[Your Name] [Your Address] [City, State, ZIP] [Date]

[Recipient’s Name] [Recipient’s Address] [City, State, ZIP]

Dear [Recipient’s Name],

I hope this letter finds you and your family in good health. I am writing to discuss the care and well-being of your grandfather, Juan, who is currently residing at the nursing home. I have been working closely with the staff to evaluate Juan’s behaviors and to formulate a comprehensive plan that will address his needs effectively and ethically.

As a Board-Certified Assistant Behavior Analyst (BCaBA), it is my responsibility to ensure that Juan receives the highest quality care, considering both his safety and quality of life. I understand the concerns raised by the nursing home staff regarding Juan’s frequent elopement from the facility and his verbal aggression, which have created disruptions among other residents. To address these issues, I have carefully considered several behavior analytic procedures and ethical principles that align with our goals.

Upon review of Juan’s case, it is evident that a Functional Behavior Assessment (FBA) is necessary to gain a deeper understanding of the functions of his problem behaviors. While previous strategies recommended by the BCaBA, such as setting limits and being consistent with rules, can be valuable components of a behavior intervention plan, they do not provide a comprehensive understanding of the antecedents and consequences driving Juan’s behaviors. Conducting an FBA is in accordance with the Behavior Analyst Certification Board (BACB) ethics code, specifically under the following codes:

Responsibility as a Professional: The BACB ethics code dictates that behavior analysts have a professional responsibility to assess behavior and provide evidence-based interventions (1.0). Conducting an FBA aligns with this code as it ensures that our interventions are based on a thorough analysis of Juan’s behavior patterns.

Assessment: Behavior analysts are obligated to use appropriate assessments to inform their interventions (2.01). In Juan’s case, an FBA is a critical assessment tool that will allow us to identify the specific triggers and consequences related to his elopement and verbal aggression.

Planning and Supervision: The BACB code emphasizes the importance of thorough planning and supervision (10.0). By conducting an FBA, we are engaging in due diligence and adhering to ethical guidelines to create a well-informed and effective behavior intervention plan.

I recommend that we proceed with the FBA to gain a more comprehensive understanding of Juan’s behavior. This assessment will involve direct observation, interviews with staff and family members, and a review of his medical history. It will allow us to identify the specific functions of his problem behaviors, which may include escape from aversive situations, seeking attention, or obtaining preferred items.

Once the FBA is completed, we can develop a behavior intervention plan that is tailored to Juan’s unique needs. This plan may include the use of Differential Reinforcement of Alternative Behaviors (DRA), a behavior analytic procedure that focuses on reinforcing desirable behaviors as an alternative to problem behaviors. By identifying specific alternative behaviors that serve the same function as Juan’s challenging behaviors, we can reduce the occurrence of elopement and verbal aggression while improving his quality of life.

However, it is essential to acknowledge that the use of DRA must be carefully implemented to ensure it aligns with ethical principles. The following BACB ethics codes are particularly relevant:

Intervention Plan: Behavior analysts must ensure that behavior intervention plans are comprehensive, systematic, and based on the results of assessments (4.02). In Juan’s case, our intervention plan will be grounded in the findings of the FBA.

Least Restrictive Procedures: Behavior analysts must prioritize the use of the least restrictive procedures (4.08). While we aim to reduce problem behaviors, we will also consider Juan’s rights and preferences to maintain his dignity and autonomy.

Client’s Rights: Juan has the right to effective treatment (4.09), which means that our interventions must not only reduce problem behaviors but also enhance his overall well-being.

In conclusion, I recommend conducting a Functional Behavior Assessment to gain a deeper understanding of Juan’s behaviors and their functions. This assessment will allow us to develop an ethical and effective behavior intervention plan that may include the use of DRA. By following these ethical guidelines and considering Juan’s best interests, we can work toward improving his quality of life while ensuring his safety and well-being.

I look forward to discussing this recommendation with you and your family in more detail and collaborating with the nursing home staff to implement a comprehensive plan that best serves Juan’s needs.

Please feel free to reach out to me with any questions or to schedule a meeting at your convenience.

Sincerely,

[Your Name] Board-Certified Assistant Behavior Analyst