As a clinician, it can be challenging to find the right curriculum that meets the needs of your learners. Some curricular options are too basic. Others cover advanced skills but offer behavior analysts and technicians little to no direction on how to teach the skill. They tend to serve more as an inventory of skills than a curriculum. Additionally, many of these curriculums aren’t necessarily sequenced in a way that truly captures an element-compound relationship that is so necessary.
Many clinicians use assessment targets as their curriculum, which is not aligned with best practice. It’s also common for organizations to spend money on curricula only to spend more money on resources to improve them. If all of this sounds familiar, you’re not alone. Many struggle with finding or developing a robust curriculum to meet the needs of their diverse clients. Continue reading for a more in-depth view of what clinical curricula entail and why ABA organizations struggle to create their own.
Lack of Instructional Design Experience
An incredible 50% of the BCBAs currently certified earned certification in the last five years (Behavior Analyst Certification Board, 2023). As a rapidly expanding field, many clinicians have not yet had the opportunity to build a firm foundation of experience in instructional design to develop high-quality clinical programs . While new BCBAs are critical to an organization’s ongoing growth and success, they are often not in a position to support the development of a company’s curriculum. The best made curricula currently available today are developed by well-seasoned analysts with years of experience across a multitude of settings and learners. With extensive experience in instructional design, such curricula are able to provide a systematic framework for clinicians of all experience levels while preserving individualization to accommodate the unique needs of the learner, skill, and environment.
Teaching Clinicians to Program
Developing programs with individualized targets for each goal can be complex and time-consuming. Each skill can have many paths to teaching, depending on the learner's baseline and other skill sets. While graduate programs and fieldwork experience touch on teaching clinicians to program, newer analysts often lack the knowledge and expertise to program from entry-level to mastery level.
While senior clinicians may be experts at this, many are either not taught this strategy or lack the experience to conceptualize or include the important variable attributes needed to properly teach the boundaries of the skill to ensure maintenance, generalization, and true generativity.
Rather than developing an internal curriculum, seeking a pre-created thorough and systematic curriculum may be more beneficial. A comprehensive curriculum must include specific information within each step that guides clinicians on how to teach, not only what to teach. General procedures should be written in entry-level RBT language so BCBAs can assign and go when facing time constraints. Prerequisites for each skill should also be clearly defined so BCBAs can determine if prerequisite skills are missing. With the increasing importance of writing medically necessary goals, a medical necessity statement should also be included with each skill that can be seamlessly incorporated into treatment plans and other reports. Lastly, programs must include the necessary supplies, mastery criteria, target lists, and dependent variables.
Building in Suggestions and Tips
As clinicians begin implementing a program, it is not uncommon for them to identify challenges they were not trained to troubleshoot. Highly experienced curricular designers combine their vast knowledge and creativity to develop suggestions and tips to guide the implementation of clinical programs. These can include advice on what to look out for, how to pivot, strategies for making the skill easier to achieve if it is too challenging for the learner, or ways to make the skill harder if it is too easy. Recommendations for how to continuously ensure client dignity and assess for assent are also critical for maintaining ethical care and client safety.
Designing for Progress Monitoring and Program Evaluation
Another challenge organizations face in developing and implementing clinical programs is avoiding linear progress. Often, clinicians use curricula to program a skill from start to finish, regardless of emerging abilities along the way. ABA curriculum should include suggested benchmark steps where BCBAs can conduct intermittent probes to evaluate emergent responding so they can make curricular leaps.
References
Behavior Analyst Certification Board. (2023). BACB Certificant Data. https://www.bacb.com/bacb-certificant-data/
