Applied Behavior Analysis and the Abolitionist Neurodiversity Critique: An Ethical Analysis

Neurodiversity and the Neuro-Neutral State

Over the past decade, many philosophers have argued that to respect the moral equality of their citizens, states should be neutral toward certain forms of diversity among their populations. Areas in which the state neutrality has been advocated include, but are not limited to, citizens' different religions; languages; and sexual orientations. However, there remains an important area where its normative (ir)relevance has not been discussed: That of neurodiversity. After identifying several ways in which contemporary states disfavor the interests of neurodivergent groups relative to the neurotypical majority, including those of autistic people; dyslectic people; and people with ADHD, the most promising would be-justifications for such unequal treatment are considered. They maintain respectively that states only have to be neutral toward differences that feature in people's conceptions of the good life; that addressing the discussed neuro-inequalities is too costly, whether financially or otherwise; that doing so raises intolerable risks of a public backlash; and that a commitment to neuro-neutrality leads to overinclusion. None are found to be convincing across the board, which leads me to conclude that states should become significantly more neuro-neutral than they are today.

I'm One Person, I Can't Be Everywhere: Challenges and Needs of Bilingual Behavior Analysts

Autistic children from Spanish-speaking homes are part of a growing group of children at the intersection of multiple marginalized identities. Research suggests a "bilingual advantage" exists, similar to that experienced by neurotypical bilingual children, and autistic adults report positive social outcomes due to being bilingual. However, much less is known about providers' experiences who play a crucial role in whether families can maintain their heritage language(s) with their children. This exploratory qualitative study examined ethical challenges and needs of U.S.-based bilingual behavior analysts who provide home-based support for autistic children from Spanish-speaking homes. This study was informed by a demographic questionnaire and semi-structured interviews with participants (N = 14) across the United States. Participants' experiences were analyzed thematically. Findings included major themes and subthemes including challenging ethical experiences and behavior analysts' needs to provide high quality services. Implications are presented across the organizational, provider, and research and higher education levels.

Supplementary Information

The online version contains supplementary material available at 10.1007/s40617-024-00916-2.

Tourette Syndrome: A Catalyst for Operationalizing Neurodiversity

Our goal, taking Tourette syndrome as a case example, is to introduce neurologists to, and motivate discussion on, the neurodiversity paradigm. This philosophical construct considers some neurologic conditions in diversity, instead of simply disease. Moving from philosophical idea to empirical construct draws from patient and family perspectives on (1) quality of life and discrimination, (2) disability pride, and (3) unique profiles of different patient cohorts. Listening to patient voices, attending to family, advocacy group, and societal views on neurologic disorders can strengthen precision neurology practice. Dialogs on neurodiversity, including antitherapy sentiments, offer to enhance neurologic care, patient agency, and autonomy; encourage respectful communications with patients who challenge the idea their condition is pathologic; and to set the stage for future empirical investigations and practice guidelines.

The Social Validity of Behavioral Interventions: Seeking Input from Autistic Adults

Many in the autistic community have expressed concerns regarding the use of behavioral interventions with autistic children, suggesting that these interventions may not be socially valid. Though behavioral interventions have evolved to be more naturalistic and child-centered, little structured research has been done to explicitly seek autistic perspectives on the acceptability of specific components of behavioral interventions. Autistic adults (N = 235) were recruited online to take the Autism Intervention Attitudes Scale (AIAS), a questionnaire designed to gather feedback on common intervention goals and practices. Results indicate that participants find goals and practices that highlight quality of life, safety, and autistic interactions acceptable, while those that focus on normalization based on neurotypical standards are not. An exploratory graph analysis revealed three communities of goals ("uncontroversial goals", "controversial goals", and "social goals"). Comparison between naturalistic and structured intervention components additionally showed that autistic participants favored naturalistic strategies. These findings are in line with known criticisms of behavioral intervention from autistic adults, but also provide more information on the specific ways in which behavioral interventions can be reformed. This information can guide professionals in the development of appropriate goals and decisions around intervention planning.

When Cultural Awareness Reveals Conflicting Cultural Values: A Pragmatic Approach

Cultural awareness reminds ABA service providers of the importance of considering the cultural practices of others when programming for behavior change. Decisions about the appropriateness of services may be difficult, however, when the values of the client conflict with the values of the culture(s) to which the client belongs or with the cultural biases of the practitioner. To minimize such conflicts, we propose a decision-making model that integrates client-centered and culture-centered assessments of habilitative validity. Throughout the proposed evaluation process, the behavior analyst and the recipients of services collaborate to refine program goals that will increase access to reinforcers for the client and their cultural groups. Given that cultures arrange reinforcers and punishers for the individual, assessing habilitative and social validity for the cultural groups affected by services is emphasized as an essential component of the model. We illustrate how the proposed model could be used to suggest appropriate courses of action by analyzing a situation that may involve conflicts of values.

From direct contingencies to derived relations: the ever-developing nature of theory and practice in behavior analysis

Purpose

To illustrate the processes of development within the behavioral theory and the corresponding expansion of the areas in which it is applied, especially the advancement (conceptual developments) of the functional analysis of language inspired by Relational Frame Theory (RFT) research.

Views

Classical and operant conditioning are well-established behavioral learning processes, discovered and described at the beginning of the twentieth century. They provide the tools for analyzing, establishing and modifying the functions of stimuli and responses of the organisms through manipulation of the environment. Although B. F. Skinner provided grounds for the functional analysis of complex behaviors such as language, it was not until the beginning of the twenty-first century that RFT was introduced. From this moment behavior analysts could use behavioral principles to explain how stimulus functions may change without direct learning. The practical application of the growing knowledge about Arbitrarily Applicable Relational Responding (AARR), a basic generalized operant described within RFT, allows us to analyze, explain and change behaviors that had hitherto been beyond the scope of behavioral therapy. The continued growth and development of behavior theory and practice holds the promise for an expansion of its application to new areas and populations in need. One such development is the functional analysis of verbal behavior e.g., relational frames, ROE (relating-orienting-evoking).

Conclusions

It seems useful to add advancements proposed by RFT to the behavioral toolbox with which we could effectively describe, explain and change behavior with precision, scope and depth.

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.