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Risk-Benefit Worksheet |
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| ABA Procedure: Electric shock for Behavioral Control. | |
| Special methods: Low rates of administration of electric shock. | |
| Risk | Notes |
| FBA was done without supervision from a BCBA | The conducting of FBA by a BCaBA was not done with the oversight of a BCBA hence making the results less reliable |
| Previous treatments for behaviors lacked empirical support | Sensory integration therapy and facilitated treatments methods have been used in the past but do not have enough empirical evidence to back them up. |
| Potentially harmful to the client | Use of electric shocks is likely to have long-lasting negative effects on the child. |
| Lack of expertise by individuals administering the treatment | Normally, the treatments will be administered at school. Teachers and staff involved may not be well trained on implementation. |
| Benefits | Notes |
| Decrease in behaviors | If treatment is well implemented, cases of eloping from school and aggressive behaviors will reduce in frequency. |
| Improvement of concentration and academic performance | When the treatment becomes successful, students will give more time and concentration in classwork. Sequentially, this will improve academic performance. |
| The decrease in self-harm done. | His aggressiveness has caused harm to others. Therefore, if the treatment is successful harm being done to himself and others will reduce. |
| Summary Risks vs. Benefits: Generally, the information given on the length of time that treatment would take, personnel involved, and possible health outcomes of the treatment was inadequate (Linscheid et al. 1990). However, looking at the information in the worksheets the benefits outweigh the risks hence the need to give the treatment a try. | |
Letter to Parents
September 3 rd, 2019
To whom it may concern,
I hope this letter finds you well. Thank you for contacting me regarding your son. This letter is in regards to the treatment procedure that requires the use of electric shock to reduce the frequency of eloping and aggressive behavior towards others. There was some information that had been provided by the school principal regarding the same case. Therefore I conducted a risk-benefit analysis in order to compare the risks and benefits of using the procedure. I will attach the risk-benefit worksheet together with this letter so that it can be helpful in decision making on the best treatment options available for your son. In addition, I will gladly give my opinion as a profession on the use of electric shock procedure.
Delegate your assignment to our experts and they will do the rest.
The first step of the procedure is recommending a functional behavior analysis (FBA). The purpose of this analysis is to determine why your child is so aggressive and eloping from school. It is a requirement that the FBA process is conducted by either a BCaBA or BCBA. Information from the functional behavior analysis is important for therapy which will be effective in the decrease of aggressive behavior. An understanding of the BCBA Ethical Code Elements is thus important to analyze before the FBA analysis.
BACB Ethical Code Elements relevant to the Procedure
Just like any other profession behavior, analysts ought to have an ethical code of conduct so that they are mindful of how they treat their clients. At all times these ethical guidelines have to be followed when working with clients. Even after becoming familiar with all the ethical code elements, there is a likelihood that behavior analyst violates them in some cases. For instance, in this procedure there are a number of BACB ethical code elements being violated like choosing electrical shock as a treatment of choice and not paying close attention to how and who will implement.
The first most relevant ethical code is BCAB element 4.09 which requires the use of least restrictive procedures on clients. The electric shock procedure is not the least restrictive in this case. According to the BCAB code of conduct behavior analysts are supposed to review and appraise how restrictive a procedure is before being used on a client (Board, 2014). The second element violated by the use of this procedure is BCAB element 4.08 which prohibits the use of punishment to decrease behavior. Analysts are not supposed to use a procedure that inflicts punishment on a client. Use of electric shock is a punishment which can be harmful to the client. If punishment procedures have to be used, they have to be the last option. This is after analysts have made sure that other treatment options were considered for the scenario but rendered to be ineffective.
The third code of that has been violated is BACB element 4.10. According to the code, behavior analysts are not supposed to use potentially harmful reinforcers in the implementation of the procedure (Board, 2014). Forcing the procedure can be harmful to the patient in terms of their development. In this case, the teachers want by all means the student to stop eloping and decrease his aggressiveness while interacting with others. They could result in the use of excessive motivating operations in order to make the procedure very effective and rep maximum benefits.
BCAB code element 4.02 requires that clients be involved in the planning and consent for behavior change programs. In this particular procedure, the consent of the client was not sought. Another code element relevant in this procedure is 4.04 which requires approval of behavior change programs (Board, 2014). Behavior analysts are required to obtain written approval of the change of program and procedure before implementation or making changes that are significant.
Additional Points to Consider
It is also important for you as parents to be aware of risks that reviewing the report and the use of a particular target treatment. One of the risks is the lack of empirical evidence from treatments that had been used in previous procedures. There is no support or justification for the effectiveness of electric shocks. Secondly, there is potential that the administration of shocks can be harmful to the young child. The effects may be long-term to an extent that it may be difficult to manage your child in future. Thirdly, in the previous treatment the FBA was conducted by a BCaBA without supervision from a BCBA. This could be an issue if the incorrect function was determined. Also, there is a likelihood that the expertise involved in the implementation of this procedure may be inadequate. Besides, the teachers are likely to be so hard on reinforcement so that the procedure can be effective. However, if the implementation process is successful, behaviors of eloping and aggressiveness will decrease. This will not only be beneficial for others who are at risk but also more time would be spent in class hence improved performances.
As a profession, I would advise that a less aversive and restrictive method is used before attempting the electric therapy. Although there are numerous benefits that could be reaped from the electric shock procedure, it is important for it to be considered as the last option after others have failed. I would also like to make you aware that you should make sure the behavior analyst follows the ethical code of elements before entrusting them with your child. This is important because the way the child is treatment can either be damaging or god for their development. Having addressed all the concerns from a professional standpoint, if you have any other issues kindly reach out. I wish you the best in your child’s treatment depending on the decision you arrive at. Thank you
Sincerely
Behavioral Analyst name.
References
Board, B. A. C. (2014). Professional and ethical compliance code for behavior analysts.
Linscheid, T. R., Iwata, B. A., Ricketts, R. W., Williams, D. E., & Griffin, J. C. (1990). Clinical evaluation of the self ‐ injurious behavior inhibiting system (SIBIS). Journal of Applied Behavior Analysis , 23 (1), 53-78.
