A Survey of Why and How Clinicians Change Reinforcers during Teaching Sessions

Morris et al. (2024) sent an anonymous survey to BCBAs. They asked how often and why clinicians swap reinforcers mid-session.

The survey captured real-time choices: Do you wait for a mand? Watch for eye gaze? Toss the item the moment it’s rejected?

Most respondents said they change reinforcers ‘frequently.’ They rely on momentary client cues, not on formal re-assessment data.

Top triggers: a spontaneous mand, a glance toward a new item, or the learner pushing the current item away.

Hoffmann et al. (2024) showed teachers only boosted token delivery after a structured PDC-HS assessment. Morris finds clinicians skip that step and decide on the fly. The two studies sit side-by-side: teachers need a formal tool, while BCBAs trust in-the-moment judgment.

Robinson et al. (2019) proved that letting tokens accumulate beats frequent swaps for kids with ADHD. Morris shows clinicians still swap often. The papers don’t clash; they highlight a gap—what works in controlled studies versus what happens in real rooms.

Blackman et al. (2025) used the same anonymous-survey method to map BCBA burnout. Together the surveys sketch a busy practitioner who juggles reinforcers and job stress at once.

If you change reinforcers on the fly, you are the norm, not the outlier. Build one-minute mand-based choice probes into your session plan. They give you the data to back up your gut and keep you from flying blind when the next supervisor asks, ‘Why’d you switch?’