Topics in ABA: The Controversy and the Research
As practitioners it is our ethical responsibility to listen to autistic self-advocates and adjust our practice to ensure that we are implementing protocols that are both evidence based and compassionate.
The Ethics Code for Behavior Analysts requires that BCBAs actively “engage in professional development activities to acquire knowledge and skills related to cultural responsiveness and diversity (1.07). Another founding principle is that our field is applied meaning that we must start with the question “How immediately important is these behaviors or these stimuli to my subject?” (Baer, Wolf, & Risley, 1968).
We also have a responsibility to provide effective treatment to our clients. This means that we rely on evidence based procedures to support behavior change.
How do practitioners and autistic self-advocates collaborate to provide better, more ethical services for children? What behaviors do we target? What other services may be appropriate as part of a treatment package? What skills are fundamental to implementing behavior intervention services with autistic learners?
Address Ableism
To move forward in our field in a meaningful way, we need to be able to identify instances of ableism and respond appropriately. This includes recognizing your own internalized ableism as a practitioner. If your unsure where to start, There are a number of books, articles, podcasts, etc. that are available for you to educate yourself. If you work with children with disabilities, it is critical that you are aware of the bias that your clients face and that you reckon with your own assumptions, attitudes, and beliefs.
In order to select targets as a professional you MUST reflect on your attitudes and beliefs about what a person should know and how a person should behave across settings. How important are the skills you are teaching to your learner? Are you trying to improve their quality of life, or are you focusing on making the people around them more comfortable? We all adjust our behavior to some extent when we’re around others (e.g. I would not cough in someone’s face or blast my music loudly while in a waiting room). We teach our children to sit at a table in a restaurant instead of climbing or running around, but at what point does teaching socially expected behavior conflict with our responsibility to work on behalf of the interests of our clients?
Stay Current
Research is constantly evolving and it is our ethical responsibility to evolve our practice with it. That doesn’t mean that you should abandon any established intervention as soon as it is questioned; however, we do have a responsibility to accept feedback and identify both the benefits and harmful effects of a given strategy.
Extinction is a strategy that is well-researched; however, it is also associated with heightened emotional responding. We know well that an extinction burst is expected. While research has demonstrated that differential reinforcement + extinction are effective, there is a growing body of research demonstrating alternatives to extinction that are effective at reducing problem behavior. For example in 2017, Phillips et al. used non contingent reinforcement to reduce problem behavior in 14 of 15 participants whose behavior was maintained by social reinforcement.
Understand the Discussion
Behavior analysts and RBTs should be aware that the puzzle piece is not widely used by autistic self-advocates and can be seen as a suggestion that there is something “missing.” Another issue is that puzzles can be associated with young children. You need to understand that Autism Speaks is controversial because of its focus on a “cure” for autism, and the lack of representation by autistic individuals on the board. The color blue is actually associated with this organization, and “light it up blue” isn’t necessarily the best way to show your support for or acceptance of your autistic loved ones. I’m actually not sure whether I should have chosen this theme for my website, but I genuinely like the color palette.
Another area for reflection is how we talk about the spectrum. “High functioning” and “low functioning” give the impression that ability can be stretched out into a straight line where you have “nearly normal” on one end, and “very disabled” on the other. This is clearly problematic and not true to real experience.
What does this mean for practice?
At the end of the day, practitioners want to help people. We entered this field because we saw that we could have a profound and positive impact on people’s real lives, and that is what we live for. So how do we proceed? Remain curious. Remain engaged. Listen. Educate yourself and educate others. Own up to your mistakes. Do better next time.
References:
Baer, D. M., Wolf, M. M., & Risley, T. R. (1968). Some current dimensions of applied behavior analysis. Journal of Applied Behavior Analysis, 1(1), 91–97. https://doi.org/10.1901/jaba.1968.1-91
Behavior Analyst Certification Board. (2020). Ethics code for behavior analysts. https://bacb.com/wp-content/ethics-code-for-behavior-analysts/
Phillips CL, Iannaccone JA, Rooker GW, Hagopian LP. Noncontingent reinforcement for the treatment of severe problem behavior: An analysis of 27 consecutive applications. J Appl Behav Anal. 2017 Apr;50(2):357-376. doi: 10.1002/jaba.376. Epub 2017 Feb 8. PMID: 28177118; PMCID: PMC8793041.
