Understanding Autism

An educational resource from the Yale Child Study Center

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Behavioral Treatments

Introduction

Individuals with autism spectrum disorders exhibit a range of behavioral excesses and deficits that can interfere significantly with adaptive functioning at home, in the community, and at school. At times these challenging behaviors can cause harm to others or to the person with autism, and often contribute both to isolation and misunderstanding of the needs of the individual. Over the past 40 years a robust evidence-based research and clinical literature has contributed substantially to our understanding of the nature, causes, analysis, and intervention of these behavioral challenges, and the careful application of these practices has led to significant changes in the behavioral presentation and long-term habilitation outcomes of persons with ASD.

This lecture introduces the foundations of behavioral assessment and treatment of significant challenging behavior in persons with autism. The assessment and intervention principles discussed are firmly grounded in the behavior analytic research literature, and have enjoyed widespread clinical application with a diverse range of behaviors including aggression, self-injury, stereotypy, property destruction, and pica. Following a detailed discussion of the use of the technology of functional analysis, those variables and conditions in the environment that maintain challenging behavior are discussed in relation to the development of treatment plans that are functional, based on positive behavior supports, and that teach more adaptive prosocial behavioral repertoires. The lecture concludes with a discussion of clinical and ethical safeguards to protect the rights and dignity of those with autism during treatment.

Reading List

Glasberg , B. (2008). Stop that seemingly senseless behavior. Bethesda, MD: Woodbine House.

This excellent, follow-up companion to Functional behavior assessment for people with autism extends the process of understanding challenging behavior, to developing, implementing, and evaluating treatment plans. Detailed guidance is offered on teaching replacement skills, using reinforcement effectively, and creating more adaptive environments that will support better behavior.

Cooper, J.O., Heron, T.E., and Heyward, W.L. (2007). Applied behavior analysis (Second Edition). 

This comprehensive text provides the most thorough and up-to-date  description of all evidence-based behavioral assessment and treatment procedures available. Universally regarded as the standard in the field, the Second Edition provides a clear and concise description of the technology of behavior change and the research literature supporting specific intervention strategies.

 

Powers, M.D., Palmieri, M.J., D’Eramo, K.S., & Powers, K.M. (2010). Evidence-based treatment of behavioral excesses and deficits in individuals with autism spectrum disorders. In F. Volkmar, D. Cicchetti, B. Reichow, & P. Doehring (Eds), Evidence-based practices and treatments for children with autism. New York: Springer.

This chapter provides a comprehensive and current review of functional assessment technology, as well as a detailed review of the empirical foundations for some of the most widely used evidence-based treatment procedures for severe behavior problems in those with autism. A special section is devote to the treatment of sleep disorders in children with autism.

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