Three Important Things to Consider When Starting Intervention for a Child Diagnosed with Autism Page: 4
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Three Important Things to Consider When Starting Intervention
for a Child Diagnosed With Autism
Shahla Ala'i-Rosales, Ph.D., BCBA-D, Department of Behavior Analysis, University of North Texas
Nicole Zeug, M.S., BCBA, Easter Seals North Texas Autism Treatment Program
Do you understand the enormity of this undertaking?
Accepting responsibility for an Early and Intensive
Behavioral Intervention (EIBI) program is accepting responsi-
bility for a child's future. This is a serious undertaking. Great
outcomes are possible with well-implemented EIBI programs
(Matson & Smith, 2008) and frightening outcomes occur
when they are not (Bibby, Eikeseth, Martin, Mudford, &
Reeves, 2001). Every child is precious and has a right to live a
safe life filled with opportunities, learning, care, and affection
(United Nations, 1959). Furthermore, our ethical guidelines
require that we provide effective treatment with informed
consent (Behavior Analysis Certification Board, 2004). Skilled
and ethical behavior throughout an EIBI program can help
children access those rights, enabling them to have happy and
productive childhoods, experience harmonious family life, and
go on to become contributing members of society.
Because of the gravity of the consequences resulting from
the quality of intervention, it is especially important that one
tries to be aware of the contingencies operating on one's own
behavior. Just a few of the troublesome contingencies that
interfere with a quality EIBI program include taking on too
many clients in an attempt to alleviate everyone's suffering and
discomfort, taking on too many clients to increase income, re-
acting to momentary crises as opposed to proactive systematic
and strategic planning, responding to the social attention of
communities that value fads and structure (rather than data
and function), and failing to take data because the time is not
funded. Conversely, there are environmental arrangements that
increase the likelihood of quality EIBI implementation. For
example, consulting with trusted colleagues (Baily & Burch,
2005) and joining continuous learning communities (Ellis &
Glenn, 1995) who will provide feedback and reinforce behavior
that is in the best interests of the young children. Such commu-
nities will help identify dangerous contingencies and establish
rules to prevent harmful behavior. Working for agencies with
high standards and a record of good EIBI outcomes will also
support quality. This type of analysis is important: A behavior
analyst's self-management will affect children's futures.
Do you have the skills to do this?
EIBI is a highly specialized and difficult area of behavior
analysis. One child's program usually involves hundreds of
individualized teaching programs, across many domains, over
the course of two to three years. Within and across each of
those programs, the behavior analyst must keep up with EIBI
research evidence and engage in a complex series of decisions
and problem solving. Although research reviews are periodi-
cally published (e.g., National Autism Center, 2009), we are in
the effortful but fortunate situation of needing to keep up with
constant developments in intervention procedures and this re-
quires vigilance. In addition to knowledge and understanding
of evidence-based practice, there is a large repertoire of profes-
sional skills required of a behavior analyst working in EIBI.
To successfully implement an EIBI program, a sophisti-
cated orchestration is required that includes, but is not limited
to, keeping abreast of research, conducting individualized as-
sessments, deciding what programs to introduce when and
how, monitoring and revising programs as needed, training and
maintaining the teaching skills of all team members, support-
ing and working with families, collaborating with other profes-
sionals, managing resources, and problem solving at every level.
The best and most successful EIBI programs have developed
well-tuned and robust systems to address each of these factors
to produce favorable outcomes (e.g., Harris & Handleman,
1994). Individuals implementing EIBI programs have the same
responsibility to know the current research, demonstrate the
intervention skills, create systems to support implementation,
and to adjust at every level when necessary.
As an individual practitioner, you have three options;
all involve your ability to assess your own skills and essen-
tially "know what you don't know." A starting point for as-
sessing your own skills is to review the Consumer Guidelines for
Identifying, Selecting, and Evaluating Behavior Analysts Working
with Individuals with Autism Spectrum Disorder (Autism SIG,
2007). Once you have evaluated your skill level, select from
the following options:
Option 1: Provide services if you have the sophisti-
cated skills required to successfully implement EIBI.
Option 2: If you do not have the skills, work in a
setting where you can be mentored by a skilled and
wise behavior analyst who does have those skills and
who has produced good EIBI outcomes. With cur-
rent technology, geography is no longer a barrier to
supervision. Admittedly, the cost of supervision can be
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Ala'i-Rosales, Shahla & Zeug, Nicole M. Three Important Things to Consider When Starting Intervention for a Child Diagnosed with Autism, article, 2010; [Portage, Michigan]. (digital.library.unt.edu/ark:/67531/metadc39324/m1/1/: accessed October 20, 2017), University of North Texas Libraries, Digital Library, digital.library.unt.edu; crediting UNT College of Public Affairs and Community Service.