Association for Behavior Analysis International

Social validity, in a broad sense, considers the appropriateness and acceptability of applied behavior analysis (ABA) interventions as both process and outcome measures (Kazdin, 1977; Wolf, 1978). One aspect of social validity that should be further investigated is the impact contextual fit may have on an intervention’s overall effectiveness, efficiency, and desired outcomes (Albin et al., 1996; Horner et al., 2015; Slocum et al., 2014). The contextual fit of an intervention or teaching strategy refers to the extent that the procedures of the plan are consistent with the knowledge, values, skills, resources, and administrative support of those who are expected to implement the plans (Monzalve et al., 2020). Considerations of contextual fit become critically important with the increasing prevalence of individuals receiving a diagnosis of an autism spectrum disorder (one in 54 children) resulting in the adult system being flooded with individual struggling to have their needs met with limited services and supports (Center for Disease Control, 2020; Friedman, 2018). The ongoing advent, increased availability, and reduced costs of smart devices should be considered as one means to increase a practitioner’s ability to address issues of contextual fit particularly in the community or home environments. In 2022, the gains made in the ‘age of technology’ have revolutionized the use of assistive technology in the world of developmental disabilities. Despite these gains, research on the use of technology with older learners to increase self-management and skill of daily living, reduce reliance on others for success and independence, and to increase overall efficiencies within the community continue to be lacking. As the old adage suggests, with so much to do, and so little time, technology should be affording us the ability to ‘work smarter, not harder.”

Community-based Instruction AAC devices and programming Utilization of technology for instruction

There is clear evidence that individuals with an autism spectrum disorder receiving mental health treatment are at an increased risk for abuse and maltreatment (Brenner et al., 2017). The turnover rates for direct support professionals (DSPs) are extremely high. Estimates suggest the average adult services organization may see anywhere from a 30% to 70% DSP turnover annually (Bogenschutz et al., 2014; Bogenschutz et al., 2015; Friedman, 2018). There is evidence to suggest that DSP turnover directly impacts the quality of services provided to individuals with intellectual and developmental disabilities (ID) in community settings (Bogenschutz et al., 2015; Hatton et al., 2001; Woltmann, et al., 2008). Friedman (2021) analyzed data from 251 adults with ID (including autism) to assess their experiences with DSP turnover. Results indicated that DSP turnover negatively impacted the participant’s ability to be integrated into their community. Individuals who experienced turnover had an increased frequency of visits to the emergency room, reported increased instances of abuse and neglect and incurred an increased number of injuries compared with those who did not have any turnover in the prior 2 years. This creates a critical need for achieving independence for learners across a variety of skills and domains, but specifically targeting personal care skills and routines where individuals are at a higher risk for potential abuse. This study has targeted the independent initiation and completion of a nighttime routine for an adolescent with an autism spectrum disorder (ASD). A chain composed of brushing his teeth, using the bidet, changing into pajamas, and completing laundry tasks. The chain was initially evoked with a WhatsApp video message directing the participant to “get ready for the night”, in combination with gestural and verbal prompts. Prior to engaging the routine, a reinforcer was identified that was delivered contingent upon completion of the routine. The initiation of the routine was transferred to a telephone reminder that was pre-set to one hour before bedtime. Data showed rapid acquisition of the nighttime routine and further generalization to when the participant was alone with his parents and maintenance after 2-months follow up. Not only did the individual achieve independence in critical personal care tasks, but also increased his access to increased safety and preservation of his dignity.

Growing up in a digital world has opened up new and exciting opportunities for those individuals who require an augmentative and alternative communication (AAC) device. The decreased cost and increased social acceptability of these devices has led to increased opportunities for community participation and integration (McNaughton & Light, 2013; Shane et al., 2012). However, despite these innovations, there remain significant challenges to ensure that individuals have access to their fundamental human right to meaningfully and effectively communicate (American Speech-Language-Hearing Association, 2014; Brady et al., 2016). Light (1988) defined four social purposes for communication: expression of wants and needs, information transfer, social closeness, and social etiquette. While the field of Applied Behavior Analysis (ABA) has made considerable process in moving to using more portable, customizable devices to increase turn taking, requesting, commenting, expand vocabulary and length of utterances (Ganz & Simpson, 2018; Light et al., 2019; O’Neil et al., 2018), these devices remain ineffective and under analyzed for teaching critical social behaviors particularly while in the community. In a post COVID-19 world, the use of social space or interpersonal distance between two individuals is more important now than ever. Individuals with an autism diagnosis regularly misunderstand social situations demonstrate a broad range of competencies and preferences in interpersonal distance (Perry, 2015). There can be a considerable amount of effort required to utilize an AAC device in complex social situations which can lead to lower levels of motivation to access and utilize the device (e.g., hands full in the grocery story). This study sought to decrease the latency and response effort to make critical social requests by utilizing an Apple Watch™ as a means to gain personal space within the community. Using a multiple-baseline design, three adults with autism were able to increase their independent initiation and decrease their latency from motoric initiation to device output response while grocery shopping.