Evaluating Kupferstein’s claims of the relationship of behavioral intervention to PTSS for individuals with autism

Abstract

Purpose-Kupferstein (2018) surveyed 460 respondents and found that 46 percent of respondents met the diagnostic threshold for posttraumatic stress disorder after exposure to applied-behavior-analysis-based intervention. The purpose of this paper is to provide an evaluation a critical analysis of Kupferstein (2018) including the experimental methods and discussion of the results. Design/methodology/approach-The authors evaluated the Kupferstein's methodological rigor with respect to the use of hypothesis testing, use of indirect measures, selection of respondents, ambiguity in definitions, measurement system, and framing of the experimental question when conducting the correlational analysis in addition to Kupferstein's analysis and discussion of the results. Findings-Based upon the analysis, Kupferstein's results should be viewed with extreme caution due to several methodological and conceptual flaws including, but not limited to, leading questions used within a non-validated survey, failure to confirm diagnosis, and incomplete description of interventions. Originality/value-It is the authors' hope that this analysis provides caregivers, clinicians, and service providers with a scientific lens which will useful in viewing the limitations and methodological flaws of Kupferstein.

The Importance of Professional Discourse for the Continual Advancement of Practice Standards: The RBT® as a Case in Point

“…We are currently in a culture in which the appropriateness of behavioral intervention for individuals diagnosed with ASD is being questioned, including such drastic claims that it causes symptoms of PTSD (Kupferstein 2018 ; but also see Leaf, Ross, et al 2018 ). It is a time during which an increasing number of non-behavioral interventions are recommended for individuals diagnosed with ASD (Lilienfeld et al, 2015 ), some of which have some evidence (e.g., Early Start Denver Model) while many are pseudoscientific (e.g., Social Thinking®).…”

Exploring Quality in the Applied Behavior Analysis Service Delivery Industry

“…However, answers may be hard to come by without a definition of ASDQ that is sufficiently clear, objective, and measurable to allow the field to apply its technology to ASDQ. Additional reasons why a systematic discussion of ASDQ is urgently needed are that it may ultimately help us to deal with (1) the unknown impact of ABA business model diversity, industry growth, private equity investments, and subsequent acquisitions of ABA service providers; (2) issues related to international dissemination and misconceptions about ABA (e.g., Keenan et al, 2014); (3) opinions and narratives about negative experiences with ABA services described on social media platforms such as Twitter, Inc. ®; (4) highly flawed published research that nevertheless raises questions about practitioners' use of ABA (e.g., research addressed by the response from Leaf et al, 2018); and (5) clinical or operational practices unwittingly supported by contingencies within ABA service delivery organizations with the potential for harm to consumers.…”

“Recalling hidden harms”: autistic experiences of childhood applied behavioural analysis (ABA)

“…Kupferstein (2018) concluded heightened criteria for PTSS for those who had previously participated in ABA intervention. While critiques of Kupferstein’s approach and conclusions suggest potential bias and difficulty in interpreting which were the autistic voices in their research (Leaf et al , 2018), Kupferstein’s research builds on the foundations of autistic narratives of trauma and forced change. In addition, there are different stakeholders with vested interests in ABA.…”