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Diving Beneath the Surface of the Ethics Codes: Exploring Ethical Issues in Applied Behavior Analysis (ABA) Practice |
Sunday, May 26, 2024 |
8:00 AM–8:50 AM |
Marriott Downtown, Level 5, Grand Ballroom Salon AB |
Area: TBA/PCH; Domain: Service Delivery |
Chair: Lin Du (Teachers College, Columbia University) |
Discussant: Joyce Chenchen Tu Battersby (Easterseals of Southern California) |
CE Instructor: Weihe Huang, Ph.D. |
Abstract: Behavior analysts frequently face ethical challenges beyond what the ethics code can suggest. In this symposium, we will discuss ethical issues behavior analysts likely to encounter in clinical settings and suggest the potential solutions. The first presentation explores the complex concept of value-based ethical dilemmas and proposes a decision-making protocol for behavior analyst to deliberate these unique ethical challenges that may not be fully addressed by the BACB ethics code. Case examples are examined to illustrate the decision-making process. These cases cover concerns with cultural responsiveness to treatment and services provided in the telehealth context. The second presentation reports results from a survey regarding autistic people’s perspectives of ABA services. Suggestions for incorporating autistic people’s voices to ABA services are discussed. The third presentation is designed to share results of recent literature regarding the prevalence of psychotropic medication with our likely clients and medication effectiveness. Basic information and simple techniques likely to promote effective collaboration with a prescribing physician are discussed. The fourth presentation focuses on ethical challenges encountered by behavior analysts when conducting sexuality education for people on the autism spectrum, as well as some proposed solutions. The perceived ethical barriers in this area are also addressed. |
Instruction Level: Basic |
Keyword(s): Ethics Decision, Neurodiversity, Psychotropic Medication, Sexuality Education |
Target Audience: basic |
Learning Objectives: Participants will be able to 1. describe core ethical principles valued in the field of applied behavior analysis. 2. discriminate between value-based ethical dilemmas vs. strategy-based ethical dilemmas. 3. explain six steps in the decision-making model for value-based ethical dilemmas. 4. apply the decision-making model to solve ethical dilemmas stemming from applied behavior analytical services including telehealth-based ABA services. 5. describe the perspectives, experiences, and impacts of ABA-based practices for autistic people 6. discuss strategies to include autistic voices to enhance the social validity of ABA research and practice 7. define the placebo effect and its importance to the pharmaceutical study that pointed up the importance of the single subject design in monitoring drug effectiveness. 8. describe the role of the behavior analyst in assisting the physician in monitoring the effectiveness of a prescribed psychotropic medication. 9. describe the study that compared the effect on a target behavior of medication with ABA versus ABA alone. 10. identify the reasons why providing sexuality education is ethically necessary. 11. describe common ethical challenges faced when teaching sexuality education to people with disabilities. 12. engage in decision making strategies to make the best ethical decision under a variety of conditions. |
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Addressing Values-Based Ethical Dilemmas in Behavioral Services |
WEIHE HUANG (Creative Human Learning ), Gabrielle T. Lee (Western University), Xiaofan Zhang (University of Pittsburgh; Wuhan Linjie Rehabilitation Medical Center ) |
Abstract: Applied behavior analysis (ABA) service delivery is a complicated process and some issues stemming from this process can be controversial. Ethical dilemmas can challenge ABA practitioners and require thorough examination. In the first presentation, we will introduce a distinction between values-based dilemmas and strategies-based dilemmas for the first time. A values-based ethical dilemma exists when, in charting the course for a clinical case, tensions occur among values within the same ethical system. Strategies-based dilemmas, on the other hand, are mainly about “risk-benefits for each behavioral procedure” (Bailey & Burch, 2016). Having identified the existence of values-based ethical dilemmas stemming from potential tensions among underlying values and ethical rules, we want to provide behavior practitioners with a systematic approach to addressing these dilemmas. Specifically, we use a step-by-step protocol for ethical deliberation in situations involving values-based ethical dilemmas. We describe the application of this approach to clinical cases including services provided via telehealth. |
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Exploring the Experiences of Self-Identified Self-Advocates on the Autism Spectrum With Applied Behavior Analysis (ABA)-Based Practices and Research |
GRACE DEMERLING (University of Western Ontario), Gabrielle T. Lee (Western University), Albert Malkin (Western University), Laura E. Mullins (Brock University), Kendra Thomson (Brock University ), Priscilla Burnham Riosa (Brock University) |
Abstract: In this presentation, we will review the results from an online survey with adults who identify as being on the autism spectrum and have experience receiving ABA-based services and supports. This survey asked participants to report on their perceived success, outcomes, and challenges of ABA-based services and their impact on their identity, emotions, and well-being. A descriptive summary and thematic analysis of these experiences will be presented. A total of 14 participants completed the survey. All participants answered that they had received a formal diagnosis of autism rather than self-identifying. Thirteen of the 14 participants identified their race as white, while 1 preferred not to identify their race. Nine participants identified as male, 2 identified as female, while 3 preferred to self describe or preferred not to say. At the time of responding to the survey, participants' ages ranged from 19 to 32 (M= 25.5). The number of years participants reported receiving ABA-based services and supports ranged from 1 year to 18 years. 57% of participants reported feeling successful during their experiences with ABA-based services and supports, while 64% of participants reported feeling successful after their experience. 14% of participants reported feeling very unsuccessful both during and after their experiences with ABA-based services and supports. The majority of participants reported the outcomes of ABA-based services and supports to have been helpful later on in their lives, wth 50% of participants reporting they felt their outcomes have been helpful, 29% of participants reported their outcomes have been very helpful; in contrast, 14% of participants reported their outcomes were very unhelpful later on in their lives. This research hopes to amplify the lived experiences of autistic voices with ABA-based services and supports to better inform both practices in the ABA field and autism research. |
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Ethical Considerations in the Coordination of Behavior Analysis and Psychotropic Medication Management Services |
THOMAS R. FREEMAN (ABA Technologies Inc. ; Florida Institute of Techology) |
Abstract: Many peer-reviewed surveys over the last 3 decades have revealed that psychotropic medications are commonly prescribed for many if not most of the individuals who are most likely to receive ABA services (e.g., individuals diagnosed with ID or ASD). These medications are typically prescribed by psychiatrists, neurologists, or other medical personnel with the express purpose of changing some problematic aspect of the individual recipient’s overt and covert behavior. Despite this fact, many behavior analysts refrain from participating in this clinical domain, considering it the exclusive responsibility of the prescribing physician. However, the current edition of the Ethics Code for Behavior Analysts requires that behavior analysts “collaborate with colleagues from their own and other professions in the best interest of clients and stakeholders” (Code element 2.10 Collaborating with Colleagues). Behavior analysis is often recommended in the medical literature as the treatment of first choice to deal with the problem behavior of many individuals, as well being as an appropriate parallel to ongoing medication treatment. This presentation is designed to briefly review the prevalence of psychotropic medication with our likely clients; to share some key results in recently published literature regarding medication effectiveness and the need for behavior analysis services with individuals receiving these powerful medications; and to provide behavior analysts with some basic information and simple techniques likely to promote effective collaboration with a prescribing physician. We argue that the behavior analyst is the individual on the interdisciplinary team that is best equipped to collect solid data and other observational information on the effects, side effects, toxic effects, behavioral effects, and other impacts on the global functioning of individuals receiving psychotropic medication. The behavior analyst is also positioned to oversee the training of direct service staff in this area. The behavior analyst can then provide vital information to the prescribing physician, to assist in determining the most effective, least invasive level of these powerful substances, which profoundly alter the chemistry of an individual’s brain, and thereby affect the person’s perception of and response to their environment. |
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