Association for Behavior Analysis International

Past research has shown that individuals with autism and other diagnoses could benefit from ABA intervention. Although ABA services are often provided in the individual’s home, individuals with profound autism and other diagnoses might require more than traditional in-home ABA intervention. Profound autism is a relatively new term not yet adopted by most clinicians and researchers nor defined by diagnostic manuals or tools; however, it is a term that is being used to describe individuals with autism who require 24-hour support throughout their lives. The current presentation includes three participants with various referral concerns, such as, self-injurious behavior, property destruction, aggression, and encopresis. Prior to starting treatment, an intensive case management team collaborated with other professionals to address barriers to access ABA treatment (e.g., housing, transportation, legal matters, and access to other health professionals). These results highlight the importance of intensive case management as a vessel to address environmental and ecological barriers for ABA treatment.

Intermediate. Participants should have prior experience with experimental analysis of behavior and conducting functional analysis assessments.

In this currently presentation, a 20-year-old participant diagnosed with Encopresis, Autism, and five other diagnoses received 10 hours per week of in-home ABA treatment. However, the treatment was not successful for three main reasons: first, treatment goals were focused on following instructions and communication only. Second, the home environment did not support ABA treatment, and third, the participant was not legally conserved and refused treatment on the daily basis. A different clinical team conducted a functional behavior assessment which identify the legal, housing, medical needs of the participant. The clinical team spent three months addressing these needs prior to the re-initiation of ABA treatment in a group home setting. The result showed that ABA treatment is successful in addressing chronic encopresis only when issues relating to legal, housing, and medical needs were addressed.

Individualized assessment and treatment is a hallmark of applied behavior analysis. In this presentation, we conducted functional analyses (Iwata et al., 1994/1982) of severe problem behavior displayed by two participants with profound autism. Few more subsequent analyses were added to guide focused in-clinic ABA treatments for these participants. However, other factors such as transportation had prohibited in-clinic ABA treatments. Additional functional analyses were conducted with the participant in the family's car. The result showed that in-clinic ABA treatment was necessary to decrease severe problem behaviors. Furthermore, the result of the functional analyses in the car allowed the clinical team to address problem behaviors prior and post in-clinic ABA treatment, and generalized the effect of the treatment across settings.