Little by Little: Building and Crossing Bridges in the Pursuit of Progress

Dear blog reader, for this month’s post we are excited to be joined by Dr Olive Healy. Olive started out as one of Dermot’s PhD students back in the 90’s and has since made an undoubtedly stellar contribution to the field of behaviour analysis (and psychological science more generally), in large part through genuinely embodying the collaborative effort we are encouraging with the current series. This will become quickly evident from reading Dr Healy’s post as she describes the bridges she has crossed and helped build in pursuing the dissemination and application of behaviour-analysis, both within the discipline and to the wider community. From working with children with autism and other complex needs to conducting research incorporating psychophysiology, neurology, phenotype and smartphone technology to explore behavioural interventions, all embedded in the science of ABA at its core. And if that hasn’t convinced you, we have no doubt that Olive’s post itself will do the trick. Enjoy! 

Colin and Dermot

 

About the author:

Dr. Olive Healy is a Behavioural Psychologist and Doctoral Board Certified Behaviour Analyst® with over 20 years of clinical expertise in neurodevelopmental disorders including Autism. She is Director of the Masters programme in Applied Behaviour Analysis at the School of Psychology, Trinity College Dublin. After serving for seven years as Lecturer in Psychology (2006-2013) at NUI Galway, Olive joined the School of Psychology, Trinity College Dublin and is now an Associate Professor in Psychology. Olive was Educational Director of the first state-funded evidence-based practice school in Ireland under the auspices of the Comprehensive Application of Behaviour Analysis to Schooling® in 1998. She spent 10 years engaged in knowledge transfer from leading scholars at Columbia University NY to expert schooling established to educate children with autism and complex needs in Ireland. Olive led the establishment of five further evidence-based educational centres for Autism and disseminated knowledge and skills through ongoing collaboration with US experts. She was a founding director of the first research centre for neurodevelopmental disorders in Ireland at NUI Galway in 2012. Her research focuses on improving life outcomes for people with intellectual and developmental disorders. She now acts as Principal Investigator of an Enterprise Ireland funded project InterAcT (Accomplish & Thrive) within Trinity College Dublin (https://interact.adaptcentre.ie/). She is Associate Editor of four leading international journals contributing to peer review and research dissemination in the field of behavioural psychology. She has authored over 80 academic papers and book chapters published in both behaviour-analytic and mainstream psychology journals (https://scholar.google.com/citations?user=lzWPUr8AAAAJ&hl=en).

 

As I write this post from my office at Trinity College Dublin located in the beautiful campus in the heart of Dublin’s city centre, I think about an assertion uttered over two centuries ago by the Irish statesman and philosopher Edmund Burke: ‘nobody made a greater mistake than he who did nothing because he could do only a little’.

I think that over the last 20 years of crossing many bridges within and outside of my academic discipline, I have always attempted to keep on doing a little and then hopefully, a little more.

I am a behaviour analyst in Ireland where I direct a M.Sc. in Applied Behaviour Analysis and provide supervision to several students pursuing a Ph.D. in psychology. Recognising oneself as an applied behaviour analyst in Ireland is sometimes tricky. I say this cautiously because I am incredibly proud of my role at my university, the research I oversee and applications of this research both nationally and internationally. However, over the years I have also discovered the need to represent my professional self in ways that may be more appealing to those in various other caches within psychology.

In this post I reflect on over 20 years of learning and paying it forward and what I boldly think could be considered bravery in crossing those bridges to ensure continued learning on my part.

I was first introduced to Behaviour Analysis in 1993 as an undergraduate in Applied Psychology at University College Cork, Ireland. My initial exposure to the science involved an emphasis on the experimental analysis of behaviour through the teachings of Professor Dermot Barnes-Holmes. During the late 1990’s, Professor Barnes-Holmes was identified as the most prolific author in this field, and enthusiastically translated the fruits of his research in lectures. His teachings undoubtedly made me inquisitive about the principles of behaviour. I remember distinctly the emphasis he placed on consequential control and the effects of scheduling specific consequences to alter behavioural patterns. The behaviour analysis laboratory lead by Professor Barnes-Holmes at that time was vibrant with many different research programmes and enthusiastic students conducting experiments on diverse and novel areas of behaviour analysis. At that time, individuals like Bryan Roche, Simon Dymond, Ian Stewart were all ambitiously producing internationally renowned research with Dermot at the helm. Needless to say, I was inspired. Following my undergraduate degree, I decided to pursue a PhD in behaviour analysis with a focus on relational frame theory and the demonstration of relational responding as a higher-order operant. During the final year of my PhD I was fortunate enough to be introduced to Professor Doug Greer, Professor of Psychology and Education at Teacher’s College, Columbia University. Professor Greer’s work at this time had attracted international attention, as he focused on developing a system or school-wide intervention approach, to the education of children with autism diagnoses. This was my first introduction to the application of behavioural strategies to children with neurodevelopmental disorders. My interest and enthusiasm in Applied Behaviour Analysis (ABA) accelerated from this point and I embraced the opportunity to work and learn from Professor Greer and his colleagues.

In 1998, a team of experts including Professors Barnes-Holmes and Greer led negotiations with the Irish government to establish the first state-funded ABA school for autism in Ireland under the auspices of the Comprehensive Application of Behaviour Analysis to Schooling (CABAS®). Subsequently, I spent 10 years engaged in knowledge transfer from leading scholars at Columbia University NY to expert schooling established to educate children with autism and complex needs in Ireland. I was honoured to lead the establishment of five further evidence-based educational centres for Autism and disseminated knowledge and skills through ongoing collaboration with US experts.

The ongoing drive, passion and untiring effort shown by all parties involved in bringing ABA to the education system in Ireland, in my view allowed many families and their children achieve the best chance at a developmental trajectory that would produce optimal outcomes for their future. Expectations were high- for example, nobody working in these schools believed that an autistic child could not learn to read or write. When I now think about CABAS®, this recent quote captures the kernel of its ethos:

‘The student is not the object of the verb to teach, but the subject of the verb to learn’ (Scott Thornbury; @thornburyscott, August 23, 2016).

A transformative view of the ability of children with complex needs to access and achieve education came to the fore. Greer’s book ‘Designing Teaching Strategies’ (Greer, 2002) is an accumulation of the conspicuous characteristics of teaching as applied behaviour analysis and one that I treasure in my collection of teaching materials to this day. But with this transformation in educational practice, came much responsibility and the need to establish recognition and formal education for those providing ABA to families across Ireland.

In 2006, the first M.Sc. in Applied Behaviour Analysis in the Republic of Ireland was established at the National University Ireland, Galway and I made the giant leap from working full-time in applied settings to an academic post. After serving for seven years as lecturer in psychology (2006-2013) at NUI Galway, I joined the School of Psychology, Trinity College Dublin where I am now Associate Professor in Psychology.

There are so many wonderful advantages that being a faculty member brings. Having the freedom and ability to design and implement research programmes that involve stakeholders, which aim to improve individuals’ lives in many diverse ways, is the greatest precedence of my role. Translating and disseminating the fruits of research back to an eager student body is highly reinforcing. Over the years, my research focus has evolved, and this has certainly opened many doors to work alongside experts from other disciplines and leading international researchers.

For a long time, I have listened carefully to Professor Hank Schlinger at Cal State University. In 2015, he wrote what I consider to be a far-reaching article on behaviour analysis and behavioural neuroscience (Schlinger, 2015). In it he argued that it is possible that the field of behaviour analysis offers neuroscientists an experimental and a theoretical framework within which to investigate the neural bases of behaviours. In my view, the fields actually need each other and that future studies in the field of applied behaviour analysis will incorporate a greater focus on clinical neuroimaging studies. My students and I have begun to collaborate with neuroscientists to incorporate a neurological validation of specific behavioural interventions. We know that environmental factors and early experience plays a critical role in the development and attenuation of specific problem behaviours in autism. Behavioural interventions can significantly alter behavioural patterns, and the extent of the changes in brain pathways that mediate this as well as the resulting clinical importance, warrants further investigation in my view. There are many neurodevelopmental disorders that have not yet been examined in relation to clinical need and long-term outcomes. For example, it is only recently that children with Fragile X syndrome have been included in studies employing behavioural assessment and intervention. Results are promising but there is still a great need to determine how interventions can be tailored to additional populations and how these can alter the course of development in the long-term. My colleagues at Crumlin Hospital Dublin and I have examined phenotypic data in neurofibromatosis to determine clinical need and the utility of behavioural interventions drawn from the science of ABA in this population (Concialdi et al., 2021).

Furthermore, my graduate PhD student, Sinéad Lydon and I have been focusing on behaviour analysis and psychophysiology (e.g., Lydon et al., 2016). While operant theory has allowed for the development of effective behavioural interventions for challenging behaviours such as self-injury and stereotypy, the aetiology of such behaviours remains largely unknown. An abundance of theories exist proposing that specific behaviours may be the result of physiological dysregulation or atypical physiological processes. However, there is currently a limited body of research empirically examining the relationship between physiological activity and engagement in challenging behaviour. Such investigations may lead to greater collaboration between individuals within and outside of our field.

Unfortunately, there still remains a gap between research and practice in applied behaviour analysis in Ireland and I am passionate about attempting to address this in services for people with autism and intellectual disability. I currently lead a programme of research funded by the Irish Research Council, which facilitates an examination of the optimal means of transferring a model of systemic positive behaviour support to frontline staff within intellectual disability treatment centres. The ultimate aim is to impact policy in Ireland to ensure a right to comprehensive supports that respect human dignity.

In recent years, I have become passionate about utilizing technology to better disseminate effective practices from our field and translate them in a way that allows for a greater uptake and implementation by non-subject matter experts. I believe that our field could benefit from a taxonomy of science communication aims and one possible way to address this is by leveraging technology. Here at Trinity, my colleagues and I are attempting to contribute to science communication by providing behavioural psychology solutions in an accessible, digital platform, via a smartphone app. This project InterAcT (Accomplish & Thrive) is funded by Enterprise Ireland and has afforded me the exciting opportunity to work with families, autistic people, individuals with intellectual disability, UX/UI designers, videographers, health psychologists and neuroscientists to name a few.

Given the substantial evidence-base for behavioural interventions for skill acquisition and prevention of the onset of distressed behaviour across many cohorts, it is still extremely frustrating to me that these practices are not more widely accessible to parents, educators, psychologists and others.

It may be argued that behaviour analysis is still considered a generic science and my colleagues and I will continue to leverage technology to provide an analytical framework of science communication, to bridge the gap between behaviour analysis findings and the public including education, health and social care sectors as well as stakeholders themselves.

We hope that our technology and smartphone app will also help address some of the misconceptions and misrepresentations in Ireland and abroad about the science of Applied Behaviour Analysis. I try to encourage my students to bravely continue to correct these misconceptions when they arise in their practice and research. They too can see that even doing ‘a little’ or a lot to progress behaviour analysis can contribute considerably in the broader field of psychological science.

Throughout the ample learning experiences that I have had within and across disciplines I strongly believe that a diversity of perspectives about the applications of behaviour analysis held by different groups should be considered when solutions to the dissemination of behaviour analytic strategies are pursued. Such perspectives, I believe are vital to ensure continued success in advancing the principles and practices of the science for the benefit of so many individuals.

 

References

Concialdi, C., Kirk, C. W., Lydon, S., Healy, O., Green, A., Lynch, S. A., & McVeigh, T. P. (2021, February). Mapping the neurobehavioural phenotypes of Type 1 Neurofibromatosis (NF1). Irish Journal of Medical Science, Vol. 190, 75-75.

Greer, R. D. (2002). Designing teaching strategies: An applied behaviour analysis systems approach. Academic Press.

Lydon, S., Healy, O., Reed, P., Mulhern, T., Hughes, B.M. & Goodwin, M.S. (2016). A systematic review of physiological reactivity to stimuli in autism, Developmental Neurorehabilitation, 19:6, 335-355.

Schlinger HD (2015) Behaviour analysis and behavioural neuroscience. Front. Hum. Neurosci. 9:210.