Autism & ABA

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The National Autism Center’s National Standards Report

There is more to understanding behavior than an analysis of antecedent-consequence contingencies.
Human behavior occurs as a function of complex psychosocial variables. An individual’s behavioral repertoire in critical environments is shaped by relationships, which develop within interpersonal and larger milieu contexts. Issues of trust, autonomy, and control often play a defining role and therefore need to be part of behavioral assessment for individuals of any age. We should also not forget that socio-cultural models shape behavior in subtle ways such that we cannot be limited to understanding behavior merely as a function of access/obtain or escape/avoidance. ABA has made a great contribution to the understanding of human behavior by demonstrating the socially mediated function of reinforcement contingencies, but let’s remember that human behavior involves relational variables that do not exist in the social life of rats and pigeons. Human behavior in relationship can also be understood by way of psychological insight and empathy, and at times modified more effectively by practitioners who are observationally attuned to the diversity of temperament and milieu.

Although a great deal of lip service is given to Skinner’s acknowledgement of internal events, current ABA research does not address this aspect of his work to any significant degree. We can all be grateful to Jack Michaels for elaborating the role of Motivating Operations (Establishing and Abolishing) but the internal events commonly referred to are typically viewed in terms of deprivation and satiation. For the sake of treatment efficacy it behooves us to therapeutically engage operationally challenging internal events such as anger, sadness, and self-esteem (summarily dismissed by many prominent ABA teachers). Real world behavior analysts deal with individuals in context, their thoughts and feelings, their families, social circumstances and challenges, as well as the politics of community care. It is perhaps regrettable that the aforementioned variables and the implications thereof rarely accommodate experimental control. But let’s face it: a great deal of work in the developmental disabilities field involves situations that are very much out of anyone’s direct control. Nevertheless, even the most challenging behaviors and difficult environments can be managed by using common sense and Contextual Analysis in the application of ABA principles.

In supporting families whose children have an ASD diagnosis, intervention plans and teaching methods involve both tutors and BCBAs. The situation is initially somewhat like a blind date, with total strangers showing up and entering family homes. While a definitive Functional Assessment is the centerpiece of support plans, there are considerations of temperament, timing, the stress of deployment (for military families), sibling interactions, parenting styles, severity of challenging behavior, BCBA attitudes and orientation, insurance mandates, and a host of other unpredictable variables. For a BCBA to be effective in this environment, interpersonal skills, maturity, fluid communication and social awareness are a must. Establishing positive rapport with family members and communicating ABA principles skillfully are essential to effective treatment and positive outcomes. This is particularly true in residential care where one often encounters diverse cultures, values, and belief systems, as well the common refrain: We’ve already tried that, and it doesn’t work!

While genetic research and brain science appear to hold some future promise, there is no magic bullet on the horizon to cure autism. There is nevertheless a continuous promotion of dietary remedies and biomedical proselytizing that creates false hopes for families who are more often than not desperately seeking help. Therefore families and professionals alike are advised to refer to the work of the DPDC** and the National Standards Report of 2009 which lists the established and emerging evidence-based treatments for autism. The eleven “established” treatments are grounded in ABA principles, so there is no need to quibble about their relative efficacy.

ABA has been rightfully acknowledged as the treatment of choice for autism related disorders, but it does not have to exist in a self-created bubble, apart from the larger body of psychological research and psychotherapy. The evolution of Dialectical Behavioral Therapy and Acceptance and Commitment Therapy are evidence of this. Reaching targeted behavioral and adaptive living skill objectives are important for autistic individuals, but we need to create a larger roadmap for a more enjoyable life based on a deeper understanding of who they are and what makes them happier human beings. While we are shaping behavior, let’s not forget the person, who is so much more than their target sheet or intervention plan.

**National Professional Development Center for Autism