|Autism in Infancy: Behavioral Systems Conceptualization and Practical Considerations
|Saturday, May 24, 2014
|3:00 PM–4:50 PM
|W180 (McCormick Place Convention Center)
|Area: DEV/AUT; Domain: Service Delivery
|Chair: Erik A. Mayville (Connecticut Center for Child Development)
|Discussant: Linda A. LeBlanc (Trumpet Behavioral Health)
|CE Instructor: Erik A. Mayville, Ph.D.
Intervention based in applied behavior analysis is widely recognized as a standard approach for children with autism spectrum disorder (ASD). Following from research findings that intervention effects are more robust with younger children, the current best practice position is to provide intervention as soon as an ASD diagnosis can be made, and perhaps even earlier at the first reliable signs of characteristic deficits and excesses. Given that emerging technologies are aimed at identification of the disorder in infancy, the behavior analyst working with children with autism is likely to be faced with requests to work with infant children, a population that most behavior analysts are likely unfamiliar with. This symposium will address the following primary questions facing the practitioner considering working with infants and their caregivers: What is the current status of the evidence supporting early identification ASD-related deficits? How should the behavior analyst view the process of infant development, a concept most commonly described within other fields? What behavior analytic interventions have been investigated for this population, and for which infant and caregiver behaviors? And finally, what are some key ethical issues facing the behavior analyst working with infants and caregivers?
|Instruction Level: Basic
|Keyword(s): Autism, Development, Infant
Behavior analysts working with young children, particularly those identified with or suspected of meeting criteria for autism spectrum disorder.
|Learning Objectives: At the conclusion of the event, participants should be able to (1) Discuss the evidence supporting early identification of ASD-related deficits, including the earliest age that a “medical diagnosis” can be given; (2) Describe at least two behavior analytic interventions which have been investigated for infants and caregiver behavior; and (3) Describe at least two ethical issues facing the behavior analyst working with infants and their caregivers.
An Overview of Established and Emerging Methods of Early Identification of Autism Spectrum Disorder
|ERIK A. MAYVILLE (Connecticut Center for Child Development)
Behavioral intervention initiated early in childhood is associated with positive outcomes in autism spectrum disorder (ASD). As such, early identification of ASD-related behavioral deficits and excesses is viewed as central to achieving the best long-term intervention outcome, with the goal for treatment professionals being to intervene from the moment a diagnosis is confirmed. Current validated diagnostic procedures are based in observation of behavior and do not allow for diagnosis any earlier than 18 months of age. However, behavioral deficits indicative of high-risk status for ASD can be identified at 12 months of age, and technologies utilizing potential biomarkers in infants younger than 12 months are emerging. Therefore, ABA practitioners are likely to face demands to work with infant populations in the future. This presentation will provide a review of established and emerging technologies for identifying behavioral characteristics and biological associations of ASD, with a critical review of methods of identification for children younger than 12 months.
|Erik Mayville is the clinical director of the Institute for Educational Planning, subsidiary agency of the Connecticut Center for Child Development. He has a B.A. in psychology from the University of Nevada; a M.A. in applied behavior analysis from the University of the Pacific; and a Ph.D. in clinical psychology with a developmental disabilities emphasis from Louisiana State University. He completed his predoctoral internship in applied behavior analysis and developmental disabilities at the Kennedy Krieger Institute and Johns Hopkins School of Medicine in Baltimore, MD. Dr. Mayville has co-authored more than 20 refereed articles and book chapters on various topics relevant to people with autism and developmental disabilities, including curriculum content in ABA, problematic behavior, social skills, psychiatric disorders, and psychotropic medication. He has served on the editorial boards of several peer-reviewed journals, including Behavior Analysis in Practice and Research in Autism Spectrum Disorders, and he is co-editor of the book Behavioral Foundations of Effective Autism Treatment. He also has served as an adjunct professor in the Department of Behavior Analysis at the University of North Texas. Dr. Mayville’s practice focuses on psychological evaluation, intervention consultation, and educational program evaluation for children and adolescents with autism spectrum disorders.
Infant Development as the Behavior Analyst Views It
|GARY D. NOVAK (California State University Stanislaus)
Previously defined by DSM IV-R as a "developmental disorder," DSM 5 now categorizes autism spectrum disorder (ASD) as a "Neurodevelopmental Disorder." Although evidence of specific neurological dysfunction is lacking, the developmental basis for behavioral development in autism is not. Behavioral Systems Theory provides a framework for understanding the development, prevention, and treatment of the constellations of behaviors that characterize ASD and explains how multiple factors, including neurological, historical, and current environmental ones lead to the emergence of patterns seen in individuals. This paper will outline the basic principles of development ininfancy as viewed from a behavior analytical perspective. It will focus on processes that produce typical development as well as the acquisition of the behavioral excesses and deficits characteristic of ASD. Among the key developmental concepts involved in understanding typical and atypical are skills learning, "hidden" skills and deficits, and behavioral cusps. Some of the crucial early hidden skills and deficits in infant development will be identified and the implications for early intensive behavioral intervention discussed.
|Gary Novak is professor emeritus of psychology and child development at California University, Stanislaus. He has a B.A. in psychology from Rutgers University, a M.A. in psychology from Temple University, and earned his Ph.D. in developmental psychology from the State University of New York at Stony Brook. Dr. Novak was founding dean of the College of Human and Health Sciences at CSU, Stanislaus, where he taught for more than 35 years. He was twice Psychology Department chair, founded the campus Child Development Center, and received the university’s Outstanding Professor Award. His publications include two books on a behavioral approach to child and adolescent development: Developmental Psychology: Dynamical Systems and Behavior Analysis (also published in Italian as Psicologia Dello Sviluppo: Sistemi Dinamici e Analisi Comportamentale) and Child and Adolescent Development: A Behavioral Systems Approach. Retired and living in California wine country, Dr. Novak continues to publish and lecture on behavioral development. His most recent publications have focused on hidden skills in the development of autism.
Intervention for Developmental Delays in Infancy
|MARTHA PELAEZ (Florida International University)
In the U.S. alone, more than 1 million children are on record as having some form of autism or learning disability. This number continues to increase. Researchers have begun to recognize the enormous value of behavior analysis and early interventions in encouraging children to focus attention and shaping their early social behavior. Dr. Pelaez will present interventions with infants "at risk" of later developmental delays using specific forms of social reinforces like synchronized touch and cooing that increase infant's eye contact and gaze at mother's face. Infant massage provides the occasion for synchronized mother-infant interactions that include many of the social reinforcers outlined in this presentation. She will explain a procedure where a caregiver's vocal imitation and motherese speech increases infant vocalizations, smiles, and directs infant attention. In older infants, maternal social contingencies in the form of gestural expressions can work as signals (Sds) for the infant on when and how to respond toward an ambiguous object in the context of uncertainty--a phenomenon known as social referencing. In summary, these techniques developed for early interventions with infants have shown to be effective in improving their social behavior and explain early social learning phenomena as attachment, joint attention, and social referencing.
|Martha Pelaez is the Frost Professor at Florida International University. Her research is in the areas of mother-infant interactions and infant social learning processes. She has developed intervention protocols for infants at risk of developmental delays published in her book with G. Novak, Child and Adolescent Development: A Behavioral Systems Approach, in a chapter in Rehfeldt & Barnes-Holmes (2009), and in Mayville & Mulick (2011, Eds.), on effective autism treatment. Her theoretical and experimental contributions include a recently revised taxonomy of rules and rule-governed behavior (Pelaez, in press European Journal of Behavior Analysis); a behavior-analytic approach to moral development (Pelaez & Gewirtz, 1995) and the relation between derived relational responding and intelligence (with D. O'Hora & D. Barnes-Holmes, 2005). Dr. Pelaez has published more than 80 refereed articles in mainstream journals including the American Psychologist, the Journal of Child Development, the Journal of Applied Behavior Analysis, and Infant Behavior and Development Journal. She has served as program chair for the American Psychological Association Division 25 and past program co-chair for the Association for Behavior Analysis International. She is the founding editor (1990) of the Behavior Development Bulletin and has served on editorial boards including The Behavior Analyst. She was awarded fellowship status by the American Psychological Association (APA) and is a trustee of the Cambridge Center for Behavior Studies. Dr. Pelaez also served as a member of the Florida Board of Governors.
Ethical Issues in Autism Intervention with Infants
|SUZANNE LETSO (Connecticut Center for Child Development)
Applied behavior analysis has been demonstrated to be the most effective intervention for children with autism spectrum disorders (ASD). Following recommendations for intervention for ASD as early as possible, means of identifying infants at risk for ASD are emerging. For example, researchers have determined that younger siblings of children with ASD are at a much higher risk of developing the disorder than the general population. Additionally, biologically based tests purported to identify infants at risk for developing ASD are becoming commercially available. As a result, behavior analysts working in the field of ASD education and treatment can anticipate an increase in requests for ABA interventions for infants. This presentation will outline some of the practical and ethical issues behavior analysts must address in providing services to at-risk infants and very young children. Topics include the competencies of the behavior analyst working with infants, working within the bounds of evidence-based practice, and the potentially multifaceted role the practitioner may need to serve for caregivers through the child's infancy and into early childhood.
|Suzanne Letso is the co-founder and CEO of the Connecticut Center for Child Development. Mrs. Letso currently serves as treasurer and a member of the board of directors of the Behavior Analyst Certification Board, on the Scientific Advisory Council, a member for the Organization for Autism Research, Association for Professional Behavior Analysts’ advisory board, and is vice chair of the board of directors for Marrakech, Inc. She also has participated in the establishment of a number of other service organizations and autism-related initiatives. Mrs. Letso holds a B.A. in elementary education from Southern Connecticut State University, a M.A. in leadership from Duquesne University, and is a Board Certified Behavior Analyst. Before her work related to behavior analysis, Mrs. Letso worked as a marketing executive for international medical product manufacturers, where she was involved in new product, business, and venture capital start-up initiatives. In addition, she has been involved in organizational assessment and development of for-profit enterprises in other fields. Mrs. Letso is a registered lobbyist for the Connecticut General Assembly and has worked as an advocate on a number of legislative issues within the state of Connecticut including sustainment of funding for those served by the Department of Developmental Services, autism insurance legislation, continuation of public school funding for people with disabilities through their 21st school year, and recognition of Board Certified Behavior Analysts.