Association for Behavior Analysis International

Recent research indicates that persons with Autism Spectrum Disorder may manifest symptoms of stress, anxiety and trauma atypically, which has implications that go far beyond the implied diagnostic challenges. This is undeniably true in forensic evaluations where unusual symptoms may be misconstrued as malingering. This presentation will describe how behavior analytic strategies and trauma-informed principles were embedded in a conventional forensic assessment protocol in the case of an adolescent girl accused of sexual assault. It will do so in the context of the myriad of challenges the defendant encountered during her years-long journey attempting to navigate the criminal justice process. The nature, characteristics, functions, phenomenology and hypothesized underlying psychophysiological basis of the defendant’s defense cascade stress response (“shutdown”) will be explored. A protocol based on behavior principles designed to address allegations of malingering will also be introduced. The presentation closes with a call for a critical examination of the concept of trauma generally and for the continued development of more function-based approaches to assessment and treatment of trauma- and stressor-related disorders in persons with autism spectrum disorder.

School systems nationwide are building capacity to understand and respond to the needs of children exposed to trauma (Chafouleas et al., 2016). A trauma-informed approach to intervention may be especially critical for students with emotional/behavioral disorders (EBD) who experience more adverse childhood events relative to students without behavioral and social-emotional concerns (Bethell et al., 2014; Rajaraman et al., 2021). While the promise of individualized, function-based interventions (FBIs) has been documented (McKenna et al., 2016), the extent to which they are trauma informed remains unknown. We conducted a systematic review of FBI studies including students with EBD to evaluate the extent to which these interventions incorporate critical elements of a trauma-informed approach. Using systematic search and screening procedures, we identified 58 articles that evaluated FBIs for elementary students with EBD. We coded study characteristics, trauma-informed components, and rigor, quality, and outcomes. Additionally, we conducted a meta-analysis of challenging behavior outcomes to explore whether FBIs that incorporated more trauma-informed components were more effective than those that incorporated fewer. Results highlight areas of both alignment and misalignment between FBI components and a trauma-informed approach. Implications for incorporating trauma-informed components in FBIs for students with EBD will be discussed.