Familiarizing New Staff for Working with Adults with Severe Disabilities: a Case for Relationship Building

They have a Voice; are we Listening?

The field of applied behavior analysis (ABA) has produced powerful changes and improvements to the lives of many. However, the field is not immune from criticism. One criticism from those outside the field is that the goal of ABA therapy is to make Autistic people appear "indistinguishable" from their peers. This paper examines "indistinguishability" and its implications by defining "indistinguishable" in behavior analytic terms, exploring how the term was used in two notable studies in the field (Lovaas, 1987, Journal of Consulting and Clinical Psychology, 55[1], 3-9; Rekers & Lovaas, 1974, Journal of Applied Behavior Analysis, 7[2], 173-190), and providing a review of the social validity and ethical implications of having "indistinguishability" as an explicit or implied goal. This is partially accomplished by incorporating concerns from the Autistic self-advocate community. We argue that the Autistic self-advocate community's concerns surrounding "indistinguishability" as a goal have a degree of legitimacy and need to be given due consideration. Suggestions for addressing these concerns in ABA degree programs and research are discussed, emphasizing the importance of considering stakeholder values, taking criticisms seriously, and making changes when necessary.

Values: A Core Guiding Principle for Behavior-Analytic Intervention and Research

Values represent qualities or beliefs that are of high priority to individuals or society and represent one of the core processes within acceptance and commitment therapy or training (ACT or ACTr). The current article discusses values and valuing not only as a centralized process in ACT but also as a core process guiding the field of applied behavior analysis with applications that extend across several intervention domains. A relational frame theory model of values as hierarchical frames that augment reinforcing functions that can influence socially meaningful behavior change is reviewed. This basic model is then extended to encompass temporal, deictic, and causal frames. Values-based intervention research is emerging in areas such as guided decision making, professional development, organizational behavior management, parent training, and treatment plans for children and adults. Although this research is promising, more work is needed to further explore the role of values and valuing within ACT, and when they are used within other intervention strategies. Several potential avenues for future research that may aid in the development of values-based intervention by behavior analysts and extend the scope of our field and practice are discussed.

What encourages care workers to continue working in intellectual disability services in England? Interview findings

The article reports research aimed at identifying factors relating to retention in English intellectual disability services, drawing on a study of the social care workforce. The research involved two rounds of interviews with social care managers and staff between 2009 and 2014. The study uses social exchange theory, particularly the idea of 'reciprocity' and the mechanism of 'hope', as a conceptual framework to aid interpretation of the themes relating to retention identified in the interview analysis: 'pay', 'support', 'morale', and 'training' (related to reciprocity) and 'improving quality of life' and 'supporting personal development' (related to hope). Both groups of themes are identified as being particularly appropriate to intellectual disability services. The study concludes that reciprocity and hope seem to interact in factors related to staff retention, although the study suggests that reciprocity rather than hope is directly connected with retention.

Rapport Building and Instructional Fading Prior to Discrete Trial Instruction: Moving From Child-Led Play to Intensive Teaching

Discrete trial instruction (DTI) is effective for teaching skills to children with autism spectrum disorder (ASD). Although effective, instructional settings can become aversive resulting in avoidant and escape-related behaviors. Given the significant social impairments associated with ASD, interventions that promote social approach and reduce avoidance are warranted. Rapport building or "pairing" the therapist and teaching setting with highly preferred activities prior to instruction can reduce problematic behaviors during subsequent instruction. However, the path from child-led play to DTI is not well established. Instructional fading may assist in bridging this gap. Four participants with ASD who were beginning an intensive behavioral intervention program were included in the current study. Participants progressed through nine stages of pairing and instructional fading with minimal problem behavior and high percentages of in-seat and close proximity to the therapist. Guidelines for incorporating rapport building strategies prior to intensive teaching with children with ASD are proposed.