AMANDA SAWMA PS553 ASSESSING AUTISM INTERVENTIONS CALDWELL COLLEGE Chapter 2 Sifting Sound Practice From Snake Oil Jacobson, J. W., Foxx, R. M., & Mulick,

AMANDA SAWMAPS553 ASSESSING AUTISM INTERVENTIONS

CALDWELL COLLEGE

Chapter 2Sifting 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 individualPromise outcomes that are less:

Intrusive Costly Stressful Labor intensive Risky

Often denounce all previous treatments Example: views regarding institutions after community

movement

CHAPTER 2SIFTING 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 2SIFTING SOUND PRACTICE FROM SNAKE OIL

The Distrust and Disdain of Science

Reasons for Disdain and Distrust

Process appears arduous and slowRequires time to:

Conduct investigations Arrive at conclusions Disseminate results

Reasons for Disdain and Distrust

Sometimes seems to defy logicDoes not conform to conventional wisdomDoes 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 resultsScience 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 2SIFTING SOUND PRACTICE FROM SNAKE OIL

The Care and Feeding of Fads

Fads

Are easy to promote and popularizeDissemination 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 2SIFTING 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 researchSubject 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 2SIFTING 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 methodsEmpirical analysis is the best way to measure

effectivenessMeasures 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 practiceYield the most convincing data on the efficacy of

a new approach

Individual Cases

Cannot confirm a proposed strategyCan 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 2SIFTING 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 variablesThere are no substitutes or short cuts to

empirical validationIf 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. 2nd 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 2SIFTING SOUND PRACTICE FROM SNAKE OIL

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