B.Noncontingent Access to Preferred Stimulus
Through the years since Kanner first described infantile autism, much research has amassed on different methods of treating those diagnosed with autism and the various deficits and excesses they possess. As the 1960s began, the learning theory approach to treatment gained prominence and researchers used the principles of operant learning theory to develop new behavioral treatment techniques. Behavioral excesses and deficits were viewed as operant and controlled by environmental consequences and so modification of such consequences could change the behavior excesses and deficits. As the 1970s arrived there was an increase in the amount of research in behavioral treatment of autism with a more focused approach to target behaviors and an increase in sophisticated behavioral techniques (Matson, Benavidez, Compton, Paclawskyj & Baglio, 1996).
This has been an area of intense research and many children have benefited as a result of the developments. However, each method has its limitations and is not always significantly effective. It is said that autism is uncritical thinking dominated by fantasies that have little or no relation to reality; the gratification of wishes and desires in imagination (Goldenson, 1970). Behavioral approaches to treating autism must account for the different levels of awareness if they are to effectively change the sometimes devastating behaviors of autistic people.
Autism is a spectrum disorder with a wide range of symptoms and degrees of impairment. A person with autism lives for the most part in an isolated world unaware of the impact their behavior has on the immediate environment.
Even though some may be high functioning, the majority (around 70-75%) has some amount of associated learning disabilities and about 50% score below 50 on the IQ scale. When there are profound cognitive impairments, adequate speech development is not likely, and additionally the incidence of aberrant behavior increases (Howlin, 1996). Aberrant behaviors are behavioral excesses that interfere with interaction opportunities within an individuals environment (Matson, et al., 1996). Another high impacting area of deficiency is socialization skills. This area includes decreased responding to verbal initiations of others, inappropriate affect or facial expression during communicative interactions, eye contact and preservation on the same topic even when cues are given by the partner for a topic shift (Koegel, & Frea, 1993).
Social skill impairment has some relation to the language impairment. Expressive and receptive language difficulties occur in a high percentage of autistic individuals. Difficulties in expressing thoughts and ideas can lead to outbursts of anxiety, aggression, and self-injurious behavior in those with low ability and therefore it is often incorporated into treatment approaches for several areas (Howlin, 1998).
Treatment techniques vary widely depending on the target behavior and desired outcome. In dealing with aberrant behavior, if the behavior is extreme and destructive, then a quick end to the behavior is desired. It has been found that aversive procedures in which punishment was administered contingent on emission of the target behavior rapidly decrease aberrant behaviors.
This has been criticized as unethical. Critics have tested the effectiveness of nonaversive procedures and found them to be as effective in non-life-threatening behaviors (Matson, et al., 1996). One such effective method is that of noncontingent access to preferred stimuli. In one study researchers found that presenting an autistic individual with multiple predetermined sets of preferred stimuli or rotating the sets decreased the occurrence of self-injurious behavior (DeLeon, Anders, Rodriguez-Catter, & Neidert, 2000). Another method in modifying aberrant behaviors is to increase the amount of social skills as alternative behaviors.
In identifying pivotal behaviors, some researchers have been able to modify one target behavior and have it result in collateral changes in other behaviors. Koegel, Koegel, Hurley, & Frea (1992) reported that teaching an autistic person to respond to verbal initiations from others on a regular basis collaterally decreased the level of disruptive behavior. For some individuals the technique of self-management has been shown to be highly effective. It requires teaching of appropriate and inappropriate behavior identification as well as recording methods. It has been used to increase social skills while decreasing disruptive behavior (Matson, et al., 1996).
In social skills it has been shown that some behaviors taught generalize well to other untreated behaviors (Koegel, 1993), however, it has proved more difficult to .