3.6 Assessment Case Lab: From Preference to Supervisor Report

Case setup

An RBT is assigned to support a clinic assessment session for a seven-year-old client. The supervisor has provided three tasks: run an MSWO preference assessment with six approved items, complete ten receptive-identification skill probes, and collect ABC data if the target behavior of dropping to the floor occurs. The supervisor reviewed the procedures earlier that week and remains available in the clinic. The caregiver will be present in the waiting area and may provide routine updates through the approved communication process.

The RBT prepares by checking the written procedures. The MSWO items are bubbles, crackers, a small puzzle, a spinning light, a stuffed character, and a short video clip on a clinic tablet. The plan says to present all items in a horizontal array, use a neutral choice instruction, provide 20 seconds of access to the selected item, remove the selected item from the next trial, and rotate remaining items. The skill probes require no prompts on the first opportunity and a five-second response window.

The ABC definition for dropping is torso or hips touching the floor from standing or sitting, excluding sitting in a chair or planned floor play.

Running the preference assessment

The RBT starts the MSWO. On the first trial, the client selects the tablet video, watches for 20 seconds, and then reaches toward it again after it is removed. The RBT records tablet selected first and notes the reach toward the removed item. The RBT does not put the tablet back into the array because the procedure says without replacement. On later trials, the client selects spinning light, bubbles, crackers, stuffed character, then puzzle. During the cracker access interval, the caregiver enters and says the client skipped breakfast.

The RBT records caregiver reported skipped breakfast according to workplace rules and tells the supervisor during handoff because hunger could affect edible preference.

A weaker RBT response would be to say the tablet is the reinforcer and should be used for every program. A stronger report is narrower: the client selected tablet first in the MSWO, reached toward it after removal, and completed the selection sequence. The supervisor can decide whether to test tablet access as a reinforcer, whether to repeat the assessment, or whether edible results were affected by the caregiver report.

Running skill probes

Next, the RBT runs ten receptive-identification probes with picture cards. The RBT presents three cards at a time as directed and says the planned instruction. The client independently selects the correct picture within five seconds on six trials. On two trials, the client touches two cards at once; the scoring guide says multiple selection counts as incorrect unless a self-correction occurs within the response window. On one trial, the client does not respond within five seconds. On the final trial, the RBT accidentally gives a gestural prompt by looking toward the correct card before the client responds.

The RBT scores the first six as independent correct, the two multiple selections as incorrect, the no response as no response, and the final trial according to the prompted or procedural-error rule in the assessment directions. The RBT does not hide the accidental prompt. Reporting the prompt protects the data. Supervisors need to know whether a response was independent, prompted, or affected by implementation error.

ABC event and handoff

After the probes, the RBT says it is time to walk to the table for a short matching activity that was already in the session plan. The client drops from standing to the floor, with hips and back touching the floor for 40 seconds. The RBT records the transition instruction as the antecedent, the dropping response using the operational definition and duration, and the consequence: RBT used the planned safety response, blocked the walkway, waited quietly for 10 seconds, then represented the transition direction when the client stood. The client walked to the table with no physical prompt.

The RBT does not write that the client dropped to escape. The RBT writes the sequence.

Supervisor handoff structure:

• Direct preference data: selection order, access intervals completed, reach toward tablet after removal.
• Context: caregiver reported skipped breakfast during the assessment.
• Skill probe data: six independent correct, two incorrect multiple selections, one no response, one trial affected by RBT gestural prompt or scored as directed.
• ABC data: transition demand, dropping for 40 seconds, planned response, return to transition.
• Questions: whether the prompted probe should be repeated and whether edible preference data should be interpreted cautiously.
• No independent recommendations: the RBT does not prescribe reinforcers, functions, or new goals.

This case lab shows how multiple assessment tasks can occur in one session without the RBT leaving scope. The RBT can be active, skilled, and clinically useful while still deferring interpretation. Good assessment work is not passive. It requires preparation, timing, neutral presentation, exact scoring, and honesty about deviations.

For study, practice identifying the best next RBT action in mixed scenarios. If an item is selected, record the selection and follow the format. If a skill response is prompted, score the prompt level. If a problem behavior occurs, use the operational definition and ABC sequence. If a caregiver shares relevant information, document it as a report and tell the supervisor. If the RBT makes an error, report it. In assessment, clean data are more valuable than perfect-looking data.