May 11, 2015 6:29 pm Published by Ron Lee, Ph.D., BCBA-D
In April of 2014, the NY Times published an online article titled, “Inside the Mind of Child with Autism.” (Carey, 2014). In this article, the reporter, alludes to a new therapy in the treatment of autism. It is based on the idea that a child with autism may present sstrong interests or obsessions and that these interests or the related behaviors might serve as the foundation for promoting social development. The idea is based on the report by Ron Suskind, a parent of a child with autism, who described how he and his family were able to connect with his child through the use of Disney characters (Suskind, 2014). The approach has since been coined, “Affinity Therapy” to represent the therapeutic use of the interests, or even obsessions, with which children with autism might present.
As mentioned by Carey and others, Affinity Therapy has some similarities to other treatment approaches, such as Pivotal Response Training. An essential component of these approaches is to use a child’s interests as the foundation for building other skills and meaningful interactions. Although important, the inclusion of the preferences and interests of the learner into his/her educational and treatment program is not new and has an established evidence base for its status as a standard of practice. For example, assessing a child’s preferences is the initial step for developing effective motivational/reinforcer systems (e.g., Fisher et al. 1992). Additionally, different methods for assessing preferences exist for different purposes ( Deleon & Iwata, 1998; Deleon et al. 1999; Ringdahl et al. 1997; Roane et al. 1998). The technology of assessing preferences continues to evolve and grow with continuing research. (e.g., Groskreutz & Graff, 2009; Jerome & Sturmey, 2008; Kodak et al. 2009; Nuernberger et al. 2012; Sturmey et al. 2003; Snyder, Higbee, & Dayton, 2012). In addition to identifying stimuli that can be incorporated into intervention programs, other studies have investigated the impact of preference on academic and vocational tasks (e.g., Cobigo, Morin, & Lachapelle, 2009; Lattimore, Parsons, & Reid, 2003; Worsdell, Iwata, & Wallace, 2002). Thus, when it comes to assessing preferences, one size does not fit all and specific situations might call for a specific assessment method.
In addition to the benefits of incorporating preferences into instruction, the effects of facilitating opportunities for instruction using preferred stimuli have also been well-established. Treatment packages such as Naturalistic Instruction, Natural Language Paradigm, and Pivotal Response Training emphasize providing teaching opportunities following the spontaneous behavior of the learner. While these packages might espouse different treatment priorities, they share a common foundation in the use of a well-established technique referred to as incidental teaching. First described by Hart & Risley (1968) with disadvantaged preschoolers and later extended to children with autism (McGee et al. 1983; McGee, Krantz, & McClannahan, 1985; McGee, Krantz, & McClannahan, 1986; McGee et al. 1992), this technique involves following a learner’s initiation (e.g., movement towards an item, a reach, point, grab, or request) with an request by the instructor for the learner to elaborate. For one learner, the target elaboration might be to name or describe the item. For another learner, it might be to state the location of the item using prepositions. For still others, it might be to use social niceties such as saying, “Please” and “Thank you.” Ultimately, it is the elaborations are individualized and targeted improvement. Because incidental teaching opportunities are initiated by the learner, the instructor might set up the environment in such a way to promote more frequent initiations; a strategy sometimes referred to as behavior trapping. Frequently, these techniques occur within the context of semi-structured play sessions where the instructor will make frequent modifications to the environment based on the initiations (or lack of) by the learner. Similar methods are often found in current communication-training packages. The extensive research base in the areas of preferences and incidental teaching can lead us to the conclusion that not only can the interests of children with autism be used to promote and reinforce desired behavior but when combined with other structured behavioral techniques, such as discrete-trials instruction, it is a vital component to the overall treatment of learners with autism (Weiss, 2001).
Aside from assessing and incorporating preferences into the structure of instruction, Affinity Therapy also describes specific reinforcement procedures. For example, Carey describes the common approach of providing access to favorite materials contingent upon other desired behavior (i.e., a reinforcement procedure). To rephrase more broadly – can access to favorite animated characters be an effective reinforcer for those children with autism who demonstrate this particular interest? Although this assumption might be intuitive, the reinforcing properties of a stimulus can be influenced by a variety of factors. For example, the reinforcing properties of a stimulus can change based on contextual/environmental factors. This is referred to as motivational operations, and includes, among other things, the person’s degree of deprivation from the activity or material. Thus, something that is reinforcing at one moment might not be reinforcing at another. This is also related to the fact that reinforcers are defined functionally rather than topographically. Thus, a stimulus is only a reinforcer when it succeeds as strengthening behavior. Again, this alludes to reinforcing properties as a dynamic property. As a result, although a child with autism’s interests in animated characters persists across a variety of situations, the reinforcing effectiveness of those animated characters may be less reliable.
Second, there are numerous other factors that can influence the effectiveness of a reinforcement procedure. These include, but are not limited to, 1) the contingency of reinforcement, 2) the schedule of reinforcement delivery, 3) the immediacy with which it is delivered after a desired response, 4) the (relative) magnitude/duration of the stimulus, and 5) other concurrently available reinforcers. These factors, motivational operations, and other variables make the question of whether a specific reinforcement procedure will be effective much more complex than identifying the stimulus to be used as an interest.
Mr. Carey’s article and the report by Mr. Suskind should be appreciated for the attention that it brings to the importance and utility of using a child’s interests within their treatment programs. We should all be reminded that it is an ethical responsibility to provide a therapeutic environment: one that incorporates leisure and instructive materials (Van Houten et al. 1988). In contrast to some of the directions taken by Affinity Therapy, however, it may be of greater value to parents and practitioners to ask why such strategies are effective rather that whether they can be effective. Studying the effects of an intervention based on only animated characters narrows the field of potential reinforcers to this one class of topographical stimuli. As a result, such interventions will be limited in terms of its generality to others. For those with whom the approach appears applicable, the actual and established mechanisms for adaptive and prosocial behavior change will be concealed making it more difficult to tailor comprehensive instructional and reinforcement procedures to the individual. Additionally, problem-solving those procedures that do not produce desired or expected outcomes will also be hindered. Thankfully, there is an already extensive body of research that continues to grow that can help practitioners from all fields address these problems. Ultimately, a better understanding of the principles that govern behavior can lead to the best individualized treatment choices for all people with autism.
Carey, B. (2014, April 7). Inside the mind of a child with autism [Blog post]. Retrieved from
Charlop, M., H., Kurtz, P. F., & Casey, F. G. (1990). Using aberrant behaviors as reinforcers for autistic
children. Journal of Applied Behavior Analysis, 23, 163-181.
Cobigo, V., Morin, D., & Lachapelle, Y. (2009). A method to assess work task preferences. Education
and Training in Developmental Disabilities, 44, 561-572.
DeLeon, I. G., & Iwata, B. A. (1996). Evaluation of a multiple-stimulus presentation format for assessing
reinforcer preferences. Journal of Applied Behavior Analysis, 29, 519-532.
DeLeon, I. G., Iwata, B., A., Conners, J., & Wallace, M. D. (1999). Examination of ambiguous stimulus
preferences with duration-based measures. Journal of Applied Behavior Analysis, 32, 111-114.
Fisher, W., Piazza, C. C., Bowman, L. G., Hagopian, L. P., Owens, J. C., & Slevin, I. (1992). A
comparison of two approaches for identifying reinforcers for persons with severe and profound disabilities. Journal of Applied Behavior Analysis, 25, 491-498.
Groskreutz & Graff 2009
Hanley, G. P., Iwata, B. A., Thompson, R. A., & Lindberg, J. S. (2000). A component analysis of
“stereotypy as reinforcement” for alternative behavior. Journal of Applied Behavior Analysis, 33, 285-297.
Hart, B. & Risley, T. R. (1968). Establishing use of descriptive adjectives in the spontaneous speech of
disadvantaged preschool children. Journal of Applied Behavior Analysis, 1,109-120.
Jerome, J. & Sturmey, P. (2008). Reinforcing efficacy of interactions with preferred and nonpreferred
staff under progressive-ratio schedules. Journal of Applied Behavior Analysis, 41, 221-225.
Kodak, T., Fisher, W. W., Kelley, M. E., & Kisamore, A. (2009). Comparing preference assessments:
Selection- versus duration-based preference assessment procedures. Research in Developmental Disabilities, 30, 1068-1077.
Lattimore, L., Parsons, M.B., & Reid, D. H. (2003). Assessing preferred work among adults with autism
beginning supported jobs: Identificatino of constand and alternating task preferences. Behavioral Interventions, 18, 161-177.
McGee, G. G., Almeida, C., Sulzer-Azaroff, B., & Feldman, R. S. (1992). Promoting reciprocal
interactions via peer incidental teaching. Journal of Applied Behavior Analysis, 25, 117-126.
McGee, G. G., Krantz, P. J., Mason, D., & McClannahan, L. E. (1983). A modified incidental-teaching
procedure for autistic youth: Acquisition and generalization of receptive object labels. Journal of Applied Behavior Analysis, 16, 329-338.
McGee, G. G., Krantz, P. J., & McClannahan, L. E. (1985). The facilitative effects of incidental teaching
on preposition use by autistic children. Journal of Applied Behavior Analysis, 18, 17-31.
McGee, G. G., Krantz, P. J., & McClannahan, J. E. (1986). An extension of incidental teaching
procedures to reading instruction for autistic children. Journal of Applied Behavior Analysis, 19, 147-157.
Nuernberger, J. E., Smith, C. A., Czapar, K. N., & Klatt, K. P. (2012). Assessing preference for social
interaction in children diagnosed with autism. Behavioral Interventions, 27, 33-44.
Ringdahl, J. E., Vollmer, T. R., Marcus, B. A., & Roane, H. S. (1997). An analogue evaluation of
environmental enrichment: The role of stimulus preference. Journal of Applied Behavior Analysis, 30, 203-216.
Roane, H. S., Vollmer, T. R., Ringdahl, J. E., & Marcus, B. A. (1998). Evaluation of a brief stimulus
preference assessment. Journal of Applied Behavior Analysis, 31,605-620.
Snyder, K., Higbee, T. S., & Dayton, E. (2012). Preliminary investigation of a video-based stimulus
preference assessment. Journal of Applied Behavior Analysis, 45,413-418.
Sturmey, P., Lee, R., Reyer, H., & Robek, A. (2003). Assessing preferences for staff: Some pilot data.
Behavioural and Cognitive Psychotherapy, 31, 103-107.
Suskind, R. (2014, March 7). Reaching my autistic son through Disney. Retrieved from
Van Houten, R., Axelrod, S., Bailey, J. S., Favell, J. E., Foxx, R. M., Iwata, B. A., & Lovaas, O. I.
(1988). The right to effective behavioral treatment. Journal of Applied Behavior Analysis, 21, 381-384.
Weiss, M. J. (2001). Expanding ABA intervention in intensive programs for children with autism: The
inclusion of natural environment training and fluency based instruction. The Behavior Analyst Today, 2, 182-186.
Worsdell, A. S., Iwata, B. A., & Wallace, M. D. (2002). Duration-based measures of preference for
vocational tasks. Journal of Applied Behavior Analysis, 35, 287-290.
May 4, 2015 3:00 pm Published by Sara Giangiobbe, MAT
As we approach the end of the school year, many families find their loved ones drawing closer to graduation, and beginning the transition into adulthood. In New York State, students age out of the public school system at the end of the school year in which they turn 21. Thankfully, there are many supports and services available for individuals with disabilities as they prepare to move into life outside of school.
New York State law states that any student that receives special education services, and has an IEP, must begin transition planning by age 15. Transition plans become a key component of the IEP process, and are reviewed and updated each year. The student, their family, and the IEP team, will work together to create the transition plan. A student’s interests, goals, and skills, will be assessed and evaluated to design the plan that best meets their needs.
If the student receives OPWDD services, their Medicaid Service Coordinator can be a vital asset to the transition planning process. Service coordinators are able to assist with making referrals to appropriate services, providing linkage to resources, and advocating for the student, and their family. There are numerous options within the OPWDD system for students and families to consider during the transition process.
Day Habilitation services are designed to facilitate the development and enhancement of skills that will allow individuals to lead more independent lives. Adults receiving day habilitation services are also given the opportunity to become more involved with the community by performing volunteer work. Recently, there has been more development of “Day Habilitation Without Walls” programs. These programs are less site-based than the traditional day habilitation model, and focus more on individualized, community-based objectives (such as travel training).
Prevocational services assist adults who would like to work, but need to further develop their employment skills in order to be successful in the workplace. Individuals will work on general training skills, so that they may prepare to seek employment in the future.
Programs such as Supported Employment (SEMP), and the Employment Training Program (ETP), provide adults with the supports needed to obtain and maintain competitive employment. They will work with a “Job Coach” in order to find a job that matches their interests and skills, prepare for interviews, and successfully perform their job duties. During the IEP transition planning process, a student’s vocational skills will be assessed in order to find the program that best fits their needs.
Self-Direction (formerly known as CSS) is an alternative to traditional OPWDD services, in that the individual and their family are responsible for selecting and maintaining services, based on that person’s individualized needs, including the hiring of staff. Self-Direction allows for more flexibility in obtaining supports that best fit the individual’s needs that they may not be able to receive through the traditional route of services. There are ways to incorporate agency-supported services into self-direction as well, should this be something that the individual is interested in. Self-Direction is great way to be able to transition into adult services after graduation, and acquire the supports that the individual needs in order to be successful.
I have recently seen an increase in the amount of students that go on to attend college classes after graduation. Part of the transition planning process will assess the student’s academic skills and needs, to see if college is an appropriate option.
With careful planning, and active involvement from the student and their family, the transition from school to adulthood can be smooth and successful. By utilizing different supports such as school staff, and service coordinators, your loved one will continue to gain independence, and become more involved in their community.
OPWDD Employment Services: http://www.opwdd.ny.gov/node/668
OPWDD Day Services: http://www.opwdd.ny.gov/opwdd_services_supports/supports_for_independent_and_family_living/day_services
OPWDD Self- Direction: http://www.opwdd.ny.gov/node/763 – http://www.opwdd.ny.gov/opwdd_services_supports/supports_for_independent_and_family_living/consolidated_supports_and_services/self-direction-redesign-qa
New York State Transition Services: http://www.p12.nysed.gov/specialed/transition/home.html
Advocates for Children’s Transition Guide: http://www.advocatesforchildren.org/sites/default/files/library/transition_guide.pdf?pt=1