11/9/18 The EPIC School is a private, nonprofit ABA-Based School for 32 individuals Adaptive Behavior & Programming in with classic autism ages 3-21 years. The Behavior Analytic Mission of the Support of a Positive Quality of Life in ASD EPIC School is, through individualized evidence-based intervention, graduate students who: 1. Are employed a minimum of 20-hours/week Peter Gerhardt 2. Belong to a social community outside of his or her home EPIC School 3. Contribute, on a regular basis, to family functioning (e.g., can complete Oklahoma Statewide Autism Conference chores). 4. Have a functional and effective communication system November 14, 2018 5. Are independent in basic self-care skills 6. Can self-manage their own behavior across multiple environments, and 7. Have a reasonable medical transition plan. Post-21 Outcomes The problem is… After analyzing data from the NLTS-2, Roux and colleagues reported “ young adults with autism I am not entirely sure how we are have a difficult time following high school for going to do this. However, as a almost any outcome you choose - working, behavior analyst who is continuing school, living independently, committed to socially significant socializing and participating in the community, outcomes, I don’t see where we and staying healthy and safe . To complicate have any other option. I do, at matters, many of these youth begin their journey least, have a good idea how into adulthood by stepping off a services cliff. promote better adult outcomes Access to needed supports and services drops off than the current adult outcome dramatically after high school – with too many research would indicate is having no help at .” Roux, et al, 2015, p. 8 standard. Roux, AM, Shattuck, P, Rast, JE. Rava, JA, & Anderson, KA. (2015) National Autism Indicators Report: Transition into Young Adulthood . Philadelphia, PA: Life Course Outcomes Research Program, A.J. Drexel Autism Institute, Drexel University Our Post-21 Research-Base Shattuck, et al, (2012) conducted a comprehensive literature review regarding original research on services and interventions aimed at supporting success in Let’s Start with the Basics work, education, independence, and social participation among adults aged 18 and older with an ASD published between 2000 and 2010. They concluded that the evidence base about services for adults with an ASD is underdeveloped and can be considered a field of inquiry that is relatively unformed. Shattuck, P., et al, (2012). Services for adults with autism spectrum disorders. Canadian Journal of Psychiatry , 57, 284-291. 1
11/9/18 The goal of ABA intervention in ASD is the acquisition of skills necessary to live and work in the community with 2 proper supports. Nobody should have to 1 earn the right to be in the community. Autism is more than just behavior analysis. Yes, this is heretical but that doesn’t make it untrue. Who are 3 these I’m the SLP people? I’m the OT 4 I’m the I’m the BCBA Psychologist None of this is easy. (If it were, we wouldn’t be here today.) I’m the I’m the Special Parent Educator A working definition of a critical skill Once acquired, enables the individual to independently A complete a variety of relevant tasks and engage in desired critical activities, AND skill is Is used with sufficient frequency to remain in the individual’s repertoire. The exception here are safety skills one which, ideally, are low response frequency skills, AND that: Can be acquired within a reasonable time frame*. 2
11/9/18 But a simpler definition of essential skills can be found The Essential Eight outside of Behavior Analysis (McGreevy, Fry, & Cornwall, 2012) 1. Making requests 2. Waiting after making requests 3. Accepting removals, making transitions, sharing, and What you do EVERY DAY matters taking turns more than what you do once in a 4. Completing 10 consecutive, brief, previously acquired tasks while. 5. Accepting ‘No’ 6. Following directions related to health and safety -Gretchen Rubin 7. Completing daily living skills related to health and safety 8. Tolerating situations related to health and safety McGreevy, P., Fry, T, & Cornwall, C. (2012). Essentials for Living: A Communication, Behavior and Fundamental Skills Assessment, Gretchen Rubin is the author of several books, including the New York Times bestsellers Better than Before (2015) and Curriculum, and Teaching Manual. The Happiness Project (2009). Between 5:00AM & 6:00AM, Mon-Fri, I… Application of Social Validity • Wake to the alarm clock In ABA • Turn off the alarm clock • Actually get out bed Not all of these “ Colleagues, editors, and community • Pee/Flush/Wash hands skills should be members were asking us about the • Turn on Keurig considered behavioral goals that we had chosen for • Take coffee mug out of dishwasher essential for training the teaching-parents and the youths • Make coffee with Keurig everyone but at participating in the community-based, • Put on a pair of pants. least some of family-style, behavioral treatment program • Put on a jacket & baseball cap them would. at Achievement Place. They would ask us: • Put leashes on the dogs "How do you know what skills to teach? You • Leave apartment/Call for elevator talk about appropriate skills this and • Take elevator to 1 st Floor appropriate skills that. How do you know that • Exit building and begin walking the dogs these are really appropriate?” (Wolf, 1978, p. 206) Social Validity in ABA Social Validity in ABA “The suggestion seemed to be that society would need to validate our ”It is clear that a number of the most important work on at least three levels: concepts of our culture are subjective, perhaps even 1. The social significance of the goals. Are the specific behavioral the most important. Martin Luther, as the story goes, goals really what society wants? was severely criticized for setting Protestant hymns to 2. The social appropriateness of the procedures. Do the ends justify the means? That is, do the participants, caregivers and other the popular melodies of songs and dances of the time. consumers consider the treatment procedures acceptable? He replied, "Why should we let the devil have all the 3. The social importance of the effects. Are consumers satisfied with best tunes?" Well, why should we let the others have the results? All the results, including any unpredicted ones? all of the best human goals and social problems?” We have come to refer to these as judgements of social validity.” (Wolf, 1978, p. 210) (Wolf, 1978, p. 207) 3
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