If I had to be a “traditional” behavior analyst (BA), I would be a terrible one.  

The repetitive nature of discrete trial training would have me reading the Geneva Conventions and conferring with geopolitical legal experts during the  lunch break on my first day of employment.  

I’m not here to say my colleagues who live in the world of tacts and mands, in addition to possessing a fluency in all the types of differential reinforcement, are somehow better (or worse) BAs. To me, they are most impressive and admirable, given the totality and complete command of the science of behavior analysis they possess.  

However, this is not my experience as a behavior analyst, and to be honest, I have never conducted even one minute of discrete trial training.  My experience?  Here are a few examples from a Tuesday morning in September:

• “Ley, do you need to write in the behavior programs that the residents can’t carry guns?”
  • After several seconds of audibly laughing and then returning to reviewing a behavior graph, I noticed an awkward silence. This was a question awaiting a response.  

• “We need to remember the psychiatrist will treat the person, not the level” was my response to an astute direct support professional (DSP) who was inquiring about blood work for a person taking valproic acid who was “tearing the joint down.”
  • This gem of information came from sitting in countless interdisciplinary team meetings led by psychiatrists.  

• “I told the doctor what you said and tried to show him what you wrote. They said they don’t believe any of that, didn’t order anything, and said it is behavioral. We spent 45 minutes in the waiting room and 2 minutes in the back.”
  • Do you recognize this situation?  This was diagnostic overshadowing and, these days, is an intoxicating fight always worth having.  

You may be thinking, “This guy cherry-picked three anecdotes from the last six months to illustrate his point and grab my attention. Also, why is he telling me this?”  

Regarding the former, you are not wrong, but these three issues arose in a 90-minute period during a routine site visit on a random Tuesday morning. To answer the latter, the most common question I hear is, “You say you’re a behavior analyst, but what do you actually do?!”  

An Assessor, An Analyst, and a Writer 

What we are trained to do and what we “produce” are behavior assessments and behavior programs. We tabulate and analyze data, write progress notes, and ensure fidelity of plan implementation.  

Peel back a layer and you will find we are educators. We train staff and caregivers on the “how and why” of behavioral presentations, which is done within the framework of the evidence-based field of applied behavior analysis.  

Also, we write – a lot.  For a profession fundamentally rooted in interacting with people, I spend a shocking amount of time alone, in front of a computer, typing.   

Admittedly, this is not a particularly enchanting and engaging description of a behavior analyst.  Perhaps the question is not “what does a behavior analyst do?”, but rather “what makes a behavior analyst?”  This question would best be answered by discussing the approach of a BA.  

Everything is on the Table

What if I said a BA examines a person’s behavior with the notion “everything is possible”?  This eliminates the constructs of the setting event-antecedent-behavior-consequence model that inherently limit the scope and reach of effective behavior analysis.  

Sure, most any BA can tell you a medical condition is a setting event (and/or antecedent) and say, “make sure you always think medical first!”However, what “makes us” is what lies beyond the identification of the components of behavior.   

For example, if Jane has a history of urinary tract infections (UTI), a BA can identify and incorporate into the behavior program her individualized UTI symptoms. Through this, the BA can then educate staff and caregivers of what Jane’s UTI symptoms are likely to be and, if observed, could advise to consult a medical professional, present the symptoms (which are likely acute onset behaviors!) in the context of her medical history, and perhaps a urinalysis is completed to rule out a UTI.  

A non-invasive, relatively quick diagnostic procedure can resolve an acute, treatable medical condition, while avoiding consultation with a psychiatrist because the (possible) behavioral characteristics of the untreated UTI were cognitive changes and increased problem behaviors.  Additionally, and perhaps most importantly, the BA could help Jane recognize her UTI symptoms and teach her how to communicate her discomfort and need for assistance.  This is what makes a behavior analyst.

A Simple Behavioral Analyst

Are we medical doctors?  Most of us, no.  Are we nurses?  SLPs, OTs, PTs, pharmacists?  Probably not. Most of us are simply behavior analysts.  

What makes us BAs, beyond credentials, is our willingness to be inclusive of all disciplines by recognizing their necessity in helping us be more robust and complete analysts of behavior.  

It is not enough for BAs to identify the setting event and pass the medical issue off to a nurse or primary care physician. BAs must have a working knowledge of how the treatment strategies and approaches impact the lives of the people we serve.  Additionally, by incorporating the strategies and expertise of other disciplines into our assessments, programs, and approaches, we can enhance the desired and positive outcomes for the people we serve.  This is what makes a behavior analyst.

It’s About the Person

I have pondered what being a behavior analyst means to a Direct Support Professional, other professional disciplines, or to persons who do not work in the ID/RD human services field. The answer, I have come to realize, differs dramatically depending on why a person may have an interaction with a BA.  

As a BA, my belief is that we have a responsibility not to tell people what we do, but to explain what makes us behavior analysts. For me, this means telling people that a behavior analyst has the ability to examine all behavior (not just maladaptive or aberrant) by incorporating the totality of a person, in an inclusive, interdisciplinary fashion that focuses on the individual needs of the person.

All of Ley’s work is original and no form of AI was used to write this blog. 

This piece originally appeared in HELEN as part of Ley’s co-authored series on “Unlocking Behaviors.”

Never disregard professional medical advice or delay seeking medical treatment because of something you have read in this article.