Leading ABA Software Provider CentralReach Names Health Tech Veteran, Cheryl Michael as Chief Product Officer

CentralReach strengthens its position in the Applied Behavior Analysis space with the appointment of Cheryl Michael to Chief Product Officer.

CentralReach, a leading provider of EHR and practice management solutions that enable Applied Behavior Analysis (ABA) clinicians and educators to produce superior outcomes for people with autism and related disorders, announced the addition of Cheryl Michael as Chief Product Officer to the CentralReach leadership team. This announcement comes at a time when the company is heavily investing in its product, organization and offerings to serve its mission of providing the end-to-end software and services platform that ABA professionals need to succeed.

As the newest member of CentralReach’s leadership team, Michael brings over 18 years of healthcare experience, most recently as EVP of Product Management and Engineering at Envera Health. Her experience optimizing product management practices and delivering innovative healthcare technology solutions will play a key role in advancing CentralReach’s mission to provide the end-to-end platform of software and services that help our customers produce superior outcomes for their clients and further solidify CentralReach’s position as a leader in the ABA market.

“I’m thrilled to welcome Cheryl to the leadership team,” said CEO of CentralReach, Chris Sullens. “Cheryl brings an incredibly unique combination of skills and experiences that will support us through this extraordinary period of growth and set us on a path of continued product excellence. In a capacity constrained market like that of autism – only 30,000 Board Certified Behavior Analysts (BCBAs) available to address the needs of the 15 million children and young adults currently diagnosed on the autism spectrum – clinicians need to be armed with the right tools and services to get more kids in the door faster. With Cheryl on board, we are better equipped to increase the size of our product team, mature our product development processes and accelerate development velocity so that we can better serve the needs of our customers.”

This announcement comes on the tails of other investments to the product organization. Most recently, Dave Stevens stepped into the role of Senior Director of Product Management and is currently leading the charge in advancing the company’s clinical offerings. Prior to CentralReach, Stevens ran Chartlytics, the best-in-class precision data measurement and advanced analytics technology that was acquired by CentralReach in May 2018. Chris Bruckner was also added to the team as the Product Owner of CR Practice Management and brings more than nine years of experience in revenue cycle management (RCM) to the table. The team has also added two new senior user experience designers to enhance the platform’s already easy-to-use experience.

These hires will support the many product launches and enhancements planned for 2019, including the recently introduced CR Insights analytics module – a new business intelligence solution that provides advanced reporting and industry benchmarking to drive operational, financial and clinical results to keep customers moving in the right direction. Other planned solutions include the introduction of CR Institute, a centralized hub of industry-leading content and courses backed by the 20 BCBA staff employed by CentralReach that support BCBAs in their ongoing commitment to continuing education, software training, professional credentialing and more.


About CentralReach
CentralReach is a leading provider of EHR and practice management solutions that enable Applied Behavior Analysis (ABA) clinicians and educators to produce superior outcomes for people with autism. Powered by its acquisition of Chartlytics, the company is revolutionizing the ABA space with cutting-edge solutions including precision teaching, clinical data collection, scheduling, billing, and learning management. Trusted by more than 52,000 clinicians and educators, CentralReach is committed to ongoing product improvement, market-leading industry expertise, world-class client satisfaction, and support of the ABA community to propel industry practitioners into a new era of excellence. For more information, please visit www.centralreach.com or follow us on Twitter @CentralReach.

Despite the many social strides that have been made in 2018, it’s still far too difficult for adults with autism to find work. With prevalence rates now showing 1 in 40 people with autism, only 16 percent are in full-time paid positions, and those people can face criticism, isolation, and discrimination in the workplace.

People with autism deserve more opportunity for employment and fair treatment when they are employed. Furthermore, it’s possible that in minimizing employment opportunities for those with autism, we miss out on the benefits of a neurodiverse workforce, in which the range of differences in individual brain function and behavioral traits are regarded as part of a normal variation in the human population, and squander their unique talent.

In 2018, we have finally begun to see a national conversation budding around advocacy for adults with autism spectrum disorder (ASD) in the workplace, but simply put, adults with autism want and deserve more opportunities to exercise their strengths and feel engaged in the workplace.

At CentralReach, we’re working to create those opportunities through our ReachOut Program. While our clients support the lifespan of needs of children and adults with intellectual, developmental and physical disabilities, we saw the incredible need of creating employment opportunities for adults on the autism spectrum. CentralReach now employs an inclusive team that includes adults on the autism spectrum.

Beyond how the program proudly seeks to address the need for greater neurodiversity in the professional world, we are excited to see how it is making a significant difference in the everyday morale not only for the adults in the program, but for their families who have witnessed a major change in their adult children and have entirely new outlooks on what is possible for them in their adult lives.

Family members of participants in the ReachOut Program report that they have seen huge improvements in the quality of life of their adult children as a result of the program.

“My son was incredibly bored, disengaged, and longed for a job,” said one mother. It was difficult for her to imagine an independent future for him where so few job opportunities existed. After just six months in the program, he has a newfound sense of responsibility, a better relationship with his family, is helping to pay bills and opening up more. Another program participant has learned to drive and bought his own car since joining the program, and many more examples exist.

These individuals bring remarkable talent and work ethic to the team at CentralReach. We’re excited to continue to grow the ReachOut program in the coming year, and to advocate for the equal opportunity and treatment of adults with autism in the workplace.

CentralReach, a leading provider of EHR and practice management solutions that enable applied behavior analysis (ABA) clinicians and educators to produce superior outcomes for people with autism, today announced its newest addition to the executive team, Michelle Moylan, Vice President of People. As a strategic hire, Moylan will work closely with the CEO and leadership team to help advance the company in its commitment to hire and retain top talent to support the company’s position as a market leader.

“We’re happy to welcome Michelle to the CentralReach leadership team,” said Chris Sullens, CEO of CentralReach. “At a time when we are growing, and growing fast, investing in our people and culture is central to our success. Michelle’s experience in building dynamic cultures that maximize an organization’s ability to attract, retain and grow top talent will be a valuable addition to the organization, allowing us to better leverage our team to drive innovation within the ABA space.”

As Vice President of People, Moylan is responsible for all of talent management at CentralReach, including recruiting, onboarding, professional development and human resource initiatives.

CentralReach has made significant strides in the past six months towards building an enterprise-ready organization. With accelerated investment in people, products, processes and systems, the company is better positioning itself to increase client satisfaction, all with the goal of fulfilling its mission of providing powerful, intuitive ABA solutions that enable CentralReach clients to produce superior outcomes for people with autism.

About CentralReach
CentralReach is a leading provider of EHR and practice management solutions that enable applied behavior analysis (ABA) clinicians and educators to produce superior outcomes for people with autism. Powered by its acquisition of Chartlytics, the company is revolutionizing the ABA space with cutting-edge solutions including precision teaching, clinical data collection, scheduling, billing, and learning management. Trusted by more than 50,000 clinicians and educators, CentralReach is committed to ongoing product improvement, market-leading industry expertise, world-class client satisfaction, and support of the ABA community to propel industry practitioners into a new era of excellence. For more information, please visit www.centralreach.com or follow us on Twitter @CentralReach.

Media Contact:
Niki Franklin
617-624-3291
centralreach@racepointglobal.com

CentralReach, a leading provider of EHR and practice management solutions that enable applied behavior analysis (ABA) clinicians to produce superior outcomes for people with autism, announced the recent acquisition of Bronco Billing, a managed billing services provider. The acquisition serves to extend CentralReach’s end-to-end offerings by giving customers access to billing expertise that has been proven to expedite and maximize revenue received.

“I couldn’t be happier to add Bronco Billing to the CentralReach platform,” said Chris Sullens, CentralReach CEO. “The company has developed proven workflows that not only help clients improve their clean claim rates but also help them uncover missed revenue from otherwise unfiled claims. By adding Bronco Billing and their expert billing services to the CentralReach portfolio, we are better positioned to offer our clients the best end-to-end practice management solution that they need to grow their business and focus on what matters most – producing superior outcomes for their clients.”

In conjunction with this acquisition, Bronco Billing will be renamed CR BillMax Services to reinforce its strategic importance to the CentralReach platform and complement the company’s revenue cycle management software, which will be powered by BillMax technology. Under the new name, customers will now have access to managed billing services such as receivables collections, post payments, claims submission, denial re-submissions and more. CentralReach will also be adding a white-glove experience to help customers implement billing the right way from day one. The service includes access to proven billing workflows, personalized training workshops for internal staff and more. With the cost of caring for Americans with autism expected to rise to $461 billion by 2025, the addition of these billing services will provide CentralReach therapy providers with the tools they need to prepare for that rapid growth.

The acquisition is just one example of how CentralReach is investing heavily in its product. Most recently, the company embarked on a multi-state product roadshow to elicit customer feedback on the future of CentralReach solutions. These collaborative events enable CentralReach to share its vision, preview planned feature enhancements and identify additional pain points that the company can address for its client base. The company will continue to host product roadshows and plans to introduce a user conference in 2019 to expand opportunities to engage with its client base and feed key inputs to its product management team.

About CentralReach

CentralReach is a leading provider of EHR and practice management solutions that enables applied behavior analysis (ABA) clinicians and educators to produce superior outcomes for people with autism and related disorders. Powered by its acquisition of Chartlytics, the company is revolutionizing the ABA space with cutting-edge solutions including precision teaching, clinical data collection, scheduling, billing, and learning management. Trusted by more than 50,000 clinicians and educators, CentralReach is committed to ongoing product improvement, market-leading industry expertise, world-class client satisfaction, and support of the ABA community to propel industry practitioners into a new era of excellence. For more information, please visit www.centralreach.com or follow us on Twitter @CentralReach.

About Bronco Billing

Bronco Billing, Inc. was formed to support individuals, small practices, and large healthcare providers with obtaining reimbursement they deserve in a timely manner. The team is comprised of professionals with over 20 years of experience in behavioral health and medical billing, specializing in Applied Behavior Analysis, Occupational Therapy, Physical Therapy, and Speech Therapy claims. Bronco Billing services support claims and billing processes for clinicians so that they can focus on clinical care of their patients.

 

Media Contact:

Niki Franklin

617-624-3291

centralreach@racepointglobal.com

CentralReach, a leading provider of EHR and practice management solutions that enable applied behavior analysis (ABA) clinicians and educators to produce superior outcomes for people with autism, has been named a silver winner in the “Fastest-Growing Company of the Year – Medium” category by Best in Biz Awards, the only independent program judged each year by prominent editors and reporters from top-tier publications in North America. The 8th annual program proved to be a particularly tough competition, garnering close to 700 entries from an impressive array of public and private companies of all sizes and from a variety of geographic regions and industries in the U.S. and Canada.

“We’re honored to receive this recognition from Best in Biz Awards,” said Chris Sullens, CEO. “I’m very proud of all that we have accomplished in 2018 thanks to our hard-working, passionate CentralReach team. Our number one focus is to help our customers produce superior outcomes and I’m certain our commitment to this mission will continue to spur growth in 2019 and beyond.”

Under the leadership of Sullens, the company is heavily investing in people, products, processes and systems, which has been one of the main drivers behind this growth. In 2018 alone, CentralReach expanded their customer base to over 50,000 active users with 43 million therapy appointments cumulatively scheduled through the company’s platform. The company was also recognized by Deloitte and NJBiz for the rapid growth seen in 2018.

For a full list of Best in Biz Awards 2018 award winners, visit: http://www.bestinbizawards.com/2018-winners.

About CentralReach

CentralReach is a leading EHR and practice management platform that enables applied behavior analysis (ABA) clinicians and educators to produce superior outcomes for people with autism and related solutions. Powered by its acquisition of Chartlytics, the company is revolutionizing the ABA space with cutting-edge solutions including precision teaching, clinical data collection, scheduling, billing, and learning management. Trusted by more than 50,000 clinicians and educators, CentralReach is committed to ongoing product improvement, market-leading industry expertise, world-class client satisfaction, and support of the ABA community to propel industry practitioners into a new era of excellence. For more information, please visit www.centralreach.com or follow us on Twitter @CentralReach.

About Best in Biz Awards
Since 2011, Best in Biz Awards has made its mark as the only independent business awards program judged each year by a who’s who of prominent reporters and editors selected from top-tier publications from North America and around the world. Over the years, Best in Biz Awards judges have ranged from Associated Press to the Wall Street Journal and winners have spanned the spectrum, from blue-chip companies that form the bedrock of the world economy to local companies and some of the most innovative start-ups. Best in Biz Awards honors are conferred in two separate programs: North America and International, and in 70 categories, including company, team, executive, product, and CSR, media, PR and other categories. For more information, visit: http://www.bestinbizawards.com.

 

Media Contact:

Niki Franklin

617-624-3291

centralreach@racepointglobal.com

Holmdel, NJ, November 20, 2018 – CentralReach, a leading provider of EHR and practice management solutions that enable applied behavior analysis (ABA) clinicians and educators to produce superior outcomes for people with autism, today announced that it was ranked 10 in NJBIZ’s Fast 50™. The list recognizes the 50 fastest growing companies in New Jersey according to revenue growth between fiscal year 2015 to 2017.

The 2018 NJBIZ 50 Fastest Growing Companies awards program, held on Nov. 13 recognized companies progressively contributing to the success of the state’s economic growth and stability. To qualify, companies had to meet selection criteria that included a revenue size of at least $500,000 within the past two out of three years and growth in revenue over a three-year period, dating from fiscal year 2015 to 2017.

“CentralReach is thrilled to be recognized by NJBIZ,” said Chris Sullens, CEO of CentralReach. “New Jersey, along with our home in Florida, play a critical role in our mission to advance the quality of care for people with autism and related disorders by streamlining ABA practice management and clinical solutions. Our investments in our people, products, processes and systems, to improve both client and employee satisfaction has enabled us to grow rapidly, servicing 50,000 active users nationally with 43 million therapy appointments scheduled through the CentralReach system to date. This is only the start of the growth we expect to see.”

The company was also recently named 130 on the Deloitte’s 2018 Technology Fast 500™ which recognizes the fastest growth technology companies in North America. These recognitions along with an uptick in the number of open positions CentralReach is recruiting for are just a glimpse into the organization’s financial and operational growth since its launch in 2012.

About CentralReach

CentralReach is a leading provider of EHR and practice management solutions that enable applied behavior analysis (ABA) clinicians and educators to produce superior outcomes for people with autism. Powered by its acquisition of Chartlytics, the company is revolutionizing the ABA space with cutting-edge solutions including precision teaching, clinical data collection, scheduling, billing, and learning management. Trusted by more than 50,000 clinicians and educators, CentralReach is committed to ongoing product improvement, market-leading industry expertise, world-class client satisfaction, and support of the ABA community to propel industry practitioners into a new era of excellence. For more information, please visit www.centralreach.com or follow us on Twitter @CentralReach

About NJBIZ

NJBIZ is New Jersey’s leading business journal with a circulation of more than 15,000 copies. The publication provides 24/7 business news coverage through its website and multiple daily e-newsletters. Founded in 1987 and based in the Somerset section of Franklin Township, it is also well-known throughout the state for its events honoring New Jersey’s top business professionals.

NJBIZ is owned by BridgeTower Media, the leading provider of business-to-business information, research and marketing solutions across more than 20 local economies in the U.S. For more information, visit http://www.njbiz.com/ or follow @NJBiz on Twitter.

 

Media Contact:

Niki Franklin

617-624-3291

centralreach@racepointglobal.com

CentralReach, a leading provider of EHR and practice management solutions that enable applied behavior analysis (ABA) clinicians and educators to produce superior outcomes for people with autism, today announced that it was ranked #130 in Deloitte’s Technology Fast 500™. Produced annually by Deloitte, this list ranks the 500 fastest growing technology, media, telecommunications, life sciences and health tech companies in North America.

“It’s a tremendous honor to be recognized by Deloitte for our team’s efforts to provide software and services that meet the needs of our clients in the ABA community,” said Chris Sullens, CEO of CentralReach. “CentralReach is rooted not only in our understanding of the needs of clinical organizations, but also in our passion for the individuals, children, families and communities impacted by autism spectrum disorder (ASD). By delivering an end-to-end practice management and clinical solution designed to meet the needs of our clients, we streamline and automate critical workflows to enable clinical staff to spend less of their time on back office tasks and more of it helping families and children with autism and related disorders.”

Deloitte’s Technology Fast 500 provides a ranking of the fastest growing technology, media, telecommunications, life sciences and health tech companies—both public and private—in North America. Technology Fast 500 award winners are selected based on percentage fiscal year revenue growth from 2014 to 2017.

“Congratulations CentralReach for this impressive achievement,” said Sandra Shirai, vice chairman, Deloitte LLP, and U.S. technology, media and telecommunications leader. “Chris Sullens and his team at CentralReach are innovators who have converted their disruptive ideas into products, services and experiences that can captivate new customers and drive remarkable growth.”

In 2018, the Centers for Disease Control (CDC) and Prevention estimated that one in 59 children is diagnosed with an autism spectrum disorder (ASD). The cost of caring for Americans with autism had reached $268 billion in 2015 and is expected to rise to $461 billion by 2025 in the absence of more-effective support across the life span, according to Autism Speaks.

“CentralReach’s mission is to advance the quality of care for people with autism and related disorders by streamlining ABA practice management burdens while also providing next generation clinical solutions,” added Sullens. “By focusing on improving both client and employee satisfaction through investments in our people, products, processes, and systems, we’ve grown rapidly, enabling our 50,000 active users to complete over 43 million appointments with families and children to date. As we increase investment in all these key areas, I’m excited to see what we can achieve in the next phase of our company’s growth.”

About CentralReach

CentralReach is a leading provider of EHR and practice management solutions that enable applied behavior analysis (ABA) clinicians and educators to produce superior outcomes for people with autism. Powered by its acquisition of Chartlytics, the company is revolutionizing the ABA space with cutting-edge solutions including precision teaching, clinical data collection, scheduling, billing, and learning management. Trusted by more than 50,000 clinicians and educators, CentralReach is committed to ongoing product improvement, market-leading industry expertise, world-class client satisfaction, and support of the ABA community to propel industry practitioners into a new era of excellence. For more information, please visit www.centralreach.com or follow us on Twitter @CentralReach.

About Deloitte’s 2018 Technology Fast 500™

In order to be eligible for Technology Fast 500 recognition, companies must own proprietary intellectual property or technology that is sold to customers in products that contribute to a majority of the company’s operating revenues. Companies must have base-year operating revenues of at least $50,000 USD, and current-year operating revenues of at least $5 million USD. Additionally, companies must be in business for a minimum of four years and be headquartered within North America.

About Deloitte
Deloitte provides industry-leading audit, consulting, tax and advisory services to many of the world’s most admired brands, including more than 85 percent of the Fortune 500 and more than 6,000 private and middle market companies. Our people work across more than 20 industry sectors to make an impact that matters — delivering measurable and lasting results that help reinforce public trust in our capital markets, inspire clients to see challenges as opportunities to transform and thrive, and help lead the way toward a stronger economy and a healthy society. Deloitte is proud to be part of the largest global professional services network serving our clients in the markets that are most important to them.

 

Media Contact:

Niki Franklin

617-624-3291

centralreach@racepointglobal.com

Get ready for the 2019 CPT® codes for Adaptive Behavior Analysis. On September 5, 2018 the American Medical Association CPT Editorial Panel announced new CPT codes, including 10 new codes for ABA billing. These codes will take effect and be available for use effective January 1, 2019, but payors may implement them over various time schedules.

These new billing codes matter — especially since reimbursement for your hard work with clients depends on correct billing procedures. At CentralReach, we want to support you through this transition so you can continue to deliver superior ABA services. The following FAQs and resources were developed to jumpstart your preparation efforts and help you successfully adopt these new CPT codes.

Let’s get started!

What are CPT codes?

The Current Procedural Terminology (CPT) is a listing of terms and identifying codes used to report services and bill medical insurance providers. The CPT codes are issued, maintained, and copyrighted by the American Medical Association (AMA). Category I codes are permanent, and Category III codes are temporary (to allow for data collection in emerging fields).

What are the key differences between the new and old CPT codes for ABA?

  • The set of codes is smaller (10 new versus 16 old)
  • All codes are timed (minimum 15 minute increments)
  • There are NO codes for indirect services. However, there may be allowance under code 97151 to “analyze and interpret” and to “prepare.”

How might my practice benefit from the new CPT codes?

The ABA codes previously fell under Category III (temporary). Now, most will be elevated to Category I (permanent). Status as Category I codes should lead to fewer denials of coverage due to rationale such as “experimental” or “unproven” or “not medically necessary.”

Also, HIPAA requires the implementation and use of Category I codes, so reimbursement may be easier.

How might the new CPT codes affect my revenue stream?

Implementation of the new codes may take a quarter or longer, depending on the payor. Your revenue stream may be disrupted. Additionally, you may need to negotiate new rates with your payors, since the codes do not cover indirect services.

How should I prepare for CPT code implementation?

It may take several months for your payor to adapt the new CPT codes, but you can get a jumpstart by taking the following steps:

  1. Read the codes. While we recommend reading the full AMA CPT codes, the BACB provides a helpful crosswalk between the old and new codes. All 16 old codes were Category III codes, which were temporary. The 10 new codes include Category I codes (8 permanent codes) and Category III codes (2 temporary codes).
  2. Attend a local or online training. Ensure your billing and clinical teams understand the services included under each code. Consider external trainings and resources such as Q&A sessions by the Association for Professional Behavior Analysis, and this recorded webinar by the Behavioral Health Center of Excellence.
  3. Get in constant contact with your payors. Your provider network reps will be the most valuable point of contact, as they are employed by the insurance carriers and will have access to information specific to that carrier. Use CentralReach’s CPT Payor Checklist, a resource designed to help you get prepared to discuss key information about your payors’ timelines, authorizations, and new unit rates.
  4. Continue to read your CentralReach emails. Look for a future webinar, implementation guide, and other aids to assist you with setting up the new CPT codes in your CentralReach account.  

Even though the implementation of the new CPT codes may create some challenges, CentralReach cares about your success and wants to see your practice thrive. Our platform has the flexibility and tools needed for you to smoothly implement these codes based on each of your payors’ specific requirements and timelines. Stay tuned for more information and resources on setting up your practice for 2019 CPT billing success!

Data functions as the lifeblood of behavior analysis. How does a practicing behavior analyst know if a particular intervention worked? Data. By what means do behavior analytic journals evaluate the effectiveness of experiments? Data. And in what manner do insurance companies assess the medical necessity for behavior analytic services? If you said data, right again!

Saying that data pervades behavior analysis would evoke nods of agreement from fellow behavior analysts (and maybe get you a beer at the conference if you said it enthusiastically). From Skinner to contemporary behavior analysis, data plays a pivotal role in basic research and applied practice.

Yet the sheer amount of data, along with questions about how to use it properly, can pose an overwhelming task for those entering the field. Functional assessment, single case design, and social validity all require data. And each of these behavioral applications uses data in significantly different ways.

Practitioners of the science of behavior (i.e., BCBAs and RBTs) often work directly with individuals. The BCBA conducts an assessment to determine areas of client needs and strengths. From the assessment data, a behavioral plan or program emerges. The behavior analyst or some other person (e.g., parent, registered behavioral technician, teacher) applies the intervention. Someone collects data and evaluates the intervention. However, collecting intervention data and analyzing assessment data sometimes get mixed up.

IVs and DVs

What people examine in science can vary considerably. But all scientific experiments share commonalities, including the concept of variables. Behavior analysis qualifies as a science and has several variables: independent variables, dependent variables, extraneous variables, confounding variables, and controlled variables.

The independent variable (IV) and the dependent variable (DV) form the basis of understanding a functional relation (i.e., one variable operates in a specific manner as a function of another variable).

The IV represents the event or variable the behavior analyst attempts to control. In applied practice, those IVs go by the name of “interventions.”

On the other hand, the DV constitutes a variable measured or tested. The DV will show what, if any, effects the IV has. Some example IVs and DVs in behavioral experiments include:

  • A person may smoke fewer cigarettes (DV) when exposed to negative images portraying the terrible health effects of smoking (IV).
  • A child may raise her hand more often in class (DV) when the teacher praises her for hand raising (IV).
  • A telemarketer may keep a potential customer on the phone longer (DV) when he compliments the customer (IV).

The above examples illustrate the ease with which people can identify IVs and DVs. Yet, sometimes BCBAs have so much intervention and assessment data collected the lines between the two can blur.

Accuracy Building Interventions

Many behavioral interventions help learners acquire or become accurate with content: Discrete Trial Instruction (also called Discrete Trial Training, and Discrete Trial Teaching), Natural Environment Teaching, or Pivotal Response Treatment, to name a few.

Discrete Trial Instruction (DTI) has become a very popular accuracy building intervention, especially for those working with children with autism. With DTI the behavior analyst implements five components: 1. Presenting the discriminative stimulus; 2. Providing a temporary prompt if necessary; 3. Waiting for the behavior to occur; 4. Providing a reinforcer; and 5. Finishing with a brief pause before beginning the next trial (Mayer, Sulzer-Azaroff, & Wallace, 2012). One discrete trial would capture the application of steps 1 through 5.

A behavior analyst working with a client would have a goal for DTI. The intervention may target color identification, gross motor imitation, or matching kitchen utensils. The behavior analyst would use DTI to help the client attain the goal (often expressed in percent correct such as “The child will imitate 25 two-step chains of motor behavior with 80% accuracy on 2 out of 3 sessions across a variety of trainers”).

The question becomes, what data should the BCBA chart? A review of program books or program binders reveals at least two practices.

  1. Some BCBAs will chart prompt levels. The prompt levels display prompt level data. Did the BCBA or RBT use physical (full or partial), modeling, gestural, verbal, or visual prompts?
  2. BCBAs also record plus/minus (i.e., plus for a correct, a minus for incorrect response). The plus/minus data then convert to a percentage. For example, for five trials of matching yield 3 + (pluses) and 2 – (minuses). The data transform to 60% correct (3 correct out of 5 trials).

In both of the previous cases, the data tell a story. For the prompt levels, the data speak to BCBA or RBT behavior. Prompts come from the behavior analyst or behavior technician, and the data communicate what the adult did, not what the client did.

In the second example, the percent correct reports the accuracy of the client’s behavior. Specifically, how well or how accurately did the client perform with the set of discrete trials. The client participated in 5 discrete trials and correctly completed 3 of them (60% correct).

The recorded data on a graph will show trend, level, and variability of the data. But does any of the data answer the question, “Did the client meet his performance goal?” In other words, if a behavior analyst set a goal for a client that involved matching the five primary colors, do the recorded and graphed data answer the question?

The discrete trial data reflect progress with the accuracy building intervention itself, not necessary an independent assessment of client behavior.

Prompt data certainly do not get at how well a client can match the colors. And the discrete trial data reflect progress with the accuracy building intervention itself, not necessary an independent assessment of client behavior. What better options exist for data-scrupulous BCBAs and RBTs?

Data Options

The behavior analyst must first decide what data to chart. A review of the IVs and DVs may help. Imagine the following experimental question:

Will the accuracy building intervention discrete trial instruction improve a client’s ability to label five primary color swatches?

The previous experimental question offers options. The behavior analyst could record data on the IV (DTI), the DV (labeling the five primary colors), or both. Monitoring data on the DV or IV provides the behavior analyst and behavior tech with different information.

table1_data_monitoring_IV_DV-01

Table 1. Difference between data monitoring and analyzing the DV and IV

Table 1 does indicate advantages to recording, graphing, and analyzing data on the intervention (IV). And while the behavior analyst can learn about the intervention, not having any data on the DV means not knowing or understanding the effects on a client’s behavior. The behavior analyst must decide when, on what, and how much data to collect.

The decision to collect data doesn’t end with a data binder. In Precision Teaching, and embedded in Chartlytics software, several options for displaying data exist. The data display choices include Geometric Mean, First, Last, Stacked, Median, Summative, Best, and Worst. Each will provide different information for the DV and IV.

What does each option mean and when should a behavior analyst use each? Table 2 provides the answers. Deciding whether to use First, Best, or Geometric resides with the BCBA, RBT, and in some cases the client. Part of the data process involves different people looking at the data. The options for focusing in on one particular aspect of data display will depend on clinical circumstances.

table2_points_to_display-01

Table 2. Definition of different points to display with advantages for each

Some other considerations include the following:

  1. Many Precision Teachers use Best when employing “celeration aims.” Using First may also work best with setting daily improvement goals or aims.
  2. Summative may help guard against multiple observers who pass data sheets around. Summative, as with duration data, have great utility when collected across more than one observer.
  3. Remember, none of the previously mentioned data options matter if the BCBA or RBT collects only one data point per day.

The options for displaying intervention or measurement data make for different narratives. An example of multifaceted data appears in Figure 1. In one session an RBT ran six discrete trials that produced six sets of data points.

The data come from Chartlytics and show the accel and decel data for each trial, as well as the date, time, and person collecting the data. The recorded time provides an account of the pace with which the discrete trials occurred.

Figure 1 Screenshot data

Figure 1. Data collected from one day of DTI

As shown in Figure 2 below, the BCBA can inspect the data with any of the previously mentioned options from Table 2. The graphical embodiment of the different “Points to Display” bring into focus the advantages listed in Table 2. Each chart segment has a Count Per Day vertical axis and Successive Calendar Days horizontal axis. The yellow aim bands convey the aim or goal for the intervention data (i.e., corrects = 20 and incorrects = 1 to 0).

Figure 2 Eight different displays

Figure 2. Data represented with different options

Contrast the First and Last data displays. The First discrete trial had more incorrects than corrects while the Last flips the interpretation. The Geometric Mean and Median look very similar suggesting the mean or average for the data set lie at 4 or 5 corrects with 4 incorrects. The Best and Worst also drastically differ from each other, demonstrating the margins of improvement in the overall session. And Stacked paints a picture of all performance data on one view. The dispersal of corrects and incorrects reveal the variability and accuracy of discrete trials.

The data views in Figure 2 all speak to the IV or intervention (DTI) and not an independent assessment of the skill (labeling five primary colors). The ability to see all of the different displays and Points to Display contextualize the data. A behavior analyst gains understanding and insight when inspecting the data with different options.

Conclusion

Focusing on intervention data communicates how special conditions arranged by the behavior analyst may affect client behavior. The answer to how much client behavior does change becomes visible with an independent assessment of target behavior outside of the intervention. Having different options to display IV and DV data lead a data analyst (e.g., BCBA, RBT, client, stakeholder) down a fruitful path — discovering functional relations and what works best for each client.

Rick Kubina, Ph.D., BCBA-D
Director or Research, CentralReach
Professor, The Pennsylvania State University

References

Mayer, G. R., Sulzer-Azaroff, B., & Wallace, M. (2012). Behavior analysis for lasting change (2nd ed.). Cornwall-on-Hudson, NY: Sloan.

How do people achieve fluency, or true mastery with content area knowledge? For example, subjects like biology, statistics, physics, and history all possess their own vocabulary and concepts. Mastering abstract information such as the Linnaean Taxonomy (biology), probability (statistics), velocity (physics), or the branches of the government (American history) pose challenges to all students.

Many self-study methods exist which help students, or anyone, learn content. Researchers surveyed college students and discovered 11 different study strategies. After (1) rereading notes or the textbook and (2) engaging with practice problems, students used (3) flashcards (Karpicke, Buttler, & Roediger, 2009).

Many studies examine flashcards and their benefits. For instance, flashcards have helped young children learn to read better, aided medical students acquisition of terms, increased university students psychology exam scores, and even heightened patients understanding of diabetes and medication adherence.

Flashcards continue to attract the interest of researchers and practitioners due to their effectiveness, adaptability, and portability. Yet even with the previously stated benefits and popularity of flashcards, several factors limit their potential.

  1. Almost all flashcard practice trials have no set timed practice interval. In other words, students will practice in an untimed manner.
  2. No uniform performance goals exist. Students may practice to any accuracy criteria (e.g., 80%, 90%, or 100%).
  3. Flashcards lack instructional design. Creating flashcards comes with no set of rules and each deck may contain widely discrepant methods for presenting target content.

The previously stated limitations make flashcards less effective. Students using the popular instructional tool may not learn content as effectively or efficiently as they like. Furthermore, retaining information and moving forward with more complicated content may occur at slower place or not at all. Fortunately, a method exists that addresses the flashcard limitations and has research demonstrating accelerated performance gains and learning.

Flashcards Morph into SAFMEDS

In 1978 Ogden Lindsley and Steve Graf pioneered a practice and assessment procedure called SAFMEDS (Potts, Eshleman, & Cooper, 1993). SAFMEDS stands for Say All Fast, a Minute Every Day, Shuffled. In other words, learners would:

  • See the front of the card and Say the answer.
  • Practice with the entire set or All of the content in the deck
  • Go through the content Fast instead of slow to produce steeper celerations (faster learning).
  • Practice with timed units such as a Minute or other consistent interval (e.g., 20 seconds).
  • Assess progress and practice content Every Day instead of weekly or some other protracted time interval.
  • Shuffle the deck instead of practicing the cards in order.

A host of studies demonstrate the superiority of SAFMEDS over flashcards and other self-study practices. Research indicates that SAFMEDS form an effective instructional and assessment method in many domains (View some examples under Resources at the bottom of this article).

A study conducted by your friendly blog author demonstrates how SAFMEDS can help behavior change agents improve understanding of important Precision Teaching concepts such as movement cycles.

SAFMEDS and Movement Cycles Study

Staff who work with people with disabilities such as autism, intellectual disabilities, and learning disabilities can employ Precision Teaching to enhance measurement, decision making, and communication of data among team members and stakeholders. Precision Teaching has four steps:Pinpoint, Record, Change, Try Again.

The first step consists of creating a pinpoint. And at the core of the pinpoint exists a movement cycle. Movement cycles contain two parts, an observable action described by an active verb and the object involved with the action.

The essence of every behavior originates in a movement cycle. Composing an essay would translate to “writes essay” (action verb + object involved with the action). “Aggression” could include several movement cycles: hits staff, slaps face, or scratches arm. And complex behavior such as “joint attention” may encompass aims gaze, points finger, or follows gaze.

Behavior change agents can profit from Precision Teaching knowledge such as movement cycles. A study, for example, demonstrated a 94% difference in detection accuracy when comparing movement cycles with operational definitions (i.e., 35% detection accuracy for operational definitions and 68% for movement cycles). Another experiment examined how behavior analysts and special education teachers working with students with autism would learn movement cycles with SAFMEDS.

In the Kubina, Yurich, Durica, & Healy (2016) study, the experimenters crafted two SAFMEDS decks with pictures depicting students behaving. The picture on the front of the card had a corresponding movement cycle (i.e., two words = active verb in the simple present tense + object receiving action) on the back of the card.

Figure 1 came from one of the decks. The student had a specific behavior participants needed to translate into a movement cycle. In the picture circles and arrows focused precision and indicated movement. The larger circle showed a hand while the smaller circle centered on two fingers. The arrow portrayed downward motion. Therefore, if the participant said “presses toy” the experimenters would score the response as correct.

Figure 1

Figure 1. A picture of a card taken from a movement cycle deck.

The participants made many competing, incorrect responses to the SAFMEDS cards at the beginning of the study. Participants might say the incorrect active verb (push instead of press), use the incorrect verb tense (pressing – present progressive tense – instead of presses – simple present tense), choose an incorrect object receiving the action (piano instead of key), or not use the proper format of action + object involved with the action (saying “He is hitting the doll”)

Additionally, the participants initially performed the assessment task slowly, with hesitations, or skipped answers outright. The following clip came from one participant’s baseline. The X’s in the video represent incorrect responses.

Across time the participants increased their frequency. The students practiced saying their answers and self-correcting their responses. The participants also practiced on the whole deck each day and shuffled it before a practice trial.

Figure 2 illustrates skill progress. In baseline, all of the participants made more incorrect (x) than correct (dot) answers. Furthermore, incorrect responses accelerated in baseline, a worsening condition for saying movement cycles.

Figure 2. A multiple baseline design for group 2 using Deck A movement cycles.

The experimenters applied the SAFMEDS intervention and the same learning pictures emerged: correct responses grew rapidly while incorrect responses decelerated quickly.

The transformation appeared remarkable. The following video captures one of the performances of a participant toward the end of the SAFMEDS intervention. The dots on the video mark each instance of a correct response made in time.

 

The SAFMEDS study had several important findings:

  1. SAFMEDS offers a reliable method to help adult learners quickly gain competency with the targeted content (e.g., movement cycles);
  2. Participants retained information across time;
  3. SAFMEDS facilitates extension of content to novel content (i.e., Participants performed very well on a novel deck demonstrating transfer of learning);
  4. A performance criterion or frequency aim can signal how fast and accurate participants must respond in order to achieve their goal; and
  5. Analyzing performance results on a Standard Celeration Chart provides a wealth of visual and statistical information.

Conclusion

SAFMEDS supports the learning of simple and complex content for young and older learners. SAFMEDS also gives rise to important learning outcomes such as long-term retention and maintenance, application or extension of content to novel material, and social validity seen in meaningful participant behavior change and stakeholder satisfaction (see references below and in article).

Rick Kubina, Ph.D., BCBA-D

Director of Research, CentralReach

Professor of Special Education, The Pennsylvania State University

References

Karpicke, J. D., Butler, A. C., & Roediger III, H. L.(2009). Metacognitive strategies in student learning: Do students practice retrieval when they study on their own? Memory, 17, 471-479.

Kubina, R. M., Yurich, K. L., Durica, K. C., & Healy, N. M. (2016). Developing behavioral fluency with movement cycles using SAFMEDS. Journal of Behavioral Education, 25, 120-141.

Potts, L., Eshleman, J. W., & Cooper, J. O. (1993). Ogden R. Lindsley and the historical development of precision teaching. The Behavior Analyst, 16(2),177-189.

Resources

Branch, A., Hastings, R. P., Beverley, M. & Hughes, J. C. (2018). Increasing support staff fluency with the content of behaviour support plans: An application of precision teachingJournal of Intellectual & Developmental Disability, 43, 213-222.

Chapman, S. S., Ewing, C. B., & Mozzoni, M. P. (2005). Precision teaching and fluency training across cognitive, physical, and academic tasks in children with traumatic brain injury: A multiple baseline studyBehavioral Interventions, 20, 37-49.

Mason, L. L., Rivera, C. J., & Arriaga, A. (2018). The effects of an avoidance contingency on postsecondary student SAFMEDS performanceEuropean Journal of Behavior Analysis, 19, 62-71.

Peladeau, N., Forget, J., & Gagne, F. (2003). Effect of paced and unpaced practice on skill application and retention: How much is enoughAmerican Educational Research Journal, 40, 769-801.