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1 LITERATURE REVIEW

Behavioral Analysis Approach to Potential Treatment of Autism Spectrum Disorder

Learner’s Name

Capella University

PSY5002: Foundations of Theory and Practices for Master's Psychology Learners

Literature Review

July, 2020

2 LITERATURE REVIEW

Abstract

Interventions for autism and the larger spectrum of disorders referred to as autism spectrum

disorder (ASD) primarily cater to children with autism, whereas adults with autism are largely

ignored despite the difficulties they face. My analysis of the psychological literature produced on

autism and adults reveals that behavioral interventions are moderately to highly effective in

mitigating the symptoms of ASD. My interview with a behavior analyst has provided me with

insights into behavior analysis and an ethical principle to guide my future practice. The

phenomenon of the optimal outcome individual suggests that there is a slight possibility for

individuals with autism to lose their diagnosis. However, I have found that most studies focus on

the benefits of behavioral interventions. An integrated approach that uses behavioral analysis and

other fields related to the mind (such as neuroscience) could help understand and treat ASD.

Accordingly, additions have been made to my goals.

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Behavioral Analysis Approach to Potential Treatment of Autism Spectrum Disorder

Autism, or autistic disorder, is one of the disorders classified under autism spectrum

disorder (ASD). Individuals diagnosed with ASD characteristically display social deficits that are

often exacerbated by intellectual disabilities. Although some individuals might develop their

skills enough to raise themselves above the threshold for diagnosis of ASD, most struggle with

ASD throughout their lives (Anderson et al., 2014; Fein et al., 2013). Assistance for treating

ASD exists primarily for children, but little research has been produced on the occurrence and

effects of ASD among adults (Lai et al., 2014).

An estimated one in 88 children is diagnosed with ASD in sites across the United States

under surveillance by the Autism and Developmental Disabilities Monitoring Network (Baio et

al., 2018). Of these autistic children, only 1–16% lose their diagnosis as they progress into

adulthood (Anderson et al., 2014). However, there is a general dearth of psychological research

on autism in adults and a subsequent lack of support systems for them. My research question

addresses the core of the treatment of autism in adults: What practices help mitigate the

difficulties faced by adults with autism?

Well-Being and Self-Sufficiency

The ideal type of life envisioned for an individual with autism is one of general well-

being and self-sufficiency. Currently, the most effective interventions for ASD are behavioral

and educational (Lai et al., 2014), which seek to “maximize an individual’s functional

independence and quality of life through development and learning, improvements in social

skills…, reductions in disability and comorbidity, [and] promotion of independence” (Lai et al.,

2014, p. 904). The aim of these interventions is to mitigate any symptomatic differences an

individual with autism might display in comparison to a neurotypical person.

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Anderson et al. (2017) understand employment to be beneficial to individuals and the

society to which they belong. This ideal notion of life may be observed in optimal outcome

individuals (OO) who no longer meet the threshold for diagnosis. Fein et al. (2013) found that

OO individuals had IQ and social interaction scores on par with their neurotypical counterparts.

The current research seems to measure the quality of life of the individual by how effectively

they can perform tasks that a neurotypical person can perform.

Success of Behavioral Interventions

Behavioral interventions have been shown to be the most effective in mitigating the

symptoms and effects of ASD. Instead of tackling the physical bases that might underlie ASD,

behavioral interventions strive to bring about desired productive behaviors. The study by Roth et

al. (2014) revealed a rate of 81% medium to high success among the 20 behavioral interventions

surveyed. In their study of OO individuals, Fein et al. (2013) evaluated participants from across

the United States and Canada. The researchers note that most of the 34 OO individuals in the

study were faring well in their lives. Only a few of them showed signs of non-autism–related

difficulties such as anxiety, depression, or impulsivity. Overall, most of the individuals in the

study were from the north-eastern part of the United States, an area that has infrastructure for

early behavioral interventions for ASD. At the very least, the conclusion that may be derived

from this observation is that early behavioral intervention programs provide an environment that

is conducive to the development of the OO individual. The results of the study by Anderson et al.

(2017) reveal that behavioral interventions are effective in teaching vocational skills to adults

with autism. Overall, these articles show that behavioral interventions are highly effective in

improving the lives of adults with autism.

Dearth of Research on Adults with ASD

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Another key finding from my review is that the authors of all three articles stressed on the

need for more research on autism among adults. Roth et al. (2014) found that although most

behavioral interventions have a medium to high success rate, their research was limited in scope

because of the small number of studies they could take into consideration. Anderson et al. (2017)

found that scholars paid significant attention to behavioral skills training, whereas other

interventions such as self-management and video-based interventions were largely ignored. In

their study, Fein et al. (2013) attempted to draw attention to the existence of the group of OO

individuals. The few studies that proved the existence of such a group did not examine the

conditions that enable certain individuals with ASD to lose their diagnosis and become OO

individuals. Additionally, these three studies are limited in their scope of consideration of

alternative explanations or methods for the treatment of ASD.

Conclusion

Although infrastructure exists for the treatment of children with ASD, there are limited

resources for adults. The surveyed literature reveals that the effects of ASD are best mitigated

through behavioral interventions. This suggests that choosing to specialize in applied behavior

analysis at the master’s level is the right decision for me. Applied behavior analysis relies on

fundamental principles that are applicable across different populations. However, other

approaches to ASD are not given as much attention, and this has lessened the possibility of a

solution that is interdisciplinary. I have found the possibility of the influence of brain structure in

the occurrence of the disorder interesting. Thus, an additional goal is to follow the developments

in neuroscience to complement my studies on ASD as a psychotherapist. My vision to improve

the state of the adult with autism has been further developed and strengthened because of my

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research. All of this will be guided by the ethical principle to always place my clients first by

considering whether my decisions benefit them.

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References

Anderson, A., Moore, D. W., Rausa, V. C., Finkelstein, S., Pearl, S., & Stevenson, M. (2017). A

systematic review of interventions for adults with autism spectrum disorder to promote

employment. Review Journal of Autism and Developmental Disorders, 4(1), 26–38.

https://doi.org/10.1007/s40489-016-0094-9

Anderson, D. K., Liang, J.W., & Lord, C. (2014). Predicting young adult outcome among more

and less cognitively able individuals with autism spectrum disorders. The Journal of

Child Psychology and Psychiatry, 55(5), 485–494. https://dx.doi.org/10.1111/jcpp.12178

Baio, J., Wiggins, L., Christensen, D. L., Maenner, M. J., Daniels, J., Warren, Z., Kurzius-

Spencer, M., Zahorodny, W., Rosenberg, C. R., White, T., Durkin, M. S., Imm, P.,

Nikolaou, L., Yeargin-Allsopp, M., Lee, L-C, Harrington, R., Lopez, M., Fitzgerald, R.

T, Hewitt, A., … Dowling, N. F. (2018). Prevalence of autism spectrum disorder among

children aged 8 years—autism and developmental disabilities monitoring network, 11

sites, United States, 2014. (Morbidity and Mortality Weekly Report 2018 No. SS-6).

Centers for Disease Control and Prevention http://dx.doi.org/10.15585/mmwr.ss6706a1

Fein, D., Barton, M., Eigsti, I.-M., Kelley, E., Naigles, L., Schultz, R. T., Stevens, M., Helt, M.,

Orinstein, A., Rosenthal, M., Troyb, E., & Tyson, K. (2013). Journal of Child

Psychology and Psychiatry, 54(2), 195–205. https://dx.doi.org/10.1111/jcpp.12037

Lai, M.-C., Lombardo, M. V., & Baron-Cohen, S. (2014). Autism. The Lancet, 383(9920), 896–

910. https://dx.doi.org/10.1016/S0140-6736(13)61539-1

Roth, M. E., Gillis, J. M., Reed, F. D. D. (2014). A meta-analysis of behavioral interventions for

adolescents and adults with autism spectrum disorders. Journal of Behavioral Education,

23(2). 258–286. https://dx.doi.org/10.1007/s10864-013-9189-x

https://doi.org/10.1007/s40489-016-0094-9

https://dx.doi.org/10.1111/jcpp.12178

http://dx.doi.org/10.15585/mmwr.ss6706a1

https://dx.doi.org/10.1111/jcpp.12037

https://dx.doi.org/10.1016/S0140-6736(13)61539-1

https://dx.doi.org/10.1007/s10864-013-9189-x