Association for Behavior Analysis International

Up to two-thirds of youth with autism spectrum disorder develop challenging behaviors, which are the most common cause for referral to behavioral health services in this population. While progress in treatment in this area has been made, many youth remain treatment refractory or unresponsive to the work of a single discipline. Specialized acute inpatient psychiatry units can be utilized to bring together the strengths of applied behavior analysis and other disciplines to assess and treat complex challenging behaviors. The service landscape, approach, and treatment evidence for these settings will be reviewed, and emerging novel approaches utilizing detection of physiologic signals in relation to challenging behaviors will be presented.

Practicing behavior analysts, administrators of ABA programs, clinical researchers.

Dr. Siegel is an Associate Professor of Psychiatry and Pediatrics of Tufts University School of Medicine, Vice President of Medical Affairs, Developmental Disorders Service of Maine Behavioral Healthcare, and Faculty Scientist II at Maine Medical Center Research Institute. He has developed a nationally recognized continuum of treatment and research for individuals with autism, intellectual disability and co-occurring mental illness and challenging behaviors.

Dr. Siegel attended Amherst College, Stanford Medical School and trained at Brown University in child psychiatry, psychiatry, and pediatrics. He is the Principal Investigator of the Autism and Developmental Disorders Inpatient Research Collaborative (ADDIRC), a network of specialized child psychiatry units performing studies of children severely affected by autism and intellectual disability. Dr. Siegel is nationally recognized for his expertise in inpatient care and the treatment of serious challenging behaviors. He served on the Autism and Intellectual Disability Committee of the American Academy of Child & Adolescent Psychiatry for a decade and is a co-author of the Academy’s Practice Parameter on the Assessment and Treatment of Children and Adolescents with Autism Spectrum Disorder and the Parameter for the Assessment and Treatment of Psychiatric Disorders in Children and Adolescents with Intellectual Disability.

Researchers in the field of autism spectrum disorder (ASD) have made significant progress in assessment of social-communication and other ASD-related impairments. However, there is still a great deal to be learned about profiles of ability and disability characteristic of individuals with different neurodevelopmental disorders (NDDs), and about the ways in which particular abnormalities manifest at different points in development. Dr. Bishop will present information about behavioral dimensions that are most relevant to assessment and differential diagnosis of ASD and other NDDs. She will also discuss the importance of considering individual factors such as age, sex, IQ, and language level when interpreting scores from standardized measures for diagnostic or other purposes. Integrated assessment across multiple behavioral domains is not only needed to ensure valid diagnostic practices, but more importantly, to generate individualized and meaningful treatment plans. Improved coordination between diagnostic and treatment providers is essential for increasing efficiency and utility of current assessment practices. Additionally, there is a need for increased coordination of measurement strategies across disciplines, in order to ensure appropriate selection of short-and long-term goals and corresponding measures of change. Ultimately, we must toward more coordinated and goal-directed assessment practices that do not place such a premium on diagnostic labels, but instead focus on generating information that directly facilitates treatment for a given individual at a particular moment in time.

We draw artificial boundaries between our lives at home and at work, and between our waking and sleeping hours. Each person is living a whole life where all of their environments, relationships, behaviors, and physiological states interact. The body we take with us to work is the one we had with us at home, and both work and home environments (resources, physical environment, psychosocial environment, responsibilities/demands) impact our physical health.

Total Worker Health® (TWH) is an approach initiated by the National Institute for Occupational Safety and Health (NIOSH) in 2003 developed to address such interactions, and to advance science and practice for protecting workers’ safety, health, and well-being. The TWH approach represents an expansion of traditional occupational safety and health research and practice, with strong safety protections for workers as its foundation. NIOSH defines TWH as “…policies, programs, and practices that integrate protection from work-related safety and health hazards with promotion of injury and illness prevention efforts to advance worker well-being” (Tamers et al., 2019). TWH recognizes that work is a social determinant of health and therefore takes a holistic approach to worker safety, health, and well-being by acknowledging the interdependence between worker well-being and their success at work. As an extension of traditional occupational safety and controls, the TWH approach prioritizes addressing and removing occupational exposures that threaten the safety and well-being of workers, and prescribes that such hazard reduction is accompanied by efforts to improve the overall health status of workers as well.

This is a very exciting time for occupational science and practice. From a TWH perspective, the “action is in the interactions” between safety, health, and well-being. This includes interactions between work and life exposures and each person’s genes, biology, and daily behaviors. This reciprocol and interactive perspective is highly consistent with Skinnerian and other approaches to behavioral science, as well as organizational systems analysis approaches. Skinner (1957) wrote that “[People] act upon the world, and change it, and are changed in turn by the consequences of their action” (p. 1). Similarly, Bandura (1978) proposed a triadic form of reciprocal determinism, focused on interactions among a person’s environment, traits, and behaviors. At both individual and organizational levels of analysis, systems approaches (Brethower, 1982; Rummler & Brache, 2012) highlight the adaptive importance of reciprocal internal and external feedback processes, as well as sustaining and interactive relationships between each system (person, organization) and its host environment (organization, economy). With its Skinnerian and systems analysis roots, and associated historical emphasis on environmental conditions and interventions, the Organizational Behavior Management community can make great and important contributions in the TWH domain.

Board certified behavior analysts; licensed psychologists; graduate students.

Autism spectrum disorder (ASD) is a lifelong disorder that affects children and families in several ways. A growing body of research has documented the ways in which racial disparities affect the rate of identification, access and use of services, and relationship with professionals making the diagnoses. In general, Latino children are diagnosed with ASD later in life; usually with more severe symptoms, lower IQs, and more health conditions, compared with non-Latino children. Furthermore, cultural factors can shape how the signs of ASD are conceptualized and how families accept a positive diagnosis, especially how they are affected by stigma. Diminished access to diagnostic services as well as having a caregiver with a non-English primary language can act as barriers to identifying children with ASD, in particular Latino children. This lecture will review current research in health disparities in both early identification and access to services of Latino children with ASD. Research with this underserved population contributes to enhancing diagnosis and identification methods for Latino children with ASD and assessing the unidentified risk factors and barriers to accessing services, hence improving their outcomes.

researchers, allied health professionals, educators