Behavior Analysts' Use of and Beliefs in Treatments for People with Autism: A 5‐Year Follow‐up

Abstract

As autism prevalence rises, parents of children with autism rely upon professionals to recommend the most effective treatment for their children. Historically, these professionals have chosen a range of treatments from empirically supported to nonempirically supported treatments. This study replicated and extended that work by surveying Board Certified Behavior Analysts to determine what treatments they promoted and used. Results showed that although most respondents used evidence‐based, behavioral procedures, many did not. Influential stimuli most likely to contribute to behavior analysts' choices of treatments were beliefs in effectiveness, ease of implementation, and persuasion by others. Self‐reported reinforcers for treatment use included perceived observed success, praise from others, and financial gain. Behavior analysts continue to use a variety of nonscientifically supported treatments, including those that have been deemed ineffective and harmful to people with autism. Future training of Board Certified Behavior Analysts must stress adherence to the ethical code for certified behavior analysts, adherence to data‐based decision‐making, and strict fealty to the scientific process in which all behavior analysts have been trained. Copyright © 2016 John Wiley & Sons, Ltd.

Behavior analysts' perceptions of the population specificity or comprehensiveness of autism treatments

“…When constructing treatments, behavior analysts must design behavior change programs conceptually consistent with behavior analytic principles (Code 4.01). Although the professional code has existed for years, research has indicated that behavior analysts continued to use and recommend non‐scientifically supported autism treatments (Schreck, Karunaratne, Zane, & Wilford, 2016; Schreck & Mazur, 2008). In fact, some behavior analysts reported using or recommending treatments deemed possibly harmful.…”

“…Choosing to recommend or advocate for these varieties of treatments despite evidence of their designation as not an EBP may occur due to a variety of factors. Behavior analysts have reported these factors to include (a) persuasion and praise by other people (e.g., colleagues, employers, internship supervisors, workshop presenters), (b) marketing (e.g., online ads and websites, newspaper articles), (c) a priori beliefs in treatment effectiveness (e.g., changes behavior, is easy to use, is cost effective), (d) popularity of the treatment, or (e) monetary gain (Schreck et al., 2016; Schreck & Mazur, 2008). The use and endorsement of non‐scientifically supported treatments also may indicate that behavior analysts do not use a radical behavior analytic perspective in their treatment choice decisions.…”

Recommendations for behavior analysts regarding the implementation of Social Stories for individuals diagnosed with autism spectrum disorder

“…We understand that in these real‐world settings, behavior analysts may be up against competing contingencies, recommendations from outside professionals and parents, and/or circumstances outside of their control. A recent study conducted by Schreck, Karunaratne, Zane, and Wilford (2016) has shown that behavior analysts are susceptible to implementing non‐evidence‐based interventions (e.g., sensory integration, facilitated communication) for a variety of reasons. These reasons included educational experiences, online propaganda, the costliness of an intervention, and persuasion to conform to the intervention from employers, colleagues, and/or parents.…”

Understanding and addressing pseudoscientific practices in the treatment of neurodevelopmental disorders: Considerations for applied behavior analysis practitioners

“…As there has been increased demand for services for individuals with developmental disabilities, especially ASD, the use of pseudoscientific treatments has also increased (Metz, Mulick, & Butter, 2016), and many behavior analysts in practice are likely to encounter the use of such treatments with their clients. For example, as reported through a survey administered to Board Certified Behavior Analysts ® , pseudoscientific practices, such as facilitated communication, auditory integration training, sensory processing or integration therapy, and gentle teaching, are implemented by behavior analysts in their own treatment of children with neurodevelopmental disorders (Schreck, Karunaratne, Zane, & Wilford, 2016; Schreck & Mazur, 2008). Many of these pseudoscientific practices start out as fads, then gain popularity to the degree that they seemingly become part of a standard and unquestioned treatment protocol to meet the behavioral needs of individuals with neurodevelopmental disorders.…”

“…As a result, they may continue to request and pursue these strategies even when their goals and outcomes are contrary to typical areas of treatment when ABA treatment is followed. Even more concerning is that some behavior analysts have reported they were persuaded to use pseudoscientific interventions by clients' families (Schreck et al, 2016). Therefore, behavior analysts would benefit from training on how to appropriately and empathetically respond to such requests.…”