeah, yeah. So it was a very real decision. But if you waited too long, then they got cold and they weren't good. They were only good really hot. But it was dangerous. It's dangerous food.
- [72:15]
B
Oh, man.
- [72:16]
A
And that's it for pairings.
- [72:18]
B
That was a good one. I like that one, Dan. That's good. I. I love a Funny story with your. With your snacks. The ones where it's like, this is what you're having for dinner after we're done recording. Or fun too, because it's like a preview. All right, folks. Well, that brings us to the end of the show, which means you probably want to hear that second secret code word, and it is bully.
- [72:40]
A
B U L, L Y. Bully. Hopefully you don't have a bully, but this. Actually, I know why this was selected, so I'll tell the listeners as well. We were chatting before the show and Neil currently works at Mississippi State University. So I noticed that in his, you know, signature email. Signature brought it up because my grandfather taught at Mississippi State University, so their mascot is the Bulldog, whose name is Bully. So hail State.
- [73:08]
B
I thought it was a love of the PlayStation 2 game Bully.
- [73:11]
A
Oh, yeah, yeah, you loved that one. But it's. Bully is the word. B U L L Y.
- [73:15]
B
That game is like. It's like Grand Theft Auto. But what if I were just a kid who were mean to other people?
- [73:20]
D
Yeah.
- [73:20]
A
Yeah.
- [73:21]
B
I don't know if that game. Maybe that game hasn't aged very well. You're. You're more misunderstood than a bully.
- [73:27]
A
And a kid looked like Kevin's brother in Home alone.
- [73:29]
B
Buzz. Yeah, Buzz your girlfriend. All right, well, thank you all so much for listening. And a special thank you to all of our patrons on patreon.com ABA Inside Track who chimed in with a vote for an episode on Risk Assessment. It was all ethics choices, so you weren't going to go wrong. But I think this was definitely a winner. So thank you all so much for voting. If you would like to vote on a future episode of ABA Inside Track, we do these listener choice episodes once per season. And if you would like to get a CE as a patron member, just go to patreon.comabainsidetrack where you can subscribe really at any level to get all the episodes a week ahead of time. Or you can subscribe at the $5 level to get access to these listener choice episodes with the free CE to all of our polls. But if you want even more, you can go to that $10 level and get all of our book club episodes as soon as they come out and get the two CES for listening to those. So there's quite a value there. You get your listener choice, your book clubs. But again, if you just love listening, hey, we love doing these shows. We love having awesome guests, so you can do that too. But if you're interested in something a little extra. Patreon.com ABA Inside Track Some final thanks certainly again to our guest Dr. Neil Deoshan, Dr. Becky Eldridge, and Dr. Stephanie Peterson. Also, big thanks to Dr. Jim Carr for recording our intro outro music, Kyle Sturry for his interstitial music, Indian Abbott of the podcast Doctors for his fabulous editing work. We'll be back next week with another fun filled episode, but until then, keep responding.
- [75:02]
A
Bye bye.