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Controversial Behavior Analytic Procedures Nikki Petty Department of Social and Behavioral Sciences, Capella University PSY 7710: Ethics for Behavior Analysts Meredith Mates August 13, 2023

2 Controversial Treatment There are many interventions out in the world that have had research done on them but are often not ethically appropriate and that we as psychology professionals should try our best to avoid. Extinction is often used in treatment for autism because it helps to fade away and eventually to eliminate certain behaviors. Attention extinction for example is if a child who is used to constantly being held by their caregiver and now you have to cuddle the client in order to avoid certain behaviors then the BCBA might recommend to put the reinforcer of cuddling on extinction. With attention extinction reinforcement is being held in response to a maladaptive behavior and it is also important to know which attention seeking reinforcement it is that you have to withhold. What attention extinction treatment looks like is removing a preferred reinforcement such as eye contact, physical contact or verbal contact with the client while they are engaging in any problem behavior that is related to autism and not giving them that attention until they are engaging in more appropriate behaviors. Attention is crucial for developing higher level executive functioning (Ridderink et al., 2018). Pros to Controversial Treatment The intervention of attention extinction has been practiced for years and still heavily used in the field of ABA. The reasoning behind this is because there are a lot of proven pros regarding this controversial treatment including the first and main point that attention extinction used used to benefit the client with decreasing inappropriate behaviors such as tantrums, screaming, SIB, etc. Though there is a high increase in behaviors once the treatment of attention extinction first begins, these behaviors are often temporary and eventually decrease, especially in tantrums.. The second pro would be the fact that attention extinction helps the client to better depend on themselves to self regulate and to calm themselves down, instead of depending on those around

3 them and in fact difficulty with independent functioning impacts the overall outcomes for individuals with ASD (Hume et al., 2009). Therefore, using this treatment helps them in that aspect. Lastly, attention extinction helps lead clients to functional better in school settings which also helps lead them to brighter futures. The goal of early intervention is to help transition clients into school settings and within early intervention and with my experience I know that attention extinction is still used in these practices. ABA works toward decreasing challenging behaviors and preparing a child to enter group learning as school approaches. Cons to Controversial Treatment Though attention extinction used quite often it is also known to have its downsides. Findings from basic and applied research suggest that treatment with operant extinction may produce adverse side effects; two of these commonly noted are an increase in the frequency of the target response (extinction burst) and an increase in aggression (extinction-induced aggression) (Lerman et al., 1999). An extinction bursts and is best known as preliminary theory of a temporary increase in the rate of an operant response with the transition to extinction (i.e., the extinction burst) is proposed. Another con would be that removing the reinforcement of attention can cause clients (specifically children) to feel a sense of abandonment and higher levels of stress. There are a lot times where clients are engaging in behaviors that can be tolerated and do not pose safety concerns/behaviors that are understandable (a child crying because they stubbed their toe) and sometimes it is often difficult to tell rather or not attention extinction should be used because of this. Lastly, intervention that includes attention extinction can often put the therapist in harms way and to show in increase in aggressive behaviors from the

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4 clients. Aggressive behaviors such as hitting, biting, kicking, or scratching may be exhibited during extinction bursts and can physically put those involved in treatment, in harms way. Evaluation of Ethics 2.12 of the ethics for Behavior Analysts mentions considering medical needs for clients behaviors is important. This relates to attention extinction because with extinction bursts comes with a lot of aggressive behaviors that may put them into harms way. This may also be one of the reasons why this treatment is controversial. Ethics code 3.12 mentions advocating for appropriate services. Because attention extinction is already a treatment that has been debated upon then it seems as professionals it would important to advocate for a treatment that is not controversial. Lastly, ethics code 2.01, providing effective treatment states that the clients have the rights to intervention treatments that are effective in which after doing much research shows that attention extinction isn’t effective in some ways and has some cons. Conclusion Often times we believe that attention extinction is all about ignoring both the client and that clients maladaptive behaviors. However, attention extinction is much deeper than that. It is important to know when to practice this treatment, which is one of the main reasons why it remains controversial. Attention extinction comes with both pros and cons that include decreasing maladaptive behaviors to putting both professionals and clients in harms way. There are also a few ethical guild-lines that goes against what attention extinction stands for ethically and as professionals we must protect our clients and in order for us to do that, we just follow by these guidelines in our treatment. The main way to tell if that this treatment is effective or ethical or not is by reading the behavior analyst codes and according to codes 2.12, 3.12, and 2.01 attention extinction may not be ethically aligned.

5 References Behavior Analyst Certification Board. (2020). (n.d.). Ethics code for behavior analysts. https://www.bacb.com/wp-content/uploads/2022/01/Ethics-Code-for-Behavior-Analysts-230119- a.pdf Lerman, D. C., Iwata, B. A., & Wallace, M. D. (1999b). SIDE EFFECTS OF EXTINCTION: PREVALENCE OF BURSTING AND AGGRESSION DURING THE TREATMENT OF SELF-INJURIOUS BEHAVIOR. Journal of Applied Behavior Analysis , 32 (1), 1–8. https://doi.org/10.1901/jaba.1999.32-1 Hume, K., Loftin, R., & Lantz, J. (2009). Increasing independence in autism Spectrum Disorders: A review of three focused interventions. Journal of Autism and Developmental Disorders , 39 (9), 1329–1338. https://doi.org/10.1007/s10803-009-0751-2

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