A total of 5 U.S. autism researchers investigated the opinion of Autistic adults on behavior interventions. Their study is titled, “The Social Validity of Behavioral Interventions: Seeking Input from Autistic Adults” and is open access for your review.

APA citation:

Baiden, K. M., Williams, Z. J., Schuck, R. K., Dwyer, P., & Wang, M. (2024). The social validity of behavioral interventions: Seeking input from autistic adults. Journal of Autism and Developmental Disorders, 1-15.

The authors include both autistic individuals and those experienced in behavior analysis, claiming to offer a balanced view on the topic. A total of 235 autistics participated in an online survey. Overall, findings indicate a preference for naturalistic strategies and goals that enhance quality of life, and not ABA.

any participants expressed that interventions should enhance quality of life rather than making autistic individuals conform to non-autistic norms. Autistic adults preferred interventions that are more natural and client-centered, rather than highly structured ones. There was a strong preference for using any effective communication method, not just focusing on verbal speech. Some traditional methods like Applied Behavior Analysis (ABA) were criticized for emphasizing compliance and normalization, which can lead to stress or trauma.

The article makes several recommendations for improving the social validity of interventions for autistic individuals:

1. Incorporate Autistic Perspectives: It’s crucial to include the voices and experiences of autistic individuals in the planning and evaluation of interventions to ensure they align with their values and needs.
2. Focus on Quality of Life: Interventions should prioritize enhancing the quality of life rather than enforcing conformity to societal norms.
3. Emphasize Naturalistic Approaches: There is a preference for interventions that are more naturalistic and client-centered, as opposed to highly structured methods.
4. Promote Inclusive Communication: Encourage the use of any effective communication method, not just verbal speech, to support diverse communication needs.
5. Address Ethical Concerns: Traditional methods that focus on normalization and compliance should be re-evaluated to avoid potential stress or trauma.
6. Use Strengths-Based Approaches: Clinicians should adopt culturally competent and strengths-based approaches that respect autistic identities and lived experiences.
7. Tailor Interventions to Individual Needs: Interventions should be adapted to meet the specific needs of each individual, considering their unique traits and preferences.

Conclusion

Though behavioral interventions have been used with autistic children for decades, assessing the social validity of such programs has not been prioritized (Callahan et al., 2017; D’Agostino et al., 2019; Ledford et al., 2016), and many autistic people described what they believe are flaws in both the goals of intervention and their common practices. This study helps identify which common intervention goals, practices, and procedures are socially valid from the perspectives of autistic adults, which are perceived as problematic, and which require more investigation. Our findings show that participants did overwhelmingly endorse many common intervention goals, specifically those that focused on overall quality of life and safety, as well as common intervention strategies, namely those that emphasized individualization, use of natural intervention strategies, and taking individuals’ feelings and preferences into account. Results also indicate that participants clearly do not support certain goals and practices, particularly those that prioritize normalization (e.g., reducing vocal/physical stimming and fixations, promoting communication by focusing primarily on verbal speech). These findings can be used as a starting point to help guide clinicians and educators toward designing intervention goals and using intervention practices and procedures that are seen as socially valid by autistic individuals, which will hopefully lead to more neurodiversity-affirming interventions that address the concerns of the autistic community.

Action:

If you think this is research heading in the positive direction, write to the lead researcher: kpenner@ucsb.edu