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Creating Protocol to Prevent and Treat Trauma with Limited Functional Language

Ethics Scenario Archive
1. Approaching Former Adult Client
2. Medical Marijuana
3. Pro Bono Work
4. Supervision Has Multiple Relationships with Family Receiving Services
5. Parent Training Concerns
6. Parents Not Implementing Procedures
7. Soliciting Parent Testimonials
8. Retaliation Towards Mandated Reporting
9. Family Rejecting Safety Measures
10. Parental Collaboration
11. Hostile Work Enviornment
12. Creating Protocol to Prevent and Treat Trauma with Limited Functional Language
13. Parent ABA Practice Questions in OT & Speech
14. Potential Gifts From Clients on Social Media
15. Helping Close Relationships With ABA Tips
16. Parent Utilizing CBD & THC
17. Client Pre-Authorization Denied For Much Needed Services
18. Supervisee Slaps Child in School Setting
19. Changing Direction of Treatment from Previous BCBA
20. BCBA Subpoenaed in Family Court
21. Terminate Services Due To Parent Behavior
22. Parents Offering Token Items During Check Out/Transition
23. Family Doesn’t Want Details Released To Funding Source Without Permission
24. Resources for IRB Approval for Independent Researchers
25. Speech Therapist Refusing To Do PECS
26. BCBA Receives Cease & Desist
27. Unlicensed, Certified BCBA Provide Supervision
28. Rapid Prompting Method (RPM)
29. Parent as Witness to Accident
30. Website Testimonials
31. Student Using Social Media Inappropriately
32. Hiring Behavior Analyst Trainees at a School District
33. College Recommendation Letter for Client
34. Connecting Families That Are Clients
35. Employer Requiring Same Number of ABA Hours for All New Clients from New BCaBA
36. Do we have any ethical guidelines regarding shared work spaces among two companies that provide similar ABA services in a private property?
37. Client Assessment & Discontinuation
38. Caseload Concerns

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A BCBA is working with a medically fragile teenager, significantly impacted in several domains (communication – very little functional language, daily living, social skills etc.). The client suffers from a rare heart condition requiring an AED (on her person – in backpack) at all times. The family recently learned of the only potential surgery that could save her life (implant of internal defib). However, the setting on the implant cannot be set for her specific needs so it will “fire” a shock, at random times, to ensure appropriate electrical functioning. The medical provider requested the BCBA implement a protocol to prevent and treat trauma associated with the unpredictability of the electrical shock. The BCBA has experience with PTSD clients but is unsure of all the components involved in this scenario. The medical provider shared that there is no way to measure the intensity of the shock, as that is relative to the patient (this client does not have enough functional language to share such information). Parents are unsettled regarding the procedure but feel it is the only way to ensure her safety, long-term. Parents are requesting a coordinated plan of care prior to surgery. What are the next steps for this BCBA?

Response

  • Ensure experience and competency with PTSD and trauma, if not, seek out additional resources and supports

 

  • Reviewing what is in our scope of practice; risk benefit analysis for getting the surgery vs. keeping defib on her person at all times

 

  • Discuss with doctor as well as previous patients if available to talk about the effects and intensity of the shock

 

  • Refer to counselor or psychologist for family care and ongoing needs that the client would need to build a collaborative team

 

  • BCBA, continuing to build communication, Likert scale for communicating pain etc.

 

  • Taking a supportive approach to parent training after the surgery and keeping in mind the fragile state of the family to slowly integrate protocol training into sessions
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