The Social Validity of Behavioral Interventions: Seeking Input from Autistic Adults.
Kaitlynn M P Baiden, Zachary J Williams, Rachel K Schuck and 2 others
PMID 38470531WHAT IT FOUND
Autistic adults endorsed safety, communication, and quality-of-life goals, but rejected goals aimed at stopping stimming, fixations, or eye contact.
They preferred any working communication method over speech alone and wanted autistic input in goal setting.
Key findings
01Most participants endorsed goals about safety, communication, quality of life, and reducing self-injury, while fewer than 20% endorsed reducing vocal or physical self-stimulatory behaviors or fixations, and over half strongly disagreed with reducing stimming, fixations, or increasing eye contact.
02Almost all participants agreed that interventionists should see the child's perspective and promote any communication technique that works, but only 13.1% endorsed promoting communication primarily through verbal speech.
03Participants preferred natural rewards over external rewards, child-chosen goals over parent-chosen or professional-chosen goals, home settings over clinic settings, non-profit providers over for-profit providers, and attention to internal thoughts and feelings over observable behaviors.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The Autism Intervention Attitudes Scale was created for this study and has not been rigorously validated. The sample was recruited online through autism organizations and social media, so it may overrepresent people interested in this topic, able to read the survey, and able to access the internet. Most participants identified as White, and many were female or nonbinary, which is not fully representative of autistic people who receive behavioral intervention. Only 70 participants reported receiving behavioral intervention during childhood, and the average age at diagnosis was 24.87 years, so many respondents may not have direct experience with these services. The survey assessed goals and procedures, but not intervention outcomes. Some goal statements were broad, and participants were not given context about when or for whom a goal might apply. Open-ended responses were collected but not reported in this paper. Participants were not asked about play skills, which may be important for some autistic children.
The easy way to misread this
Do not read these ratings as evidence that behavioral interventions work or as the settled opinion of all autistic people. The study used an unvalidated survey, a convenience online sample, and many participants had not received behavioral intervention as children.