Peter Gerhard – OAR – MABA President

ABA and older learners (adults) with autism – what constitutes EBP?

 

•    Importance of valid research

o    Seeing is not believing

o    Correlation not causation – due to intermittent reinforcement schedules

o    A lot of people are not taking data

o    Refers to Penn and Teller

o    One in a million occurrences happen to 300 Americans each day just due to chance alone

o    As an ethical practitioner…

•    Nobody studies adults with autism –

o    We look at problem behavior

o    No one looks at adaptive behavior

o    Since it’s not a core problem – very little research

o    We need more information – we don’t know yet!

•    Publication hits increases exponentially – very few with autism and adults

o    More likely to be a descriptive or position papers as opposed to experimental

o    “If you’ve met one person with autism, you’ve met one person with autism” – Stephen Shore

•    Need to know lots about people to fund research

o    The rules don’t always apply

o    Expectations aren’t clear – different standards of competence

•    You need to become a conditioned reinforcer – if you are working with an adolescent/adult

o    There are dozens of people in their lives

o    Most of the time – adults go away – children will wait them out

o    Develop a positive relationship before working with a child

•    Nobody seems to go to college to work with kids with autism

o    To work with adults – do not need to be “highly qualified”  - standards end at the age of 22

•    Adult outcomes – (Masefshy, Williams, & Minshew, 2008)

o    Adaptive behavior is more important than academic skills

o    Is it more important to do a math worksheet or use the bathroom/cross the street?

•    Green, et al – despite high IQ – adaptive skills were limited. 

o    None were considered by their parents as competent

o    These skills are socially reinforced

o    Need to look at different contingencies

•    Howlin (2004) – IQ above 50 – 58% poor or very poor outcomes

o    “we need to do better”

•    Cederlund, et al (2008) – lower occupations and activities/friends

•     Ivey (2004) – expectations of parents

o    Safe from abuse and harm very high

o    Ranked that it would actually happen low on the list

•    High hopes, low expectations – teacher rankings (2007) – teachers are saying that good outcomes are less likely

o    We need to argue and increase what is possible

•    Using ABA as applied to competent adulthood

o    Socially important – most likely to be displayed

•    We need to program for generalization – general case programming, multiple exemplars

•    We can’t just be satisfied with behavioral reduction

•    The outside world – less contingencies out of the BA’s control

•    Telling people about autism to understand some of the idiosyncrasies

o    Contextual

•    We are not good at giving contextually appropriate reinforcement

•    Good at praise and head rubs

•    We fade but don’t replace with socially appropriate reinforcers

•    Master the skill that I expect to be reinforced to maintain the skill

•    We need to get better at real reinforcement

•    Intensity of instruction

o    DTT – 1000 trials

o    Functional skills – nowhere near 1000 trials;  no wonder why things aren’t mastered!

o    We don’t give sufficient opportunities for practice – social issues

•    Research on personal living skills

o    Discusses several studies from 1985-present

o    We can teach this stuff – BUT IS IT A PRIORITY?  What is socially valid?

o    Lou Brown – criteria of ultimate functionality – if the child doesn’t know how to do it,  will someone have to do it for them?

•    Independence protects children instead of taking a chance!

o    Set the standards high!

o    Expand our instructional behavior to the community at large to respond to our kids!

•    Under-researched areas

o    Sexuality – teaching kids with autism to be sexually safe – no intervention studies

o    Except menstrual care and names of body parts – “private parts”

•    So everything else is public parts and behavior there is OK?

o    Stokes, Newton, & Kaur (2007) – AS often don’t understand appropriate courting behaviors

•    Prison system a real possibility

o    Adaptive behavior and incarceration – often in JJ

o    JJ not a safe place for AS

•    If we know how, how come our outcomes are poor

o    Focus on production

o    Three components – ADD THIS INTO 414 NEXT SEMESTER

•    Production – what to do

•    Social – wait, social mores, social rules

•    Navigation – find things to produce

o    If you just teach “skills”, you are missing the boat

o    We often teach skills  that are easy or safe or both

•    Very few skill excesses that the community cannot be taught to accept except:

o    AGG/SIB

o    Inappropriate Eating

o    Inappropriate Toileting

o    Inappropriate Sexual behavior

o    Age inappropriate clothing and hygiene

•    What are our priorities?

•    Yet we focus on”

o    Assembly, sorting

o    Shoe tying/dusting

o    Money concepts/purchasing skills

o    School based activities v community based activities

o    Nonfunctional academics

•    EBP – teaching inconsequential skills well is not better than teaching essential skills poorly

o    If you need a maintenance skill book – students aren’t using them in the real world

•    After 10 years of age – intensity of instructions decrease

•    We focus on the wrong contingencies

o    We fall under the same contingencies as our students

o    Reinforcement of absence of problems is often our greatest motivator

o    Train the community and look at the community contingencies

•    Read outside the literature based

o    ABA Beyond JABA

o    Same skills, different names

o    Emotional intelligence literature can influence behavior analysis

•    Skills

o    Necessary – skills upon which social survival/independence may depend

o    Preferred –skills that support independence but may not be critical

o    Marginal – skills that, while valuable, may be negotiable

•    Look at response efficiency

•    Find a way to “get around the boulder”

o    Don’t get stuck

o    Bluetooth technology – allows for prompting

•    Usually verbal prompting

•    Allows for more independent functioning

•    Reduces stigma

•    Increased social validity

•    Shows a very good set of data - agg

o    Follow-up

o    Supported with less money

o    Volunteers

o    Goes out to lunch

o    Joined a gym

o    Works with a wide number of staff

o    Agg decreased

•    ABA is a very long path – throughout the lifespan