ABA and PBS: The dangers in creating artificial dichotomies in behavioral intervention.

Abstract

Parents of children with autism, as well as numerous practitioners, are bombarded with potential treatment options for the individuals for whom they care. These treatments include biological interventions, such as psychotropic medications, specialized diets, and highly experimental procedures, such as chelation or hyperbaric oxygen therapy. In addition, several non-biological interventions have emerged that have little or no empirical support. Examples of these include Relationship Development Interventions and DIR/Floortime (Greenspan, 1992; Greenspan & Wieder, 1998; Wieder & Greenspan, 2001) and facilitated communication (e.g., Eberlin, McConnachie, Ibel, & Volpe, 1993; Simpson & Myles, 1994). The majority of parents of children with autism pursue a combination of medical and educational treatments. Most individuals with autism receive some combination of empirically verified and experimental treatments. The intervention with the most support is Applied Behavior Analysis (ABA; e.g., Matson, Bernavidez, Compton, Paclawskyj, & Baglio, 1996; New York State Department of Health, 1999; Rosenwasser & Axelrod, 2001). ABA has been recognized by the Surgeon General of the United States as the treatment of choice for autism in the mental health report for children: Thirty years of research demonstrated the efficacy of applied behavioral methods in reducing inappropriate and in increasing communication, learning, and appropriate social behavior (U.S. Department of Health and Human Services, 1999). However, even within the discipline of ABA, there is confusion about definitions of terms and about approaches to the intervention process. This paper will explore the emergence of two disciplines within the field of behavioral intervention, both of which have considerable empirical support: Applied Behavior Analysis (ABA) and Positive Behavior Support (PBS). PBS is generally considered to be an extension of ABA. However, in recent years, practitioners have fought over the current status of PBS. While some people consider PBS to be an extension of ABA, others consider PBS to be a separate science. While theorists squabbling about the current status of PBS may not be of interest to most consumers or practitioners, there are potential dangerous consequences of having a fractured discipline. These include rampant consumer confusion, divisiveness within the professional community, and dilution of the strength of the field in advancing broader goals. What follows is a brief discussion of ABA and PBS, a discussion about what these disciplines have in common, why the divergence of the science may be problematic, and suggestions for how to address these issues. Applied Behavior Analysis Behavior analysis is a field in psychology dedicated to the study of and the natural events and causes of behavior. Behavior analysis differs from other areas of psychology in that is the subject matter, rather than an index of some underlying cause or state (e.g., self esteem, perception). The three facets of analysis are radical behaviorism (i.e., philosophical and conceptual understanding of behavior), experimental analysis of (i.e., the study of analytic principles in controlled, laboratory settings), and applied analysis (i.e., the application of analytic principles to socially significant behavior) (e.g., Pierce & Epling, 1999). Behavior analysts believe and the causes of can be observed, measured, and controlled by a combination of genetics and environmental events. Both the experimental analysis of (EAB) and applied analysis (ABA) use this conceptualization to understand the of organisms but differ in the types of under evaluation. EAB is concerned with the study of under controlled conditions. ABA is concerned with the study of socially significant under natural conditions. …