Behavior Modification http://bmo.sagepub.

com/

More Contributions of Applied Behavior Analysis to the Education of People with Autism
Beth Rosenwasser and Saul Axelrod Behav Modif 2002 26: 3 DOI: 10.1177/0145445502026001001 The online version of this article can be found at: http://bmo.sagepub.com/content/26/1/3

Published by:
http://www.sagepublications.com

Additional services and information for Behavior Modification can be found at: Email Alerts: http://bmo.sagepub.com/cgi/alerts Subscriptions: http://bmo.sagepub.com/subscriptions Reprints: http://www.sagepub.com/journalsReprints.nav Permissions: http://www.sagepub.com/journalsPermissions.nav Citations: http://bmo.sagepub.com/content/26/1/3.refs.html

>> Version of Record - Jan 1, 2002 What is This?

Downloaded from bmo.sagepub.com at UNIV FEDERAL DE JUIZ DE FORA on November 6, 2013

Rosenwasser, BEHAVIOR MODIFICATION Axelrod / MORE CONTRIBUTIONS / January 2002

More Contributions of Applied Behavior Analysis to the Education of People With Autism
BETH ROSENWASSER SAUL AXELROD
Temple University

This is Part 2 of a two-part special series on contemporary behavioral contributions to helping people with autism and their families (see Behavior Modification, October 2001). As the approach to autism with the most comprehensive and extensive research (Matson, Benavidez, Compton, Paclwaskyj, & Baglio, 1996), applied behavior analysis (ABA) has branched beyond the now classic longitudinal study by Ivar Lovaas and his colleagues at the University of California, Los Angeles (Lovaas, 1987). The researchers demonstrated that early, intensive, and language-focused behavioral education led to profound differences in IQ and degree of inclusion in mainstream educational settings as compared with two control groups. Subsequent investigation has focused on specific strategies for improving language and social skill acquisition, successfully mainstreaming children with autism, working with teens and adults, and vocational preparation, as well as curriculum sequencing, staff training, cost-effectiveness, and the dimensions of service delivery such as frequency and duration. As a whole, ABA has the best documented outcome data supporting their approach as compared with other methods (Jacobson, 2000). In addition, ABA has emerged with widespread recognition beyond the limited community of academic and behavioral psychologists and special educators. For example, ABA was recently recognized by the Surgeon General of the United States as the treatment of choice for autism in his mental health report for children (Department of Health and Human Services, 1999).
BEHAVIOR MODIFICATION, Vol. 26 No. 1, January 2002 3-8 2002 Sage Publications

BEHAVIOR MODIFICATION / January 2002

Showcasing both review articles and original research that go beyond Lovaass original work, this two-part series updates readers with a total of 10 offerings by highly recognized researchers and practitioners working within the behavior analytic paradigm. A brief review of the contents of Part 1 begins with Pelios and Lunds (2001) selective overview of several topics in autism organized around the difficulties of diagnostic classification due to heterogeneity in symptomatology, causation, and etiology, and significant variance in response to intervention. Taking an integrative approach, they present etiological conceptualizations from cognitive neuroscience and neuropsychology and move on to highlight key aspects of early behavioral intervention. Sundberg and Michael (2001) review the strengths and limitations of behavioral approaches to language acquisition and provide a detailed and well-referenced conceptualization of the benefits that may accrue when autism language training programs make increased use of Skinners (1957) functional approach to verbal behavior. In this beautifully written article, readers will gain a clear understanding of Skinners unique way of understanding language through the example of autism. Bondy and Frost (2001), the developers of the well-known Picture Exchange Communications System (PECS), provide a specific example of a functional, socially based approach to teaching language to people with limited speech. In this article, they present their protocol and report research supporting its use. Reflecting the general trend in special education, ABA emphasizes the placement and teaching of children with disabilities in integrated environments. Koegel, Koegel, Frea, and Fredeen (2001) present a data-based, natural observational study of five children with autism and compare them with their typically developing peers in an inclusive setting. Specifically addressing the social skills deficits that inhibit children with autism from benefiting from integrated environments, they help dispel the myth that ABA treatment targets academic and language acquisition, but not social-emotional needs (as do several other articles in this special series). Harrower and Dunlap (2001) continue this theme with a comprehensive review of the research support and empirically supported ABA strategies available for facilitating the progress of children with autism in inclusive settings. Concluding Part 1, Weiss and Harris (2001) examine behavioral, social,

Rosenwasser, Axelrod / MORE CONTRIBUTIONS

and emotional skills training across the life span, many of which are specifically relevant to use in inclusive settings such as the use of scripts to increase social initiations, self-management strategies, and class-wide interventions. In this issue (Part 2), four more exceptional contributions demonstrate both the continuity and the diversity of ABA development relevant to people with autism. Help for adults with autism, an often neglected topic of interest to professionals and family members alike, is addressed by McClannahan, MacDuff, and Krantz, who have developed and run a successful private school for children with autism. Here they present their model for adult follow-up programming. Although they draw on the same behavioral principles that have been successful with children, including comprehensive, intensive, and individualized curricula, they also emphasize the need for a wider range of options to respond to the diversity of skills seen among adults with autism. Discussing their methods of program evaluation, they also report outcome data on the employment of their adult program participants: A full 93% have had some supported employment, and 73% have held supported employment for a majority of their participation in the program. This is encouraging, given the low rates of employment (50% to 75%) generally found among people with developmental disabilities (Wehman, 1992). Another area of progress for ABA treatment of autism involves the development of more effective ways to disseminate effective ABA interventions. Meeting the increased demand for services and well-trained practitioners created by heightened public recognition of ABAs benefits requires more scalable training programs. The field of ABA has begun to systematize training and certification of practitioners competent enough to implement this broader range of interventions. In this issue, Shook, Alai-Rosales, and Glenn identify key areas for training practitioners at various levels and discuss the importance of increased professionalization of ABA service provision. Credentialing, and perhaps in the future licensing, was initiated as a joint response to professional behavior analysts, agencies within several state governments, and parents who rightfully desire a way to determine if the treatment that their family member is receiving is what has been empirically supported by competent professionals. During

BEHAVIOR MODIFICATION / January 2002

Lovaass early work, he and other practitioners trained all of their own staff. Today, in several states, many autism programs and parents of autistic children have the advantage of being able to hire staff with solid training in basic behavioral principles and procedures, which may then be tailored to recipients. What a benefit for people with autism, as well as the field of ABA. Finally, this issue features two original research studies: One is a groundbreaking empirical group comparison controlled study by former students of Lovaass, Smith and Eikeseth, and their colleagues, Jahr and Eldevik; the other is a painstakingly detailed quantitative single case study conducted by a leader in the field, Gina Green, and her colleagues, Brennan and Fein. The group comparison study led by Eikeseth, Smith, Jahr, and Eldevik builds on Lovaass demonstration that early, intensive intervention is critical to developmental progress by comparing the effects of 1 year of intensive behavioral treatment with the same dosage of eclectic treatment on 4- to 7-year-olds. They found that ABA, rather than eclectic treatment, produces superior outcomes on standardized tests. This is critical because although we currently see increased public and private sector funding and recognition of the importance of intervening early and intensively, the expense of 40 hours of weekly treatment calls for increased interpretation and justification: This study helps clarify that specific aspects of behavioral treatment account for the increased success of its recipients. In a very different type of research, Green, Brennan, and Fein give us a detailed account of a successful, very early, intensive ABA intervention for a child at high risk for autism. In this study, intervention began at age 1 year, 2 months and continued through 4 years, 11 months, although at decreasing intensity as warranted by ongoing assessment. The article is informative, even to seasoned practitioners. First, it reviews the ideal strategies common to behavior analytic early intervention programming. Second, it convincingly uses an instructive range of both standardized and typical individualized behavioral dependent variables measured before, during, and after interventions. Third, as it should, the study shows how these data were used for educational decision making. Finally, the article states the roles and educational backgrounds of the various people involved in helping this young girl and details the settings in which treatment took place. The

Rosenwasser, Axelrod / MORE CONTRIBUTIONS

outcomes should be inspiring for parents, direct staff, and consultants alike. Despite the progress being made, much remains to be learned about autism, from its etiology to successful interventions for the diversity of needs of people with autism spectrum disorder. In this search, we encourage those working in the field to employ a range of research designs, each relevant to the questions needing answers. Many do not realize that although behavior analysts have a strong theoretical base with highly developed conceptualizations of behavior and basic animal and human research to support it, we are above all pragmatic and empirical. This means that we strive to practice what is actually demonstrated to be effective through quantitative research. As more attention is given to the needs of people with autism, it is imperative that energy not be wasted within or among behaviorists and other helping orientations on theoretical arguments. In the end, testimonials and strongly held beliefs do not help people; rather, painstaking research using quantitative case studies, typical ABA within-participant designs, and controlled group designs will be what actually leads to useful strategies for people with significant initial differences who need skills to navigate the world.

REFERENCES
Bondy, A., & Frost, L. (2001). The picture exchange communication system. Behavior Modification, 25, 725-744. Department of Health and Human Services. (1999). Mental health: A report of the surgeon general. Rockville, MD: Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Mental Health Services, National Institutes of Health, National Institute of Mental Health. Harrower, J. K., & Dunlap, G. (2001). Including children with autism in general education classrooms: A review of effective strategies. Behavior Modification, 25, 725-744. Jacobson, J. W. (2000). Converting to a behavior analysis format for autism services: Decision-making for educational administrators, principals, and consultants. The Behavior Analyst Today, 1 (3), 6-16. Available from http://www.behavior.org Koegel, L. K., Koegel, R. L., Frea, W. D., & Fredeen, R. M. (2001). Identifying early intervention targets for children with autism in inclusive school settings. Behavior Modification, 25, 745-761. Lovaas, O. I. (1987). Behavioral treatment and normal intellectual and educational functioning in autistic children. Journal of Consulting and Clinical Psychology, 55, 3-9.

BEHAVIOR MODIFICATION / January 2002

Matson, J. L., Benavidez, D. A., Compton, L. S., Paclwaskyj, T., & Baglio, C. (1996). Behavioral treatment of autistic persons: A review of research from 1980 to the present. Research in Developmental Disabilities, 17, 433-465. Pelios, L. V., & Lund, S. K. (2001). A selective overview of issues on classification, causation, and early intensive behavioral intervention for autism. Behavior Modification, 25, 678-697. Skinner, B. F. (1957). Verbal behavior. Acton, MA: Copley. Sundberg, M. L., & Michael, J. (2001). The benefits of Skinners analysis of verbal behavior for children with autism. Behavior Modification, 25, 698-724. Wehman, P. (1992). Transition for young people with disabilities: Challenges for the 1990s. Education and Training in Mental Retardation, 27, 112-118. Weiss, M. J., & Harris, S. L. (2001). Teaching social skills to people with autism. Behavior Modification, 25, 785-802.

Beth Rosenwasser, Ed.M., B.C.B.A., is a doctoral student in educational psychology at Temple University. Saul Axelrod, Ph.D., is a professor in curriculum, instruction, and technology in education at Temple University.