Association for Behavior Analysis International

The growth of the applied behavior analysis (ABA)-based autism care system has forced the pediatric and behavior analytic communities into collaborative relationships where they 'share the care" of children with autism and their families, but do not have clear relationship practices, common principles of conduct, or mutual accountability. At the same time, the behavior analytic community is increasingly subject to working under principles, practices and cuture of the healthcare ecosystem with its own functions and operating model that may not be native to behavior analysis as a discipine or profession. This presentation will explore the risks of this knowledge/practice gap, and the opportunities inherent in the transformative integration of behavior analysis and pediatrics to affect outcomes for all children. Real-world examples will be used to explore the cultural, disciplinary, regulatory, and sustainability issues in such integration, and make specific programmatic recommendations to build mutually valuable bridges between the two professional disciplines, specifically related to the principles of collaborative treatment planning, care coordination, shared decision making, and 'whole-child' frameworks for outcomes measurement.

Behavior Analysts

Autism spectrum disorder (ASD) and epilepsy are both neurological conditions that can significantly impact a child's development and overall well-being. While they may appear to be independent diagnoses, there is a higher co-occurrence rate than chance would predict. This presentation will explore the complex relationship between ASD and epilepsy, equipping therapists with the knowledge and tools to better support their clients who experience both conditions. The presentation will delve into the following key areas: • Prevalence and Risk Factors: We will examine the co-occurrence rates of ASD and epilepsy, exploring potential risk factors and underlying biological mechanisms. • Clinical Presentations: We will discuss the diverse ways in which epilepsy can manifest, including potential challenges in identifying and diagnosing epilepsy in individuals with ASD. • Treatment Considerations: We will explore the evidence-based practices for treating epilepsy to address the unique needs of this population. Here, we will also discuss potential side effects of anti-seizure medications and how they may impact behavior or learning, equipping applied behavior analysis (ABA) therapists to collaborate with the medical team for optimal treatment. • Emerging Technologies: We will explore the potential of using new technologies including AI analysis of EEG (electroencephalogram) data for early detection of ASD. This discussion will highlight the promise and limitations of new technologies, emphasizing their role as potential tools to support informed clinical decision-making. • Collaborative Care: We will emphasize the importance of collaboration between ABA therapists, neurologists, and other healthcare professionals in developing comprehensive treatment plans.

Therapists and physicians taking care of individuals with ASD

For Skinner (1957), if reading larger units, such as words, are taught, the control by smaller units, such as phonemes and syllables can emerge, without direct training. Basic researches during fifteen years have been conducting in order to verify this statement and check what are the relevant variables. Experiments were conducted at USP verbal operant laboratory (LEOV) in Brazil with pre-school children, from 3 to 4 years old. Through equivalence-based instruction and systematic recombination of minimal verbal units of disyllabic words in Portuguese, thirty neurotypical pre-school children learned to read twelve disyllabic words and were tested for generalization in reading new words, composed by the same units (syllables and letters) of the learned ones, with recombination of its positions in the words. The design was pre and post tests intra participants, but also with inter participants comparisons between several experimental variables effects upon 30 participant’s performances. Results were individually analyzed and showed that the main experimental variable to produce minimal verbal unit control in reading was the systematic recombination of these units in three sets of four disyllabic words. After this procedure was conducted, all children improved reading scores (next to 100% of accurate reading) with a completely new set of four disyllabic words. At the level of phoneme unit, teaching this unit only produced accurate reading of new words, when teaching phonemes was combined with systematic recombination of the syllable unit. Positive implications for practice will be pointed out, highlighting the possibility to teach reading to children with autism spectrum disorder (ASD) with few errors.

Behavior analysts

In 2021, the Lancet Commission on the future of care and clinical research in autism proposed the term “profound autism” to refer to autistic individuals with comorbid intellectual disability with IQ <50 and minimal-to-no language who require 24 hour supervision and assistance with activities of daily living. The profound autism rubric was meant to allow for a more accurate and precise autism diagnosis than what is currently offered within the DSM-5, with the goal of better characterization of all individuals across the autism spectrum in order to enhance clinical care, research and long-term outcomes for everyone. The Lancet Commission’s emphasis on diagnostic clarity was consistent with other scientific initiatives to establish clinically meaningful autism subtypes rather than erroneously lumping everyone together and potentially missing important distinctions carrying direct impact on autistic individuals, their families, global health and psychosocial functioning. Multiple issues are of particular and heightened concern for those with profound autism, including challenging and maladaptive behaviors, psychiatric comorbidities, vastly discrepant service needs with an associated nationwide dearth of such, and unequal representation in crucial research. While some autism advocates have decried “profound autism” as ableist and discriminatory, this stance is largely inconsistent with science and often paradoxically leads to the exclusion of those in greatest need. Understanding and acceptance of the profound autism concept is critical in terms of serving individuals across the autism spectrum disorder (ASD) spectrum.

Behavior analysts

Profound autism is a newly established administrative term that describes a subset of the autism spectrum that is frequently misunderstood, misrepresented, and excluded. Understanding what this administrative term means and how it can be utilized to design and implement individualized, evidence-based services for the population it represents is vital. Additionally, advocating for meaningful supports and services for people with profound autism requires knowledge of and a unique strategic perspective.

Autism service providers, caregivers, community-members

There are many interventions that have been recommended as interventions for challenging behavior andpsychological and behavioral concerns related to autism. Some have clinical trials and other evidence-based research to support their use, but many do not. In this presentation we will discuss some of the recent research on the psychotropic medications, supplements, and other biomedical treatments that have been recommended to families and autistic individuals. We will discuss how we can wade through the information on social media supporting claims and how we can work with families and providers to understand what works and what doesn't.

Practitioners, families, providers, and autistic individuals

All behavior analysis practitioners work with learners and families from diverse backgrounds; however, training programs may not adequately prepare students to work with culturally and linguistically diverse learners. Additionally, pervasive myths and misconceptions about these learners may impact clinical decision-making. This presentation will review these myths and misconceptions and describe how they can affect learning outcomes and hinder culturally responsive practices. Drawing from research in behavior analysis, key areas will be explored to highlight the tangible impacts of the language of instruction on linguistically diverse learners. The presenter will discuss the importance of collaborative interdisciplinary practices in developing and implementing effective language support strategies.

BCBAs, BCaBAs, graduate and undergraduate students, related service professionals