BA285 Unit 9 Restrictive Procedures Paper Example

A Helmet, a Swat and a Break Card: A BA285 Unit 9 Restrictive Procedures Paper

[Student Name]

Purdue University Global

BA285: Ethics in Behavior Analysis

Unit 9 Restrictive Procedures Paper

[Instructor Name]

[Date]

The writer, her supervisor and the family are composite; the code and articles cited are real.

The Problem

Tanner, introduced in Unit 3, is the boy I visit at home whose head banging once bruised him. When services began in April, he banged his head against walls and floors several times a day, sometimes hard enough to bruise. His crisis plan, which I implement under my supervisor's direction, uses blocking and padding to prevent injury in the moment. By June, the blocking was working to prevent the worst injuries, but the head banging continued at about the same rate.

Three responses were proposed over the following weeks. At a family gathering, Tanner's uncle told his mother, Ms. Webb, that a swat on the leg would end it. At a checkup, Tanner's pediatrician suggested a padded protective helmet. And my supervisor proposed completing a functional analysis and designing a plan based on what it found. This paper evaluates all three.

The Right to Effective Treatment

Van Houten et al. (1988) set out a position on the rights of people receiving behavioral treatment. They argued that clients have a right to a therapeutic environment, to services whose overriding goal is personal welfare, to treatment by competent behavior analysts, to programs that teach functional skills, to behavioral assessment and ongoing evaluation, and to the most effective treatment procedures available. They held that restrictive procedures may be justified only when less restrictive ones have been tried and failed or would expose the client to greater harm, and that such procedures require consent, oversight and data.

The position cuts in two directions. It rules out punishment used because it is convenient or traditional. It also rules out withholding an effective treatment, including one with some restriction, when the alternative leaves the client harming himself.

The Code

The behavior analyst code directs practitioners to select and design interventions based on assessment, to prioritize reinforcement-based procedures, to minimize the risk of harm from behavior-change interventions, and to use restrictive or punishment-based procedures only after less intrusive procedures have proven ineffective or the risk of harm from the behavior outweighs the risk of the procedure, with documentation, consent and supervisory review (Behavior Analyst Certification Board, 2020).

The Swat

The uncle's suggestion fails every test. It is not based on any assessment of why Tanner bangs his head. It skips every less restrictive option. Physical punishment of this kind is not part of any accepted behavior-analytic practice and could cause harm, damage Tanner's trust in his caregivers and, if the head banging is maintained by escape or attention, have unpredictable effects. Ms. Webb asked me what I thought. I told her that hitting was not part of any plan our agency would support and that my supervisor would be glad to talk with her and her brother about other options. My supervisor called her that week.

A swat would have been the most restrictive response with the least information behind it.

The Helmet

The pediatrician's suggestion is different. A protective helmet does not aim to change behavior; it reduces the injury the behavior causes. It is a restriction, since it can limit movement, sensory experience and social interaction, and some children find it aversive. But when head banging causes bruising, protection may be necessary while a treatment takes effect. The question was not whether to use a helmet but how and for how long.

My supervisor's view was that a helmet could be used during the periods of highest risk, with a plan for fading it as the behavior decreased, and only alongside an active treatment. Ms. Webb consented to that plan, and the agency's review committee approved it.

The Function-Based Plan

The most important response was assessment. Iwata et al. (1994) demonstrated that functional analysis, systematically testing conditions such as attention, escape from demands, alone time and play, can identify the variables maintaining self-injury, and that treatments based on function are more effective than treatments chosen without that information.

Tanner's functional analysis, conducted by my supervisor with safety precautions, showed head banging was highest in the demand condition, pointing to escape. Carr and Durand (1985) showed that teaching a communicative response that produces the same consequence as problem behavior can reduce that behavior. Tanner learned to tap a break card on his tablet, which produced a short break from the task. Demands were gradually reintroduced as he used the card reliably.

Over eight weeks, Tanner's head banging fell from several times a day to about once every few days. The helmet was faded from all afternoon to only the first hour of homework time, and then removed.

Talking With the Family

The hardest conversation in this case was not with my supervisor but with Tanner's family. Ms. Webb was exhausted. She had watched her son bruise himself for years, and her brother's suggestion came from frustration and love, not cruelty. When my supervisor met with them, she did not lecture. She explained what the functional analysis was for, showed them the graph of Tanner's head banging under each condition, and asked the uncle what he thought the graph showed. He said it looked like Tanner hit his head to get out of work. My supervisor agreed and explained that a swat would add something painful without giving Tanner any other way to get a break, while the card would give him one. The uncle later helped practice the card with Tanner during weekend visits.

Comparing the Three

The three responses differ in restrictiveness and in information. The swat was highly restrictive and based on none. The helmet was moderately restrictive, justified by real risk and used as protection rather than treatment, with consent and a fading plan. The function-based plan was the least restrictive and most informed, and it produced the change. That order reflects the logic of the right to effective treatment: protect the client, assess first and use restriction only to the degree and for as long as the evidence justifies.

Conclusion

Tanner's case shows how restrictive procedures should be weighed. The right to effective treatment and the ethics code both require assessment, reinforcement-based treatment and restriction only when less intrusive options fail or the risk is greater. Physical punishment was rejected outright. A helmet was used briefly, with consent and a plan to fade it, while a function-based plan taught Tanner a safer way to ask for a break.

References

Behavior Analyst Certification Board. (2020). Ethics code for behavior analysts. Author.

Carr, E. G., & Durand, V. M. (1985). Reducing behavior problems through functional communication training. Journal of Applied Behavior Analysis, 18(2), 111-126. https://doi.org/10.1901/jaba.1985.18-111

Iwata, B. A., Dorsey, M. F., Slifer, K. J., Bauman, K. E., & Richman, G. S. (1994). Toward a functional analysis of self-injury. Journal of Applied Behavior Analysis, 27(2), 197-209. https://doi.org/10.1901/jaba.1994.27-197

Van Houten, R., Axelrod, S., Bailey, J. S., Favell, J. E., Foxx, R. M., Iwata, B. A., & Lovaas, O. I. (1988). The right to effective behavioral treatment. Journal of Applied Behavior Analysis, 21(4), 381-384. https://doi.org/10.1901/jaba.1988.21-381