Focus on Generalization and Maintenance

On more than one occasion, I’ve been in the situation that a student will only demonstrate a skill in my presence. And I’ve heard from other colleagues that they have had similar experiences. This is highly problematic. When it happens with one of my students, there is only one person I can blame: myself.  A skill that a student can only demonstrate in my presence is a pretty useless skill and does nothing to promote independence.

TeacherSo what do you do when you find yourself in this situation? You reteach, with a focus on generalization. This means that, from the very beginning, you are teaching with a wide variety of materials, varying your instructions, asking other adults to help teach the skill, and demonstrating its use in a variety of environments. Preparing activities takes more time on the front-end for the teacher, but saves a ton of time later because your student is more likely to actually master the skill. (Generalization, after all, does show true mastery.)

Hopefully, you don’t have to do this, though. Hopefully, you’ve focused on generalization from the first time you taught the skill. You may see generalization built into materials you already use, such as 300-Noun List at AVB press.

Another commonly cited issue teachers of children with autism encounter is failure to maintain a skill. In my mind, generalization and maintenance go hand-in-hand, in that they require you to plan ahead and consider how, when, and where you will practice acquired skills. Here are a few tips that may help you with maintenance of skills:

  • Create notecards of all mastered skills. During the course of a session, go through the notecards and set aside any missed questions or activities. You might need to do booster sessions on these. (This can also be an opportunity for extending generalization by presenting the questions with different materials, phrases, environments, or people.)
  • Set an alert on your phone to remind you to do a maintenance test two weeks, four weeks, and eight weeks after the student has mastered the skill.
  • Create a space on your data sheets for maintenance tasks to help you remember not only to build maintenance into your programs, but also to take data on maintenance.

Considering generalization and maintenance from the outset of any teaching procedure is incredibly important. Often, when working with students with special needs, we are working with students who are already one or more grade levels behind their typically developing peers. Failing to teach generalization and maintenance, then having to reteach, is a waste of your students’ time.

WRITTEN BY SAM BLANCO, MSED, BCBA

Sam is an ABA provider for students ages 3-15 in NYC. Working in education for twelve years with students with Autism Spectrum Disorders and other developmental delays, Sam utilizes strategies for achieving a multitude of academic, behavior, and social goals. Sam is currently a PhD candidate in Applied Behavior Analysis at Endicott College. She is also a lecturer in the ABA program at The Sage Colleges.

 

 

Focus on Reinforcement

Focus on Reinforcement

Teaching can be incredibly overwhelming, especially in a special education classroom. Between paperwork, lesson planning, updating bulletin boards, and actually teaching, the day can get pretty hairy. Sometimes, that stress leads to a short temper, which can lead to a punitive classroom environment.

If things seem to be going in the wrong direction in your classroom, the first thing you should do is focus on reinforcement. Here are a few steps to consider:

  1. Identify 1-3 behaviors you would like to see your students exhibiting. For instance, maybe you’d like to see an increase in hand-raising (as opposed to calling out.) Clearly define the behaviors you want to see.
  2. Set up a contingency for increasing those behaviors. Maybe you’ll wear a MotivAider to give yourself a reminder throughout the day to provide verbal praise to students exhibiting the target behavior. Maybe you’ll have students earn points that they can exchange for other things, such as a homework pass or lunch with the teacher. Maybe you’ll encourage students to recognize each other when they engage in the target behavior.
  3. Teach the students about the target behavior(s). Introduce the goals to the students. It’s helpful to create a sign or other visual to remind students about the new goals.

While these are simple steps, providing more verbal praise and other reinforcement can turn around a classroom with too much time spent on reprimands and punishments.

It’s also helpful to remember (especially for new teachers) that you can make changes at any time. One of my mentors in my first year of teaching told me to tell my class we had gotten off track, so we were having a brand new first day of school. (I was teaching fourth and fifth grade students with emotional behavioral disorders.) It was shocking how well that new first day of school went over. The students were excited about the idea of a “fresh start” in the middle of the school year, and it helped me get back on track with creating a more positive learning environment.

Ultimately, the goal is to teach students about appropriate behavior by spending more time showing them what they’re doing right than focusing on what they’re doing wrong.

 

WRITTEN BY SAM BLANCO, MSED, BCBA

Sam is an ABA provider for students ages 3-15 in NYC. Working in education for twelve years with students with Autism Spectrum Disorders and other developmental delays, Sam utilizes strategies for achieving a multitude of academic, behavior, and social goals. Sam is currently a PhD candidate in Applied Behavior Analysis at Endicott College. She is also a lecturer in the ABA program at The Sage Colleges.

 

Autism and the Peer Review Process

Autism peer review process

If one wanted to market a scientifically-unproven intervention, device, or pill as a valid autism treatment to families affected by autism, how would one go about it? Glossy pictures? Glowing testimonials? Miracle claims? Hyped social media pitches? Charming infomercials? Answer: All of the above.

And, here’s another marketing strategy: portraying one’s product as having scientific validation when, in fact, such validation does not exist. To do this, one might make references to “scientific evidence” in material that, upon systematic inspection, is less than convincing.

I was reminded of this when I recently reviewed a web page that boldly claims, “SCIENTIFIC RESEARCH Verifies The Son-Rise Program® WORKS!” Findings support the efficacy of parent-delivered SRP intervention for promoting social-communicative behavior in children with autism spectrum disorders.”

What are these findings? On the website, the Son-Rise marketers provide a link to a key source of their “verification” – a paper entitled “Training Parents to Promote Communication and Social Behavior in Children with Autism: The Son-Rise Program”. This paper, written by a trio of Northwestern University researchers, presents a study of the purported benefits of intervention delivered by 35 parents of children with autism who participated in a five-day parent-training course on Son-Rise Program methods, as well as an advanced follow-up course 3-12 months later. Parents completed The Autism Treatment Evaluation Checklist (ATEC), a rating scale that contains items on communication, sociability, cognition, physical status and behavior.

The authors divided the 35 parents into three groups based on how many hours of intervention the parents reported giving their child each week during the interval between their first and second Son-Rise trainings (i.e., no intervention [11 parents], 1–19 hours [13 parents], 20 or more hours [11 parents]). The authors present results reflecting statistically significant higher ATEC scores at second ATEC completion relative to the first, and they suggest that these higher scores reflect real improvements in communication, social skills, and sensory and cognitive awareness. They go on to point out that children with greater gains were more likely to have had more hours of parent-administered SRP.

As linked on the Son Rise web-site, this study is typeset like a published research article, prompting me to try to determine which peer-reviewed journal had published it. Through email correspondence, the third author, Cynthia K. Thompson, reported that the study had not been published because the team had decided to collect additional data prior to submission for peer review. In other words, this study is a “work in progress” and certainly not a verification of treatment effectiveness. In fact, this practice of repeatedly analyzing results prior to the close of data collection is, in itself, problematic from a scientific standpoint, as the process involves conducting many analyses that often yield varying results but are never reported (see Simmons, Nelson, & Simonsohn, 2011).

One of the mechanisms that make science such a powerful engine for progress is the reliance on the peer review process. The scientific method requires that, when a scientist makes an assertion (e.g., “This treatment works!”), (s)he knows that there exists a responsibility to show other scientists how they arrived at their conclusions with enough specificity that others can replicate the study. It is through this process of peer review that faulty assertions about the data are challenged and, hopefully, rejected in short order.

Typically, in the peer review process, an editor reviews a manuscript and, if deemed appropriate, shares the manuscript with a team of reviewers with demonstrated expertise in the relevant subject area. In many cases, these reviewers are “blind” to the identity of the authors and vice-versa, so as to minimize personal biases (e.g., affiliations, personal grudges). The reviewers are charged with the task of evaluating the contents of the manuscript on the basis of scientific merit, including the methodology, statistical analyses of the data and logic of the authors’ conclusions. The reviewers then describe, in writing, their opinions regarding the strengths and weaknesses of the study and make a recommendation regarding publication. The editor synthesizes this feedback and provides a summary to the author(s). In many cases, the editor will reject the manuscript for publication altogether. In other cases, he or she may require revisions, acknowledge limitations, temper conclusions or make other substantive changes prior to publication.

In the case of the manuscript written by Thompson and her colleagues, I suspect that, if it were submitted to a journal with a legitimate peer review process, a multitude of questions would be raised about it, including:

  • participant recruitment (35 self-selected parents out of a pool of 430 parents, many of whom participated in the first training but apparently did not return for more)
  • group distribution (non-random group assignment)
  • the outcome measure (one brief checklist completed by parents)
  • treatment fidelity (no way of verifying the quality or quantity of actual treatment), and
  • control for placebo effect, expectancy bias or any number of potential threats to the validity of responses.

And, despite some effort on the part of the authors to control for this, there is no real way of knowing what other interventions the child was engaged in during the interval between their parents’ first and second Son Rise training.

Of course, scientists who make up peer review committees are vulnerable to the same kinds of human frailties as the rest of humanity (i.e., jealousy, ego, bias, profit motive); however, the communal nature of the process, as well as another scientific safeguard- replication of results by others- helps to minimize the degree to which these frailties impact decisions regarding the quality of a study and our confidence in the results. The scientific method is far from perfect, but it is probably the best game in town for vetting new interventions.

Parents and other consumers of product pitches can watch for treatment claims that look like they have been established through the scientific process but in actuality fall short. Discuss potential treatment options with licensed and/or board certified experts whom you trust. Practice skepticism, especially when fantastical claims are made. Use resources, such as ASAT’s Treatment Summaries for quick reference. Families affected by autism deserve honest, direct communication about the state of the science for treatment options. Accept nothing less.

References

Simmons, J. P., Nelson, L. D., & Simonsohn, U. (2011). False positive psychology: Undisclosed flexibility in data collection and analysis allows presenting anything as significant. Psychological Science, 22, 1359–1366.

Cite This:

Mruzek, D. W. (2012). Focus on science: “Verification” and the peer review process. Science in Autism Treatment, 9(3), 18-19.

About The Author

Daniel W. Mruzek, Ph.D., BCBA-D is an Associate Professor at the University of Rochester Medical Center (URMC), Division of Neurodevelopmental and Behavioral Pediatrics in western New York. He received his doctoral training in Psychology at the Ohio State University and is a former Program Director at the Groden Center in Providence, Rhode Island. Currently, he is an associate professor and serves as a clinician and consultant, training school teams and supporting families of children with autism and other developmental disabilities.

Mruzek coordinates his division’s psychology postdoctoral fellowship program in developmental disabilities and is an adjunct faculty member in the University of Rochester Warner School of Education. He is actively involved as a researcher on several externally funded autism intervention research studies and has authored and co-authored more than 20 peer-reviewed articles and book chapters on autism and other developmental disabilities. Dr. Mruzek is on the editorial board for the journals Focus on Autism and Other Developmental Disabilities, Behavior Analysis in Practice, Journal of Mental Health Research in Developmental Disabilities, and Intellectual and Developmental Disabilities. Dr. Mruzek is a former member of the Board of Directors of the Association for Science in Autism Treatment.

To learn more about ASAT, please visit their website at www.asatonline.org. You can also sign up for ASAT’s free newsletter, Science in Autism Treatment, and like them on Facebook!

Who’s Most Qualified To Work With Your Child.txt

Parents of children with autism are faced with a wide range of choices when it comes to the education and support of their children. The most important question of all is who’s most qualified to work with your child? Although a great deal of research supports Applied Behavior Analysis (ABA) as the only effective treatment for autism, there are still many other interventions that are touted as potentially helpful. Research shows that combining ABA with other interventions is less effective than implementing it alone, with high fidelity and intensity (Howard, 2005).

Who's Most Qualified To Work With Your Child? Not all behavioral professionals are created equal. There is little control over the use of terms like “behavior specialist,” “behavior therapist,” and “behaviorist.” Just about anyone can claim to be one of these, often on the basis of very limited training and virtually no on-going supervision.  Consumers are often not aware that these are uncontrolled titles, and may put their trust in untrained, unsupervised practitioners. 

The problem of lack of quality control in behavior analysis was addressed by the development of state certifications for behavior analysts, and eventually the Behavior Analyst Certification Board (BACB) was formed. 

BACB credentials allow consumers some degree of confidence in the education, training, and supervision of the professionals they entrust their children to.  If someone claims to have one of these credentials, consumers should be able to find them on the BACB registries, easily accessed online at www.bacb.com

What does the BACB mean for consumers?  Those seeking behavioral interventions for themselves or others can look for professionals who have met the standards of the Behavior Analyst Certification Board with the confidence that that they have a minimum level of education, experience, and supervision and that they are obligated to follow an ethical and professional code.  Whether looking for a school program, privately hiring a professional, or seeking insurance coverage of services, the BACB designations can help consumers to determine if professionals and staff members providing services are well-qualified. They are also not at all easy to accomplish, so it is safe to say that someone with one of these credentials has achieved a high level of understanding of the science of behavior and the practice of behavior analysis.

Some states now license and certify behavioral professionals, and the standards for state licensure and/or certification may be more or less than those required by the BACB.  Having a BACB credential in addition to state licensure ensures that the professional also meets the BACB’s high standards. 

Credential Minimum education requirement Type of work Supervision
Registered Behavior Technician (RBT) High school diploma or equivalent Direct implementation of behavioral interventions (paraprofessionals) Ongoing by a BCaBA, BCBA, or BCBA-D
BCaBA Bachelor’s degree Practice under supervision, supervise RBTs Ongoing by a BCBA or BCBA-D
BCBA Master’s degree Independent practice, supervision of BCaBAs and RBTs None
BCBA-D Doctoral degree Independent practice, supervision of BCaBAs and RBTs None

 

Guest post written by Dana Reinecke, PhD, BCBA-D.

 

References

www.bacb.com, retrieved January 28, 2017

Howard, J. S., Sparkman, C. R., Cohen, H. G., Green, G., & Stanislaw, H.  (2005).  A comparison of intensive behavior analytic and eclectic treatments for young children with autism.  Research in Developmental Disabilities, 26, 359-383.

National Autism Center.  (2015). Findings and conclusions: National standards project, phase 2. Randolph, MA: Author.

Spotting The Difference Between Fake and Real News

Spotting The Difference Between Fake and Real News

The decisions of many consumers are influenced by what they read in the newspaper or on the Internet and hear about on television or radio. It is our belief that access to effective treatment for the autism community is enhanced by accurate representations of autism treatment by these media outlets. Unfortunately, many media representations are fraught with inaccuracies. Here’s what you need to know about spotting the difference between fake and real news.  

Effective treatments typically receive less press attention because their providers are often focusing on maximizing outcomes in an accountable manner rather than on soliciting media attention. They are also limited by ethics codes on how they can promote their treatment and services.

Many of you may be familiar with the Latin phrase, “Caveat Emptor,” which means “the buyer alone is responsible for checking the quality and suitability of goods before a purchase is made.” With scores of “miracle cures” and “breakthroughs” for autism receiving widespread media attention well before they have been shown to be beneficial through credible, peer-reviewed research, “Caveat Lector: Let the Reader Beware” seems to be a very suitable guiding principle across all media platforms (e.g., print, radio, television, Internet) particularly at a time when “fake news” is becoming commonplace. In other words, the reader is put in the position of being him/herself responsible for evaluating the quality and suitability of information being presented to him or her.

As a consumer, you bear a responsibility to scrutinize sensational claims related to various autism treatments and to be knowledgeable enough to consider such stories through a skeptical lens. We wish you did not need to work so hard to differentiate good information from bad, but that is the sad reality of autism treatment today, with 500+ treatments being touted. Unfortunately, many writers and journalists are not well versed in research methods, unless they specifically write about science, which is a very small portion of all individuals writing about autism out there.  With all this in mind, when reading or hearing about an autism story in the media, please consider the following questions:

About the Intervention

  • Does the article or story describe how the intervention actually helps individuals with autism? In what ways?
  • Are those ways observable and measurable? Substantial? Meaningful?
  • Does the article or story report the costs of the intervention? Are these costs reasonable, both in monetary and human resource terms?
  • Is there any report of harm imposed by this intervention? What are the risks? What are the side effects? Does the article or story appear balanced between these?
  • Who can carry out this intervention? What kind of education, training and supervision do individuals need to have before implementing the intervention?

About the Experts

  • Whom did the author interview for this story and what are this person’s qualifications? Is he/she presented as an expert?
  • Is the interviewee making claims of efficacy/effectiveness that are supported by scientific data? What does the interviewee/expert stand to gain from this story? Who may benefit financially from this particular media exposure? How would they benefit?

About the Underlying Scientific Support

  • Did the article or story mention the existence of research articles published in peer-reviewed journals documenting the efficacy of the intervention method discussed? If not, could it mean that no such research exists?
  • If so, did the writer comment on whether these studies were well designed? Are any limitations to the studies revealed?
  • Is this study or studies presented as an extension of existing work, or rather sensationalized as a “breakthrough,” keeping in mind that often interventions are pitched as a “breakthrough” when indeed, they are not?
  • On the other hand, does the author acknowledge the absence of underlying research?  Is this acknowledgement rightly framed as a concern or rather just potentially baseless but encouraging statements suggesting that “groundbreaking research” is coming soon?

Some Final Questions to Consider

  • Are other media outlets reporting on this story or topic? If yes, favorably or unfavorably? Did they consider research data in their articles?
  • Has ASAT responded to this article via its Media Watch efforts? Please visit this page to peruse our library of archived media watch letters.
  • Has the author consulted with an unbiased and knowledgeable individual for his/her input about the intervention described (e.g., someone who is not personally benefitting from the story or someone with a strong grasp of research)?

 

Sadly, inaccurate and biased portrayals of autism treatments in the media are abundant.  In our experiences, inaccurate portrayals often fall within the following themes:

  • Exaggerating the research support for an intervention for which little or no research exists;
  • Ignoring the research basis that may already exist for the treatment in focus;
  • Disregarding the relevance of science;
  • Disregarding position statements from various professional organizations that may warn against or discourage the use of a particular treatment; and
  • Failing to acknowledge research that does NOT support a particular intervention.

Being mindful of these themes will enable you to truly embody the principle of “Caveat Lector.”  Please consider liking our Facebook page as we routinely showcase our Media Watch efforts. ASAT’s Media Watch responds to both accurate and inaccurate media portrayals of autism treatment in an effort to increase access to effective treatment for the autism community.

Citation:

Celiberti, D., & Wozniak, R. (2016). Caveat Lector: Let the reader beware. Science in Autism Treatment, 13(1), 8-9.

Author Biographies:

David Celiberti, PhD, BCBA-D, is the part time Executive Director of ASAT and Past-President, a role he served from 2006 and 2012. He is the Co-Editor of ASAT’s newsletter, Science in Autism Treatment. He received his PhD in clinical psychology from Rutgers University in 1993. Dr. Celiberti has served on a number of advisory boards and special interest groups in the field of autism, applied behavior analysis, and early childhood education, and been an active participant in local fundraising initiatives to support after school programming for economically disadvantaged children. He works in private practice and provides consultation to public and private schools and agencies in underserved areas. He has authored several articles in professional journals and presents frequently at regional, national, and international conferences. In prior positions, Dr. Celiberti taught courses related to applied behavior analysis (ABA) at both the undergraduate and graduate levels, supervised individuals pursuing BCBA certifications, and conducted research in the areas of ABA, family intervention, and autism.

Renee Wozniak, PhD, BCBA-D, joined the ASAT Board of Directors in 2016. Prior to serving as a Board Member, Renée was a part of ASAT’s Externship, where she assumed the roles of Media Watch Co-Coordinator and Media Watch Lead. Renée received her Ph.D. in Special Education, focusing on Autism Spectrum Disorders (ASD) and Applied Behavior Analysis (ABA), from Arizona State University. She has worked in the fields of ASD and ABA in a variety of capacities since 1998, serving in public schools as a special education teacher, behavior intervention teacher specialist and district-wide autism trainer, and in clinical and home-based ABA programs as a research assistant, clinical/behavior interventionist, and program supervisor. Renée has trained families, therapists, teachers, teacher candidates, paraprofessionals, administrators, and others working with individuals with autism, and has instructed master’s level ABA, ASD, research and special education courses. She continues to stay involved in the field as a home-based ABA program supervisor, and as an instructor in ABA and ASD master’s degree programs. Renée is passionate about helping individuals with autism and their families by supporting and disseminating scientific research in autism treatment.

Why All Parents Should Use Token Economies

Why All Parents Should Use Token Economies

As parents, we want our kids to want to have good behavior. They should want to behave because it’s the right thing to do, right? Yeah right. This is why all parents should use token economies.

Have you met a 3 year old with an innate desire to good for this world? It’s in there somewhere but at age 3, it’s more like threenager-ville. Little humans do what gets them what they want. They behavior in a certain way to achieve a certain outcome.

A threenager is likely to tantrum to get access to their favorite toy, TV show, candy, a left shoe they can see on the other side of the room — you name it. They are acting a certain way (tantrum) to achieve a certain outcome (getting whatever they want).

What can we do about this? Is there any way to teach them to behave?! Well, we can make sure they get what they want not by having a tantrum, but by engaging in desired behaviors.

We can use positive reinforcement in a more structured and specific way than just handing out praise and rewards willy-nilly.

The definition of a token economy is: a behavior change system consisting of three major components: (a) a specified list of target behaviors; (b) tokens or points that participants receive for emitting the target behaviors; and (c) a menu of backup reinforcer items.

Token economies can possibly take the form of sticker charts, chore charts, marble jars, etc. You need a physical token that your child can earn when they engage in the desired behavior. You do NOT need to go out and spend $50 at the nearest school supply store making a big fancy chart. You can draw 5 circles on a piece of paper. When they do the desired behavior, draw a check mark in the circle. Done. Grab that piece of junk mail off the kitchen counter and a half-eaten, I mean half-broken, crayon.

The next step is to define the behaviors. Again, you don’t need a big fancy dictionary. Just pick one to three behaviors that will earn the tokens. You need your Little to understand this so it can’t be a big grown up idea like ‘being responsible’ or ‘showing respect’. What does that mean to a Little? Be specific. You earn a token for: (1) following instructions without yelling; (2) eating 5 bites of every food Mom puts in front of you; and (3) putting on your shoes when instructed to.

Pick your battles. You may have a list of 20+ things your Little could stand to improve. I’m pretty sure I have a list of 20+ things to put myself on a token economy. Let’s prioritize and make it understandable by the kiddo.

Lastly — what can they earn with these tokens? You can give choices before earning and they can decide at the beginning or at the end. You can make a fancy menu of reinforcers — Chuck E Cheese is the perfect example of this. This many tickets = this super awesome toy.

Or, you can just say: get all the stickers, get 5 check marks, get 10 marbles and earn a fun activity. You can pick from: extra screen time, trip to the library, a new toy from the dollar spot, etc.

All of that in short form:

  1. Pick 1-3 behaviors and make sure your Little understands what they are.
  2. Have an actual token they can earn and set a goal.
  3. Provide the reward when they reach that goal. Make it a big deal!

Tips:

  • When you first start out, set the goal low. If it’s too hard to achieve, that won’t motivate anyone, especially a Little who is struggling with those behaviors to begin with.
  • Over time, raise the goal. Make the reward bigger for a bigger goal, smaller for a smaller goal. Play with it to see what is successful for your Little and doable for you in your busy day.
  • Make every token earned a big deal — lots of praise and excitement.
  • Don’t spend a lot of time and money setting up a fancy system. Like all things we do as parents — as soon as we get a good system down, our Little changes things up on us and we have to be flexible. My own daughter sees a strip of printer paper and thinks I’ve made her a new sticker chart. That’s how fancy sticker charts are at my house!
  • Be creative!
    • My aunt gave this idea from her life: She had a picture of a poodle and her daughter glued cotton balls on it. When she filled the picture, they actually got the poodle!
    • My sister let her oldest pick out his marbles for a marble jar on a special shopping trip to the craft store (less than $5 — don’t go overboard, folks!). That helped him buy into the process form the get go.
    • Cut up a picture of the prize like a puzzle. They get a puzzle piece as a token. The finished puzzle earns the prize!
    • Look in the app store. Seriously — there are many apps for reward charts.
    • Google ‘behavior chart’. You’ll find a gazillion cute templates if that’s what you’re into — cutesy.
    • I once made a necklace for a student who was really into jewelry. It was a laminated sticker chart necklace and she loved it.

One last thought: Someday you will find that things are going well and the token economy goes by the wayside. Remember it when a new problem behavior crops up and you are once again at your wit’s end. Start over. Pick new behaviors, new rewards, same system.

Don’t take my word for it — this is just the tip of the iceberg in behavior analytic research supporting token economies.

If you’re not a crafty person, you can always check out our reward chart here

Citations:
Cooper, J., Heron, T., & Heward, W. (2007). Basic Concepts. In Applied Behavior Analysis(2nd ed., pp 560-567). Columbus: Pearson.

Kazdin, A. E. (Ed.). (1977). The token economy: A review and evaluation. Plenum Publishing Corporation.

Kazdin, A. E. (1982). The token economy: A decade later. Journal of Applied Behavior Analysis15(3), 431-445.

Skinner, B. F., Ferster, C. B., & Ferster, C. B. (1997). Schedules of reinforcement. Massachusetts: Copley Publishing Group.

Reitman, D., Murphy, M. A., Hupp, S. D., & O’Callaghan, P. M. (2004). Behavior change and perceptions of change: Evaluating the effectiveness of a token economy. Child & Family Behavior Therapy26(2), 17-36.


Leanne Page, M.Ed, BCBA
 has worked with kids with disabilities and their parents in a variety of settings for over 10 years. She has taught special education classes from kindergarden-grade 12, from self-contained to inclusion. Leanne has also managed a center providing ABA services to children in 1:1 and small group settings. She has extensive experience in school and teacher training, therapist training, parent training, and providing direct services to children and families in a center-based or in-home therapy setting. Since becoming a mom, Leanne has a new mission to share behavior analytic practices with a population she knows needs it- all moms of littles! Leanne does through her site parentingwithaba.org and through her book ‘Parenting with Science: Behavior Analysis Saves Mom’s Sanity”.  You can contact her at lpagebcba@gmail.com.

The Pitfalls of Testimonials

When searching for a great restaurant or choosing a movie to go see, often we consider the personal reports of neighbors, work associates and friends. Why not? Their “testimonies” give us a quick method for judging the probability that a particular restaurant or movie will be a good investment. Of course, our friends and associates are not always right, but their testimonials serve as either shortcuts or as corroboration of other sources of information (e.g., restaurant or movie reviews). As such, they contribute to efficient decision-making about relatively low-stakes events. Here’s what you need to know about the pitfalls of testimonials.

the pitfalls of testimonials

We commonly see testimonials made by happy consumers presented by marketers of autism treatments. Indeed, testimonials are a standard feature on for pills, exercises, devices, interventions and therapies to potentially unwary consumers. Many testimonials take the form of simple, quoted statements (e.g., “The [marketed treatment] has had an amazing effect on my son!”). On the internet, video testimonials may be particularly compelling. Marketers know that the testimonials of some people, including attractive people, familiar celebrities, and people who may remind the potential consumer of him — or herself may be particularly effective. Adding pleasant theme music and using artful filming may complete the effect and increase the probability that families separate from their hard-earned money.

But, how should we use testimonial evidence in selecting potential autism treatments? When confronted with testimonials about possible autism treatments, it is recommended that families be especially cautious, particularly when the testimonials are the only source of support for the intervention. Marketers can find a few individuals who provide testimony that their product is effective, even when the product is wholly ineffective. This is because, as consumers, our opinions about the quality of a product — including perceived effectiveness — are colored by our previous experience, what we have been told by others, and our expectations. Furthermore, because human behavior — including the behavior of individuals with autism — is variable (i.e., changes across time), a treatment benefit may appear to exist, even when it does not exist at all.

For example, imagine that a marketer sold a “special” trampoline to 100 parents with the guarantee that daily use of the trampoline by their child would “open learning channels” and “promote language acquisition”. Of those 100 parents, it is reasonable to expect that at least a small number of them — perhaps 5 or 10% — may report that the product “seems to help”, even if the trampoline is not at all effective as an intervention in the way described by the marketer. A savvy marketer is watching for members of this small subgroup of consumers as their source of new testimonials!

And, how about all of the parents who purchased the trampoline and, subsequently recognized that it did not “open learning channels” and “promote language acquisition”? You can be assured that their opinions will not grace the marketer’s website, social media or glossy print advertisement. As a result, the marketers promote an illusion of product effectiveness where one may not exist at all.

It is for these reasons that parents and other consumers of autism “treatments” are cautioned to view testimonials skeptically. Testimonials are a wonderful way for business people to market merchandise but a poor way for families to determine true effectiveness of a treatment, device or intervention. Decisions regarding autism treatment are best guided by the scientific record, as supplied by trusted sources (e.g., a competent physician, psychologist or other autism expert). When it comes to making decisions about expensive autism interventions and the allocation of precious resources, persons with autism — and their families — deserve nothing less.

Cite This:

Mruzek, D. W. (2012). The pitfalls of testimonials. Science in Autism Treatment, 9(2), 12

 About The Author

Daniel W. Mruzek, Ph.D., BCBA-D is an Associate Professor at the University of Rochester Medical Center (URMC), Division of Neurodevelopmental and Behavioral Pediatrics in western New York. He received his doctoral training in Psychology at the Ohio State University and is a former Program Director at the Groden Center in Providence, Rhode Island. Currently, he is an associate professor and serves as a clinician and consultant, training school teams and supporting families of children with autism and other developmental disabilities.

Mruzek coordinates his division’s psychology postdoctoral fellowship program in developmental disabilities and is an adjunct faculty member in the University of Rochester Warner School of Education. He is actively involved as a researcher on several externally funded autism intervention research studies and has authored and co-authored more than 20 peer-reviewed articles and book chapters on autism and other developmental disabilities. Dr. Mruzek is on the editorial board for the journals Focus on Autism and Other Developmental Disabilities, Behavior Analysis in Practice, Journal of Mental Health Research in Developmental Disabilities, and Intellectual and Developmental Disabilities. Dr. Mruzek is a former member of the Board of Directors of the Association for Science in Autism Treatment.

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