Chapter 2 Sifting Sound Practice From Snake Oil

1. Chapter 2Sifting Sound Practice From Snake Oil AMANDA sawma Ps553 assessing autism interventions Caldwell college Jacobson, J. W., Foxx, R. M., & Mulick, J. A. (Eds.). (2005) Controversial therapies for developmental disabilities: Fad, fashion, and science in professional practice. Hillsdale, NJ: Erlbaum

2. Progress in Developmental Disabilities • Teaching of adaptive skills • Independence • Functional skills • Treatment of behavior problems • Allows for less-restrictive environments • Overall quality of life • Reduction in the need for institutionalization

3. Fads in Developmental Disabilities • Vulnerable to questionable ideas and movements • Auditory integration • Greenspan’s Floor Time • RDI • Son-Rise • The Miller Method • Diets • Gluten-Free, Casein-Free • OSR#1 Dietary Supplement

4. Fads • Claim to produce results that are: • More rapid • More beneficial • Easier to achieve • No stress or challenges on the individual • Promise outcomes that are less: • Intrusive • Costly • Stressful • Labor intensive • Risky • Often denounce all previous treatments • Example: views regarding institutions after community movement

5. The Rules and Rewards of Science Chapter 2 Sifting sound practice from snake oil

6. What is Science? • “Used properly, the word science refers to a systematic approach for seeking and organizing knowledge about the natural world.” (Cooper, Heron, & Heward, 2007) • Levels of understanding: • Description, prediction, and control • Attitudes of science: • Determinism • Empiricism • Experimentation • Replication • Parsimony • Philosophical doubt

7. Science • Can test the effects of a treatment • Establishes or disconfirms its value • Determines whether it is a beneficial part of services and supports • “Science separates sound practice from snake oil.” (Jacobson, Foxx, & Mulick, 2005)

8. Science • Requires: • Quantitative, direct measures of observable events • Analysis of whether the intervention functionally caused the obtained effects • Replication to assess reliability

9. Science • Has established knowledge and technology to teach individuals with developmental disabilities • Enabled an emphasis on: • Growth in people with developmental disabilities • Supports to facilitate their development • Greater independence and enjoyment of life • Community-living among family and friends • Reduced use of drugs • Reduction in stigmatizing behavior problem • Improvements in functional skills

10. The Distrust and Disdain of Science Chapter 2 Sifting sound practice from snake oil

11. Reasons for Disdain and Distrust • Process appears arduous and slow • Requires time to: • Conduct investigations • Arrive at conclusions • Disseminate results

12. Reasons for Disdain and Distrust • Sometimes seems to defy logic • Does not conform to conventional wisdom • Does not conform to common sense

13. Reasons for Disdain and Distrust • Process appears: • Arcane • Complex • Confusing • This is true for: • The developmental disabilities community • The general public • Professionals not trained in the values, method, and logic of science

14. Reasons for Disdain and Distrust • Not widely taught, even in graduate level courses in education, medicine, psychology, or other professional human service areas • Highly-trained professionals may be: • Well-versed in their discipline • Unfamiliar with the scientific method • Prevents effective evaluation of new developments • Relies on popular beliefs

15. Reasons for Disdain and Distrust • Appears preoccupied with methodology, not meaningfulness of results • Media coverage: • Elaborate and costly research • “Trivial” or “obvious” results • Perceived as: • Self-serving • Detached from and unresponsive to real issues

16. Reasons for Disdain and Distrust • May deliver unexpected or unwanted results • Science is “value-neutral” • Results may not be consistent with beliefs, wisdom, or treatment and instructional philosophy • Promising or hopeful approach may be disconfirmed • Painful to families • Implications for professionals • Example: vaccines and autism

17. Reasons for Disdain and Distrust • The scientific approach is not explained to: • Consumers • The public • Human service professionals • Scientists communicate: • With other scientists and professionals within their field • Via scientific journals • Via professional meetings

18. Reasons for Disdain and Distrust • Dissemination usually focuses on results, not experimental rigor • Consuming audiences cannot evaluate the scientific method • Families and professionals are left vulnerable to fads and promises

19. The Care and Feeding of Fads Chapter 2 Sifting sound practice from snake oil

20. Fads • Are easy to promote and popularize • Dissemination is easy • Families are in search of help • Press is in search of hype • Critical evaluations often begin after the fad has wasted resources and financial investments

21. Fads • The field of developmental disabilities is especially vulnerable to fads • Lead to false observations and conclusions • Variability in behavior • Superstitious behavior • Focus on salient environmental events • The use of multiple and frequent interventions

22. Fads • Variables affecting individual promoting a method or movement • Be forgiving to those whose ideas are proven misguided or wrong • Be less forgiving to those who reject efforts to test ideas, or continue claims despite evidence against them

23. Fads • Philosophical and political pressure on the field • Positive impact on field • Example: early intervention in autism • Negative impact on field • Example: restraint for problem behaviors

24. Applied Behavior Analysis: An Example of the Fruits of Science and the Foundation of Fads Chapter 2 Sifting sound practice from snake oil

25. Behavior Analysis • Vital in the treatment and training in developmental disabilities • Developed community-based supports • Effective treatments • Training strategies • Based on solid research • Subject of major criticism from the public and other professionals

26. Behavior Analysis • Behavior analytic processes are: • Slow and methodical • Difficult and expensive • Empirical, not values based • Not as dramatic or fun as some fads • Different from popular culture and sometimes common sense • Became popular after psychiatric and medical communities could not help individuals with developmental disabilities

27. Contrasts Against Behavior Analysis • “Positive Behavioral Support” • Viewed as alternative to, not derivative of behavior analysis • “Person-centered planning” • Builds support plan based on strengths, preferences and personal desires • Viewed as opposite of behavioral approaches • Ignores foundation of behavior analysis • Focuses on preferences, reinforcers, strengths, and needs

28. Essential Steps Toward Sound Practice Chapter 2 Sifting sound practice from snake oil

29. New Ideas • “The way to have a good idea is to have lots of them” • Encourage new models, methods, and movements • Emphasize systematic evaluation and analysis of new ideas • Empirically evaluate ideas if agreed upon by the individual’s family and supporting professionals • Must be ethical, and not likely to cause harm

30. Scientific Research • Optimal way to test new models and methods • Empirical analysis is the best way to measure effectiveness • Measures conducted on ABA programs • Data collection • Treatment outcomes

31. Single-Subject Research Designs • Focus on the analyses of effects with a small number of individuals • New level of sensitivity and relevance to research in developmental disabilities • Allow evaluation of unique adjustments and effects with individuals • Incorporate information gained into conclusions drawn • Combine research and practice • Yield the most convincing data on the efficacy of a new approach

32. Individual Cases • Cannot confirm a proposed strategy • Can identify nonfunctional or harmful methods

33. Measurement • Reliable and valid measurement can address many debatable issues • Should include multiple dimensions • Example: the reduction of demand-induced self-injury should be measured with skill acquisition • Should include measures of: • Practicality • Cost • Social acceptability

34. Decision Making • Someone must decide what is appropriate for individuals who cannot decide for themselves • Decision making can be conducted by: • Broader agencies • Can raise issues and offer alternatives • Families • Closest to the issues • Will experience consequences of decisions

35. Summary Chapter 2 Sifting sound practice from snake oil

36. Science vs. Fads • Scientific method is the only real means of sifting sound practice from snake oil • The principles and processes of the scientific method are not yet embraced • Science is viewed as arcane, especially by the public and professionals not trained in the scientific method • Fads and movements are easily advertised and promoted by families, the public, and the media

37. Developmental Disabilities • We must encourage new ideas • Use empirical tests • Measure the full effects of intervention • Analyze functional relationship between the dependent and independent variables • There are no substitutes or short cuts to empirical validation • If proponents refuse to use empirical validation their motives and methods must be questioned • Consumers and professionals should refuse approaches if they are denied data

38. The Individual • Science and ideology cannot make value-based decisions in individual cases • No idea, model, method, or movement should dictate what is right or wrong for an individual • Decisions regarding the issues should be made by those closest to the individual • The field of developmental disabilities must provide sound options to those making such decisions

39. References Cooper, J. O., Heron, T. E., & Heward, W. L. (2007). Applied Behavior Analysis. 2nd Edition. Upper Saddle River, New Jersey: Pearson. Jacobson, J. W., Foxx, R. M., & Mulick, J. A. (Eds.). (2005) Controversial therapies for developmental disabilities: Fad, fashion, and science in professional practice. Hillsdale, NJ: Erlbaum.

40. Questions and Comments Chapter 2 Sifting sound practice from snake oil