AMANDA SAWMA PS553 ASSESSING AUTISM INTERVENTIONS CALDWELL COLLEGE Chapter 2 Sifting Sound Practice From Snake Oil Jacobson, J. W., Foxx, R. M., & Mulick, J. A. (Eds.). (2005) Controversial therapies for developmental disabilities: Fad, fashion, and science in professional practice. Hillsdale, NJ: Erlbaum

Progress in Developmental Disabilities Teaching of adaptive skills  Independence  Functional skills Treatment of behavior problems  Allows for less-restrictive environments Overall quality of life  Reduction in the need for institutionalization

Fads in Developmental Disabilities Vulnerable to questionable ideas and movements  Auditory integration  Greenspan’s Floor Time  RDI  Son-Rise  The Miller Method  Diets  Gluten-Free, Casein-Free  OSR#1 Dietary Supplement

Fads Claim to produce results that are:  More rapid  More beneficial  Easier to achieve  No stress or challenges on the individual Promise outcomes that are less:  Intrusive  Costly  Stressful  Labor intensive  Risky Often denounce all previous treatments  Example: views regarding institutions after community movement

CHAPTER 2 SIFTING SOUND PRACTICE FROM SNAKE OIL The Rules and Rewards of Science

What is Science? “Used properly, the word science refers to a systematic approach for seeking and organizing knowledge about the natural world.” (Cooper, Heron, & Heward, 2007) Levels of understanding:  Description, prediction, and control Attitudes of science:  Determinism  Empiricism  Experimentation  Replication  Parsimony  Philosophical doubt

Science Can test the effects of a treatment  Establishes or disconfirms its value  Determines whether it is a beneficial part of services and supports “Science separates sound practice from snake oil.” (Jacobson, Foxx, & Mulick, 2005)

Science Requires:  Quantitative, direct measures of observable events  Analysis of whether the intervention functionally caused the obtained effects  Replication to assess reliability

Science Has established knowledge and technology to teach individuals with developmental disabilities Enabled an emphasis on:  Growth in people with developmental disabilities  Supports to facilitate their development  Greater independence and enjoyment of life  Community-living among family and friends  Reduced use of drugs  Reduction in stigmatizing behavior problem  Improvements in functional skills

CHAPTER 2 SIFTING SOUND PRACTICE FROM SNAKE OIL The Distrust and Disdain of Science

Reasons for Disdain and Distrust Process appears arduous and slow Requires time to:  Conduct investigations  Arrive at conclusions  Disseminate results

Reasons for Disdain and Distrust Sometimes seems to defy logic Does not conform to conventional wisdom Does not conform to common sense

Reasons for Disdain and Distrust Process appears:  Arcane  Complex  Confusing This is true for:  The developmental disabilities community  The general public  Professionals not trained in the values, method, and logic of science

Reasons for Disdain and Distrust Not widely taught, even in graduate level courses in education, medicine, psychology, or other professional human service areas Highly-trained professionals may be:  Well-versed in their discipline  Unfamiliar with the scientific method  Prevents effective evaluation of new developments  Relies on popular beliefs

Reasons for Disdain and Distrust Appears preoccupied with methodology, not meaningfulness of results Media coverage:  Elaborate and costly research  “Trivial” or “obvious” results Perceived as:  Self-serving  Detached from and unresponsive to real issues

Reasons for Disdain and Distrust May deliver unexpected or unwanted results Science is “value-neutral” Results may not be consistent with beliefs, wisdom, or treatment and instructional philosophy  Promising or hopeful approach may be disconfirmed  Painful to families  Implications for professionals  Example: vaccines and autism

Reasons for Disdain and Distrust The scientific approach is not explained to:  Consumers  The public  Human service professionals Scientists communicate:  With other scientists and professionals within their field  Via scientific journals  Via professional meetings

Reasons for Disdain and Distrust Dissemination usually focuses on results, not experimental rigor  Consuming audiences cannot evaluate the scientific method  Families and professionals are left vulnerable to fads and promises

CHAPTER 2 SIFTING SOUND PRACTICE FROM SNAKE OIL The Care and Feeding of Fads

Fads Are easy to promote and popularize Dissemination is easy  Families are in search of help  Press is in search of hype Critical evaluations often begin after the fad has wasted resources and financial investments

Fads The field of developmental disabilities is especially vulnerable to fads Lead to false observations and conclusions  Variability in behavior  Superstitious behavior  Focus on salient environmental events The use of multiple and frequent interventions

Fads Variables affecting individual promoting a method or movement  Be forgiving to those whose ideas are proven misguided or wrong  Be less forgiving to those who reject efforts to test ideas, or continue claims despite evidence against them

Fads Philosophical and political pressure on the field  Positive impact on field  Example: early intervention in autism  Negative impact on field  Example: restraint for problem behaviors

CHAPTER 2 SIFTING SOUND PRACTICE FROM SNAKE OIL Applied Behavior Analysis: An Example of the Fruits of Science and the Foundation of Fads

Behavior Analysis Vital in the treatment and training in developmental disabilities  Developed community-based supports  Effective treatments  Training strategies Based on solid research Subject of major criticism from the public and other professionals

Behavior Analysis Behavior analytic processes are:  Slow and methodical  Difficult and expensive  Empirical, not values based  Not as dramatic or fun as some fads  Different from popular culture and sometimes common sense Became popular after psychiatric and medical communities could not help individuals with developmental disabilities

Contrasts Against Behavior Analysis “Positive Behavioral Support”  Viewed as alternative to, not derivative of behavior analysis “Person-centered planning”  Builds support plan based on strengths, preferences and personal desires  Viewed as opposite of behavioral approaches  Ignores foundation of behavior analysis  Focuses on preferences, reinforcers, strengths, and needs

CHAPTER 2 SIFTING SOUND PRACTICE FROM SNAKE OIL Essential Steps Toward Sound Practice

New Ideas “The way to have a good idea is to have lots of them” Encourage new models, methods, and movements Emphasize systematic evaluation and analysis of new ideas Empirically evaluate ideas if agreed upon by the individual’s family and supporting professionals  Must be ethical, and not likely to cause harm

Scientific Research Optimal way to test new models and methods Empirical analysis is the best way to measure effectiveness Measures conducted on ABA programs  Data collection  Treatment outcomes

Single-Subject Research Designs Focus on the analyses of effects with a small number of individuals New level of sensitivity and relevance to research in developmental disabilities Allow evaluation of unique adjustments and effects with individuals Incorporate information gained into conclusions drawn Combine research and practice Yield the most convincing data on the efficacy of a new approach

Individual Cases Cannot confirm a proposed strategy Can identify nonfunctional or harmful methods

Measurement Reliable and valid measurement can address many debatable issues Should include multiple dimensions  Example: the reduction of demand-induced self-injury should be measured with skill acquisition Should include measures of:  Practicality  Cost  Social acceptability

Decision Making Someone must decide what is appropriate for individuals who cannot decide for themselves Decision making can be conducted by:  Broader agencies  Can raise issues and offer alternatives  Families  Closest to the issues  Will experience consequences of decisions

CHAPTER 2 SIFTING SOUND PRACTICE FROM SNAKE OIL Summary

Science vs. Fads Scientific method is the only real means of sifting sound practice from snake oil The principles and processes of the scientific method are not yet embraced Science is viewed as arcane, especially by the public and professionals not trained in the scientific method Fads and movements are easily advertised and promoted by families, the public, and the media

Developmental Disabilities We must encourage new ideas  Use empirical tests  Measure the full effects of intervention  Analyze functional relationship between the dependent and independent variables There are no substitutes or short cuts to empirical validation If proponents refuse to use empirical validation their motives and methods must be questioned Consumers and professionals should refuse approaches if they are denied data

The Individual Science and ideology cannot make value-based decisions in individual cases No idea, model, method, or movement should dictate what is right or wrong for an individual Decisions regarding the issues should be made by those closest to the individual The field of developmental disabilities must provide sound options to those making such decisions

References Cooper, J. O., Heron, T. E., & Heward, W. L. (2007). Applied Behavior Analysis. 2 nd Edition. Upper Saddle River, New Jersey: Pearson. Jacobson, J. W., Foxx, R. M., & Mulick, J. A. (Eds.). (2005) Controversial therapies for developmental disabilities: Fad, fashion, and science in professional practice. Hillsdale, NJ: Erlbaum.

CHAPTER 2 SIFTING SOUND PRACTICE FROM SNAKE OIL Questions and Comments