Association for Behavior Analysis International

For the past several years, ABAI has been working with the American Medical Association to establish new billing procedures for ABA and related services for children and youth with autism. Recently, the AMA adopted Current Procedural Terminology (CPT) Category III codes. The AMA codes recognize that applied behavior analysis (ABA) is an empirically supported and medically necessary intervention. Drs. Travis Thompson and Wayne Fisher, who were instrumental in the approval of these codes, will be the instructors for this training, which will explain the how the new codes define procedures and services performed by behavior analysts. Over time, the codes will result in systematic and standardized valuation of ABA services, as well as simplify and streamline the billing and collection processes for ABA services. These codes provide recognition from the American Medical Association that ABA is an empirically supported and medically necessary intervention; will improve access to ABA services for families of children with autism and severe behavior disorders; will reduce financial burdens on these families; will, over time, result in systematic and standardized valuation of ABA services; and will, over time, simplify and streamline the billing and collection processes for ABA services (e.g., facilitate electronic billing).

Psychologists, behavior analysts, practitioners, and graduate students.

Behavior analytic methods in the areas of autism, Autism Spectrum Disorders (ASD), and developmental disabilities are among the most powerful known. Contextual Behavioral Science (CBS) is a wing of behavior analysis that has for years been exploring functional, contextual methods approaches to language and cognition, and their implications for verbal interventions in a wide variety of areas. In this talk, Dr. Hayes will review the progress of this wing, in areas of relevance to autism and related areas. While Relational Frame Therapy (RFT), is not yet as well established as direct contingency principles, it offers a variety of new conceptual tools that are worth exploring. ACT methods appear to be helpful to higher functioning populations in this area. The specific properties of CBS required some degree of focused development, but advances in this area are available to anyone in behavior analysis who chooses to apply them.

Psychologists, behavior analysts, practitioners, and graduate students.

Historically, autism has presented major challenges for treatment providers, educators, families, and the community at large. Before the 1960s while there were isolated examples of successful treatments reported in lay documents and books, such as Itard's The Wild Boy of Aveyron, nothing systematic or replicable was reported and most believed that intervention for this population was impossible. Fortunately, in the 1960s and '70s researchers such as Lovaas, Hewett, Lovett, Wolf, Risley, Sloane, etc., showed that behavioral interventions (developed through ABA) could substantially improve large numbers of individual target behaviors, including self-help skills, academic skills, disruptive behavior, and language skills. This initial research led to very large degrees of optimism and hope for children with autism, particularly for families who had previously been told their children were uneducable and should be institutionalized. Initially, the interventions dealt with literally thousands of individual target behaviors, and required extremely large amounts of time and effort for both the interventionists and for the children. Beginning in the 1980s, researchers were finding that certain core pivotal areas of autism appeared to be responsible for very large numbers of response classes of both appropriate and inappropriate behaviors, and the possibility existed for developing a very efficient and effective treatment that would treat those "pivotal areas," that could result in widespread, fluidly integrated gains. Although it took decades to identify interventions for pivotal areas, iterations of interventions developed through ABA, such as Pivotal Response Treatment, could dramatically improve the speed and naturalness of the recovery process. That is, by targeting key pivotal areas, such as motivation for social communication, literally thousands of fluidly integrated improvements occurred extremely rapidly, improving not only thousands of individual target behaviors, but also improving the entire condition of autism, as well as reducing stress for family members. This presentation will describe the various pivotal areas that have been researched and procedures for implementing Pivotal Response Treatment. Research outcomes, including single subject designs and randomized clinical trials will be presented as well as videotaped vignettes of Pivotal Response Treatment being implemented.

Psychologists, behavior analysts, practitioners, and graduate students.

A number of studies have examined variations of commonly used instructional strategies for children with autism, including prompting and reinforcement procedures. Results often show that the relative effectiveness of different procedural variations is idiosyncratic across children. These findings indicate that it may be beneficial to link individualized assessment to treatment when developing acquisition programs for children with autism. Dr. Lerman will present the method and results of experiments that illustrate an assessment-based approach for identifying the most effective prompting procedures, error correction strategies, and reinforcement contingencies for individual learners.

Psychologists, behavior analysts, practitioners, and graduate students.

Autism spectrum disorders (ASD) are defined, in part, by restricted inflexible behavior. At the Behavior Analysis Research Clinic at the University of Florida, Dr. Vollmer has been collaborating with colleagues and students to evaluate such behavior in a range of contexts. One, they have compared the behavior in children with ASD to typically developing children using arbitrary play activities. Although both groups showed restricted interests, the ASD children were far less likely to switch activity upon request to do so. Two, they have extended their work on restricted inflexible behavior to socially relevant activity such as restricted food interests and restricted interest in sedentary activity such as video games, videos, and computer surfing. They are examining shaping procedures to increase variability in responding. Three, they have evaluated repetitive behavior disorders such as stereotypy and severe self-injury. They are currently investigating emergency treatment procedures for situations when a single instance of problem behavior may be too dangerous. Results from this collection of studies will be presented and discussed.

Psychologists, behavior analysts, practitioners, and graduate students.

Although a diagnosis of autism is not dependent on problem behaviors like meltdowns, self-injury, or aggression, one or more of these types of problems will likely require address at some point in the life span of a person diagnosed with autism. There is strong evidence supporting behavioral intervention to address these problem behaviors, with better outcomes evident when a functional analysis is part of the pretreatment functional assessment process. Nevertheless, assertions regarding the legitimacy of different types of functional assessment vary substantially across published studies. In addition, the research literature shows an unfortunate trend toward the standardization of the functional analytic part of the process. In this session, a highly individualized and practical functional assessment process that leads to fast, safe, and effective outcomes will be described. The comprehensive and socially validated treatments for problem behavior that result from this particular functional assessment process also will be described.

Psychologists, behavior analysts, practitioners, and graduate students.

It has long been hypothesized that the early cooing and babbling of infants may be shaped into their native-language speech sounds in part via auditory feedback from their own voices. In behavioral terms, this means that vocalizations that resemble speech sounds regularly heard in the infants' environment function as reinforcers for vocalizing. Clinicians and researchers have translated this hypothesis into a stimulus-stimulus pairing intervention intended to increase novel vocalizations of nonverbal children with autism and other developmental disabilities. However, the literature to date has produced mixed results. In this presentation, Dr. Petursdottir will discuss strengths and limitations of the existing literature on stimulus-stimulus pairing, and use data from her lab to illustrate alternative procedures intended to establish speech sounds as conditioned reinforcers.

Psychologists, behavior analysts, practitioners, and graduate students.

Historically, individuals with autism have had difficulty obtaining meaningful health insurance coverage. Since 2007, however, more than 35 states have enacted legislation requiring insurers to cover autism interventions, including applied behavior analysis. The purpose of this session is to explain the new laws and examine the underlying grassroots advocacy that resulted in their passage. Ms. Unumb will discuss the terms of the new laws, the different types of insurance policies that consumers may have, and the potential pitfalls that consumers may face in obtaining coverage.

Psychologists, behavior analysts, practitioners, and graduate students.