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The Ethics of Actually Helping People: Targeting Skill Acquisition Goals That Promote Meaningful Outcomes for Individuals with Autism Spectrum Disorder

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Abstract

As a field that predominately supports individuals with autism spectrum disorder (ASD), we have an ethical duty as behavior analysts to ensure that the goals we write and interventions we prescribe promote best outcomes across the lifespan. This is critical, given that as it stands now, outcomes in adulthood for individuals with ASD are poor in every area assessed. The Ethics Code for Behavior Analysts can be interpreted to provide support for teaching the right goals, the right way, with respect to inherent rights of those we serve, in order to help affect positive changes in these outcomes. The present article highlights ethical themes that are relevant in order to affect these changes that are supported by the Code, as well as actionable steps to take next. The aim is to provide a resource for practitioners to use in clinical practice and in making ethical decisions that will help to improve outcomes for individuals with autism in adulthood. In addition, recommendations are made about integrating these values and approaches in terms of training, supervision, advocacy, and research.

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Notes

  1. A note about terminology: throughout this article, the terms “autism,” “on the autism spectrum,” “ASD,” “person with autism,” and “autistic person” are used interchangeably. Although the authors recognize that among the clinical, medical, and neurodiverse communities there are preferences and conventions in terminology use, the selection of terminology in this article is based on grammar and stylistic needs and does not reflect a particular terminological intent.

  2. The authors also note that, although this article is focused on ASD, the ideas discussed are applicable to a wide range of individuals, especially those with similar disability labels, such as various intellectual and developmental disabilities. Also, as is the case with all human behavior, the individual and their unique presentation of behavior within their given environment is more important than the specific disability label they may carry.

  3. It should be noted that the American Academy of Pediatrics asserted that, “Medically necessary services generally are defined as being clinically appropriate, based on evidence and likely to produce incremental health benefits that justify their cost” (Giardino, 2022). Thus, the medical necessity designation is open to interpretation and, it can be argued, supports teaching skills outside of the ASD diagnostic criteria that include vital adaptive behavior skills that promote independence.

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Authors and Affiliations

  1. Endicott College, Beverly, MA, USA

    Shanna Bahry, Peter F. Gerhardt, Mary Jane Weiss, Justin B. Leaf & Robert F. Putnam

  2. Meaningful HOPE, East Providence, RI, USA

    Shanna Bahry

  3. The EPIC School, Paramus, NJ, USA

    Peter F. Gerhardt

  4. Autism Partnership Foundation, Seal Beach, CA, USA

    Justin B. Leaf

  5. May Institute, Randolph, MA, USA

    Robert F. Putnam

  6. Pyramid Educational Consultants, New Castle, DE, USA

    Andy Bondy

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Bahry, S., Gerhardt, P.F., Weiss, M.J. et al. The Ethics of Actually Helping People: Targeting Skill Acquisition Goals That Promote Meaningful Outcomes for Individuals with Autism Spectrum Disorder. Behav Analysis Practice 16, 672–695 (2023). https://doi.org/10.1007/s40617-022-00757-x

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