Association for Behavior Analysis International

There is an urgent need to teach and facilitate use of self-determination skills for adults with intellectual and developmental disabilities (IDD). Self-determination and autonomy are linked to a variety of long-term outcomes including quality of life. In many cases caregivers and staff are the individuals tasked to teach these skills. In this symposium, presenters will describe research related to incorporating aspects of self-determination in skill-building interventions, training caregivers/staff to implement these procedures, and interventionist factors that support self-determination for adults. The symposium highlights a variety of different ways autonomy and self-determination can be evaluated and incorporated in adults with IDD’s lives and discusses the important future research needed in this area.

BCBA & BCBA-D; Prerequisite skills needed include: some experience implementing direct assessments and interventions with individuals with intellectual and developmental disabilities (IDD) and intermediate knowledge of behavior analytic principles and applied behavior analytic intervention procedures.

The presence of independent and functional living skills increases autonomy and predicts better outcomes for adults with intellectual and developmental disabilities (IDD). Teaching caregivers to successfully teach functional living skills is an indirect way to positively impact the lives of adults with IDD. Behavior skills training (BST) is an evidenced-based approach to train caregivers and provides a blueprint for systematic skills training. This study uses a multiple probe design across caregivers to evaluate the effectiveness of BST delivered via telehealth on caregiver use of teaching procedures, generalization of caregiver teaching skills, and improvement in functional living skills of adults as a result of the skill instruction they receive. Additionally, the adult with IDD participants in this study selected the functional life skills they learned. The use of person-centered practices, such as including participant interest and preference, can assist caregivers in selecting goals related to functional living skills that are important to and important for the learner. Initial results demonstrate this approach is effective for teaching self-selected functional skills to adults with IDD and caregiver use of teaching procedures.

Limited literature exists investigating the acquisition of daily living skills that can lead to autonomy and agency in adults with developmental disabilities. The purpose of the current study is to test the effects of total task chaining with least to most prompting to teach one 18-year-old with autism spectrum disorder (ASD) to 1) ask for help, 2) ask for a break, and 3) complete an activity schedule independently in the context of using his augmentative and alternative communication (AAC) device during housework and job-related tasks. Using a multiple probe design across behavior chains, we measured the percentage of steps completed independently and accurately. We implemented intervention across at least two settings and two interventionists. Upon mastery of each skill, we probed for use of skills across novel settings and interventionists. Across three behavior chains, the participant mastered asking for help and asking for a break in two settings and with at least two interventionists. The participant also used this skill in a novel setting, with a third, novel interventionist. Further acquisition of completing an activity schedule is to be determined. Teaching skills related to independently completing tasks and self-advocating can help in preparing individuals with developmental disabilities for job readiness.

The purpose of this presentation is to highlight findings from a longitudinal randomized control trial investigating the impact of an intervention designed to facilitate Direct Support Professionals (DSP) to more effectively support self-determination (SD) of adults with intellectual disabilities (ID) living in community-based residential settings. The results of behavior observations of study participants will be presented as they relate to the exercise of SD in their environment. Implications for future DSP training will be discussed. Research on the self-determination (SD) of individuals with intellectual disabilities (ID) has traditionally relied on self-report assessments or proxy evaluations (e.g., surveys and interviews). Given the developing communication skills and low levels of SD of many individuals with ID as well as limitations in the knowledge of DSPs about individuals they serve, there is a need for an assessment technique that does not require self-report or proxy responses based on recollections of the past, but rather, provides more objective data based upon direct behavioral observation. Drs. Abery, Tichá and their colleagues at the University of Minnesota have developed and validated an observation system SD-CORES (Self-Determination and Control Opportunity and Response Evaluation System) that provides information about behaviors related to SD for people of any level of ID. Study participants included individuals with ID, their direct support staff and supervisors living in 21 group homes. Observations of DSPs suggest that their support of consumer SD is both infrequent and short in duration. Although DSPs are almost always present, they are socially engaged with consumers only 25% of the time. Extremely low levels of consumer-consumer interaction were also observed across all homes and agencies. Staff (opportunities & support) and consumer SD behaviors (assessed using the SD-CORES) were found to be significantly related to each other in a positive manner. A significant positive relationship was found between consumer SD Index Scores and the degree to which DSPs provided opportunities and support for SD (SD-CORES). In addition, the consumer SD Index Score was significantly positively related to consumer SD behaviors as observed by SD-CORES.

Self-determination (SD) refers to the degree to which people exercise the degree of control they desire over those aspects of life viewed as important. It is not an internal attribute but rather embedded within relationships. Research indicates that people with intellectual disabilities (PWID) exercise lower levels of SD in comparison to peers. Traditional approaches to enhancing SD have centered on supporting the development of personal capacities. An alternative is to focus on changing the behavior of those who support PWIDs. The purpose of this presentation is to highlight findings relevant to factors associated with Direct Support Professionals (DSP) engaging in behaviors supportive of SD. Participants included PWIDs and their DSPs living in 21 group homes managed by multiple agencies. Data was collected via both direct observation using SD-CORES (Self-Determination and Control Opportunity and Response Evaluation System) and interviews with staff. Perceived DSP roles, consumer maladaptive behavior, and house culture all significantly predicted DSP behavior supportive of SD. DSPs who viewed their role as supporting SD rather than as care-taking were significantly more likely to engage in behavior facilitative of SD which predicted frequency of decision -making among PWIDs as measured by direct observation. Lower levels of internalized maladaptive behavior was associated with PWIDs exercising higher levels of SD. Differences between residences contributed a large amount to the total variance explained over and above PWID and DSP characteristics. Implications of findings for PWIDs and providers will be discussed.