Friday, November 30, 2007

Nature abhors a vacuum

Recently, just this morning, I was visiting with an excellent young therapist. We started talking about data collection and about making it simpler to which she responded how difficult it was to simplify data collection on the aggressive behaviors she was observing and which she was at times on the receiving end. (It is important to note that the therapist is not in any danger of harm in this situation.)

This brought me back to my tired old record, which I play quite often, about finding the reason for aggressive or harmful behaviors and finding and teaching a replacement behavior.
It is important to do a thorough assessment of current levels of behaviors of the person that you are working with.
Occasionally it is important to reassess the level of those behaviors, especially if there is danger; you can not totally ignore them. Safety comes first.

Our conversation thought, brought me to talking about the Hawthorne Effect. A good therapist should have a good understanding of a number of different effects including Hawthorne, Pygmalion and Halo. See: http://www.psy.gla.ac.uk/~steve/hawth.html#pyg & http://en.wikipedia.org/wiki/Halo_effect . You must ask yourself what the effect has been, is and/or will be of continually and frequently measuring an inappropriate behavior.

I know this therapist and her husband fairly well and I asked her what the result would be if she started taking data on how many times her husband left the toilet seat up. While this may decrease the behavior there may be some additional consequences. (Frankly, while I know them fairly well, I don’t know them well enough to even know if this is an issue.) Anyway, since in a situation like this, the goal should not be to not have the toilet seat left up but to have it put down, a simple reinforcement (perhaps even a simple request) of putting the seat down is likely to be more productive all around. For a better example, if someone needs physical touch and is filling this needs in a socially inappropriate fashion, then trying to eliminate all touch is probably not reasonable. If flinging feces provides needed attention, then perhaps it would be beneficial to teach and reinforce another more appropriate way to get attention. Remember that whenever you are trying to decrease a behavior, you need to be increasing another more appropriate behavior that still fills the needs met by the less or inappropriate behavior. If you do not, the person will find another, perhaps even less appropriate way to meet their needs. As Spock astutely said in The Wrath of Kahn “Nature abhors a vacuum.”

Please also visit http://www.childrenofthecode.org/interviews/shonkoff.htm#Adaptation:

Click here to continue with this information: Transition Plans

Friday, November 23, 2007

Now try it out

Write a measurable behavioral objective.
Include an operational definition if needed.
Included brief training instructions.
Include data collection methods.
Keep it parsimonious.

Give what you have written to a friend/colleague (do not answer any questions or provide any additional information).
Have your friend/colleague implement what you have written with another friend/colleague (not a client/participant).
Have two other friends/colleagues observe and independently collect data.
Note: for the purpose of this exercise you do not need to include reinforcement.
Answer these questions:
Did the client/participant do what you initially intended him/her to do?
Did the two people collecting the data collect it exactly the same? Did they collect what you wanted them to collect?
If you answered yes to all three of those questions you may be on the right track.

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A little more on data

This may seem a little redundant but it is crucial. We have already talked about data. For some people data is just something that has to be done to satisfy someone else who is paying the bills. It is sometimes no more than an afterthought or something to manipulate in order to either continue to do what they think is best or to continue to be paid. This may sound harsh, but unfortunately it is true. I have seen people do all of the above and heard people admit to doing these things. In some situations there has been national scandal resulting from the uncovering of fraudulent, lazy, or poorly designed data practices and reporting. Some times therapists/interventionists do what they believe to be the best thing for the individual. Without good appropriately interpreted data, it is difficult if not impossible to know what the best thing is for the individual or even if what is believed to be good is helpful.
Three of the most common honest problems with data are:
1. Lack of clarity about what data is being collected;
2. Additonal variables; and
3. Too complicated.

Note: Sometimes people cheat on their data because of one or more of the above problems. Assuring clarity, parsimony and that you know are really measuring what you want to measure helps to increase validity and is one essential component to improved outcomes.

Additional note: I’ve liked the word “parsimonious” from the moment I heard it and learned its meaning. It may be my rather dry sense of humor. Years ago in graduate school I learned that one of the four assumptions of science is that it is parsimonious. I found this rather ironic because it was explained to me that the meaning was that it was short, simple and to the point. The word “parsimonious” of course is not short or simple. According to Wikipedia, the free encyclopedia; “Parsimony is a “less is better” concept of frugality/economy/stinginess or caution in arriving at a hypothesis or course of action. The word derives from Middle English parcimony, from Latin parsimonia, from parsus, past participle of parcere; to spare”. And “Parsimony: The simplicity with which a theory explains phenomena”. From Practicing Educational Psychology; by Margaret M. Clifford (1981).

1. Problem one is usually resolved by a well written and well thought out Measurable Behavioral Objective, which is based on good evaluations/assessments (Including a good functional analysis of behavior whenever possible and appropriate). Please ask questions in the comments section if you have any.

2. Problem two is often helped by a good Measurable Behavioral Objective but unfortunately it is not quite as simple as that. I remember reading a paper that stated that the data demonstrated the effectiveness of an intervention and yet they compared samples from an urban area where services were available against samples from a rural area where the services were not available. There were so many possible additional variables or additional reasons why the children in the city progressed at a different rate than the children in the rural setting that the entire study lost validity and any real credibility. When you read the research design from a paper, you may note design flaws as large as or larger than the one mentioned. There are a few things that you can do to decrease tainted data resulting from variables which are unintentional and/or unaccounted for.
a. Separate data by: setting; therapists; times; and additional possible distractions. While your goal may be to increase a behavior across settings, therapists, and other environmental factors, and your overall data report may include everything, it is often a good idea to collect data separately for the purpose of analysis and intervention refinement.
b. Assure that intervention is provided consistently and as written.
c. Collect data in as unobtrusive manner as possible (this will be discussed in a little more detail under problem 4).

3. Problem three is helped by keeping it as simple as possible. (Keeping it simple can also help to keep it less obtrusive. Collecting data in public in a more obtrusive manner is not respectful of the individual and in any setting can be an additional variable affecting behavior.) A couple of ways to keep data collection simple and less obtrusive is through the use of a counter. You can even use two different counters in different pockets allowing you to collect data on a couple of different behaviors. Another option is the use of a stop watch, which can also be kept in a pocket. In some situations you do not have to collect data all the time. You can take samples; however, it is imperative that you sample across environmental variables. If you do take samples, it may add to validity to intermittently take data all the time to better assure accuracy and validity. Obviously these ideas will not work in every situation. Brainstorm how you can make it simpler. Discuss options and ask questions in this section (do not share confidential information).

Note: Make sure that you collect data in the same way that the objective is written. If you write an objective around increasing a behavior, do not record data around a different and possibly decreasing behavior. If you write the objective such that Johnny will increase the number of times he does something, do not record data in percentages etc.

Click here to continue with this presentation: Now try it out

Saturday, November 17, 2007

Examples of poorly written objectives:

What are the problems with the objectives as written below?
Please rewrite the objectives filling in missing information as you wish in the comments section. You may need to include operational definitions.
Please discuss the rewritten objectives in the comments section.
1. Isaiah will cross the street safely 4 out of 5 times.
2. Sarah will come to class without smelling badly.
3. Annie will behave in class.
4. Thomas will take out the trash.
5. Margaret throws a fit only five times.
6. Dalton will try to sit quietly.
7. Sally will transition in a timely manner.
8. Charlie will walk.

To continue with this information click here: A little more on data

Monday, November 12, 2007

Measurable Behavioral Objectives Critiques

Please use this comments space to write objectives that you would like critiqued by myself and others. Do not include any confidential information. Do no use the real name of anyone that you are working with. Do not use any information that would identify the person even without the name.

Click here to continue with this information: Examples of poorly written objectives:

Measurable Behavioral Objectives

"A complete behavioral objective will:
a. Identify the learner [the child/participant];
b. Identify the target behavior;
c. Identify the conditions under which the behavior is to be performed (using words such as "when" and "in"); and,
d. Identify criteria for acceptable performance".
Idaho Intensive Behavioral Interventions Student Manual from the Idaho Training Cooperative
*Criteria for acceptable performance should increase for mastery, a demonstration of a consistent level over time.

In other words:
Who, What, When/How and How
Who: Who is the learner?
What: What do you want this person to DO
When/How: When or how will the person know that it is time to DO the behavior. This could be a natural cue, such as a school bell or getting up in the morning, it could be a verbal cue or almost any other type of appropriate cue.
How: How will you AND OTHERS observing, know that the behavior has been accomplished.

Do not use words like: try or understand. There will be a long list of additional words not to use in the comments section.

Note: Operational definitions are often required for clarity and consistency.
Note: Specific, clearly defined reinforcements/consequences (appropriate to the child/participant and situation) are usually paired with a well written measurable behavioral objective. (Sometimes reinforcements/consequences can produce unintentional consequences, reinforcing something other than or in addition to the target behavior.) Often successive approximations are preferable and helpful with the exception of safety issues.
These are not easy to write. Please leave comments and additional questions.

Please leave comments here about examples of unintentional reinforcement

Now for an example:
1.Pete will instruct the group (all you folks) {a.} how to write a measurable behavioral objective
{b.} when ever (100% of the time) {d} anyone from the group (all you folks) writes a plan for a child or an adult {c to include the previous "when"}.
(Measurable is defined as having both validity and reliability across time, location and people (observing and recording data). A Behavioral Objective requires all four components listed previously.

Note:
Typically, well written goals, objectives and plans will contain time lines, which may or may not be the same. eg. the time line or expected completion date of an objective may come before the expected date of completion for the overall goal.

Click here to continue with this information: Measurable Behavioral Objectives Critiques

Goals

Goals should be positive, and logically tie back to both formal and informal assessments. Many goals will have multiple objectives.

“Because goals are projected over long periods of time they are written in broader terms but they should still be written as observable and measurable behaviors. Verbs such as demonstrate, be able to, increase, develop, decrease, or complete are all the kinds of behaviors that can be observed and documented. The person writing a plan would then convert broad goals into statements of instructional intent (measurable behavioral objectives)”.
Idaho Intensive Behavioral Intervention Student Manual, developed by the Idaho Training Cooperative.

One more note, be consistent in numbering goals and objectives. Goal 1, Objective 1b should always be goal 1, objective 1b even if it is accomplished and no longer being persued, trained or worked on for this individual. Those numbers should not be used again for a differen goal or objective for the same individual/plan.

To continue with this presentation click here: Measurable Behavioral Objectives

Now for some historically poor examples of valid and reliable measurements.

What’s a “foot.” (Measurement)
What’s a cubit? (When I think about cubit I often think about the old Bill Cosby monologue <http://msxml.excite.com/info.xcite/clickit/search?r_aid=7AFE09E17BF54135B9C52579F61E71C0&r_eop=1&r_sacop=3&r_spf=0&r_cop=main-title&r_snpp=2&r_spp=1&qqn=5V%40ex3Z%40&r_coid=239138&rawto=http://www.jr.co.il/humor/noah4.txt>) If you ever get a chance to hear it, it's worth it. Bill Cosby is one of the premiere comedians of my life time. This bring out another important point about plan writing and measurement and keeping things valid and reliable. My life time probably covers a lot more time that yours. I've read some reports where people have used generational slang. Keep it professional. Remember that other professionals will be reading what you write. Don’t use slang, "expressions" or acronyms.

Some additional examples:
Many surveys are reliable yet not valid; they do not accurately report what they claim to report.
Some assessments are not accurate across cultures or individual situations. For example some IQ tests are not valid across cultures.
Another example, a standard eye test is not valid for a non reader. (I remember living and working in a group home when I was younger. I took a non reader to an eye doctor for his annual exam. The doctor took the man and gave him a test and returned and told me he was legally blind. He wasn't legally blind. The Optometrist had showed him a letter and asked him what it was and he would just simply say: "I duno!" and shake his head. Knowing that this person had good vision I spoke with the doctor who tried a different type of test where they many only had to point. His vision was 20/20.

Some additional threats to Validity are: Multiple Variables; Something else happened or is happening at the same time. Maturation: The participant grows into it or out if it and would have without the intervention (this is one of those "other" variables" mentioned earlier); Observer Bias, We see what we wantor expect to see.

To continue with this information click here: Goals

Valid

Validity in this sense is measuring what an instrument or data collection plan says it measures, accurately. You can sometimes improve validity by assuring that you are measuring the target behavior or its successive approximations.

Click here to continue with this presentation: Now for some historically poor examples of valid and reliable measurements.

Reliable

Reliability in this sense is allowing something (may be an instrument) to measure the same thing over and over again by different people in different settings and getting the same result. Clear operational definitions can improve reliability.

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Measurable

Anything measurable must have both validity and reliability to the highest level possible.
What does reliability mean?
What does validity mean?

Please click comments to discuss this topic

Click here to continue with this information: Reliable

Now let’s discuss well written objectives

They are almost always:
1. Measurable,
2. Observable, and
3. Repeatable


Click here to continue with this information: Measurable

Let's discuss data and statistics

There are usually three types of data collected from therapeutic plans: Frequency, Duration, and Intensity. There can also be combinations of these. What are some examples of each? Sometimes levels of assistance can be considered intensity data. If you ares not extremely careful, intensity can be very difficult to record accurately without instruments of measurement.

Before talking about statistics, there is an old story that I would like to share. There was a company that wanted to hire a statistician. They had a full day of interviews and started early in the morning with the first applicant. After asking a number of questions. One of the interviewers wrote on the board "2 + 2 =" and asked the applicant to solve the problem. This went on all day. Finally the last applicant came in. Same questions and same problem at the end but with one exception. This time the applicant got up and went to the door and glanced outside the door then locked it. The applicant then went to the window and closed the blinds. Finally the applicant moved closer to the interviewers and whispered: "What would you like the answer to be?"
The joke may sound a little outrageous; however, I am a strong believer in data, if it is collected and analyzed fairly and correctly. There is a lot of data that is not worth the paper it is written on. There is a lot of research that is absolute garbage. Usually by reading the information, including the research design or the design of the data collection, you can get an idea about the value of the data. Sometimes it is worthless as collected. Sometimes it becomes worthless by the way that it is analyzed or summarized. We’ll discuss this a little more in the subsequent postings.

Some problems with data collection (and these are not the only problems) are not factoring in other variables that may effect the data, not having a clear and concise written statement about what is being measured, and using the wrong type of data collection for the situation.

Click here to continue with this information: Now let’s discuss well written objectives

Focus on what you want to increase

Note: Everyone has strengths/assets. The key is to locate, develop, integrate, and enhance, existing assets, being open to the possibilities. This can also require a shift in thinking. Instead of focusing on what is going wrong, one must spend more energy looking for what is going right. Instead of spending most of your time finding and recognizing problems, you must refocus your thinking towards solutions. It is usually easier to strengthen an asset than to eliminate a deficit. Amazingly, deficits often decrease or even disappear as assets are developed. An asset or strength based approach appreciates that the glass is half full, asks why it is half full, and then finds ways to fill it even more. This is not a suggestion to hide your head in the sand and ignore deficiencies, which sometimes must be addressed (for example suicidal or unsafe behavior). This is a suggestion that WHAT WE FOCUS ON INCREASES. Spend more time on the positive (or Assets), quickly deal with the deficits when it is required, and you will be amazed at how much more quickly the positive (Assets) increases.

Try this exercise. Picture a cow. Perhaps a friendly looking black and white Holstein. Think about all the things that come from cows. Milk and other dairy products, leather products and anything else associated with cattle.
Set a timer for one minute and then time yourself and do not think about anything to do with cows. Don’t think about milk or cheese or any beef products. Don’t think about anything to do with cows or cattle for one minute. Go ahead and try it.

Click on comments and tell us how you did. Were you able to do it? If you were, how did you do it? There is a common thread for those who are able to do it.

Click here to continue with the presentation: Let's discuss data and statistics

A well written Implementation Plan will include, among other things:

1.A well written goal;
.One or more measurable behavioral objectives;
3.Specific steps including settings and cues to achieve the objectives;
4.Specific instructions for data collection.
5.Sufficient technical clarity for another professional, paraprofessional and/or parent to read, understand, correctly implement and reliably collect data.
(Reliably in this sense means to collect data the same across multiple observers and time.)

To continue with this information click here: Focus on what you want to increase

Reinforcement

“There are two types of reinforcers: Positive and Negative.”
“ A positive reinforcer is a (desirable event). Positive reinforcement is the giving of a (consequence), which increases the probability that the (desired) act will be repeated.”
“A negative reinforcer is an undesirable event that can be withheld or removed. It can be equated with relief. Negative reinforcement is the act of withholding or removing an undesirable event, which in turn increases the probability that the preceding act will be repeated.”
From Practicing Educational Psychology; by Margaret M. Clifford (1981). (Possibly the best book on behavioral intervention and learning ever written)

Note: Avoid the common problem of inadvertently reinforcing a behavior that you want to decrease.

To continue with this information click here: A well written Implementation Plan will include, among other things:

What are the essential components for a therapeutic plan?

Evaluation/Assessment: Evaluations come in a number of different formats and can be formal or informal or a combination. Evaluations provide the foundation. They provide the background, diagnoses, barriers, strengths and desires (and should often include functionality of inappropriate behaviors). They tell you where you are, and create a starting point for your journey. They tell you what kinds of consequences/reinforcements provide what kind of results in what circumstances for the individual. Often they give you an idea of where you have the most chance of future success.
Plan:The plan is the map; it tells you where you are going and how you are going to get there. (Generally including reinforcement/consequences/ successive approximations.)
Plan implementation: These are the actions required in order to follow the map. Even if you had a perfectly wonderful map to an incredible treasure, if you don’t follow the map, or if you don’t follow it exactly, you probably won’t find the treasure. (Generally includes reinforcement/consequences/ successive approximations.)
Reassessment/evaluation:This can include both formal and informal evaluations and includes the gathering of data as the implementation of the plan progresses. This must be an ongoing and continuous process. What is the data telling you? If it isn’t telling you anything, there is a problem.
Adjustment: Solid, inflexible, unalterable and unchanging plans are almost always like the brittle bolts of the titanic, easily broken and quite useless under any stress. Plans should be adjusted as often as needed and is helpful for the individual child/participant and/or care giver. The same plan year after year is almost ALWAYS outdated and ineffective, even if it was initially effective. (Each time this training is presented, I request feedback and adjust. When a plan is being implemented, there should almost always be adjustments for improvement in any component of the plan needing adjustment.)
: Remember the importance of the immediacy and value of the consequence. Remember satiation and natural and logical consequences. Is the consequence tied specifically to the target behavior and nothing else? How do you handle and vary schedules of reinforcement?

To continue with this information click here: Reinforcement

Saturday, November 10, 2007

Implementation Plan writing requires the integration of a number of events/processes.

None of these can stand alone but must be integrated with the others in order to write an effective plan.
Note: Sometimes we believe that the problem for lack of progress is inconsistent implementation because we can not get someone to consistently implement what we have written. Sometimes this is true; however, we must explore if we have sufficiently partnered/collaborated with the this person (including a parent in some situations) in developing a plan that is appropriate and fits with the needs, beliefs and abilities of the parent/guardian…or other caretaker/service providers or others who would implement this plan. Authors John Walter and Jane Peller in Becoming Solution-Focused in Brief Therapy stated: “There is no such thing as a resistive client, only inflexible therapists.” Sometimes this also applies to our work. We need to ask ourselves not only if the plan reflects the assessments but also if we will have the support and cooperation of the parents/guardians, other caretakers, teachers, service providers or whoever would implement the plan. What about the support of the participant? This may seem like a strange question to some; however, taking into consideration a participant’s strengths, weaknesses and preferences is absolutely critical.


To continue with this information click here: What are the essential components for a therapeutic plan?

One example is the story about the Turkey, the Cannon, and the Airplane

Once upon a time there was a company who developed a special cannon that would shoot (discharge) turkeys. (The cannon was not for shooting at turkeys, but to shoot turkeys at something.)
The purpose of this cannon was to help manufactures of windshields for airplanes ascertain if their windshields were strong enough to withstand the frequent hazard of running into a flock of birds, especially on takeoff and landing.
The cannon was designed and built by engineers. The engineers also wrote a detailed and technical operations manual.
The cannon was purchased by a company manufacturing windshields for airplanes. The manual was read by their engineers… however; there was a problem.
Every time they shot a turkey at their windshield, the windshield shattered. They looked at the manual again. They looked at their windshields again. Finally they called the company that manufactured the cannon…who came to observe.
Click comments to find out what happened.


Click next to continue with this information: Implementation Plan writing requires the integration of a number of events/processes.


(This is an apocryphal story; however, provides a good example)

Plan writing is one form of technical writing.

Technical writing can be a very difficult skill to master but one which is required in order to write a good implementation plan that meets the standards generally required.
You have probably all read manuals and directions that were very difficult to follow and hopefully some that were easy to follow. When you read something that explains “how to” do something such as putting a bike together, running a computer program, operating your car stereo system or even a cook book, that is usually technical writing. As with most cook books, it often assumes a certain level of understanding on the part of the reader.
College students often spend most of their college career trying to figure out how to make their paper longer in order to fill a required number of pages. They learn to write in five or six pages what a good technical writer may write in one paragraph. There is a place for lengthy descriptions and sometimes even for vague and imprecise communication; however, case notes, reports to the court, and implementation plans almost always require technically accurate, precise and parsimonious writing.
Some of us are not great technical writers (including myself ). It is often helpful to have someone read and edit your work. I find it easier to edit other people’s writing than to write it myself. I also find it helpful to have others edit my writing when I write. Usually two heads really are better than one. All of this may require more time and I understand the pressures on time and billing; however, better preparation almost always saves time in the long run and almost always provides better outcomes. Preparation is also generally required by some rule or regulation.
Technical writing should never be a mystery. It must be clear, complete and concise, and easily understood by others, both professionals and nonprofessionals.

To continue with this information click here: One example is the story about the Turkey, the Cannon, and the Airplane

What is technical writing?

When I was in college most students had to take a technical writing class.
What are some examples of technical writing?
*”How to….”
*Usually a resume
*Reports to the court
*Plans
I am not a great technical writer. Because of this I ask people to review my work. This is what I suggest you do.


To continue with this information click here: Plan writing is one form of technical writing.

Try this communication activity

Create and print out a page of eight or nine fairly simple shapes.
Sit back to back with someone and describe the shapes while the other person draws them. The other person can not see the drawings but can ask questions for clarification.
Feel free to ask questions about this activity in the comments section.


You may want to use the example below.

£ ◊


.....♦ ~~

▲ {]

◄ ^




This is not as easy as you might think.


To continue with this information click here: What is technical writing?

Learn how to write Measurable Behavioral Objectives

“Without goals and plans to reach them, you are like a ship that has set sail with no destination.” Fitzhugh Dodson

Click next to continue with this presentation: Try this communication activity.

Learn how to achieve Better Outcomes through Community Collaboration and Consensus and Public Participation

For information and discussion please go to: http://www.communitycollaboration.blogspot.com

Understand how assessment, plans, objectives, plans and data are related.

This presentation will take you through the relationship between assessments, plans, objectives, and data.
Please ask questions if you would like to discuss or ask questions.

Click next to continue with this information: Learn how to write  Measurable Behavioral  Objectives

Learn the practical use of assessment and data:

“Map out your future, but do it in pencil”. Jon Bon Jovi,
“There is nothing so useless as doing efficiently that which should not be done at all”. Peter Drucker


"Assessment is the Process of Collecting Data for the Purpose of Making Decisions About Students." Ysseldyke, 1995

Click here to continue with the information: Understand how assessment, plans, objectives, plans and data are related.


Supplemental information
http://books.google.com/books?id=fo6SBc-97UEC&pg=PA66&lpg=PA66&dq=%22assessment+is+the+process+of+collecting+data+for+the+purpose+of+making+decisions+about+students%22&source=web&ots=-kCjqT8dIQ&sig=nU1IOa_PixHjKtQcUkEqX8eqV2c&hl=en&sa=X&oi=book_result&resnum=1&ct=result#PPA62,M1

Goals and Objectives

“If you aim at nothing, you'll hit it every time”. Author Unknown
“You got to be careful if you don’t know where you’re going, because you might not get there.” Yogi Berra


Click here to continue: Learn the practical use of  assessment and data

Supplemental information:
Setting Goals for Measurable Outcomes

Better Outcomes

The purpose of this blog is to help you and the people that you work with achieve better outcomes.
The steps toward this goal include: better plan writing; better assessment and input; more measurable behavioral objectives; better instructions; better methods of collecting and displaying data; and better follow-up.
This will include both theraputic and organization goals and plans.
You can find information about and discuss community collaboration and public participation at:
http://www.communitycollaboration.blogspot.com/

Click next to continue with the information: Goals and Objectives