Young adults with autism or developmental disabilities often have a long history of reinforcement for problem behaviors. These behaviors can lead to restrictive lifestyles for their families, negatively impacting mental health and quality of life. Understanding the “why” behind these behaviors is complex, but the Practical Functional Assessment (PFA) process can help identify situations that trigger problem behaviors and the consequences that maintain them. This is the crucial first step in addressing problem behavior—pinpointing and understanding its context. Following this, the Skill-Based Treatment (SBT) process teaches individuals the skills needed to replace problem behaviors with functional communication.
Why PFA & SBT Work
PFA and SBT are effective tools for safely teaching individuals to express their wants and needs through appropriate communication methods. These methods aim to replace problematic behaviors often used to achieve desired outcomes. While much discussion surrounds their application for children, it’s important to note that these approaches are equally successful for adolescents and adults with autism or developmental disabilities. Although the general protocol remains consistent across age groups, implementing SBT with older learners requires specific considerations tailored to their unique needs.
Start With the End Goal
When initiating SBT, families should start by envisioning the desired outcome. Whether it’s helping John sit calmly during a haircut or enabling him to complete homework independently, having clear goals expedites planning and decision-making. Families collaborate closely with a Board Certified Behavior Analyst (BCBA) to define these objectives, which guide the development of individualized SBT steps.
Older learners may have different end goals than younger ones, influenced by factors such as age, interests, strengths, weaknesses, cognitive abilities, and developmental levels. These personalized goals ensure relevance and effectiveness in treatment.
Prioritizing Safety
Safety is incredibly important when working with older individuals who exhibit problem behavior. During PFA, precursor behaviors—early indicators of escalation—are reinforced instead of waiting for severe actions like aggression or self-injury. For example, if John yells “no!” before engaging in harmful behavior, reinforcement occurs immediately after he yells “no!” to prevent escalation.
The Enhanced Choice Model further ensures safety by allowing learners to opt into or out of practice sessions. This open-door policy not only maintains safety but also provides valuable feedback; frequent opt-outs signal adjustments are needed in the treatment approach.
Maintaining Dignity
When working with older learners in Skill-Based Treatment (SBT), maintaining dignity is a top priority. Dignity in Applied Behavior Analysis (ABA) means treating individuals with respect, fostering autonomy, and ensuring their learning experiences are empowering. For older learners, this often involves shifting the role of the instructor from a passive observer to an active participant in tasks.
For example, if John’s goal is to work as a busboy, his SBT might include clearing tables, wiping them down, and rolling silverware. To preserve his dignity, the instructor should model or imitate these actions alongside him rather than standing nearby giving directives. This collaborative approach not only enhances the learner’s experience but also ensures that the process appears respectful and natural to outside observers.
Televisibility, or how treatment looks to others, is another critical consideration in SBT. The treatment process should be designed to appear positive and respectful from an outsider’s perspective. This is especially important when working with older individuals, as their behavior and treatment are more likely to be observed by peers or community members. For instance, instead of using coercive methods or visibly controlling the learner’s actions, practitioners should focus on creating an environment where the learner feels empowered to participate willingly. This approach fosters a perception of mutual respect and collaboration.
By prioritizing dignity and televisibility, SBT not only helps learners achieve their goals but also ensures that the process aligns with ethical standards and promotes social acceptance.
Restoring Hope Through Individualized Treatment
Older learners often have extensive histories of unsuccessful behavioral interventions, which can lead families to lose hope. However, skill-based treatment offers renewed optimism by teaching individuals appropriate ways to tolerate life’s inevitable disappointments while reducing problem behaviors.
Although the steps in PFA and SBT remain consistent across all learners, individualization is vital for older individuals. By starting with clear end goals and emphasizing safety, dignity, and televisibility throughout treatment, families can achieve meaningful improvements in behavior.
Contact us today if you have any questions about PFA and SBT.
