As the field of Behavior Analysis continues to expand, there are a variety of certifications and licensures that guide the practices of a Behavior Analyst. For example, the Behavior Analyst Certification Board is an international organization that allows for appropriately credentialed individuals to become Board Certified Behavior Analysts (BCBA). Most relevant in the state of New York is the legislation that went into effect in 2014 that allowed for the licensure of Behavior Analysts who reside in New York (NY Educ L § 8800, 2014). While the BACB and various state legislature provides ethical and legal guidelines around what a Behavior Analyst may or may not do, Van Houten et al. (1988) published an article that provides six tenents to be included in any program that provides behavioral services to individuals. My colleagues and I at the QSAC Day School will be writing a series of blog posts that review each of these tenents and how they may be interpreted.
The first tenent outlined by Van Houten et al. (1988) is that “an individual has a right to a therapeutic environment” (p. 381). The authors indicate that a therapeutic environment is a prerequisite for effective treatment, meaning that before we can even begin to evaluate the services being provided, we must first look at the environment in which the services will be provided. Perhaps the most obvious aspects of a therapeutic environment are the physical characteristics. The rooms/building should be free of needed repairs, sanitary, and functional (i.e., meet the needs of its intended purpose). Educational and preferred items or activities should be present and age-appropriate.
Beyond the physical structure, a therapeutic environment also includes the people who are part of the environment. For example, Van Houten et al. indicate that the environment includes “parents, teachers, and staff who are competent, responsive, and caring” (p. 382). When evaluating the people in the environment, one might consider the interactions that take place between staff members, supervisors, and individuals receiving services. The interactions should be positive and promote learning for all parties involved. Staff members providing services should be able to describe the services they are providing and the reason said services are being provided.
Lastly, and perhaps the most difficult aspect to evaluate, the authors state that a therapeutic environment “imposes the fewest restrictions necessary, while ensuring individual safety and development” (p. 382). Individuals receiving services often require various levels of support to complete certain tasks and activities. While support is provided to assist the individual with appropriately completing the task or activity, it is important that the task is completed with least amount of support necessary. Providing too much support or implementing too many restrictions may have the adverse effect of limiting the individual’s independence with the task or activity and inhibit potential learning opportunities.
One of the greatest strengths of the field of Behavior Analysis is its focus on individualized interventions. That being said, a therapeutic environment may be perfectly appropriate for one individual, and completely inappropriate for another. It is important that the needs of the individual receiving services are taken into consideration with every aspect of the environment so that the program can provide the most effective services possible.
Todd A. Merritt, M.A., BCBA is currently a Senior Applied Behavior Analysis Coordinator at QSAC’s Day School. He received his bachelor’s degree in psychology from Western Michigan University, master’s degree in applied behavioral science from The University of Kansas, and is a Board Certified Behavior Analyst.
New York Education Law, Title 8, Article 167 § 8800 (2014).
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(4), 381-384.
The movement towards independence in adulthood is a strong motivator for families and individuals with autism spectrum disorder (ASD). Even with a strong desire, reaching the maximum level of independence has proven to be more difficult due to core deficits of the disorder. As students transition from 1:1 support within the educational system to the adult world, it has become clear that direct support from others needs to be faded dramatically so that individuals are more capable of reaching higher levels of independence. With an array of independent skills that need to be systematically taught to individuals with ASD (ranging from washing their hands to using public transportation), it is important to break down skills in a way that can be taught effectively. Organization is key for teaching skills, and this can be done by focusing instruction to decrease distractibility, set up productive sequencing, increase generalization, and promote independence without the assistance from others (Dunlap & Johnson, 1985).
Work systems are an evidence-based practice that visually structure sequences of skills that can be practiced across settings (Hausler & Bernard-Opitz, 2011). They use visual supports that provide extra information to the learner. Visual schedules often tell the individual where to go, yet work systems include what to do once they are in the correct location. Information provided includes what tasks they need to complete, how many tasks to complete, how the individual will know they are finished, and what the individual needs to do once all tasks are complete. All information is provided visually, and is dependent of adult support. Work systems can be used with a variety of activities, and can include:
Preparing a meal
Riding the subway or bus
Completing a hygiene activity such as washing hands
Vocational task such as sorting office materials
At QSAC’s Hollis Day Habilitation Program, structured work systems are in full effect in a vocational greeting card program that our individuals are beginning to participate in. The work systems follow a routine- work flowing left to right, and have a location for finished products making it very clear for the individual to know exactly what is required to complete the task in full, and what to do when they are finished.
Structured work systems are a great way to increase independence for individuals with ASD. The work systems provide opportunities to organize materials to meet the needs of the learners by decreasing distractibility, setting up productive sequencing, increasing generalization, and promoting independence without the assistance from others.
Clare Penny, M.A., BABA serves as the Assistant Clinical Director for QSAC’s adult day habilitation programs. Professionally, she has been working with individuals with Autism Spectrum Disorder for the past seven years. She has her Master’s Degree in Applied Behavior Analysis, with an emphasis in Autism. Her current research interests focus on structured work systems and the use of the AFLS assessment for curriculum building. Clare is beginning her PhD course work in Applied Behavior Analysis in January 2016.
Anya K. Silver, M.A., BCBA Director of Clinics Services for Day Habilitation, has been working in the field of autism and applied behavior analysis for over 20 years. Anya received her Bachelors Degree in 1995 in Psychology from Queens College. She completed her Masters Degree in 1996 in Child Development at Tufts University. Anya worked in the field of Early Intervention and Autism for over 10 years supervising ABA programs across NYC and Long Island. Currently, Anya works with the adult autism community. She is the Clinical Director of Day Habilitation programs for Quality Services for the Autism Community (QSAC). Anya is a Board Certified Behavior Analyst and an active member of the autism community. She presents at local and national conferences on topics related to autism intervention. Anya is a Media Watch Writer for the Association for Science in Autism Treatment (ASAT). She has presented research on staff training and published articles on humanistic and behavioral perspectives as well as teaching deception skills to students with autism spectrum disorders.
Dunlap, G. & Johnson, J. (1985). Increasing the independent responding of autistic children with unpredictable supervision. Journal of Applied Behavior Analysis, 18, 227-236.
Hausler, A., & Brenard-Opitz, V. (2011). Visual support for children with autism spectrum disorders. Shawnee Mission, KS: AAPC Publishing.
One of the key markers of autism is significant social deficits. Even on opposite ends of the spectrum, having difficulties with social cues and relationships is consistent. That being said, this is not to say that people with autism do not want to have meaningful relationships with others. In fact, many of the people I have helped support have expressed a desire to become closer to their families, make friends, and even find a romantic partner.
When we think about “natural” supports, we think about those in our lives whom we are naturally connected to. Then, we have “paid” supports, such as doctors, whom we pay to support us in different facets of our lives. Individuals with autism often have more paid supports in their lives than natural ones. This is in contrast to those of us without autism, who find ourselves with more natural supports in our lives than paid ones. It is important to encourage and support individuals with autism to gain more natural supports, as well as enhance existing natural supports to have even more meaningful relationships.
Many of the services that are available to individuals with autism have a common goal of providing the necessary supports to further their socialization skills. For school-age children, some of these services include weekend/holiday recreational programs, after school programs, and summer camps. Children are provided with the opportunity to interact with their peers, and engage in meaningful activities together. They are encouraged to initiate interactions with their peers, as well as increase their socialization skills so that their interactions are appropriate.
For adults, there are also a number of recreational activities that provide the opportunity to engage in activities with peers. Some of these programs involve community activities, where individuals socialize with their peers while also becoming a bigger part of their community. Accessing community resources allows for individuals with autism to be a part of their natural community, and have truly meaningful relationships with those in their environment.
There are also social skills peer groups, and other topical groups such as self advocacy. In a self advocacy group, individuals with autism (and other developmental disabilities) gather together to talk about rights and responsibilities, and being able to advocate for one’s own wants and needs. In QSAC’s self advocacy group, the group decides which food they would like for the evening, and then share a meal together just as friends often do when they come together. Topics are discussed over food, much like those of us without autism do with our friends. Although these do not happen as often as regular self advocacy meetings, there are also events such as speed dating, which provide them with the opportunity to pursue romantic relationships. Existing members of our self advocacy group, as well as potential new members, recently went on a day trip to Six Flags in New Jersey. The most special part of the day, in my opinion, was watching bonds form; not just between the individuals we were supporting, but also the relationships we were forming together. There was not such a sense of “individuals” separated by “staff”, but more of a sense of friends enjoying their time, together, at the theme park.
Although individuals with autism have difficulty with social interaction, it does not mean that they do not have the desire to be close to others. By providing them with the appropriate supports and services, they will be able to have meaningful and supportive relationships in their lives. This will allow their lives to become enriched, more meaningful, and certainly more independent.
Sara Giangiobbe, MAT serves as a Medicaid Service Coordination Supervisor in QSAC’s MSC Department. She has been serving in a multitude of roles with QSAC since 2004. In addition to her professional role in the field of autism and developmental disabilities, she has a younger brother who is diagnosed with autism. She is a proud sibling and professional, and is also a regular contributor to onQ, QSAC’s blog.
This past year has been a challenging one as much as a rewarding one. When I first started working for QSAC, I did not realize the impact I would have as a self-advocate and mentor to young adults with disabilities, but as time went on, myself and others have come to understand this more and more.
I realized that this learning experience was just as new to me as the individuals I was mentoring. The way I learned in this endeavor was through respect and willingness to grasp information from others, a s well as being open to replicate in return.
Advocating is a skill that has ignited the fuel of my mind, bringing out my passion and opening my heart. I learned this when I realized my true potential for this task. I’ve shared my story at numerous presentations, hoping that it influences others in my position to be greater and become better advocates. During this process, I have learned that change is a natural part of life. What would have been acquaintances have become friends and unfamiliar strangers have common bonds.
Learning my skills have made an impact on me from being a volunteer to better worker. Having rights and understanding the power of them is truly necessary such as: being aware of having choices, getting involved in healthy relationships, working and/or volunteering, having free speech, and owning up to our responsibilities. This is supported by our amendments in the Bill of Rights.
Being safe in this community is a big right for everyone. One way that I learned how to be safe in a community is by having support staff, helping me get familiar with the community and feel safer. Knowing this, I have advocated my experience in hopes that others will follow my example to feel safer in the community.
I have also attended many workshops and volunteered for many organizations such as Americore and O.P.W.D.D. I do this continuously and in my spare time to set an example for others like myself. My most valuable experience has been these connections that have brought out my true voice, and these impacts on others and those around me. I hope to continue to be a voice for many others, and I hope to help them create their own voice.
Danielle Lazzara serves as a Development Assistant in QSAC’s Development Department and as an instructor in the Self-Advocacy Training Program funded by the Long Island Unitarian Universalist Fund (LIUU Fund) of the Long Island Community Foundation. Danielle is a self-advocate and presents regularly at local and regional workshops and conferences on the topic of self-advocacy. She has been a member of QSAC’s Development Department since 2013 and writes regularly for onQ, QSAC’s blog.
QSAC is a New York City and Long Island based nonprofit that supports children and adults with autism, together with their families, in achieving greater independence, realizing their future potential, and contributing to their communities in a meaningful way by offering person-centered services.
QSAC pursues this mission through direct services that provide a supportive and individualized setting for children and adults with autism to improve their communication, socialization, academic, and functional skills.