Saturday, August 20, 2011

This is how to gain the consent of the recipients of behavioral interventions.

[Edit note April 28, 2017: I retain this post. The ethics remain intact. It is my main statement on dual consent, how the recipient of ABA has the right to say "No" to ABA abuse. It's probably due for a fresh reading, reconsideration, and overhaul, but only a new reading will determine the direction of future edits here. As we delve into the feelings of the recipient we enter cognitive behavioral territory, so even the title here is only preliminary in our work. ABAers back then were thanking me for disseminating ABA as positive, which we now know it is not, despite this kind of misrepresentations. They were roping me into the cult. Autistics helped to pull me out. Then I felt the brunt of their attacks directly online, as they went after me in droves, in force. The first shocker was an ABAer who said a cop cannot use positive reinforcers who shut his mouth when I showed them a video of a cop dancing in a park with inner city youth. I was shocked. Hadn't Skinner warned them all against coercive punishment. No! Only on the surface did he make these wonderful arguments to which I still subscribe, in part, in sync with Positive Behavior Support, (PBS), which has also become a terrible disappointment when you see how it really plays out in real life despite the rosy theoretical claims of positive-only.

[I was calling ABA science then. It wasn't until much later that a reader critique of the original ABA-is-a cult-of-science led me to see how ABA is a pseudoscience masquerading as science. At this date, and up until 2014, after having believed Skinner and his followers, naïvely for seven blind years that they could be ethical if only they followed Skinner's warnings against punishment. Eventually, I came to see the hypocrite in each of them, especially Skinner, when in 2017 we see for certain that Skinner only opposed punitive coercion upon whom he called "normal" people. The others, disabled people especially, were "beyond" the reach of reinforcers only, as Skinner actually said and as Skinner actually led. I retain this post for historical and developmental purposes over the development of my findings, from blinded by the misrepresentations, subtle and obvious, out from the cave of darkness where the light to #NoABA, other ways instead, shines big and bright.]

[Edit note: February 12, 2017. After writing this Behavioral Ethics report, which spelled out what he eventually called the Reward and Consent (R+C) Cognitive Behavioral Teaching method, this blogger eventually experienced first-hand through character assassination, defamation, and ostracism from their main Facebook groups, the brunt and abuse of all Applied Behavior Analysis' (ABA's) extreme addictions to punitive techniques. When he began his inquiry in 2007, he expected to find an ABA community which would follows the warnings of their founder B. F. Skinner against ABA punitive techniques. What he found was not only adamant defense of their punitive coercions, but also what he felt directly was the brunt of this abuse through public shaming. Eventually he came to call ABA a pseudoscience cult, largely on the basis of how they have always treated him, an ABA critic who fluently speaks their language. To this day, he remains dumbfounded to explain how aversive they really and truly are, despite their denials. ABA, of all people, ought to know better, but it is blind to the problem with punishment.]


Wikimedia photo.


This paper advocates that behavioral practitioners should obtain the dual consent of the children or disabled adults as well as their parents or guardians when they plan to increase or decrease the response rates of certain target behaviors they warrant as important enough to try to control. These followers of B.F. Skinner's assertion that changes in the environment cause changes in human behavior use four basic contingencies to regulate behavior. These contingencies include positive and negative reinforcement and punishment. Consent to undergo a behavioral intervention is a form of verbal behavior. Consent is not necessarily a mental process of an autonomous, fully-cognizant adult. Consent can be automatic and uninformed. During consent, the golden rule of ethics is paramount, to do to others what you’d have them do unto you, to respect others as you'd have them respect you, no matter how young or disabled the consenting individual may be. A highly ethical professional would seek the permission of both the subject and the subject's surrogate-in-charge to perform an act upon him or her. Since culture-at-large encompasses a wide-scale aggregation of individual behaviors, and since behavior change done well can improve the human condition, it follows that more ethics in the practice of behaviorism and more behaviorism in the practice of ethics can improve the state of the world.

Some Background Fundamentals of Applied Behavior Analysis

In behavior science there are four basic contingencies that can change the emission strength of specified behaviors. Thus, a teacher, a parent, or a psychologist can add or remove a reinforcing or a punishing stimulus soon after a child exhibits a behavior (or while he or she emits it). Reinforcement increases the probability of future occurrences of a behavior and punishment decreases it or suppresses it temporarily, as measured by a change in the subsequent rate of response or by a count of total responses over a period of time.

1) In positive reinforcement a payout at the slot machine causes us to gamble more often. We call it "positive" because we add a stimulus (cash) and "reinforcement" because we strengthen the rate of future occurrences of behavior. 2) In negative reinforcement, we remove a punisher to increase behavior strength. So getting away from the rain by raising an umbrella causes us to raise the umbrella more often when it's raining. We call it "negative" because we remove a stimulus, the rain on our heads, and "reinforcement" because we increase the rate of behavior, umbrella-raising. 3) In positive punishment we add an aversive stimulus to decrease or suppress the frequency of future incidents of a behavior, so a slap on the paw of a rat while it's pressing a lever suppresses its rate of lever presses. It is "positive" because we add a stimulus and "punishment" because we reduce behavior strength, either temporarily or in the long run. 4) In negative punishment, we remove a reinforcing stimulus to decrease behavior, so when the boss announces she will dock the pay of an employee when he shows up late for work, it causes him to avoid being late in the future.

In the mid-twentieth century B.F. Skinner discovered the form of learning he called "operant conditioning." During the four basic contingencies, the organism's action operates on the environment, which delivers a consequence that changes the probability of future occurrences of the behavior. So when a child asks his mother for food, the mother and the food reinforce the food seeking behavior. The child is operating on the mother who operates on the food. Her delivery of the food influences how often he will ask her for food in the future.

As he was discovering the principles, Skinner put pigeons and rats into highly-controlled experimental chambers that can kept other variables constant (weight of the organism, previous food deprivation, noise, temperature, species, etc.). He determined the effect of a change in an independent variable (the delivery of food reinforcement) upon a dependent variable, the rate of response (button pecks per minute.) Since then, behavior analysts have taken the principles discovered experimentally (positive reinforcement strengthens behavior) and put them into practice in more natural settings (a classroom). Today they might measure the effect of teacher attention on student compliance even though it is more difficult there to account for uncontrolled extraneous confounding variables that might distort the findings (the student's history of reinforcement or punishment with the teacher.)

Behaviorism works. To see how behavior scientists have demonstrated their ability to change people’s behavior, read through the articles in the Journal of the Experimental Analysis of Behavior or the Journal of Applied Behavior Analysis which are freely accessible on the internet. Behaviorism is a science. It has many detractors, but an argument against behaviorism is like an argument against pharmaceutical chemistry. Chemotherapy can kill fast growing cancer cells, but it can also harm the immune system. As in any technology, behaviorism can aide or injure an individual, but we should not let the risk of ill effects interfere with the judicious application of the knowledge base they have accumulated, provided, of course, that it's ethical. To make it more ethical, this paper attempts to fit the ethics of consent into the behavioral framework.

Consent as a Form of Verbal Behavior

Defining consent with the external terminology of behaviorism allows the professional to proceed with an ethics that does not appeal to inner causes of behavior. Attributing a mental cause to the generation of a response can interfere with the goal of solving behavior problems. This paper elaborates further below how the outer rather than the inner locus of psychological control better explains behavior.

According to B.F. Skinner (1957), verbal behavior is an interaction between a speaker and a listener. If a speaker asks for a favor and a listener does the favor, then the request is the behavior and the favor is the reinforcement. Verbal behavior does not have to be spoken; it can also be expressed in body language. When a lover reaches out his hand, and his partner takes hold, then reaching out is reinforced by the holding of his hand. It will probably reoccur. The lover is the speaker and his partner is the listener.

This author hasn't found anything Skinner ever said about “consent” as a form of verbal behavior, but he did write about "permission." He said, "When the listener is already inclined to act in a given way, but is restrained by, for example, a threat, the (speech) which cancels the threat is commonly called permission. Go ahead. (1957, p. 40)."

The definition of consent, therefore, is speech that grants the listener permission to perform an operation on the speaker by canceling any threat that restrains the listener from acting. The speaker is telling the listener that he will not try to escape or avoid the act she is inclined to perform upon him. He is promising not to punish her for engaging in the procedure. The speaker says, "I grant you my consent to do something to me. I will not punish you for what you are about to do to me." To help make some distinctions about who is who among personal pronouns, in all of the consent illustrations in this paper, the speaker is male, the one who consents, and the listener is female, the one who seeks consent.

So if a female restaurateur hires a male chef to cook for her establishment, she seeks his consent when she hands him the contract in quest of his signature. He consents to an agreement, work for pay under the terms of a contract. He allows her to modify his work behavior when he accepts her paycheck. He gives her his permission to supervise his work, to modify his performance, and to deliver the contingent consequences as spelled out in the contract, most notably satisfactory cooking in exchange for a salary and raises. If nothing unfavorable happens to the nature of their agreement, when he signs the contract he is promising not to escape from her or punish her by terminating the contract before the term expires, by striking, intentionally burning a meal, working too slow, etc.

When a patient signs a consent form at the doctor's office he grants her permission to examine him, treat him, or operate on his body. He is promising not to press charges against her for acting on him without his permission.

Obtaining consent among normal, healthy adults is now standard American practice in the psychology clinic and in the medical and business office, but how can a one-year-old baby grant his mother permission to feed him some food? She wants him to be healthy and to eat the meal she intends to give him, but she needs him to cooperate when he takes in the food. She draws the spoon up to his mouth and by opening wide, taking it in, and swallowing, he cancels any threat of resistance. He has given his mother permission to continue with the feeding until he is full. When he's had enough the next spoon becomes an aversive stimulus. He shuts his mouth and turns his head. He withdraws his consent. If she tries to persuade him to eat too much when he is no longer hungry and she puts some potatoes into the lips he is closing, he dissents even further by spitting it out, messing up his face and his bib. Then he might fuss and cry. The mother should withhold the spoon while he is resisting, provided there is no strong nutritional reason to continue the feeding. If she is prone to feed him more, she can wait a while until he is ready for more. She can switch to apple sauce when he resists the potatoes.

Even animals can grant consent. A horse pulls away from his trainer when she is doing something aversive. He dissents. When she gives him an apple for letting her lead him around in a circle, he consents when he turns and takes the apple without resistance.

Generally we consent to positive reinforcement and we dissent from punishment. Consent is often automatic when a behavioral procedure uses positive reinforcement. When we are hungry, we don't threaten the person who offers us some food. We go to her house and let her entertain us. When we are cold, we don't resist a person who offers us a warm winter coat. She sees the twinkle in our smiling eyes when she shows us the coat. When we are poor, we don't resist the advice of an experienced employment agent. We pay her a fee if she finds us a job. When we permit an instructor to teach us how to do a math problem, consent is automatic when she tells us we have correctly computed a problem. We don't punish a teacher because her feedback tells us we got the right answer. We continue working.

In addition, dissent is often automatic under punishment, which can cause a man to retaliate, escape, or withhold reinforcement. He fights back. He reacts with a black eye for a black eye and a bloody tooth for a bloody tooth. Insults bring about counter insults. A boy can run away from the parents who hit him. An authoritarian teacher generates passive pupils. A man in his house hangs up the phone on an annoying telemarketer. These reactions are signs of dissent. They tell the punishing person that she does not have his permission to hit him, to insult him, to give him detention, or to invade his privacy.

When consent is informed, fully capable adults might approve procedures that bring them higher amounts of long-term benefit even if we might suffer some punishment in the short run. For example, see the blog post about three adults who consented to the electric shock of smoking (or see Powell and Azrin, 1968). Perhaps these smokers expected a longer, happier life if they could quit the habit and prevent emphysema and lung cancer. On the other hand, when dissent is informed, fully cognizant individuals may reject activities that bring them higher amounts of long-term harm and forgo some short-term reinforcement. When we reject a snort of cocaine, we escape the temporary ecstasy because we know an addiction to cocaine will wreak havoc throughout our lives. However, as explained below, coercive punishment is unnecessary during behavior analytical attempts to reduce an unwanted behavior.

Deprivation of a reinforcer strengthens its reinforcing effect. Satiation weakens it. Food does not reinforce when an organism has been satiated by a recent feeding. Skinner deprived his pigeons of food. When their body weight was less than normal, he was ready to reinforce their button-pecking with pieces of food. In general, people don't voluntarily consent to the deprivation of basic needs such as shelter, warmth, social interaction, and food. Therefore, reinforcing a student's study behavior with popcorn as dessert after a meal is more consensual than reinforcing him with sips of milk just before mealtime. Remember the golden rule of ethics: do unto others as you would have them do unto you. Would you consent to food deprivation in order to make food more reinforcing? Withholding a treat until reinforcement time might be somewhat aversive, but it's not unethical. It wouldn't involve the deprivation of a physiological need such as water or food. Some parents teach their children not to expect a gift, but to appreciate one as special when it arrives.

As an aside, this paper does not attempt to decide whether the Golden Rule is an ideal universal moral prescription that everyone everywhere ought to obey at all times or whether it is a societal norm that many groups, including ours, but not all groups in total, expect us to follow. This subject has been discussed elsewhere in the journal Behavior and Philosophy. (See Hocutt, 2010). Suffice it to say that Western society expects its citizens to follow the Golden Rule whether or not it is particular to the West or to all civilization in its entirety. In the United States, we are citizens of the West and we are citizens of the globe. Either way, protocol obliges us to comply.

By itself, the consent of a parent or guardian is not enough to rate a behavioral treatment as completely consensual. However, when a parent or guardian consents but the child or incapacitated adult does not, as a general standard, then the "training" proceeds in a form no better than submission training of the recipient of the resultant coercion. It blocks the self-determination, the dignity, the natural born right to autonomy everyone inherits regardless of age or ability to reason. Parents do not always look after the interests of their children and they can make poor decisions when their intentions are good. The child or disabled adult also needs to consent. The subject himself is best qualified to sense that something is wrong. After all, it's being done to him, not to his parents. Only he knows exactly how it feels. Granting a child the ability to consent helps to protect him from undesirable consequences and it respects him as a person. By seeking his permission, the therapist allows him to participate in the approval of a procedure. Under ordinary circumstances, we should not force him to accept something he doesn't appreciate. A child can dissent even though he is uninformed. He can still say "leave me alone" even though he cannot predict the potential ramifications of the behavior in question. The consent of the child should be informed as much as possible. Basic explanations are necessary. He ought to know what is going on. When a child consents to a procedure that is intended to change his behavior, he is more likely to go along with the plan. If he is not allowed to consent, he is more likely to resist the intervention.

Also by itself, the consent of a child is not enough to rate a behavior modification program as completely consensual. Children make mistakes. The parent's consent is also necessary. Fully cognizant, healthy adults are better qualified to make informed decisions for the benefit of their children. When long-term gain outweighs short-term discomfort, the parent is a better judge than the inexperienced child.

What happens when there is a disagreement between the child and the adult? Not only applied behavior analysis, but all related health fields should be concerned about dual consent. For example, a young child may dissent from his immunity vaccines by crying, screaming, and pulling his arm away from the nurse. The parent consents because he believes that taking the short-term pain of the needle will prevent the long-term suffering of disease. However, the job of the pharmaceutical company is not finished. If they could discover a way to deliver the vaccine with a patch on the skin instead of a shot, the child would be more likely to consent. In this case, the informed consent of the parent trumps the uninformed dissent of the child, but the outcome is unsatisfactory and incomplete until they develop a painless alternative.

Many Board Certified Behavior Analysts (BCBA's) are also Ph.D. psychologists. The Code of Conduct of the American Psychological Association (2010) says, "For persons who are legally incapable of giving informed consent, psychologists nevertheless (1) provide an appropriate explanation, (2) seek the individual's assent, (3) consider such persons' preferences and best interests, and (4) obtain appropriate permission from a legally authorized person, if such substitute consent is permitted or required by law." That's good, but it's not enough. What they call "assent," this author calls "uninformed consent." Calling it assent gives it a secondary connotation. Under this code, psychologists are obtaining the consent of the authorized person, but when they seek the assent of the less capable subject, they do not have to "obtain" his" permission." They only try. If they don't get it, they can proceed without it.

When this author was a special education teacher, child study teams of teachers, parents, administrators, and therapists convened to approve individual education plans for students with disabilities. Parents participated in the meetings, but children were almost always absent, even if they were teenagers. The consent of the child rarely existed.

Fortunately, behaviorists can gain the consent of the consumers of their services even when they are trying to reduce the occurrence of unwanted behaviors. Three alternatives to coercive punishment are the DRI, the DRL, and the DRO.

DRI stands for differential reinforcement of incompatible behavior. Give a child a guitar (which contains its own reinforcement) and he cannot hit his classmates at the same time he is playing it. When the Policeman's Benevolent Association runs a basketball program for inner-city youth, they are reinforcing incompatible behaviors. Teenagers cannot spray graffiti and play basketball at the same time. For a discussion on the reinforcement of incompatible behavior, see the blog post on Slouching Punished by Noise. It said it's better to reinforce healthy posture with music than to punish unhealthy posture with noise.

The DRL is the differential reinforcement of low rates of responding. For example, an autistic child might flap his hands against a surface and cause his finger tips to bleed. If a therapist wants to reduce the frequency of this kind of stimming, then she can record the amount of time he's been doing it, and reinforce him for less frequent self-stimulation.

The third alternative is the differential reinforcement of other behaviors, the DRO, which theoretically reinforces everything but the problem behavior. In other words, the autistic boy's teaching staff can reward him for not flapping his hands. If he's been stimming his hands during story time, then a teaching assistant can read to him when he's not self-stimulating. She can pause the story when the hands start flapping and continue when they rest. They would know he automatically consented to his special time alone with the staff if the data revealed a reduction in the rate of hand flapping while they read him the story.

Gary LaVigna (2013, p. 3, #4), PhD, BCBA, signed "under pains and penalties of perjury" an affidavit of deposition for the case of Judge Rotenberg Educational Center v. Commissioners of the Department of Developmental Services and the Department of Early Education and Care that the consensus of Positive Behavior Support (PBS) behavior analysts was that coercive punishment is unnecessary. Fully-defined, multi-element structural systems of positive interventions can provide long-term solutions to challenging behaviors without the punitive use of force by teaching coping strategies, for example, to life's everyday aversive challenges such as doing the things we don't want to do. In their groundbreaking PBS work, Alternatives to Punishment, LaVigna and Donnellan (1986, p.8), differentiated between the necessity to manage crises to prevent injury and the need to use effective ABA techniques to solve unwanted behavior problems. Crises should be controlled using the most neutral, non-punitive, non-aversive stimuli possible, but this should not be considered a part of a comprehensive behavior reduction program using the wide-array of non-aversive techniques available to the behavior analyst. When a crisis subsides, there is no need, therefore, for coercive punishment in order to manage challenging behaviors.

Philosophers frequently talk about ethical dilemmas. When is it appropriate to force a child to stop harming himself when he doesn't agree with the method of force? Fortunately, however, dilemmas in behavior modification don't occur every day. I'd like to know why people do the wrong thing when there is no conflict of values. A more common problem occurs when an adult uses force against a harmless behavior she deems to be "inappropriate." For example, a parent might scold a child for sloppy eating. It would be better to praise him for holding his fork in a proper manner. If a child is satisfied flapping his hands and it causes him no injury, why should they force him to stop? Society should learn to welcome different kinds of responses. Unnecessary coercion is a bigger problem than an atypical ethical dilemma, such as what to do with a head-banging adolescent. So let's separate the forest from the uncommon species of trees. Let's not allow an exception to eliminate the rule. We should almost always seek the consent of the child or the disabled adult even though, in unusual circumstances, it is sometimes necessary to look out for his interest without his approval.

Furthermore, by defining consent as an objective form of verbal behavior, we can reinforce the consent-seeking behavior of the BCBA's we hire to "solve" the behavior "problems" of autistic children and people with other disabilities, such as attention deficit disorder (ADD), intellectual disabilities, oppositional defiant disorder, conduct disorder, or schizophrenia. Without a behavioral definition, how do we know what we're trying to modify? With one, we can make sure they obtain the dual consent of the child and the parent. School superintendents can hire BCBA's who promise not to use force. We can actually improve the behaviors of individuals whose job is to improve the behaviors of others. We can help them become more ethical.

On the Locus of Control, Autonomous Thinking Versus Factors in the Environment

A reader of an earlier draft of the first section of this paper said a one year-old baby cannot consent because his mind cannot reason. He doesn't possess a free and autonomous ability to decide what's best for himself. Here is the reply.

We don't need to examine thinking when we analyze behavior. A belief in autonomy is not necessary. We can study behavior in its natural surrounding. By accepting the possibility of determinism, we can engage the principles of behavior modification without appealing to inner causes of behavior.

Behaviorists know how to change behavior and ethicists can help us decide which behaviors we should alter. If the two fields could unite, they could sift out the harmful behaviors and fill the hourglass of time with the sands of constructive responses. Somehow it looks like the paradigm of behavioral control conflicts with the ethicists' bedrock principle of freedom. How can we reconcile the difference?

The National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research (1979) published the Belmont Report of Ethical Principles and Guidelines for the protection of human subjects of research. It called for the consent of subjects in behavioral interventions and based its recommendation on "respect for persons" as "autonomous" human beings. The Oxford Dictionaries Online defines autonomy as "freedom from external control or influence." An autonomous person is someone who generates his own thoughts, feelings, and behaviors without being influenced by any external environmental factors. The language in the report said "Respect for persons incorporates at least two ethical convictions: first, that individuals should be treated as autonomous agents, and second, that persons with diminished autonomy are entitled to protection.... Respect for persons requires that subjects, to the degree that they are capable, be given the opportunity to choose what shall and shall not happen to them. This opportunity is provided when adequate standards for informed consent are satisfied."

To the contrary, B.F. Skinner claimed that human behavior is determined by our genetic endowments, our previous experiences, and the stimuli in the current environment. In 1947 he said, "To have a science of psychology at all, we must adopt the fundamental postulate that human behavior is a lawful datum, that it is undisturbed by the capricious act of any free agent - in other words, that it is completely determined. (Skinner, 1999, p. 345.)"

So who is right, the commission or Skinner? Are we free and autonomous thinkers or not?

Skinner wasn't sure that human behavior is completely determined. He said we must adopt the "postulate" of determinism. The Merriam-Webster Online Dictionary defines a postulate as "a hypothesis advanced as an essential presupposition, condition, or premise of a train of reasoning." His doctrine was only an assumption. By 1947 he had only put animals in his experimental chambers. The operant conditioning of human subjects was off in the future.

Regarding animals, however, the evidence supported his argument. He discovered predictable patterns of response by manipulating reinforcement techniques. For example, when he withheld food from a rat after continuous reinforcement of one hundred lever presses, the cumulative record of its rate of response typically showed an extinction burst. After smoothing out for fluctuations and irregularities, Skinner drew an extinction curve showing that responses per hour initially increase, leveled off, and then diminished to its original, unconditioned low rate of response. Since lever pressing was predictable, he said it was controlled by the food, the box where he placed them, its apparati, and the emotional effect of the failure to reinforce (1938, p. 74-78). Here is a rough sketch of a typical extinction curve in the blog post, Rat Behavior Extinguished.

A chemist friend once told this author we will never know for sure whether or not we are free. He said we would need a computer bigger than the universe to account for all the possible locations of a random scattering of a group of electrons around and about the universe. Behaviorism looks for variables in the environment that change the probability of future occurrences of behavior, but an infinite number of variables can affect infinite combinations of behavior chains. We cannot possibly account for them all. In order to know if we are completely determined, we would need to know all the relevant variables, to measure their accumulated affects, and be able predict with complete accuracy what a person is about to do. Skinner never claimed in his groundbreaking book, The Behavior of Organisms (1938), that he could predict the exact size of the reserve of total responses elicited in an extinction burst. He also could not account for the irregularities in the hourly rate of response curve.

But Skinner was a pragmatist. He seemed to be saying, "We don't know with absolute certainty that we are determined, but it's useful to proceed as though we are." With determinism as our assumption, we can try to discover the laws of human behavior, if in fact they exist. When we assume determinism, we can search the environment for factors that can remedy behavior problems. He argued that man-made problems such as nuclear weapons, climate change, extreme wealth in the face of extreme poverty, and overpopulation in a world of limited resources demand that we learn how to modify behavior to improve the odds for the long-term survival of our species.

The cognitive approach to psychology is ineffective, he added, when we are trying to find solutions. When people assume that human behavior is generated by an inner, autonomous, thoughtful free will, then the investigation stops there and the true environmental causes of behavior remain undiscovered (see Skinner, 1974).

So let's present some hypothetical questions and contrast the differences between the internal cognitivists and the external behaviorists. For example, we might ask, "Why did that man go to that particular store instead of this other store?"

The cognitive psychologist might answer, "He thought it was a good idea to go to the store, he wanted to go, he liked it, he felt like going, or he was exercising his freedom to choose."

Mentalism is an assumption that a self-powered mind generates action independent of external causes, but we can't see his thoughts, so how do we know we’ve changed his mind? We can’t count them, we can’t measure them, and we can’t draw a line on a piece of graph paper that shows an increased rate of abstract ideas. According to Skinner, having an autonomous mind is an imaginary explanation. He said Freud's representation of the psychic energy flowing between "the ego, superego, and id as inhabitants of a psychic or mental world subdivided into regions of conscious, co-conscious, and unconscious mind," is "an elaborate set of explanatory fictions (1953, p. 375)."

On the other hand, a behaviorist might say, "He went to the store because he was reinforced by fresh produce every time he shopped there in the past. If the food was rotten, he wouldn't have returned. If the produce manager wants him to come back, she should care more about the quality of her fruit and less about his thinking. She can't read his mind and she can't change a mind she doesn't see, but she can chuck the bad apples to keep him coming back."

So the internal explanation doesn't tell us what to do. Only the external explanation of behavior provides a real solution to the problem of how to generate revenue in a produce market.

To take another example, we also might ask, "Why does a particular child on the playground hit his classmates while they are playing?"

A cognitive or a psychoanalytic therapist might answer, "He hits because he is an angry child, he has an aggressive tendency, he is a bully, he doesn't know the difference between right and wrong, he is a bad boy, he is undisciplined, or his id predominates over his superego."

"So what?" Skinner would say. These explanations only lead to further questions. "Why is he undisciplined, why is he aggressive, or why is he a bully?" Once they label him a bully, the investigation stops there. We have no idea how to keep him from hitting. They're not looking in the environment for potential solutions.

Alternatively, a Board Certified Behavior Analyst (BCBA) can perform a functional analysis by observing the child in the playground. The BCBA can record the "ABC's" of the situation, the "Antecedent" stimuli, the rate of hitting "Behavior," and the "Consequences" of the behavior. She might notice the teacher reprimanding the boy when he's hitting, but she's not removing him from the scene. Perhaps the teacher doesn't know that attention is a powerful reinforcer to an attention-starved child, even if it's criticism. The analyst might guess that the teacher is unwittingly reinforcing his aggression. She can test her hypothesis by instructing her to talk to him when he's doesn't hit and to tell him to go sit down on a bench away from the playground when he does. If the hitting response diminishes, they've nailed the problem.

So the explanation by way of inner causes doesn't solve anything. Only the analysis of behavior provides a solution.

Skinner (1953, p. 31) said it well:
When we say that a man eats because he is hungry, smokes a great deal because he has the tobacco habit, fights because of the instinct of pugnacity, behaves brilliantly because of his intelligence, or plays the piano well because of his musical ability, we seem to be referring to causes. But on analysis these phrases prove to be merely redundant descriptions. A single set of facts is described by the two statements: "He eats" and "He is hungry." A single set of facts is described by the two statements: "He smokes a great deal" and "He has the smoking habit." A single set of facts is described by the two statements: "He plays well" and "He has musical ability." The practice of explaining one statement in terms of the other is dangerous because it suggests that we have found the cause and therefore need search no further. Moreover, such terms as "hunger," "habit," and "intelligence" convert what are essentially the properties of a process or relation into what appear to be things. Thus we are unprepared for the properties eventually to be discovered in the behavior itself and continue to look for something which may not exist.
He did not deny the existence of thought. He called it a private event taking place under the skin, unobserved by everyone but the thinker himself. Yet that's not a problem for a behaviorist. It's not necessary to know what someone is thinking if our goal is to alter her behavior. He once said, given that A causes B and B causes C, we can conclude that A causes C without knowing anything about B. In other words, if a change in the environment causes a change in thinking, and a change in thinking causes a change in behavior, then we can conclude that a change in the environment causes a change in behavior. We don't need to know anything about the thought process involved.

So according to Skinner, it's useful to assume that human behavior is lawful because the principles we discover allow us to explain, predict, and control it through manipulations of the environment.

This author agrees with him that it's a good idea to proceed as though an independent mind was not the cause of our behavior. Cognitive psychology in the therapist's office might help lift us out of depression, but how can it stop the arms race? Behaviorism is more hopeful today than cognitive psychology and neurology if we want to solve our man-made international predicaments.

This author cannot comprehend how a nonphysical idea can physically cause a person to stand up and walk to the store, but if neuro-psychology could demonstrate that thinking was just an electro-chemical activity in the brain, he could accept its role in a causal chain of events. Skinner said that someday we might have the technology to observe what's happening inside the box. Today we are imaging the brain, but it's too soon to see if it will do us much good. Knowing the location of a thought in the brain doesn't solve the problem of warmongering politicians. We on the other hand as a people united through positive reinforcement with mass emails, demonstrations, contributions, and phone calls can get together en masse to diminish their aggressive behavior.

So this author is agnostic on the question of free will versus determinism, but he rejoices in the optimism of science and its ongoing discovery of relevant factors that allow us to explain, predict, and influence human behavior - but only if it's ethical. It must be rewarding and consensual.

Now here's the problem with the internal explanation of behavior as it relates to the overriding theme of this essay. In the end, parents and therapists use the autonomous, rational explanation of consent as an excuse to avoid seeking the consent of the child or the incapacitated disabled adult to a behavioral intervention. They don't have enough capacity to reason, the argument goes, so they cannot make good decisions. They are immature, inexperienced, and not yet emancipated. They shouldn't be given the right to determine their fates until they are free, independent, and grown up. This author has explained why the inner justification of behavior is unnecessary and impractical. He reasoned why children and disabled adults should be able to say, "Leave me alone." Viewing consent as an internal process blocks the people with less power from exercising their right to self-determination. Consent as a form of verbal behavior empowers them with a more ethical rationale to give them a voice in decisions that affect their lives.

An External Justification of Consent

Remember that the Belmont Report said that "respect for persons" is fundamental to behavioral research if its scientists are going to be ethical. They implied that people have value because they are free and autonomous beings. They are free to choose what will happen to them, so an investigation should not proceed without consent. Give them all the information they need to make autonomous, self-generated decisions and then they respects them as persons and have fulfilled their obligation to follow the consent procedure.

This author agrees with the commission that we should respect an individual and obtain his consent, but as he said before and he reiterates now, we don't need a belief in autonomy as our reason for granting consent. We don't need to assume a nebulous psychic ability of free will hidden deep inside a person that enables him to choose a behavior through an independent channeling of thought.

Instead we can appeal to the survival of the species to justify why we should respect our fellow human beings. In this era of diminishing resources and global threats to humanity it is crucial to respect one another. It's self-evident to me.

In conclusion, if we harbor any doubts, we can apply the golden rule of ethics. Everyone tends to consent to reinforcers and dissent from aversive stimuli. Even a baby can tell us if we are causing him some harm. Within reason, shouldn't we grant everyone the right to consent? Isn't that how we like it done to us?

People have told this writer that they are afraid of behaviorism. When behaviorism becomes more ethical, then the public will accept it and use it more often. Behaviorists are everyday people. When we reinforce them for actively seeking the consent of the disabled children whose behavior they modify, behaviorism improves. When ethics adopts behaviorism, then philosophers can strengthen the behaviors they recommend. Politicians are people too. We can motivated them with money and a pat on the back for doing a good job. With internet technology, ethical proscriptions, judicious use of human science, and the concerted activities of massive amounts of people, together we can improve the behaviors of the people we elect. We can inhabit a much better world.


American Psychological Association (2010). Ethical Principles of Psychologists and Code of Conduct. [Electronic version]. Retrieved September 20, 2011 from the American Psychological Association Web site:

Gonnerman, J. (2007). School of shock. [Electronic version]. Mother Jones. August 20, 2007, pp. 1-6. Retrieved September 17, 2011 from the Mother Jones Web site:

Hocutt, M. (2010). Morality: What in the world is it? Behavior and Philosophy, 38, 31-38. Retrieved December 31, 2012 from the Cambridge Center for Behavioral Studies website: U.S. National Institutes of Health PubMed Central database Web site:h ttp://

National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research. (1979). The Belmont report: Ethical principles and guidelines for the protection of human subjects of research. Retrieved August 19, 2011 from

Powell, J. & Azrin, N. (1968) The effects of shock as a punisher for cigarette smoking. [Electronic version]. Journal of Applied Behavior Analysis, 1, 63-71. Retrieved July 15, 2011 from U.S. National Institutes of Health PubMed Central database Web site:

Skinner, B. F. (1938). The behavior of organisms: An experimental analysis (1991 ed.). Cambridge, MA: B.F. Skinner Foundation.

Skinner, B. F. (1953). Science and human behavior (2005 internet ed.). Cambridge, MA: B.F. Skinner Foundation. [Electronic version]. Retrieved September 19, 2011 from the B. F. Skinner Foundation Web site:

Skinner, B. F. (1957). Verbal behavior (1992 ed.). Cambridge, MA: B.F. Skinner Foundation.

Skinner, B. F. (1974). About behaviorism (1976 ed.). New York: Vintage.

Skinner, B.F. (1999). Current trends in experimental psychology. In V. G. Laties and A. C. Catania (Eds.), Cumulative record (Definitive ed.) (pp. 341-59). Acton, MA: Copley Publishing Group. (Original work published 1947.)


  1. Skinner kept his own child in a box for 2 years. Enough said!

    Free will - no one knows how to define it and the permutations as you allude to, of human reaction are infinitesmal.

    By the same token, what else is being provided to young children, particularly children with 'severe' autism that comes close to helping them develop early learning skills?

    I suppose we need to think about why we define things like ABA as an 'intervention' to autism. What exactly is an intervention? Who are we to 'intervene' - instead we should, as parents and teachers, etc, be educating and helping, assisting, and celebrating all the wonderful children who have autism by developing our own understanding as much as possible, losing the judgements and 'fix it' mentality.

    Nature loves a vacuum and in lieu of other methods that can teach young children by breaking down tasks into small steps, ABA is one thing that presently fills that void.

    Unfortunately, ABA can be a world of money making, 'bad' practices, and charlatans as much as any thing else. Children are more than just 'behaviour' and ABA really does seem to suggest that autism is a nail, to which ABA is the only hammer.

    It's us that need the behaviour adjustment.

  2. After reading this I must say, wow! Why do more people not understand this? I still stand believing, perhaps in ignorance, that one day people will be able to view each other objectively. Not as people who are so divided in differences, but as people who are united in common ideas of peace, love, and most importantly tolerance. Tolerance, regardless of religion, gender, sexual orientation, etc... Thank you for the great read, I really enjoyed it!


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I am an advocate for people with disabilities certified to teach special education with a Master of Arts in Teaching. I am not a Licensed Psychologist or a Board Certified Behavior Analyst. When in doubt, seek the advice of an MD, a PhD, or a BCBA. My ability to analyze the ethics of ABA stems from the fact that I am disabled and ABA interventions are often done to people like me, which I voluntarily accept, but only when I alone am the person granting consent, and not a parent, sibling, guardian, or institution.