The use of concurrent operants preference assessment to evaluate choice of interventions for children diagnosed with autism.

Abstract

Two common instructional approaches for teaching basic academic skills to children diagnosed with autism are Applied Behavior Analysis (ABA) and the Treatment and Education of Autistic and Communication Handicapped Children (TEACCH). According to Choutka, Doloughty, and Zirkel (2004), both approaches advocate parent involvement, structured transition periods, and supportive teaching arrangements. Despite these apparent similarities, a number of differences exist between the core values and philosophies of these instructional approaches. The goal of ABA programs is to provide the child diagnosed with autism the skills needed to appear indistinguishable from peers (Jennett, Harris, & Mesibov, 2003; Kazdin, 2001), whereas the goal of TEACCH is to respect the culture of autism, therefore, not focusing on diminishing the differences between children diagnosed with autism and typically developing children (Mesibov & Shea, 2004). Furthermore, the ABA and TEACCH programs differ in terms of which skills are determined to be of greatest importance to teach. While ABA programs focus on teaching children new skills in areas that the child has documented deficits, the TEACCH program emphasizes the child's strengths and interests when determining which skills should be taught. The goal of this process is to continue strengthening the areas in which the child has already demonstrated interest and ability (Jennett et al., 2003). In terms of reinforcement, ABA therapists focus on using external sources of reinforcement (social praise, tangible items, etc). According to Jennett et al. (2003) TEACCH therapists shy away from the use of external reinforcement, and instead use activities for which the child has demonstrated a preference. The differences in the philosophy and values of the two interventions often cause a split in the opinions of professionals who work with children diagnosed with autism, with professionals often being loyal to one approach over the other. Additionally, the decision regarding which treatment to use often is made by professionals and/or parents, not the child in question due to the fact that the child often does not have the ability to specify which treatment program he or she prefers. Thus, loyalty to one intervention over the other may solely influence the decision regarding which treatment program will be selected for a child. Although the chosen treatment should be supported by empirical evidence, the preference of the individual receiving the treatment should also be taken into account before a treatment plan is devised given the importance of providing choice or considering preference when developing programs for individuals with autism and other disabilities (e.g., Romaniuk & Miltenberger, 2001). When attempting to examine a nonverbal child's preference for training programs, difficulties arise because one cannot simply ask such a child which training program he or she prefers. One strategy to assess preference in such cases is the use of a concurrent-operants arrangement. In a concurrent-operants assessment two or more responses are available to an individual, and each response is associated with an independent schedule of reinforcement or different reinforcing outcome (Hanley, Piazza, Fisher, Contrucci, & Maglieri, 1997). Thus choice responding is a highly sensitive measure of the individual's preference for concurrently available reinforcers (Fisher & Mazura, 1997). Research has indicated that such a paradigm is effective for assessing an individual's preference for different schedules or types of reinforcement (Catania & Sagvolden, 1980; Hanley, et al., 1997; Herrnstein, 1964) and for different approaches to treatment (Hanley et al., 1997). In a study conducted by Hanley et al. (1997), a concurrent-operants preference assessment was used to evaluate the relative preference for two treatment procedures: functional communication training (FCT), and noncontingent reinforcement (NCR). …