UNT research may point the way to better treatment for people with autism

A recent study conducted by the University of North TexasKristin Farmer Autism Center found that traditional behavioral interventionists in the field of autism may lack many important clinical and interpersonal skills.

The results of a survey of more than 200 university students majoring in behavior analysis and other human services majors was presented in May at the annual International Society for Autism Research (INSAR) conference in Rotterdam, Netherlands. This research could have significant implications for the preparation and training of effective service providers in autism, according to the study’s authors.

“If our final analyses support our hypothesis that behavioral artists are more effective at delivering behavioral therapy — applied behavior analysis, or ABA, in particular — this could be very significant for the field of autism intervention,” said Kevin Callahan, executive director of the autism center and a member of the research team. “Our results could help schools, clinics, and families screen more effectively for therapists more likely to be successful with their students, clients, and children, respectively.  Ultimately, by screening and hiring service providers with higher levels of behavioral artistry, and then training them to recognize and effectively demonstrate all of the characteristics of artistry, they will have better outcomes in improving the lives of persons with Autism Spectrum Disorder.”

Susan Nichols, associate executive director of the Kristin Farmer Autism Center; Mary-Ellen McComb, human resources coordinator at the center; and Gabrielle Segal, an undergraduate research assistant, attended the three-day conference that brought together "scientists who study autism from a broad range of disciplines, alongside policy makers, practitioners, autistic people and their families, to learn about latest research and share new ideas,” according to the event organizers

The three UNT staff members, who are also part of the research team, shared information and research derived from the article “Twenty-five years of Applied Behavior Analysis: Lessons Learned.” Written by Richard Foxx, the article summarized insights from three decades of research and treatment in the field of Applied Behavior Analysis, concluding that the effectiveness of ABA therapy may be negatively impacted by limited skillsets among today’s behavioral interventionists. 

In it, Foxx writes that he believes there may be important differences in outcomes between persons delivering ABA services in a traditional way, “Behavioral Technologists,” and those who demonstrate a broader set of humanistic and interpersonal behaviors, “Behavioral Artists.”

Behavioral Technologists often simply deliver a scripted set of procedures without a focus on the overall quality of the interaction. In contrast, Behavioral Artists demonstrate eight characteristics which mark these therapists as “natural behavior analysts,” including having a sense of humor, using effective communication skills, and being caring, flexible and optimistic, among others.

Callahan said ABA has been criticized for being overly aversive. For example, its practitioners have been called “abrasive, harsh, and unpleasant” and its drills and routines “cruel,” “misguided” and jargonistic, as well as too highly structured, which makes the therapy appear robotic and mechanical to many observers. 

“We believe it is important for ABA therapists and service providers to demonstrate the more humanistic aspects of behavioral therapy, including showing a sense of humor, care and concern, a sense of optimism, etc. By encouraging a work force with the wider range of skills and behaviors associated with behavioral artistry in addition to the many evidence-based practices associated with ABA, the fields of behavior analysis and autism intervention may become more broadly respected and accepted,” Callahan said.

The UNT research investigated Foxx’s conclusion that behavioral interventionists today lack important interpersonal behaviors associated with Behavioral Artists when compared to service providers in other human services professions, and whether parents of children with autism, and other service providers, prefer characteristics associated with behavioral artistry.

The researchers found that students majoring in behavior analysis had a lower overall percentage of self-reported Behavioral Artistry traits than those in all other human services majors. In addition, parents of children with autism significantly preferred the factors associated with Behavioral Artistrys over non-Behavioral Artist’s traits.

The research team used the personality assessment known as the “16PF” to measure characteristics associated with behavioral artistry. The results of this assessment place an individual on a continuum of behaviors based on 16 personality factors. 

“We spent about one year correlating the factors best matching our concept of behavioral artistry; however, we needed to conduct social validation to determine if parents of children with autism supported our conclusions about which traits are most preferable,” Callahan said. “In every case, the vast majority of parents in our small but national sample (about 90 parents) favored the traits of behavioral artists as those they would prefer from the persons working with their children. This is important because if parents don’t support the behaviors they see by their therapy team members, they are less likely to engage with and conduct appropriate support activities.”

The research team is now collecting data to determine if individuals who have higher and lower levels of Behavioral Artistry deliver behavioral therapy differently, and if the outcomes of children with autism are impacted. Future research will investigate whether characteristics of behavioral artists can be effectively trained, and whether persons in schools, clinics, and homes can screen and hire Behavioral Artists, who may be more likely to have success delivering behavioral therapy for children with autism.