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2002 26: 3Behav ModifBeth Rosenwasser and Saul Axelrod

More Contributions of Applied Behavior Analysis to the Education of People with Autism  

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BEHAVIOR MODIFICATION / January 2002Rosenwasser, Axelrod / MORE CONTRIBUTIONS

More Contributions ofApplied Behavior Analysis to

the Education of People With Autism

BETH ROSENWASSERSAUL AXELROD

Temple University

This is Part 2 of a two-part special series on contemporary behav-ioral contributions to helping people with autism and their families(see Behavior Modification, October 2001). As the approach to autismwith the most comprehensive and extensive research (Matson,Benavidez, Compton, Paclwaskyj, & Baglio, 1996), applied behavioranalysis (ABA) has branched beyond the now classic longitudinalstudy 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 profounddifferences in IQ and degree of inclusion in mainstream educationalsettings as compared with two control groups. Subsequent investiga-tion has focused on specific strategies for improving language andsocial skill acquisition, successfully mainstreaming children withautism, working with teens and adults, and vocational preparation, aswell as curriculum sequencing, staff training, cost-effectiveness, andthe dimensions of service delivery such as frequency and duration. Asa whole, ABA has the best documented outcome data supporting theirapproach as compared with other methods (Jacobson, 2000). Inaddition, ABA has emerged with widespread recognition beyond thelimited community of academic and behavioral psychologists andspecial educators. For example, ABA was recently recognized by theSurgeon General of the United States as the treatment of choice forautism in his mental health report for children (Department of Healthand Human Services, 1999).

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BEHAVIOR MODIFICATION, Vol. 26 No. 1, January 2002 3-8© 2002 Sage Publications

Showcasing both review articles and original research that go beyondLovaas’s original work, this two-part series updates readers with atotal of 10 offerings by highly recognized researchers and practitio-ners working within the behavior analytic paradigm. A brief review ofthe contents of Part 1 begins with Pelios and Lund’s (2001) selectiveoverview of several topics in autism organized around the difficultiesof diagnostic classification due to heterogeneity in symptomatology,causation, and etiology, and significant variance in response to inter-vention. Taking an integrative approach, they present etiological con-ceptualizations from cognitive neuroscience and neuropsychologyand move on to highlight key aspects of early behavioral intervention.Sundberg and Michael (2001) review the strengths and limitations ofbehavioral approaches to language acquisition and provide a detailedand well-referenced conceptualization of the benefits that may accruewhen autism language training programs make increased use of Skin-ner’s (1957) functional approach to verbal behavior. In this beautifullywritten article, readers will gain a clear understanding of Skinner’sunique way of understanding language through the example ofautism. Bondy and Frost (2001), the developers of the well-knownPicture Exchange Communications System (PECS), provide a spe-cific example of a functional, socially based approach to teaching lan-guage to people with limited speech. In this article, they present theirprotocol and report research supporting its use.

Reflecting the general trend in special education, ABA emphasizesthe placement and teaching of children with disabilities in integratedenvironments. Koegel, Koegel, Frea, and Fredeen (2001) present adata-based, natural observational study of five children with autismand compare them with their typically developing peers in an inclu-sive setting. Specifically addressing the social skills deficits thatinhibit children with autism from benefiting from integrated environ-ments, they help dispel the myth that ABA treatment targets academicand language acquisition, but not social-emotional needs (as do sev-eral other articles in this special series). Harrower and Dunlap (2001)continue this theme with a comprehensive review of the research sup-port and empirically supported ABA strategies available for facilitat-ing the progress of children with autism in inclusive settings. Con-cluding Part 1, Weiss and Harris (2001) examine behavioral, social,

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and emotional skills training across the life span, many of which arespecifically relevant to use in inclusive settings such as the use ofscripts to increase social initiations, self-management strategies, andclass-wide interventions.

In this issue (Part 2), four more exceptional contributions demon-strate both the continuity and the diversity of ABA development rele-vant to people with autism. Help for adults with autism, an oftenneglected topic of interest to professionals and family members alike,is addressed by McClannahan, MacDuff, and Krantz, who have devel-oped 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 beensuccessful with children, including comprehensive, intensive, andindividualized curricula, they also emphasize the need for a widerrange of options to respond to the diversity of skills seen among adultswith autism. Discussing their methods of program evaluation, theyalso report outcome data on the employment of their adult programparticipants: A full 93% have had some supported employment, and73% have held supported employment for a majority of their partici-pation in the program. This is encouraging, given the low rates ofemployment (50% to 75%) generally found among people with devel-opmental disabilities (Wehman, 1992).

Another area of progress for ABA treatment of autism involves thedevelopment of more effective ways to disseminate effective ABAinterventions. Meeting the increased demand for services andwell-trained practitioners created by heightened public recognition ofABA’s benefits requires more scalable training programs. The field ofABA has begun to systematize training and certification of practitio-ners competent enough to implement this broader range of interven-tions. In this issue, Shook, Ala’i-Rosales, and Glenn identify key areasfor training practitioners at various levels and discuss the importanceof increased professionalization of ABA service provision. Creden-tialing, and perhaps in the future licensing, was initiated as a jointresponse to professional behavior analysts, agencies within severalstate governments, and parents who rightfully desire a way to deter-mine if the treatment that their family member is receiving is what hasbeen empirically supported by competent professionals. During

Rosenwasser, Axelrod / MORE CONTRIBUTIONS 5

Lovaas’s early work, he and other practitioners trained all of their ownstaff. Today, in several states, many autism programs and parents ofautistic children have the advantage of being able to hire staff withsolid training in basic behavioral principles and procedures, whichmay then be tailored to recipients. What a benefit for people withautism, as well as the field of ABA.

Finally, this issue features two original research studies: One is agroundbreaking empirical group comparison controlled study by for-mer students of Lovaas’s, Smith and Eikeseth, and their colleagues,Jahr and Eldevik; the other is a painstakingly detailed quantitative sin-gle case study conducted by a leader in the field, Gina Green, and hercolleagues, Brennan and Fein. The group comparison study led byEikeseth, Smith, Jahr, and Eldevik builds on Lovaas’s demonstrationthat early, intensive intervention is critical to developmental progressby comparing the effects of 1 year of intensive behavioral treatmentwith the same dosage of eclectic treatment on 4- to 7-year-olds. Theyfound that ABA, rather than eclectic treatment, produces superior out-comes on standardized tests. This is critical because although we cur-rently see increased public and private sector funding and recognitionof the importance of intervening early and intensively, the expense of40 hours of weekly treatment calls for increased interpretation andjustification: This study helps clarify that specific aspects of behav-ioral treatment account for the increased success of its recipients.

In a very different type of research, Green, Brennan, and Fein giveus a detailed account of a successful, very early, intensive ABA inter-vention for a child at high risk for autism. In this study, interventionbegan at age 1 year, 2 months and continued through 4 years, 11months, although at decreasing intensity as warranted by ongoingassessment. The article is informative, even to seasoned practitioners.First, it reviews the ideal strategies common to behavior analytic earlyintervention programming. Second, it convincingly uses an instruc-tive range of both standardized and typical individualized behavioraldependent variables measured before, during, and after interventions.Third, as it should, the study shows how these data were used for edu-cational decision making. Finally, the article states the roles and edu-cational backgrounds of the various people involved in helping thisyoung girl and details the settings in which treatment took place. The

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outcomes should be inspiring for parents, direct staff, and consultantsalike.

Despite the progress being made, much remains to be learned aboutautism, from its etiology to successful interventions for the diversityof needs of people with autism spectrum disorder. In this search, weencourage those working in the field to employ a range of researchdesigns, each relevant to the questions needing answers. Many do notrealize that although behavior analysts have a strong theoretical basewith highly developed conceptualizations of behavior and basic ani-mal and human research to support it, we are above all pragmatic andempirical. This means that we strive to practice what is actually dem-onstrated to be effective through quantitative research. As more atten-tion is given to the needs of people with autism, it is imperative thatenergy not be wasted within or among behaviorists and other helpingorientations on theoretical arguments. In the end, testimonials andstrongly held beliefs do not help people; rather, painstaking researchusing quantitative case studies, typical ABA within-participantdesigns, and controlled group designs will be what actually leads touseful strategies for people with significant initial differences whoneed skills to navigate the world.

REFERENCES

Bondy, A., & Frost, L. (2001). The picture exchange communication system. Behavior Modifi-cation, 25, 725-744.

Department of Health and Human Services. (1999). Mental health: A report of the surgeon gen-eral. Rockville, MD: Department of Health and Human Services, Substance Abuse andMental Health Services Administration, Center for Mental Health Services, National Insti-tutes of Health, National Institute of Mental Health.

Harrower, J. K., & Dunlap, G. (2001). Including children with autism in general education class-rooms: A review of effective strategies. Behavior Modification, 25, 725-744.

Jacobson, J. W. (2000). Converting to a behavior analysis format for autism services: Deci-sion-making for educational administrators, principals, and consultants. The Behavior Ana-lyst 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 interven-tion 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 functioningin autistic children. Journal of Consulting and Clinical Psychology, 55, 3-9.

Rosenwasser, Axelrod / MORE CONTRIBUTIONS 7

Matson, J. L., Benavidez, D. A., Compton, L. S., Paclwaskyj, T., & Baglio, C. (1996). Behavioraltreatment of autistic persons: A review of research from 1980 to the present. Research inDevelopmental 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 Skinner’s 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 Modi-

fication, 25, 785-802.

Beth Rosenwasser, Ed.M., B.C.B.A., is a doctoral student in educational psychology atTemple University.

Saul Axelrod, Ph.D., is a professor in curriculum, instruction, and technology in educa-tion at Temple University.

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