Association for Behavior Analysis International

The purpose of this symposium is to evaluate the state of service delivery for adults with developmental disabilities and other diagnoses and highlight the current and potential role of behavior analysts in the support of these individuals. First, the use of Functional Analyses to support adults in behavioral journals over the past twenty years will be reviewed. The current state of policy and available resources in the state of California will then be discussed. Based on the identified social importance of evidence based practice to support adults in life transitions; the results of a national survey of behavior analysists' preparedness related to severe problem behavior will be presented. Finally, data from three adults receiving behavioral support during or after the transition to adult services will further illustrate the role behavior analysts can play during this tumultuous time. The discussant for the symposium, who brings decades of expertise in treating severe problem behavior, will then provide valuable insights to those assembled.

Behavior Analysts

Previous literature has demonstrated that interventions based on Functional Behavior Assessments produce the most effective treatment in the elimination of problem behavior for individuals diagnosed with developmental and intellectual disabilities. In addition, the literature is full of examples of the use of functional analyses and effective interventions aimed at eliminating problem behavior in children. However, where does the literature stand with respect to functional analyses and interventions with adult populations? When children grow up, what happens as they transition to a new environment (e.g., from school to a sheltered workshop) or when they get bigger in stature? Moreover, what about the assessment and treatment of individuals who develop problem behavior in adulthood, what is best evidence-based practice? This review evaluated the literature on functional analyses and interventions for adults with developmental and intellectual disabilities, autism, and other medical diagnoses (e.g., Alzheimer) to evaluate for evidence-based practices. We included articles that have been published over the last 20 years that utilized a functional analysis and intervention model to effectively treat problem behavior from behavioral journals. We coded whether the participants were under or over 21 years of age. If they were over 21, we coded for several factors: diagnosis, assessment and treatment setting , type of assessment, type of intervention, what kind of problem behavior was addressed, as well as whether maintenance, generalization, or social validity data were reported. This presentation will summarize the state of the current literature with respect to evidence-based practice for adults with problem behavior.

In 1977, the Lanterman Developmental Disabilities Act, passed in the state of California to enforce human rights of individuals with developmental disabilities. More than forty years later, we are still feeling the effects of this mandate. In the state of California, behavior analysts are being called to provide increased services to adults with developmental disabilities. This increased demand for adult-focused behavior analytic services is simultaneously happening while several new initiatives are currently underway at the state policy level. The current presentation will discuss the policies behavior analysts are currently encountering regarding the transition from center based day-programs to community-based programs, self-determination, and person-centered planning. In particular, what does the "Final Rule" policy mean for our consumers, the transition away from the traditional "group home" settings, and how does this impact the movement toward self-determination and person-centered planning? Are behavior analysts in general prepared to support these changes and provide the level of services this population of adults may require?

Recently, Reed and Henley (2015) surveyed 382 individuals with respect to various types of staff and supervisory training offered to BACB certificants. Their results suggest several areas that require increased attention; in particular, half of the respondents indicated that they did not receive initial pre-service training and nearly one third of respondents indicated that they do not receive on-going training in their work setting. The outcomes of Reed and Henley's investigation provide several valuable avenues for future research and practice. It is important to note, however, that only 18.9% of respondents reported that they work in the home setting (the remainder worked in center- or school-based programs). Moreover, the topography and severity of challenging behaviors may differ across home and other settings for a given individual. As such, the purpose of the current investigation was to extend Reed and Henley by 1) surveying BACB respondents who practice in the home setting and 2) gathering more data on the nature of training and supervision received by the respondents (with attention given to severely challenging behaviors). The present study surveyed 139 BACB certificants with regard to initial and ongoing supervision for home-based services. Of that group, 125 respondents were included in a section on training and support for severe problem behavior in the home-setting. Potential benefits associated with establishing a more robust definition of on-going training and performance management will be discussed. Implications for the concept of "Continuing Education" will also be presented.

Transitioning into adulthood is a time of change and uncertainty. According to Friedman, Warfield, and Parish (2013), this is a particularly vulnerable time, as the entitlements of the children's service system end and young adults with ASD and their families encounter fragmented and underfunded systems of care which suggests that the current models of school-based transition planning are not meeting the needs of youths with ASD. Hendricks and Wehman (2006) indicate some individuals with ASD are able to successfully transition; however, most are faced with significant obstacles in multiple areas as they attempt to negotiate their way into college, work, community participation, and independent living. This transition often involves securing appropriate behavioral services and access to community resources, including educational, vocational, and tailored day programming, as well as identifying options for residential and long-term care. The purpose of this presentation will be to review the clinical outcomes for three adults with developmental disabilities who engage in severe problem behavior, and examine how behavioral support services may influence the course of their transitions. Functional analyses conducted in relevant community settings suggested that target problem behaviors were maintained by social reinforcement in the form of access to preferred items and/or escape. Treatment data, collected in each individual's relevant environment including the progression of services, will be presented. Identified barriers to continued progress and social validity outcome measures also will be discussed.