Behavior Analysis Center for Autism - BACA

BACA provides ABA therapy to help children with autism.

Katherine Johnson

Top 5 Autism Studies from the Last Year

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BY KATHERINE JOHNSON, M.S., BCBA
SENIOR DIRECTOR OF PARTNERSHIPS

Looking back at 2021, there were significant developments, both in research and thought leadership, in the field of autism and applied behavior analysis (ABA).  Here are some studies and papers you don’t want to have missed!

 

Girls’ Genetics and Autism

2021 gave us another important building block in the ongoing investigation in to how and why autism manifests differently in girls than in boys.  A study by Jack et. al. found that there was a much greater difference in brain activity in autistic and non-autistic girls, than was previously found between autistic and non-autistic boys when viewing biological motion.  In the second half of the investigation, they looked at the girls’ DNA.  What they found (greater differences in brain activity and more gene mutations among the girls) bolsters the “Female Protective Effect” theory, which holds that girls require more genetic predisposition to autism in order to show autistic traits.  Inquiries into how autism manifests differently depending on sex is integral to being able to more accurately identify and support girls on the spectrum.  

Allison Jack, Catherine A W Sullivan, Elizabeth Aylward, Susan Y Bookheimer, Mirella Dapretto, Nadine Gaab, John D Van Horn, Jeffrey Eilbott, Zachary Jacokes, Carinna M Torgerson, Raphael A Bernier, Daniel H Geschwind, James C McPartland, Charles A Nelson, Sara J Webb, Kevin A Pelphrey, Abha R Gupta, the GENDAAR Consortium, A neurogenetic analysis of female autism, Brain, Volume 144, Issue 6, June 2021, Pages 1911–1926, https://doi.org/10.1093/brain/awab064

 

How Can Behavior Analysis Help Prison Reform?

Many behavior analysts have heeded the call to focus on their own cultural competence and anti-racism work; this paper outlines ways they can put those skills to good use.  Crowe and Drew review the history and current state of a social injustice faced by many people with disabilities: segregation via incarceration.  The authors posit that behavior analysts can help to interrupt the “school-to-prison pipeline” and outline their theory.  Although the authors call for a grand restructuring of the prison system (including abolition of the current system), they also offer thoughts on how behavior analysis could improve current institutions.

Crowe, B., & Drew, C. (2021). Orange in the new asylum: Incarceration of individuals with disabilities. Behavior Analysis in Practice, 14(2), 387-395. https://doi.org/10.1007/s40617-020-00533-9

 

Bridge Over Troubled Water…

If you have been following the conversation about ABA and neurodiversity, you’ll want to read this paper.  A group of Autistic and Non-Autistic authors challenge the belief that ABA is inherently harmful for Autistic people and proposes the perspective that behavioral interventions can be “compatible with the neurodiversity paradigm.”  After a history of autism and behavioral interventions, the authors delve into a thorough discussion of how Naturalistic Developmental Behavior Interventions may bridge the gap between opposing viewpoints about the use of behavioral interventions with people on the spectrum.  

Schuck RK, Tagavi DM, Baiden KMP, Dwyer P, Williams ZJ, Osuna A, Ferguson EF, Jimenez Muñoz M, Poyser SK, Johnson JF, Vernon TW. Neurodiversity and Autism Intervention: Reconciling Perspectives Through a Naturalistic Developmental Behavioral Intervention Framework. J Autism Dev Disord. 2021 Oct 13. doi: 10.1007/s10803-021-05316-x. Epub ahead of print. PMID: 34643863.

 

The Function of…. Happiness?

And the Functional Analysis (FA) gets another twist!  Thomas et. al. assessed whether or not paying attention to indices of happiness would assist in finding effective interventions to decrease challenging behavior.  They found that when interventions were derived from what they learned about the children’s happiness, they were as effective as interventions based solely on the function of the challenging behavior, and they were associated with more behavior associated with happiness.  In the search for effective treatments that are maximally acceptable to consumers, this is a useful addition to the FA!   

Thomas BR, Charlop MH, Lim N, Gumaer C. Measuring Happiness Behavior in Functional Analyses of Challenging Behavior for Children with Autism Spectrum Disorder. Behav Modif. 2021 May;45(3):502-530. doi: 10.1177/0145445519878673. Epub 2019 Sep 30. PMID: 31565953. 

 

Assent in Research

With the addition of “assent” to the BACB Code of Ethics, behavior analysts have begun the search for research, resources, and materials on the topic.  After a discussion of the federal statute and how it may or may not apply to autistic subjects, the authors discuss assent in the context of the behavior analytic values of self-determination and choice.  They then examine how frequently assent has been obtained in the behavior analytic research (spoiler alert: not frequently), note the methods that have been used, and propose a procedure for obtaining assent from nonverbal potential research participants.  This may be the only JABA article on assent in 2021, but it’s a fair bet that it will inspire many more in 2022. 

Morris C, Detrick JJ, Peterson SM. Participant assent in behavior analytic research: Considerations for participants with autism and developmental disabilities. J Appl Behav Anal. 2021 Sep;54(4):1300-1316. doi: 10.1002/jaba.859. Epub 2021 Jun 18. PMID: 34144631.

Myth: Kids with Autism Don’t Have Emotions

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BY KATHERINE JOHNSON, M.S., BCBA
SENIOR DIRECTOR OF PARTNERSHIPS

My cousin, a teenager with a broken heart, lay on my couch, crying. Her little brother, a mostly-non-verbal autistic four-year-old, wiped the tears off of her face and then tickled her to get her to laugh. 

A boy I worked with many years ago wanted desperately to get his baby brother to stop crying. He ran to get some scissors and told his mom, “Tag, Tag!” He, himself, was often irritated by tags in clothing, and, seeing his brother inconsolable, believed that maybe the tag in his onesie was the cause of his distress.    

A young autistic girl in a social skills group I ran years ago woke up earlier than her parents one day. She got out every glass, bottle, cup, and bowl in the house and arranged them in intricate patterns around the kitchen floor. When her mother got up, she looked up with pride and said, “Mommy, I made breakfast for you!” 

Autistic people have emotions. They love, they hurt, they empathize, and they care. So, where in the world did the myth about being “unemotional” come from? 

The answer may be in the concept of alexithymia. 

Alexithymia refers to the inability to recognize and express emotions. It’s not considered a clinical diagnosis or disorder but rather a condition or a personality trait, and has been studied since the 1970s. It occurs in about 10 to 13 percent of the general population but is more common among people on the spectrum, occurring in close to 50 percent of autistic folks—a high prevalence that may lead to people confusing the trait with autism itself. 

If you or your child experiences alexithymia, then you know firsthand that those with this trait still have deep feeling—they just have difficulty naming their emotions and explaining their feelings. Some may not be able to distinguish between their emotions and the bodily sensations connected to them, and may have less imagination or ability to fantasize than those without alexithymia. As one non-autistic man with alexithymia explained it: “Obviously, I’ve got a vocabulary. I’ve got words for emotions. But whether they’re the right words for the right emotion is a different point altogether.…”

Although experts have been unable to pinpoint a cause, research suggests a genetic component, and that environmental factors such as trauma, health conditions, and socioeconomic factors may play a part.  A brain injury to the anterior insula can also cause alexithymia. 

As parents and caregivers, we are always eager for more information on what we can do to help our children. Since autistic people are more likely to have alexithymia, it is important that family members, service providers, and the community at large understand the condition and the unfortunate risks that come with it. For instance, research suggests that people with alexithymia experience depression and anxiety significantly more often than those without the condition—problems that should be taken seriously and treated.  

Anxiety and depression may be due to people not understanding their own feelings, and to the effects alexithymia can have on their personal relationships. For example, some people with the condition report that they know when other people are experiencing negative emotions, which can feel distressing. Not understanding what those emotions are or how to react to them can make the situation even worse. For these reasons, it’s important for others to recognize that what may just seem like a simple skill deficit can affect an individual’s quality of life and well-being far more than they are able to communicate. And of course, if the person also has autism, communication may be even more difficult.       

When one team of researchers conducted a meta-analysis of studies on alexithymia and autism, they concluded that although the two things can co-occur, alexithymia is NOT a core feature of autism— although there isn’t yet a consensus. Regardless, since alexithymia appears to increase the risks for mental health challenges like anxiety and depression, and for unhealthy behaviors like greater alcohol consumption and lower levels of physical activity, healthcare providers consider it a trait that is important to identify. This way, alexithymic individuals—autistic and non-autistic alike—can be proactively supported in all of these areas.

The last few years have seen more and more autistic people raising their voices, sharing their experiences, and inviting others to hear their stories. As we listen, it’s important that we all work to dispel myths around autism, so that we can see people for who they truly are. Alexithymic autistic people have emotions, like everyone else. They just need support from loved ones in expressing and processing their feelings, and they need professionals to understand their unique needs so they can provide the best assistance. Likewise, non-alexithymic autistics deserve to be seen as themselves—and not bogged down in harmful myths about their lack of an emotional inner life. Once again, science arrives at a truth that harmonizes with what philosophers have long told us: regardless of what we look like—or behave like—on the outside, we are all humans, craving to connect emotionally with other humans.   

For more on mental health and autism, listen to our recent podcast, “Nobody’s Normal: How Culture Created the Stigma of Mental Illness.” Here, Roy Richard Grinker, a professor of anthropology and international affairs at George Washington University, explores stigmas around various diagnoses, including autism.

 

 

Gaigg SB, Cornell AS, Bird G. The psychophysiological mechanisms of alexithymia in autism spectrum disorder. Autism. 2018 Feb;22(2):227-231. doi: 10.1177/1362361316667062. Epub 2016 Nov 2. PMID: 27811193.

Martino, G., Caputo, A., Vicario, C. M., Catalano, A., Schwarz, P., Quattropani, M. C. (2020).  The Relationship Between Alexithymia and Type 2 Diabetes: A Systematic Review.  Frontiers in Psychology, 11, 20-26.  DOI: 10.3389/fpsyg.2020.02026.   

Kinnaird, E., Steward, C., & Tchanturia, K. (2019).  Investigating alexithymia in autism: A systematic review and meta-analysis.  European Psychiatry, 55, 80-89.  doi: 10.1016/j.eurpsy.2018.09.004. 

6 Calming Activities for the Hectic Holiday Season

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Navigating the world of autism can be especially hectic during the holidays. While you juggle your to-do list, you may also be wondering how in the world to make this the most wonderful time of the year for your special-needs child. Sometimes, that magic is hard to create. Sometimes, it’s downright impossible.

But that’s all right. Take it from moms who have been through it. There are practical ways to handle the parts of the holidays that could lead to sensory overload for your child. Enjoying the holidays with a child on the autism spectrum starts with having a plan. You need real-world solutions. Here are some practical calming activities that may work for you.


1. Pack a bag of tools and toys.

 The first activity is up to you. In the scouting spirit of “be prepared,” come up with your emergency kit you can take with you. Think of it as your bag of tricks. It’s not just a big purse full of random items. It requires thinking about what you really need to have on hand to soothe or occupy your child’s attention. Some people call it a calm-down kit.

 In her blog, Word to Your Mother, Heather Burnett says the first time her son, who has autism, had a meltdown in public, she also melted down.

 “Nobody told me what to have on hand that may help,” she wrote, “and nobody offered us a helping hand the first time we experienced a public meltdown. I felt hopeless and angry — and entirely out of control.”

 She found nothing in her purse to distract her son, but the experience made her change what she carried with her. She discovered certain toys or food were good to have on hand in case of a meltdown. Kits might include noise-canceling headphones, crunchy snacks, fidget toys, or bubbles.

 “I’m not going to lie to you and say all of these items will work,” Burnett writes, “but they are worth trying.”

2. Give your child a blanket, a book, and a quiet space.

 In Chattanooga, Tenn., Bria Jones knows when her toddler daughter, who is on the autism spectrum, needs a calming distraction, a comforting object or quiet time might help. Jones’s bag for her daughter, Anavi, includes a maroon throw blanket that Anavi loves.

 Anavi can’t verbalize what she wants, so Jones tries to anticipate her needs. Sometimes, Anavi is just hungry, thirsty, needs a diaper change or a nap. Sometimes, it takes a little more to calm her. Jones knows Anavi likes it when she rubs her feet. Sometimes, she just needs quiet, maybe a board book, and a few minutes left alone. Often, that’s enough to soothe her.

 Jones doesn’t claim to have the answers about avoiding meltdowns. She is learning as she goes. Her daughter is in a therapy program, and Jones seeks support from other moms of kids on the spectrum.

 “I don’t know it all,” she says. “I just knew my daughter was different.” And she’s learning a new way of parenting to meet her needs.

 

3. Take a bath, a walk, or make Play-Doh animals.

 Alix Strickland, an applied behavior specialist and founder of the Le Chemin ABA Learning House in Paris, France, says in addition to a calm-down kit, calming activities can help kids feel better as well. Depending on the age, she recommends drinking a glass of water, going for a walk, taking a nap, or taking a bath.

 Each of those things can distract your child, change the situation, and remind them of a familiar routine that they may crave. Preschoolers might like animal Play-Doh mats, Strickland says in her blog. She creates zoo-themed mats that have pictures of animals. She says parents can teach their kids how to roll noses or other shapes and put them on the mat. The sensory activity is something many of her students love.

4. Give your pre-teen an exit strategy.

 For older kids, a good calming activity may be coming up with a “secret code” that lets you know your child wants to leave a social situation.

 “Your kid may be eager to participate in social situations (like a birthday party) but feel anxious about what to do if it gets too overwhelming,” blogger Clara Muriel writes in Very Special Tales, a blog about parenting kids with special needs. “You can agree, for example, on a short-time attendance, a ‘secret code’ to let you know your kid wants to leave or agree on a phone call to be picked up.”

 Kids aren’t always sure how new situations will work and what rules apply when they don’t have a clear routine in place, Muriel writes. So, teaching them how to plan for a social situation by giving them an exit strategy may give them some control over the situation, she says, and make an outing a success.

 

5. Try yoga, martial arts, archery or horseback riding.

 Shelley Brewer, the blogger behind STEAM Powered Family, found plenty of calming activity ideas when her kids were young, but as her boys got older, she had to come up with her own. While she still finds things such as stress balls and essential oils useful as calming tools, she’s looked to other things to meet sensory needs for older children, tweens, teenagers, and adults.

 She says just a few minutes of yoga a day can make a difference, while something like martial arts can build strength, routine, and calmness. She has also tried activities that build body awareness, such as archery, or activities that have lots of sensory inputs, like horseback riding.

 “In the end it’s about finding what is right for each individual,” she writes, “and sometimes, that involves lots of trial and error. Also, what doesn’t work at one age, may be a great fit at a different age.”

6. Download a meditation app.

 No matter your child’s age, meditation apps developed for different age groups may be a solution for times that call for a little calm. Some teach kids specific relaxation techniques, like the cartoon-based Chill Outz, an app for kids as young as 3 and up. The characters in this app tell stories and teach kids how to relax by humming, focusing on breathing, relaxing tense muscles, or getting ready for bed.

 Other apps, like MindShift, can bring anxiety relief for pre-teens or even adults. It’s meant to develop helpful ways of thinking about things such as sleep, riding out intense emotions, dealing with social anxiety, worry, panic, or conflict.

 Another, Headspace, offers guided mediation and mindfulness for a range of ages. It focuses on improving focus, exercising mindful awareness, and reducing stress. You can find each of these apps in the App Store, where you can read more about them and follow the steps to download and use them.

 

Experiment to find what works for you and your child.

 There’s no magic wand for making your holidays especially magical. Whether you try sensory toys, yoga, or meditation apps, experimentation may offer a solution for your situation. Not every strategy will work for every child.

 Calming activities that worked for the moms in this blog have something in common – they’re all practical ways to help kids relax and unwind. Whether you’re in the toddler stages of the autism journey or raising young adults, what works for you one day may be different than the next. Trying activities like these may give you a better sense of what will calm your child — and yourself.

Learn more about making the holidays successful for kids on the autism spectrum.