A field closely related to psychology, behaviour analysis is the science of understanding behaviour and how its learning and occurrence are influenced by the environment. In short, it’s using science to understand and change how we behave.
“People see the bruises, scratches, and things like that on me, they think, ‘Oh my gosh, the work must be so difficult’, but honestly, that’s part and parcel of the job,” says behaviour analyst Jolyene Leow.
Leow’s journey as a behaviour analyst began when she volunteered to work with children in the first year of her degree – a BSc in Psychology with Clinical and Health Psychology from Bangor University.
For three years, Leow would spend time at the after-school play club attached to the university.
She worked with children who had different profiles of needs, such as difficulties with communication and requesting, challenging behaviours like pica (compulsively eating non-food items), aggression, and self-injurious behaviours.
“Interestingly, I think that’s the first time I met a child with autism,” says Leow. “I’ve never really heard the word ‘autistic’ before that.”
Born and raised in Malaysia, Leow recalls never truly learning about autism during her time in the Southeast Asian nation’s public schools.
Ultimately, the volunteering experience opened up a new path for her to focus her future on: Applied Behaviour Analysis.
This master’s programme by the University of Galway looks at how principles of behaviour analysis are applied in the real world to support learning and improve the quality of life for various people, especially those affected by developmental disabilities.
During her two-year programme, Leow’s placements had her working with young adults for the first time and children with autism and/or learning disabilities.
She also worked in Malaysia for a certain time due to Covid-19 restrictions and the need to complete her placement hours.
Since then, Leow has successfully completed her master’s programme and has earned her Board Certified Behaviour Analyst (BCBA) certification from the Behaviour Analyst Certification Board.
From working at a special needs school with children below 12 to pivoting to the UK’s National Health Service (NHS) focusing on those aged 18 and over, Leow shares her insights on what it means to work as a behavioural analyst.
What does working as a behaviour analyst with the National Health Service entail?
Behaviour analysts are referred to if an individual presents with challenging behaviour within their community or home. We’re an objective science, and our practices are evidence-based.
So, we first define the behaviour. What does it look like? Who is it impacting? When and where does it happen? What are the risks to themselves and others?
We continue our assessment by speaking to the people around the individual (or themselves, if they are able to), arranging observations, and just really getting to know the individual first.
Challenging behaviour is usually a way for an individual to communicate that their needs are not being met. This is provided that their mental health state is stable, which is why we have psychiatrists on the team as well who will do their own assessments. We are a multi-disciplinary team that consists of different certified professionals such as occupational therapists, speech and language therapists, nurses, and physiotherapists.
Once a physical and mental health assessment has been completed, we give our individualised support based on the assessment and monitor the effects of it.
This comes in many ways, like training the people directly supporting the individual or even intervening when the individual’s environment (such as the residence and people) is simply not suitable for them to continue to be in. In adulthood, we very much focus on the individual’s quality of life.
Why did you pursue your career in the UK instead of Malaysia?
When I was in the middle of my master’s, the BACB made a ground breaking announcement that they were no longer going to certify analysts living outside of the US and Canada in 2023.
For me, not having the certification wouldn’t be the end of the world, but it was something that I wanted to work towards since I first began working in this field.
This was important to me because when I was in Malaysia during my placement, I had a couple of disputes with how things were run, especially with the different parenting/teaching styles of those in the UK versus those in Malaysia.
Plus, I felt like there was just a lot more that needed to be learned to establish my own values and ethical practices. Therefore returning to a country where the practice is more known and regulated was a better choice for me.
So, I really wanted to return to the UK and get certified to get a better idea of the values I stand for and the kind of practitioner I wanted to be as well.
Certification is crucial for the kind of work we do, and I’m happy and excited that Malaysia is recognising this need! If anyone’s interested, I recommend checking out the Malaysia Association of Behaviour Analysis – I used to be involved with them and it really is a good step for Malaysia in the right direction.
Those in the UK can check out the UK Society for Behaviour Analysis instead.
What is the hardest part of the job as a behaviour analyst at the NHS?
Facing things like barriers to effective healthcare or effective care support.
Whenever I discharge someone, I think, “Who’s to say they’re not to be referred back again in six months?” I can only do so much in my position – the more time I spend with someone, the longer someone else waits on the waiting list. If they have challenging behaviours, then there’s a risk to themselves and the people around them.
I can write plans, monitor, and offer training to the support network around my client, but who’s to assure that they are going to keep up with that regime? Who’s to ensure that they are going to be consistent in all seasons?
I think that’s the toughest part of my job. It’s not being sure when barriers to effective healthcare and support, like financial aid or further awareness and understanding of learning disabilities, will cease to exist.
One comical example of improving awareness around me is when I first started my work. I used to have loads of cuts and bruises from kids biting, hitting, kicking, and scratching.
I would show them to my mum to freak her out, and she would go, ‘Are you sure you want to pursue this career?’ But now she’s on the sense of, like, ‘Aha, you weren’t fast enough, weren’t you?’ or ‘Oh, you’re too slow,’ which shows that she has normalised this to it being part of the work I do.
So, yeah, awareness and further understanding is a big thing that needs to be worked on too, on a much larger scale.
Do you get physically hurt often as a behaviour analyst?
In certain jobs, you’re equipped with training. For us behaviour analysts, it’s often to de-escalate or to break away from situations like that.
But personally, these physical altercations were never something that bugged me.
I think you need to come from a place where you understand the root of someone’s behaviour and presentation – understand that this is how they’re trying to communicate.
Don’t get me wrong — I’ll get mad at the kids sometimes, especially the ones who can verbally communicate. But at the end of the day, I find that their behaviour is a reflection of their environment.
We never say “change the kid”; we say “change the behaviour.” With that, we change the environment because any behaviour is an occurrence of the effect of the environment that’s acting on them, and we are part of the environment.
What is the most fulfilling part about being a behaviour analyst?
I’m really passionate about this community, and I do enjoy working with them, especially when you see the end result of your work – I say “end” but it might not necessarily be the actual end of the work though. Still, I guess that is what fulfils me and drives me to do what I do.
When I came to London and worked in my first job, I was put together with a boy who would scratch all over me. He gave me one of my deepest and worst scratches of all time. I realised that scratching was just a way for him to say, “look at me,” so I started teaching him to call people’s names.
One and a half years later, he’d come in and say, “Jolyene, Jolyene, come follow me,” and even call the names of the other staff. That’s as far as his communication goes. We found out the function of the behaviour was scratching to access adult interaction, so we taught him an alternative behaviour that’s effective for him and doesn’t cause harm to us.
So yeah, I guess the fulfilling part of the work is seeing the end result, especially when you’re working for the better of people.
I also find that if you’re in this field, or maybe healthcare in general, everyone’s just really lovely. I’ve made some of the best relationships here because we’re all facing this adversity together. We may not get paid the best despite working so hard, but everyone just has a genuine interest in the field.