|Problem-solving prompt||Your response||Response example|
|Problem or risk||
Escape extinction may cause an increase in the problematic behaviors.
|If the client’s behavior is escape-maintained, denying the bathroom breaks could lead to an extinction burst, extinction-induced aggression, and emotional behavior.|
|Relevant ethical codes||
2.12 – Consider medical needs
|2.13 Selecting, Designing, and Implementing Assessments – Some variation of a functional analysis should be conducted at the job site prior to making treatment recommendations
2.14 Selecting, Designing, and Implementing Behavior-Change Interventions – An escape extinction procedure is not part of the current plan
2.15 Minimizing Risk of Behavior-Change Interventions – Escape extinction is a highly restrictive procedure for an environment such as a job placement, which is low-restrictiveness
Treatment considerations – functional communication training. The therapist should seek to see if there is a medical issue before determining an intervention to implement. The therapist should confirm the function before implementing interventions.
|To stay ethical and effective, Carol will need to make some quick decisions and give the problem the attention it requires. Carol can visit and make a definitive determination regarding the function. If it is escape, she might consider ways in which the job tasks could be more engaging for the client, such as providing continuous arbitrary reinforcement (headphones), NCR for escape (scheduled breaks), and contingency-based progressive delay to create greater temporal distance between requests to use the bathroom.|