By Shaji Haq, Ph.D., BCBA-D
Over the past twenty years, applied behavior analysis (ABA) treatment providers for children with developmental disabilities—particularly autism spectrum disorder (ASD)—have multiplied exponentially. But ABA treatment facilities for adults are sparse. This is a tragedy; we’re often stopping short when treatment is still critical, and in some cases, even more so.
Many factors may have contributed to the increase in children’s ABA providers (e.g., Lovaas’ seminal study on the effectiveness of early intensive behavioral intervention in 1987, mandated insurance coverage, and funding and research for ASD treatment), but this increase addresses only part of the issue. Students with ASD often “age-out” of school systems or ABA agencies, leaving families with limited options—limited in terms of effective treatment, and limited in helping loved ones access services which are critical to independent, adult functioning.
Adult clients may lack the skill to participate in vocational or community integration programs. For example, adults with ASD who cannot successfully participate in community programs might have severely limited communication skills, difficulty managing personal hygiene, or display severe behavioral inflexibility (e.g., insistence on sameness of routines) that can be barriers to those programs. Many of these individuals also display problem behavior, such as aggression and self-injury, which often excludes them from participation.
Without ABA services to improve skills and treat behavior problems, the situation may seem bleak. But it doesn’t have to be. The key to ABA treatment is always identifying the cause of behavior. Experimental functional analyses (Iwata et al., 1982/1994), also commonly referred to as Functional Analysis Assessments (FAAs), are the gold standard for identifying the function, or purpose, of problem behavior for individuals (regardless of age) with developmental disabilities.
FAAs are an area of service CBS has begun to provide, which is not commonly found in Southern California. Our FAAs use rigorous data collection systems and research-based experimental design. Since 2004, Center for Behavioral Sciences has emphasized teaching individuals of all ages with developmental disabilities to reach greater levels of independence, and our new FAA program is a great step forward.
While an FAA and any behavior intervention translates to vastly different outcomes across individuals, at Center for Behavioral Sciences, we believe that older clients must be recognized as an equally-important population to children with ASD. Adult treatment goals may range from basic activities of daily living to more advanced skills, such as time management, decision making, how to use public transportation, and vocational training.
Iwata, B. A., Dorsey, M. F., Slifer, K. J., Bauman, K. E., & Richman, G. S. (1994). Toward a functional analysis of self-injury. Journal of Applied Behavior Analysis, 27, 197-209. doi: 10.1901/jaba.1994.27-197 (Reprinted from Analysis and Intervention in Developmental Disabilities, 2, 3-20, 1982).
Lovaas, O. I. (1987). Behavioral treatment and normal educational and intellectual functioning in young children with autism. Journal of Consultation and Clinical Psychology, 55, 3-9. doi: 10.1037/0022-006X.55.1.
Disclaimer: This article is for general information only, and is not intended as legal or medical advice. Individual circumstances and outcomes vary, and the statements in this article may not apply to you. Please contact your health care provider or attorney regarding any specific issue or problem. The opinions expressed in this post are the opinions of the individual author and may not reflect the opinions of CBS.
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