The Social Validity of Behavioral Interventions: Seeking Input from Autistic Adults

Kaitlynn M P Baiden; Zachary J Williams; Rachel K Schuck; Patrick Dwyer; Mian Wang

doi:10.1007/s10803-024-06297-3

The Social Validity of Behavioral Interventions: Seeking Input from Autistic Adults

J Autism Dev Disord. 2024 Mar 12. doi: 10.1007/s10803-024-06297-3. Online ahead of print.

Authors

Kaitlynn M P Baiden¹, Zachary J Williams^{2

3

4

5

6}, Rachel K Schuck⁷, Patrick Dwyer^{8

9

10}, Mian Wang⁷

Affiliations

¹ Gevirtz Graduate School of Education, University of California, Santa Barbara, USA. kpenner@ucsb.edu.
² Medical Scientist Training Program, Vanderbilt University School of Medicine, Nashville, USA.
³ Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, USA.
⁴ Vanderbilt Brain Institute, Vanderbilt University, Nashville, USA.
⁵ Frist Center for Autism and Innovation, Vanderbilt University, Nashville, USA.
⁶ Vanderbilt Kennedy Center, Vanderbilt University Medical Center, Nashville, USA.
⁷ Gevirtz Graduate School of Education, University of California, Santa Barbara, USA.
⁸ Department of Psychology, University of California, Davis, Davis, USA.
⁹ Center for Mind and Brain, University of California, Davis, Davis, USA.
¹⁰ Olga Tennison Autism Research Centre (OTARC), School of Psychology and Public Health, La Trobe University, Bundoora, VIC, Australia.

PMID: 38470531
DOI: 10.1007/s10803-024-06297-3

Abstract

Many in the autistic community have expressed concerns regarding the use of behavioral interventions with autistic children, suggesting that these interventions may not be socially valid. Though behavioral interventions have evolved to be more naturalistic and child-centered, little structured research has been done to explicitly seek autistic perspectives on the acceptability of specific components of behavioral interventions. Autistic adults (N = 235) were recruited online to take the Autism Intervention Attitudes Scale (AIAS), a questionnaire designed to gather feedback on common intervention goals and practices. Results indicate that participants find goals and practices that highlight quality of life, safety, and autistic interactions acceptable, while those that focus on normalization based on neurotypical standards are not. An exploratory graph analysis revealed three communities of goals ("uncontroversial goals", "controversial goals", and "social goals"). Comparison between naturalistic and structured intervention components additionally showed that autistic participants favored naturalistic strategies. These findings are in line with known criticisms of behavioral intervention from autistic adults, but also provide more information on the specific ways in which behavioral interventions can be reformed. This information can guide professionals in the development of appropriate goals and decisions around intervention planning.

Keywords: Autistic adults; Behavioral interventions; Naturalistic developmental behavioral intervention; Social validity.