Understanding Intervention Strategies for ASD
- October 9, 2021
In a previous blog post, I wrote about some common components of behavior-analytic services. In a nutshell, our mission here at Waypoints is to act as environmental engineers, providing individualized support and changing the learning conditions to help foster progress toward clients’ specific goals. Now I’d like to compare and contrast our approach with a few other intervention strategies based on ABA. It’s important to make an informed decision regarding what options will be best for you and your family!
The Lovaas Approach
While John Watson and B. F. Skinner are often cited as the fathers of the science and philosophy of behavior analysis, Ivar Lovaas can largely be credited with the development of applied behavior analysis (ABA) specifically as a treatment for symptoms of autism spectrum disorder (ASD).
As I’ve written before and almost certainly will again, at Waypoints we have deep reservations about thinking of ABA as a therapy or treatment for autism. With that being said, the empirical evidence of effectiveness provided by studies evaluating Lovaas’ methods played a huge part in ABA being deemed a “medical necessity” and thus covered by most insurance providers. You can learn more about the Lovaas Approach here, but I encourage readers to also consider the critique provided by the Therapist Neurodiversity Collective.
This position statement does condemn the practice of ABA as a whole, suggesting that “the stated end goal of ABA is an autistic child who is ‘indistinguishable from their peers’—an autistic child who can pass as neurotypical.” At Waypoints we want to strongly emphasize that that is not a goal that we want to pursue. While the science of behavior analysis is sound and an incredible body of evidence exists showing its effectiveness in promoting learning and building new skills, we feel that we must be extremely cautious regarding how that science is applied.
The Verbal Behavior Approach
Mary Lynch Barbera wrote The Verbal Behavior Approach: How to Teach Children with Autism and Related Disorders to highlight methods of ABA based upon the same scientific principles as Lovaas’ approach, but with a greater emphasis on natural environment and incidental teaching, errorless learning, reinforcement-based procedures as opposed to aversive control, and skill acquisition as opposed to behavior reduction.
In particular, as stated in the title of the book, Barbera focuses on development of verbal behavior, a critically important step toward self-advocacy. I’ve always appreciated that the author highlights the fact that verbal behavior does not need to be vocal, but can include sign language, gestures, use of augmentative and alternative communication (AAC) devices, picture exchange communication systems (PECS), and many other communication skills and forms of behavior as well.
This approach to ABA is still quite traditional in some respects; for example, a recent blog post focuses on potentially harmful forms of self-stimulatory behavior and the need to prevent that harm, but also suggests that “stimming happens when the child is not engaged in meaningful activities with high levels of reinforcement” and that stimming should be replaced with “better” and “more appropriate leisure activities.”
At Waypoints, we absolutely can assist in exploring different leisure options and learning fun new hobbies, but will not pursue elimination or reduction of stimming unless the form that it takes is of immediate and direct physical risk to the client.
Precision Teaching
Precision Teaching is a system based on the science of behavior analysis, and particularly the work of Ogden Lindsley in the 1960s. The practice of Precision Teaching, while equally based upon the science of behavior analysis, diverged from Lovaas’ methods and is implemented more so in educational settings rather than as a form of therapy. An excellent description of Precision Teaching is provided by CentralReach here.
Our practices at Waypoints don’t include every aspect of Precision Teaching, but we do emphasize setting goals based on directly observable and measurable behaviors, prompt and ongoing data-based decision-making, and Ogden Lindsley’s philosophy of “the learner knows best.”
Acceptance and Commitment Therapy
I want to end with a highlight of a form of behavior-analytic practice that is perhaps a little more off the beaten path for many readers of this blog! Acceptance and Commitment Therapy (ACT) is based on Relational Frame Theory (RFT), which is in turn an extension from B. F. Skinner’s functional analysis of verbal behavior and philosophy of radical behaviorism.
As opposed to Waypoints’ focus on skill development in a one-on-one in-home setting, ACT is a form of clinical therapy with the goal of changing the effects of one’s thoughts and feelings; this is particularly in contrast with the goal of eliminating or changing those thoughts and feelings. Common components of ACT include mindfulness, identification of values and committed actions that can be taken in pursuit of those values, and learning to accept and adapt to difficult experiences.
ACT can be a helpful resource in anyone’s life—Waypoints does not currently provide ACT-based services, but therapists offering ACT can be found via the Association for Contextual Behavioral Science here.
What to Expect at Waypoints
Ultimately, services at Waypoints make use of many of the same evidence-based practices as those used in the approaches described above.
Traditional strategies like discrete trial training (DTT) allow us to support skill development in a structured format, while natural environment teaching (NET) as highlighted by Barbera helps us to ensure that those skills will maintain long-term in day-to-day life. A high rate of learning opportunities, a critical component of Precision Teaching, gives a greater likelihood of building true fluency. The underlying philosophy of ACT reminds us that all behavior is contextual, and that we must always look to the environment when determining how best to support learning and behavior change.
Waypoints is a company founded by behavior analysts with diverse experiences with different behavior-analytic practices, and we bring a synthesis of all we’ve learned to the services we provide. What we want to set us apart is our client-centered approach, and consistent emphasis on assent and self-advocacy. If you’d like to learn more about our approach or to chat more about different behavior-analytic options that are available, I hope you’ll reach out to us at info@waypoints.life!
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