No Less Worthy: Recommendations for Behavior Analysts Treating Adults with Intellectual and Developmental Disabilities with Dignity

Abstract

In this article, the authors offer recommendations for behavior analysts on how to treat adults with intellectual and developmental disabilities (IDD) with dignity. Initially, the importance of treating adults with disabilities with dignity is emphasized in terms of the impact on people with IDD, their family members, behavior analysts and other service providers, and the behavior analysis field in general. The recommendations are based primarily on the authors' professional and personal experiences along with similar experiences of others involved either personally or professionally in the disability field. The focus is on ways in which behavior analysts speak and behave that reflect dignity versus the lack thereof as perceived by others and, where relevant, consensus opinion within the professional field of IDD. Ways for behavior analysts to acquire and maintain awareness of manners of speaking and behaving that reflect dignity within the local settings in which they work are also provided.

Neurodiversity-Affirming Applied Behavior Analysis

“…Our ability to effect meaningful changes in behavior that enhance the quality of life for those we serve requires "effective communication [which] depends on choice of language" (Carr, 1996, p. 625). Aiming to be respectful to the [identities and] preferences of individuals/groups (Reid et al, 2018) instead of demonstrating allegiance to professional traditions (Bottema-Beutel et al, 2021) provides the rationale for adapting how we use language with and regarding those whom we support. Reid et al (2018) models the self-reflection necessary to adapt personal practice, noting that had he been responsive to the stated preferences of self-advocates and their families, "his naming practices likely would have changed and been perceived as more dignified at a much earlier time" (p. 73).…”

“…Dignity, from the Latin word dignitus (merit) and dignus (worth; Kennedy, 2016), involves people being treated as worthy, valued, and respected (Reid et al, 2018). The Ethics Code for Behavior Analysts (2020), like Reid et al (2018), employs a definition of dignity that aligns to the widely understood meaning by non-behavior analysts.…”

“…Dignity, from the Latin word dignitus (merit) and dignus (worth; Kennedy, 2016), involves people being treated as worthy, valued, and respected (Reid et al, 2018). The Ethics Code for Behavior Analysts (2020), like Reid et al (2018), employs a definition of dignity that aligns to the widely understood meaning by non-behavior analysts. For example, treating "others with compassion, dignity, and respect" is operationalized as ensuring equitable treatment regardless of differences, honoring privacy and confidentiality, promoting self-determination, and offering necessary information to allow clients to make informed choices regarding services (BACB, 2020, p. 4).…”

“…Research in ABA, which informed our evidence-based practices, has largely overlooked the importance of participatory approaches (Pritchett et al, 2022) or methods that render •Ensure dignity by aligning services to the client's stated/demonstrated/known wants, needs, values, and preferences. When these are not fully understood, (1) be diligent in gaining understanding; (2) seek to be responsive to demonstrations of momentary assent and assent withdrawal; and (3) engage in self-reflection to inform how one may want their own loved one treated (Reid et al, 2018). • Seek client's input and feedback in an ongoing manner regarding (1) the goals of intervention; (2) the procedures (i.e., assessment, intervention); and (3) outcomes or effects, intended or unintended (Wolf, 1978).…”

Contributions of positive behavior support amid lingering questions over its relationship with behavior analysis: A review of Positive behavior supports for adults with disabilities in employment, community, and residential settings by Storey and Post

“…As indicated in the authors' summary of PBS in the introductory chapter, a particular focus of PBS is treating individuals with dignity. Concern exists within the disability literature that referring to adults with disabilities by their first names and adults without disabilities by their last names preceded by Mr. or Ms. reflects a lack of dignity by not respecting the adult status of the former individuals (Bigby, Knox, Beadle‐Brown, Clement, & Mansell, ; Reid, Rosswurm, & Rotholz, ). However, discrepant references to the respective adult groups in the Storey and Post () book are no different than much of the existing literature in intellectual disabilities and ABA (Reid et al, ).…”