Thursday, March 26, 2009

The ABA Establishment

As a grad student, I often read research articles -- more often than not because my teachers assign them. They like to assign articles, great big stacks of them that seem to take forever to work through... and, then, when I'm finally finished, it's just in time to start on the next stack.

Every now and then, however, one of them is particularly interesting or noteworthy. A 1999 paper by Koegel, Koegel, Harrower, and Carter published in the Journal of the Association for Persons with Severe Handicaps (24(3), 174-185) is one such.

The paper is entitled "Pivotal Response Intervention I: Overview of Approach" and is interesting for a number of reasons. On one level, the basic concept behind pivotal response intervention itself is fairly interesting and quite ingenious in a way.

More importantly, however, the paper seems to make a number of the things that are wrong with the behavior analytic establishment readily apparent.

After things which are common to the autism establishment as a whole (e.g. the strict-disability model), a disturbing pattern emerges.

For instance, take the following quote:

As mentioned, over the years, a substantial amount of research has identified a specific attentional characteristic displayed by many children with autism. This characteristic has been called "stimulus overselectivity" (Lovaas, Schreibman, Koegel, & Rehm, 1971). It refers to the tendency of certain children with autism to respond on the basis of a limited number of (frequently irrelevant) components in their environment (see Schreibman, 1997, for review).... Many children with autism, however, tend to respond to fewer and more irrelevant components (e.g. a bend in a picture card, as opposed to the relevant feature of the picture). Thus, children with autism may identify a stimulus by an irrelevant cue (Schreibman, 1997).

Given the sensory issues autistic people have -- often in manifold and varied form -- it's quite likely that the issue here is one of salience, and lies on a sensory level. Despite this, none of the relevant literature is cited... and the possibility is not referenced. Were this just a matter of this paper, I'd be less concerned, but this is a systematic thing across most of the ABA literature I've read.

It is not ethical to bury your head in the sand in this manner, especially in clinical practice. The fact that past research was not behavior analytic in nature does not give behavior analysts an excuse to ignore it!

Another revealing quote is the following:

... The term motivation, as used here, refers to observable characteristics of a child's responding. An improvement in motivation is broadly defined as an increase in responsiveness to social and environmental stimuli (R. L. Koegel, Carter, & Koegel, 1998). For example, characteristics reflective of motivation include increases in the number of responses a child makes to teaching stimuli, decreases in response latency, and changes in affect (e.g., interest, enthusiasm, happiness) (R. L. Koegel et al., in press).

This is not, by any reasonable definition, what motivation is. Motivation is an internal variable; what that list includes are signs of it. Behavior analysts have often been accused of denying the existence of the mind. Items like the above are a large part of why.

Perhaps even more revealing, however, is the opening of the next paragraph:

Traditionally, interventions for children with autism did not consider these characteristics and how they may have covaried with the actual intervention goal, thus limiting the effects of such approaches. Additionally, disruptive behaviors seemed to be at lower levels or absent and greater generalization occured when motivational variables were incorporated (R. L. Koegel et al., in press).

In other words, older interventions didn't pay any attention at all to the child's happiness, interest, or enthusiasm. They didn't care about that. They didn't even look into ways to minimize boredom as an ethical issue.

The thought -- or lack thereof -- involved makes me so incredibly sick that I cannot even begin to describe it.

Also, note the dates of those citations. Behavior analytic research into autism treatment has been going on since the '60s.

Now... what does paying attention to these things look like?

These variables include the use of child choice, frequent task variation, interspersing previously learned tasks with new acquisition tasks, using less intrusive prompting, reinforcing the child's attempts, and incorporating turn taking within the interactions.

... yeah. It's worth noting that "child choice" is defined as including letting a kid select the toy he wants to play with.

I don't think I need to say anything else here.

This, of course, is not a complete list of my gripes, and it is true that the ABA establishment is changing. These are all references to older methods -- that is, ones in common use prior to the publication of this paper.

Unfortunately, those older methods are still used today... and that paper was published in 1999.

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