Participant assent in behavior analytic research: Considerations for participants with autism and developmental disabilities

Using the ADDIE Model of Instructional Design to Create Programming for Comprehensive ABA Treatment

ABA research abounds with articles on increasing or decreasing a small set of behaviors. These articles fit nicely within the framework of Focused ABA Treatment in which the goal of treatment centers on only a few behaviors. However, many behavioral practitioners spend most of their time developing Comprehensive ABA Treatment in which a large number of behaviors are systematically changed across multiple developmental domains. Few resources are available to help in designing and implementing such programming. This article presents a model from the field of instructional design for the development of comprehensive programming. Applying the ADDIE model-Analyze, Design, Develop, Implement, Evaluate-the article identifies a consistent process to follow, critical actions to take, and helpful resources to use when developing comprehensive programming for individuals with autism.

Toward a further understanding of assent

Arranging assent opportunities is an increasingly common strategy for involving clients in therapeutic decisions within behavior analysis. Recent behavior-analytic articles have helped create a basic behavioral definition and conceptualization of assent, but much more guidance is needed for practitioners and researchers interested in embedding assent into their practices. The purpose of this article is to advance the conceptualization and understanding of assent and assent practices by refining previous definitions and conceptualizations of assent and providing six essential considerations for embedding assent into practice. The six considerations consist of determining the applicability and feasibility of assent, assessing assent-related skills, arranging assent procedures and teaching assent-related skills, arranging fair choices, selecting opportunities to assess assent, and informally assessing assent. Following the discussion of the considerations for assent practices, we issue a call for specific topics of research on assent.

Idiosyncratic effects of interviewer behavior on the accuracy of children's responses

Children are interviewed to provide information about past events in various contexts (e.g., police interviews, court proceedings, therapeutic interviews). During an interview, various factors may influence the accuracy of children's responses to questions about recent events. However, behavioral research in this area is limited. Sparling et al. (2011) showed that children frequently provided inaccurate responses to questions about video clips they just watched depending on the antecedents (i.e., the way a question was asked) and consequences (i.e., the response of the interviewer to their answers). In the current study, we replicated and extended the procedures reported by Sparling et al. and found that two of five children were sensitive to the various antecedents and consequences that we manipulated. Our findings indicate a need for more research in this area to determine the relevant environmental variables that affect children's response accuracy.

Resolving Barriers to Continence for Children with Disabilities: Steps Toward Evidence-Based Practice

Behavior-analytic toilet training (BATT) methods to support urine continence have been reviewed and replicated in numerous studies. Despite empirical validations of BATT, children with disabilities may not experience successful toilet training nor access the associated health and social benefits of urinary continence. It is possible these outcomes are partially due to practical barriers that arise throughout urine training. In practice, barriers may interfere with toilet training to the extent that training is postponed or discontinued, resulting in long-term incontinence and other related problems. Examples of barriers include problem behavior, excessive urine retention, recurrent accidents, and excessive or insufficient independent self-initiations to toilet. Researchers have sometimes described strategies to address these types of barriers. However, practitioners may not be aware of these strategies because they are secondary to the purpose of an investigation and may only apply to a subset of participants. The purpose of this review article is to synthesize the collection of barrier solutions described in published research on urine training for children with developmental disabilities. Results may assist practitioners in modifying BATT according to an evidence-based practice framework until their clients overcome barriers to achieve urine continence.

Compassion in Autism Services: A Preliminary Framework for Applied Behavior Analysis

Many have suggested that a compassion-focused approach to applied behavior analysis (ABA) services may improve provider-client therapeutic relationships and has the potential to improve program acceptability and clinical outcomes experienced by our clients. In this article, radical compassion is defined and explored as a foundational approach to the implementation of ABA, with special emphasis on practical applications in the area of service delivery for families living with autism. In this framework for care, compassion is offered as a measurable repertoire and as a philosophical guidepost for future developments in the profession. This article explores preliminary tenets of compassion-focused ABA and their implications for practice. This approach is offered in the hope of moving the field toward a future of improved acceptability and sustainable consumer preference.

Dignity and Respect: Why Therapeutic Assent Matters

During therapeutic treatment and research in psychology and related fields, informed consent by the client or participant is required when they are over the age of 18; assent is required when a client or participant is under the age of 18 or a conserved adult. During both research and treatment, behavior analysts often work with neurodiverse individuals who have language deficits, and these clients may require unique assent procedures. This article will outline reasons behavior-analytic research and therapy require field-specific assent procedures. Furthermore, the goals of research and therapy are different and therefore assent may need to differ as well. This article will also argue that therapeutic assent during behavior-analytic treatment requires a unique set of guidelines and procedures that may differ from the behavior-analytic research.

A Passing Problem: Evaluating Harm and Benefit in Autism Research

Autism research frequently seeks to evaluate interventions or inform their development. Unfortunately, researchers often assume that autism intervention should reduce autistic traits, effectively setting as a goal of treatment that autistic people attempt to "pass" as nonautistic. A growing body of evidence highlights serious potential harms from passing demands. We discuss why it is important for institutional review boards (IRBs) to scrutinize autism research for clinical passing demands, and we document the existence of such demands in outcome measures commonly employed in autism research. We propose an ethical framework for IRBs and others to make use of in evaluating the ethical appropriateness of particular treatment goals in autism intervention or intervention-adjacent research, emphasizing that treatment goals should be in pursuit of a beneficial nonpassing purpose and be the least burdensome means of accomplishing such a purpose. We also highlight potential promising practices for IRBs, investigators, and other stakeholders seeking to address these issues in autism research.

A Community-Based Approach to Longitudinal Language Research With Racially and Ethnically Minoritized Autistic Young Adults: Lessons Learned and New Directions

PURPOSE

Language and autism research each typically excludes racially and ethnically minoritized (REM) autistic individuals. In addition, in the case of autistic individuals with language impairment, investigators often approach caregivers to discuss research participation, rather than autistic individuals themselves. This gap limits the ecological validity of language research in autism. To address this gap, this clinical focus article describes strategies for engaging REM autistic young adults with language impairment using lessons learned from 5 years of longitudinal research with this population. This approach involved an ongoing community partnership, as well as participatory partnerships with REM autistic individuals and community stakeholders, consistent with a "slow science" approach.

CONCLUSIONS

The approach yielded excellent retention of participants over 5 years and led to co-development of research projects aimed at priorities described by REM autistic individuals and their families, including understanding self-determination, social determinants of health, and language variability in autistic REM individuals with language impairment. Findings support the utility of community-based methods with autistic REM young adults with language impairment, with key takeaways for diversifying research while replicating, extending, and building theory.

A review of methods of assessing preference for social stimuli

Research on preference and reinforcer assessments has historically focused on the evaluation of edible and leisure reinforcers, but the identification and use of individualized social reinforcers may be beneficial for several reasons. Recently, many studies have evaluated methods of assessing preference for social stimuli. The procedures and outcomes across these studies have varied greatly, and the current state of evidence for methods of assessing preference for social stimuli remains unclear. Thus, we conducted a review to synthesize all previous research in this area, evaluate the evidence for the utility of this general methodology, and identify factors that may influence its utility. Our results suggest that social preference assessments are likely to produce results that correspond with reinforcer assessment hierarchies. Preference assessment modality was one factor that influenced utility; video-based preference assessments had greater correspondence with reinforcer assessments than did other modalities. Directions for future research and implications for the use of social preference assessments in research and practices are discussed.

Prioritizing choice and assent in the assessment and treatment of food selectivity

Food selectivity affects up to 72% and 45% of individuals with and without disabilities, respectively, and there is a need for interventions that rely on positive, unrestrictive strategies. We evaluated an assessment and treatment package for food selectivity for young children with developmental disabilities that prioritized caregiver collaboration, client autonomy, and did not rely on restrictive procedures (e.g. escape extinction). The process involved: (a) collaborating with caregivers on the selection of foods and design of the children's functional analyses; (b) indirectly and directly measuring food preferences prior to treatment; (c) evaluating the sensitivity of mealtime problem behavior to environmental variables through an interview-informed synthesized contingency analysis (IISCA); and (c) incorporating the assessment results into a progressive treatment process consisting of choice-making opportunities and differential reinforcement of successive approximations to consumption. Children also had the ability to opt in and out of treatment sessions. The treatment was effective in increasing consumption of nonpreferred foods and successfully extended to caregivers. Practical implications and directions for future research are discussed.

Assent in applied behaviour analysis and positive behaviour support: ethical considerations and practical recommendations

The term positive behaviour support (PBS) is used to describe the integration of the contemporary ideology of disability service provision with the clinical framework of applied behaviour analysis (ABA). Assent, the participation consent of those not legally able to consent, has gained recent popularity in the fields of ABA and PBS. The goal of assent-based ABA and PBS is a person-centered approach to assessment, intervention, and all other decision-making. In this model, the learner's assent withdrawal for participation is honored, whether it be a vocal 'no' or a non-vocal expression of verbal behaviour. There is currently a limited subset of studies that mention or utilize assent with learners in ABA or PBS. The lack of published research can make assent-based practices seem to be a choice of the practitioner. The authors of this manuscript seek to further define assent, illuminate the necessity of assent-based practices, and offer assent-based procedures in ABA- and PBS-based intervention.

Cultural responsiveness in applied behavior analysis: Research and practice

The new Ethics Code for Behavior Analysts requires that certificants engage in training related to culturally responsive service delivery (BACB, 2020). There is limited work in the area of culturally responsive evidence-based practice within our field. Therefore, it is incumbent on researchers and practitioners to identify best practices for working with diverse populations. Hence, the purpose of this paper is three-fold: a) to review research within and outside the field of ABA related to culturally responsive assessment and treatment and provide practice recommendations, b) to examine the extent to which current practices in behavior assessment and treatment align with aspects of culturally responsive practices, and c) to inspire research in the areas of behavior assessment and treatment to identify best practices with regard to culturally responsive behavior analytic practices. The content of this paper is grounded in the framework described by Beaulieu and Jimenez-Gomez (2022).

Improving Juvenile Justice Settings by Decreasing Coercion: One Lab's Perspectives from Behind the Fence

In this article, we outline an emerging role for applied behavior analysis in juvenile justice by summarizing recent publications from our lab and discussing our procedures through the lens of coercion proposed by Goltz (2020). In particular, we focus on individual and group interventions that target a range of behaviors emitted by adolescents in a residential treatment facility. In general, individual interventions involve teaching adolescents to (1) respond appropriately to staff, (2) tolerate nonpreferred environmental conditions, and (3) control problematic sexual arousal. Likewise, group interventions involve low-effort manipulations that decrease disruptive behavior and increase appropriate behavior in settings with numerous adolescents. Thereafter, we describe behavioral interventions for staff working in juvenile justice. These staff-focused interventions aim to increase staff-initiated, positive interactions with students in order to change subsequent student behavior. In addition, we review our recent endeavors to assess and conceptualize other service providers' behavioral products (i.e., prescription practices) in a juvenile facility. Lastly, we discuss future directions of behavior-analytic intervention with juvenile-justice involved adolescents.