Prioritizing Behaviors

What is the very first question a BCBA has to ask when prioritizing behaviors to target?

• Does the behavior pose any danger to the client or to others?

• How many opportunities will the person have to use this new behavior?

• How long-standing is the problem or skill deficit?

• How likely is success in changing this target behavior?

Brandon is a three-year-old boy who lives with his mother, father, and brother. Brandon is language delayed and speaks in one-to-two-word phrases often repeating what others say or by echoing phrases or sounds from favorite television programs. His parents reported that Brandon will only play with a very small repertoire of toys and activities, will only finger feed (refuses food on a utensil), and he doesn't respond when his name is called. His parents also shared that when a demand was placed on him, he often will become aggressive (hitting and kicking his bother) and throwing toys. As the BCBA, what behavior would you target first?

• Expanding Play Skills

• Eating with utensils

• Aggression/ Throwing

• Responding to his name

Brandon is a three-year-old boy who lives with his mother, father, and brother. Brandon is language delayed and speaks in one-to-two-word phrases often repeating what others say or by echoing phrases or sounds from favorite television programs. His parents reported that Brandon will only play with a very small repertoire of toys and activities, will only finger feed (refuses food on a utensil), and he doesn't respond when his name is called. His parents also shared that when a demand was placed on him, he often will become aggressive (hitting and kicking his bother) and throwing toys. As the BCBA, what behavior would you prioritize targeting second?

• Manding

• Potty Training

• Functional toy use

• Eating with utensils

Rachel is a 2 year-old girl who lives at home with her mom and dad. Per parent report, she isn't yet playing with toys or imitating the words, gestures, or play actions of others. She gets the majority of her wants and needs met by hand leading. Rachel will extend her body parts to assist in getting dressed but is not yet tolerating getting her teeth brushed. Her mom shared that when other people are in her home (grandparents, friends), Rachel refuses to approach them and will run away and sometimes cry. As the BCBA, what would you target first?

• Tabletop Play

• Approaching adults (other than mom and dad)

• Imitating play actions

• Tolerating tooth brushing

Rachel is a 2 year-old girl who lives at home with her mom and dad. Per parent report, she isn't yet playing with toys or imitating the words, gestures, or play actions of others. She gets the majority of her wants and needs met by hand leading. Rachel will extend her body parts to assist in getting dressed but is not yet tolerating getting her teeth brushed. Her mom shared that when other people are in her home (grandparents, friends), Rachel refuses to approach them and will run away and sometimes cry. As the BCBA, what would you target next?

• Expanding Reinforcers

• Functional communication

  (PECS, pointing)

• Tolerating tooth brushing

• Gross Motor Imitating

Jamie is a 7-year-old boy with ASD. His parents report that Jamie engages in self-injurious behavior (biting his hand and wrist) between 2 - 6 times per day for the last 3 years. Over the past year, he has also been observed to engage in high rates of hand flapping during his leisure time and will throw materials if his parents try to redirect him. Last week, his parents noted that he kicked his brother to get access to a toy that he was playing with. Kicking has only been observed one time.

• Throwing Materials

• Aggression (kicking)

• Self-Injurious behavior

• Hand Flapping

Of the problem behaviors that Jamie engages in (Self-injury, throwing, and kicking), Self-Injury was prioritized for reduction because:

• It poses a danger to the client

• It will produce higher rates of reinforcement

• It is the longest-standing problem

• Important for future skill development

Lou is a 9-year old who lives with his mother and twin brother. Lou's mom shared with the BCBA on his case that she is concerned with is his pickiness with foods and refusal to eat anything but pizza rolls and Eggo waffles. The BCBA really wants to try a new eating protocol but has not had any practical experience implementing it. Which of the 9 questions to consider when prioritizing behaviors posed by Cooper, Heron, and Heward (2019) should the BCBA consider prior to beginning implementation?

• Does the behavior pose any danger to the client or to others?

• What will be the relative importance of this target behavior to future skill development?

• Will changing this behavior reduce negative or unwanted attention from others?

• How likely is success in changing this target behavior?

Lucy is a 10-year old girl with language delays and she communicates using an AAC device. While she is fluent at using her iPad to mand, Lucy engages in high rates of vocal stereotypy, which often sounds like a high-pitched squeal. Her parents don't mind it at home, but it has made it challenging to go out into the community as people stare and make comments, sometimes even asking her parents to "make her keep it down." Which question about prioritizing behavior is applicable here?

• Will changing this behavior produce higher rates of reinforcement?

• Does the behavior pose any danger to the client or to others?

• Will changing this behavior reduce negative or unwanted attention from others?

• What will be the relative importance of this target behavior to future skill development and independent functioning?