Newsletter
Volume 31 | 2008 | Number 3
Using ABA to Improve the Lives of Adults with Autism in Work, Community, and Residential Settings
By Dr. Gregory MacDuff, Princeton Child Development Institute
Although most adults with autism remained in institutions during the 1960s and 1970s, those decades saw the initial development of community-based programs for children with autism, and when these youngsters began to arrive
at adulthood, the demand for noninstitutional programs
for adults increased. Parents and professionals who
had observed young people’s progress during childhood and adolescence worked to develop new options for
adults, but their efforts were often hampered by a
shortage of empirical evidence.
In this climate, in 1987, the Princeton Child Development Institute opened the Adult Life-Skills Program. The parameters of the new program were (and are) very similar to those of the preschool and school (McClannahan & Krantz 1993, 2001). Staff members receive ongoing hands-on training and regular performance evaluation. Learners’ intervention programs are regularly reviewed by both internal and external evaluators to assess (a) completeness of documentation, (b) achievement of favorable behavior change, (c) appropriateness of intervention activities, (d) presence of written consent, and (e) amount of interobserver agreement on behavioral measures. In addition, many different consumer groups are annually invited to evaluate program operation and outcome. But perhaps the most important dimension of accountability is the presence of group contingencies that link outcomes of all program participants. Thus, staff members are recognized as successful when the data show that they have acquired relevant intervention repertoires and that adults with autism are acquiring new skills; trainers efforts are rewarded when evaluation data demonstrate that staff members display relevant intervention repertoires and that learners are achieving relevant goals; and the trainers’ mentors (program administrators) are deemed successful when all of these things are true and when consumer satisfaction ratings meet established criteria. These evaluation procedures are identical to those used in the preschool and school and in PCDI’s residential programs.
Key benefits are derived from a continuum of services for toddlers, preschoolers, school-age children, and adults with autism. Intervention on behalf of today’s toddlers and preschoolers may enhance outcomes for tomorrow’s adults, and data on adult’s contemporary repertoires may lead to significant revisions of the curriculum for young children.
Our data and experience suggest that unidimensional program models (e.g., only supported employment) may not be in the best interests of adults with autism. Some people, upon completing their schooling, move directly to supported employment and remain in full- or part-time positions; others may lose several jobs before retaining one; and still others may need to leave employment because of health or behavior problems. In sheltered workshops or day-training centers, competent young people may never have opportunities to enter the workforce; in programs devoted to supported employment, workers who experience job loss may be deprived of services. The diversity of skills and skill deficits characteristic of people with autism seems to recommend a multifaceted service model.