Wednesday, April 23, 2014

How necessary is the analysis of autistic behavior?

Punishment wreaks havoc. There are better ways to improve behavior than the iron fist held ready to strike the wrong-doer, the commonplace fix for anyone caught crossing the line.

Scientific discoveries of the branch of psychology called Applied Behavior Analysis (ABA) have provided techniques of rewarding "good" behaviors, and when they do it well, bad behaviors can fade away to oblivion, with no need for the cries of justice and retribution in the name of teaching accountability and responsibility. Many decades of laboratory findings with animals and humans have produced technological treatments for maladaptive behaviors emitted by all kinds of populations, especially people with serious disabilities, and autistics have topped the list. As a result, worried parents and confounded school districts often hire Board Certified Behavior Analysts (BCBA's) to modify the "problem" behaviors of autistics, but when is it really necessary? When is a problem truly a problem? Which behaviors are rightfully slated for reduction? Who has the right to deem any action "improper"? Who is a better judge, a scientist or a philosopher?

Two Alternatives to Punishment

One day about ten yeas ago I was assigned to be a substitute teacher for a first-grade class. I didn't want the little kids running around, out of control, and I didn't want to punish them either, so for five minutes I let them power walk around their desks, which were clustered together in the middle of the room, under the condition that if and only if they sat down and did their work for twenty minutes, then they could get up and do their thing.

In technical jargon, I was using the Differential Reinforcement of Incompatible Behavior (DRI). Nobody can sit and run at the same time. By reinforcing in-seat behavior during work time, unwanted out-of-seat behavior tends to go away. See Baisenger and Roberts (1972).

I was also using the Premack Principle which explains why grandmothers like to say, "You can eat your pudding after you eat your meat." Premack (1959) discovered that access to more-preferred activities after less-preferred activities strengthens the rate of engagement in the less-preferred activities. So I let them tramp around their seats after they wrote their numbers.

They consented, did their work, had some fun, and everybody seemed happy. Nobody reprimanded anybody. There was no need to keep them inside from the playground. Children, as well as adults, commonly object to punishment and its harmful effects, especially when they are the ones being punished. See The Problem with Punishment (2007). They should be allowed to say, "Leave me alone," to an authoritarian teacher. For further analysis of this kind of dissent, see The Consent of the Subject of Behavior Research and Therapy in Behavioral Ethics (2011).

Neurodiversity (When ABA Isn't Necessary)

Notwithstanding its proven success in the classroom, ABA is not without critics. The profession butters its bread with its lucrative "management" of autistic behavior, but autistic advocates are objecting to the practice. Leaders of the Neurodiversity Movement are proud to be called autistics. Behaviorists, they say, stand in the way of the growth of a healthy identity.

For example, Zurcher (2012, par.5 said, "Teaching autistic people how to ‘pass’ so they can blend in better with non-autistics is similar to the belief that a closeted gay person will live a happier and more fulfilled life by being closeted than someone who is 'out.''' She was responding to Dawson's (2004) influential paper, The Misbehaviour of Behaviourists: Ethical Challenges to the Autism-ABA Industry.

Furthermore, in a bold move against autistic 'therapies," a coalition of autistic advocates, led by the Autistic Self Advocacy Network (2014) (ASAN), sent a joint letter to sponsors of Autism Speaks (A.S.) urging them to end their support this organization. Autism Speaks was devoid of autistic leaders. They raised funds with ads that compared autism to a fatal disease. Meanwhile, autistics were running some major events of their own where Z. (2012) described the "autistic space" of the "ASAN second annual gala," free of "neurotypical" norms, where "stim toys (were) readily available."

The behavioral journals have many examples of the type of put-downs objected to by these autistic adults. For example, in the Journal of Applied Behavior Analysis, Foxx and Azrin (1973) said, "Self-stimulatory behavior continues as a major problem among retardates and autistic children (p.2)." They spoke about behaviorists trying to "eliminate" head-weaving, body-rocking, thumb-sucking, body-part-rubbing, object-mouthing, and object-spinning, with tranquilizers, electric shock, thigh-slapping, and "painting the thumb with a distasteful solution (1973, pp. 1-4)." Taken to an extreme, behavior analysts at the Judge Rotenberg Center (JRC) have been known to shock autistic children with painful electricity devices only "for minor misdeeds, like yelling or cursing (Gonnerman, 2007, p.1)."

Presumably, without knowing it, informed parents and their public school sending districts consented to JRC "torture (or) cruel, inhuman or degrading...treatment or punishment.  (Méndez, J., 2013, cover page, p. 84)." JRC would not be strapping electricity packs to the backs of children if they were granted the right to dissent.

Autistic leaders have valid objections to so-called "behavior therapy," especially when they target behaviors that don't hurt anybody, such as self-stimulation. It would be better if society could welcome and embrace neurodiversity instead of squelching their atypical expressions.

Self-Injurious Behavior (When ABA May Be Necessary)

On the other hand, when problematic behaviors cause real self-inflicted harm to autistics themselves, then ABA can be justified. Self-Injurious Behavior (SIB) such as "eye-poking, chronic rumination, frequent arm-biting, (and) violent head-banging" in autism and developmental disabilities can result in "severe, life-threatening injuries (Weiss, 2002, p. 130)."
Carr (1977)...summarized the existing literature into three possible motivations for SIB (and said) self-injury may be an operant behavior maintained by positive social reinforcement. In contrast, self-injury may also be motivated by negative reinforcement, in which behavior is maintained or strengthened by the removal of an aversive stimulus. Finally, self-injury may be reinforced by sensory stimulation. The most frequently used reinforcement-based treatments for self-injury include differential reinforcement of other behaviors (rewarding them for not injuring themselves) and of incompatible behaviors (Repp, Singh, Olinger, and Olson, 1990) (In Weiss, 2002, p. 135).
So ABA treatment can help when autistics hurt themselves. Clearly, behavior science knows how to change behavior, but the advocates should be telling them which behaviors should be targeted for change. How do the analysts decide a "target behavior" is a "problem behavior"? What are their criteria for judging a problem as a problem? 

Conclusion

Since parents and professionals can make serious mistakes, ABA is most ethical when children also have the authority to dissent from any intervention they do not want. Ethical behaviorism under maximal consent has the potential to satisfy every individual who holds a stake in the outcome of autistic behavior, including the outspoken members of the Neurodiversity community. Who is a better advocate for an autistic child than an autistic adult who knows how it feels to be autistic? They should be seated on Child Study Teams in districts containing school-wide programs of Positive Behavior Support, the educational correlate to ABA. This would provide the children with constructive alternatives to conventional school discipline, which is also known as "the pipeline to prison (School to Prison Pipeline, 2014)."

References

The Autistic Self Advocacy Network. (2014). Joint letter to the sponsors of Autism Speaks. Retrieved April 23, 2014 from http://autisticadvocacy.org/2014/01/2013-joint-letter-to-the-sponsors-of-autism-speaks

Baisinger, J., and Roberts, C. L. (1972). Reduction of intraspecies aggression in rats by positive reinforcement of incompatible behaviors. Journal of the Experimental Analysis of Behavior, 18(3), 535-540. Retrieved April 23, 2014 from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1334040/pdf/jeabehav00127-0192.pdf

Behavioral Ethics. (2011). Retrieved April 23, 2014 from http://rewardandconsent.blogspot.com/2011/08/behavioral-ethics-and-consent-of.html

Carr, E. G. (1977). The motivation of self-injurious behavior: A review of some hypotheses. Psychological Bulletin, 84, 800-816. (In Weiss, 2002).

Dawson, M. (2004). The misbehaviour of behaviourists: Ethical challenges to the autism-ABA industry. Retrieved April 23, 2014 from www.sentex.net/~nexus23/naa_aba.html

Foxx, R. M., and Azrin, N. H. (1973). The elimination of autistic self-stimulatory behavior by overcorrection. Journal of Applied Behavior Analysis, 6(1), 1-14. Retrieved April 23, 2014 from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1310802/pdf/jaba00063-0004.pdf

Gonnerman, J. (2007). The school of shock. Mother Jones, 1-6. Retrieved April 23, 2014 from http://www.motherjones.com/politics/2007/08/school-shock

Méndez, J. E. (2013). Report of the special rapporteur on torture and other cruel, inhuman or degrading treatment or punishment. (Human Rights No. A/HRC/22/53/Add.4). United Nations: United Nations General Assembly Human Rights Council. Retrieved April 23, 2014 from http://www.ohchr.org/Documents/HRBodies/HRCouncil/RegularSession/Session22/A-HRC-22-53-Add4_EFS.pdf

Premack, D. (1959). Toward empirical behavior laws: Positive reinforcement. Psychological Review, 66(4), 219-233. doi:10.1037/h0040891

The Problem with Punishment. (2007). Retrieved April 23, 2014 from http://rewardandconsent.blogspot.com/2007/01/problem-with-punishment.html

Repp, A. C., Singh, N. N., Olinger, E., and Olson, D. R. (1990). The use of functional analysis to test causes of self-injurious behavior: Rationale, current status, and future directions. Journal of Mental Deficiency Research, 34, 95-105. (In Weiss, 2002).

School to Prison Pipeline. (2013). Retrieved April 23, 2014 from http://www.naacpldf.org/case/school-prison-pipeline

Weiss, J. (2002). Self-injurious behaviors in autism: A literature review. Journal on Developmental Disabilities, 9(2), 129-143. Retrieved April 23, 2014 from http://www.oadd.org/publications/journal/issues/vol9no2/v9n2download/art12Weiss.pdf

Z., A. (2012). Finding home at the GALA. Autistic Self Advocacy Network Newsletter Retrieved from http://autisticadvocacy.org/2012/11/november-2012-newsletter

Zurcher, A. (2012 ). Michelle Dawson: Tackling that troublesome issue of ABA and ethics. Retrieved April 23, 2014 from http://emmashopebook.com/tag/michelle-dawson

2 comments :

  1. The third-tier of PBS is essentially revocation of Due Process and preparation for school-to-prison pipeline.

    ReplyDelete
  2. How is that so, Anonymous? Please elaborate and provide documentation. Dave

    ReplyDelete

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I am an advocate for people with disabilities certified to teach special education with a Master of Arts in Teaching. I am not a Licensed Psychologist or a Board Certified Behavior Analyst. When in doubt, seek the advice of an MD, a PhD, or a BCBA. My ability to analyze the ethics of ABA stems from the fact that I am disabled and ABA interventions are often done to people like me, which I voluntarily accept, but only when I alone am the person granting consent, and not a parent, sibling, guardian, or institution.