Evidence-based Strategies for Promoting Daily Happiness in Severe Autism Spectrum Disorder

1. Promoting Daily Happiness Among People With Severe Autism Spectrum Disorder: Evidence-Based Strategies Dennis H. Reid, Ph.D., BCBA-D

2. Why Focus on Happiness? • Pursuit of happiness is a fundamental right • Happiness a primary concern of family members • Reductions in problem behavior

3. In Some Ways, Happiness a Risky Venture in ABA • A private event • Usually measured by verbal report – can be risky • Verbal reports very difficult for people who lack vocal communication • Still, happiness is viewed by society as important . . . • For people with severe ASD challenges, it should not be taken for granted; it should be targeted and addressed like any other desired outcome

4. Qualifications • Primary focus on adults with severe ASD challenges • Happiness on day-to-day basis vs. major lifestyle changes • Focus on happiness and personal growth • That is, not in place of personal growth

5. Evidence-Based Protocol to Promote Happiness • Identify indices of happiness and unhappiness • Validate identified indices • Act to increase situations accompanied by happiness indices • Act to decrease situations accompanied by unhappiness indices • Monitor and evaluate routinely

6. Identifying Indices of Happiness and Unhappiness • Common indices • Happiness: smiling, laughing, yelling while smiling • Unhappiness: frowning, grimacing, crying, yelling without smiling Qualification for people with severe ASD and other developmental disabilities

7. Identifying Happiness Indices: Caregiver Opinion • Common practice • Concerns with validity • To promote validity: • Ensure familiarity of caregivers • Obtain caregiver consensus

8. Validating Happiness and Unhappiness Indices • Identify situations in which a person usually experiences happiness and unhappiness • Observe indices in above situations • Compare occurrence of indices across situations • Provide repeated choices

9. REFERENCEIdentifying and Validating Indices of Happiness and Unhappiness among Adults with Autism(and severe intellectual disabilities) Parsons, M. B., Reid, D. H., Bentley, E., Inman, A., & Lattimore, L. P. (2012). Identifying indices of happiness and unhappiness among adults with autism: Potential targets for behavioral assessment and intervention. Behavior Analysis in Practice,5, 15-25 www.abainternational.org

10. Increasing Happiness • The importance of personal relationships • Role of familiarity of staff • Preferred vs. nonpreferred status of staff

11. Familiarizing New Staff for Working with Adults with Severe Disabilities:A Case for Relationship Building Parsons, M.B., Bentley, E., Solari, T., & Reid, D.H. (2016). Behavior Analysis in Practice, 9, 211-222.

12. Purpose • Evaluate effects of familiar vs. unfamiliar staff on behavior of adults with autism on severe end of spectrum • Evaluate effects of a familiarization process for new staff

13. General Procedures • Setting (work focus) • Participants • 4 men with features of autism on the severe end of the spectrum • DVs: happiness and unhappiness indices, compliance, problem behavior, on task • Familiarization program: fun time and phase-in

15. Developing a Relationship:Summary • Spend time doing things that the person likes to do • Fun Time Program • Establish familiarity (phase-in) • Occurrence of happiness indices during interactions suggests a good relationship

16. Increasing Happiness • Providing individual choices • Choice opportunities must be provided based on individual skill level for responding with a meaningful choice

17. Increasing Happiness by Reducing Unhappiness • Rationale: continuum of happiness and unhappiness • Impact on some problem behavior • Process • Identify situation with unhappiness indices • Eliminate the situation if possible • Alter the situation

18. Making Undesired Activities More Enjoyable: Example • Preference-Based Teaching • Reid & Green (2005) • www.behaviordevelopmentsolutions.com • Rationale • Some learners engage in challenging behavior to escape or avoid teaching programs • If teaching programs are fun, no need for challenging behavior

19. To Effectively Promote Happiness . . . • Happiness should be a goaled, desired outcome just like more traditional outcomes • Must have behavioral objectives for monitoring and increasing/maintaining happiness (indices)

20. Don’t Forget Support Staff • It is unlikely staff will effectively promote consumer happiness if staff are frequently discontented with their work environment

21. And all of the above withDIGNITY • From . . . • Reid, Rosswurm, & Rotholz (2018). No less worthy: Recommendations for behavior analysts treating adults with intellectual and developmental disabilities with dignity. Behavior Analysis in Practice, 11, 71-70

22. How We Speak: Recommendations • Attend to local customs • Use people-first language • Refrain from speaking in front of people with IDD without their involvement • Refer to people, not their behavioral characteristic(s) • Avoid “low functioning” • Respect adult status (prefixes, local customs)

23. How We Behave: Recommendations • Escorting and traveling with adults with IDD • “side by side” walking • prompting • in groups • avoid “local segregation”

24. Dignity and the “Golden Rule” • Treat others as you desire to be treated: a multi-cultural value (not to be taken for granted but to be trained and supervised among support staff) • Practical guideline . . .

25. Reference for Increasing Happiness • Reid, D.H. (2016). Promoting Happiness Among Adults with Autism and Other Severe Disabilities: Evidence-Based Strategies. • www.behaviordevelopmentsolutions.com

26. Contact: • Denny Reid; drcba@outlook.com • FINALLY, IN YOUR SUPPORT SETTING, HOW OFTEN DO YOU SEE INDICES OF HAPPINESS AMONG THE PEOPLE YOU SUPPORT?