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Autistic
Behavior, Behavior Analysis, and the Gene
Richard W. Malott1
Behavior Analysis Program
Department of Psychology
Western Michigan University
Abstract
This article addresses the meaning of autism, the etiology
of autistic behavior and values, the nature-nurture debate, contingencies vs.
genes, and resistance to a behavioral analysis of autism.
Prolog
I am a radical, fanatical behavior analyst who thinks he knows everything there
is to know about the use and misuse of reinforcement contingencies. Two semesters
ago, I started working with a beautiful, non-verbal 4-year-old boy in the
preschool autism classroom at Croyden Avenue School—my
first hands-on experience with these kids. And like all my students who do
their practica there, I fell in love with my child.
One day, we are quietly standing outside, waiting for the school bus, hand
in hand, when I notice a little tear sliding down his beautiful cheek. My heart
breaks and I immediately give him a warm, caring, supportive hug, and a nanosecond
later I realize I am reinforcing inappropriate behavior, whatever behavior
it was that squeezed out that little heart-breaker tear. Only the coldest,
most calculating of refrigerator professors could have resisted, even after
having come to grips with the overwhelmingly counter-intuitive notion that,
usually, if not always, emotional behavior may be controlled by its reinforcing
consequences.
Last semester I had the privilege of working with another four-year-old boy;
this boy had learned to speak during the year he had been in the program. And
as his six-hour work day would enter its last two hours, he would ask with
increasing frequency, “I see Mommy?” And the discrete-trial trainer
would reassure him, “Yes, at the end of the day.” “In two
minutes?” “OK, yes, in two minutes.” They would frequently
interrupt their discrete-trial training to do that Mommy-two-minutes dance.
But, we more-experienced behavior analysts knew that this disruptive behavior
was controlled by the social reinforcers of attention and perhaps by brief
escapes from the training task. So we ignored it, not prepared for the disastrous
consequences, the escalation from a whine to a full scale tantrum so effective
that it brought over all the staff to see what horrible things we were doing
to the poor child. However, the staff agreed that extinction was the intervention
of choice; so they implemented extinction classroom wide—everyone would
ignore this behavior.
And, of course, I was the most consistent in implementing this extinction
procedure; I was the consummate professional, with the cold eye and the warm
heart. At least until the child learned to say my name. “Dr. Malott.” What
powerful music, at least to my ears, “Dr. Malott.” He
knows me, he respects me, he needs me, he appreciates me, he loves me. And
probably, he even knows that my calculated extinction of his Mommying is with
his best interest at heart. So I continued the extinction with graceful ease,
until after several ignored I-see-Mommy’s, he said, in the most hear-breakingly
plaintiff voice, “Dr. Malott, I see Mommy?” Me!
He needs me! He needs Dr. Malott to reassure him. It was
all I could do to refrain from rushing to his aid with the perfunctory reinforcer, “In
two minutes;” and if my students had not been covertly watching me, I
would have. It is so hard to come to grips with the notion that, emotional
behavior may be more of a learned response controlled by its reinforcing consequences
than an expression of inner need, a cry for help from deep within the soul
of the child.
In any event, this five-year-old boy had become so skilled in his autistic
behavior that he brought us all to our knees, radical, fanatical behavior analysts
included; eventually, we officially copped out with some cognitive, face-saving
variant of, “In two minutes.”
Now, dear reader, you may be chuckling to yourself, “Of course, why get
into a power struggle with a five-year-old.” And you may be right, or
you may not be. But my point is that even when we think we know what we are
supposed to do, applied behavior analysis can be so counterintuitive, so against
our gut reactions, so against the immediate contingencies, that even the most
dedicated of true believers sometimes have trouble doing it right.
Now, take 100 million average moms and dads, without PhDs in behavior analysis,
or more important, without ten years doing discrete-trial and natural-environment
training. And take some little, accidental contingency that happens to get
some insignificant, little autistic behavior going in their one or two-year
old. There is no way Mommy and Daddy are going to do it right. No way are they
not going to reinforce that crappy little behavior and fail to reinforce that
tiny, little appropriate behavior. And depending on the roll of the dice, a
few of those episodes can spiral into a small percentage of children who do
not learn to talk but do learn all sorts of dreadful alternatives. The amazing
thing is not that there are so many children who do not talk and do all sorts
of bad alternatives. The amazing thing is that so many children do learn to
talk and keep their bad alternatives to a minimum. There but for the grace
of a few rolls of the dice, go we all.
Why the Resistance?
Public Relations
As readers of this journal know, the most successful interventions
with autistic repertoires and values have involved removing the
contingencies that functional analysis suggests support autistic
behavior, adding performance-management contingencies that support
the learning of appropriately functional behavior, and pairing
of stimuli and events with reinforcers to create appropriately
functional learned reinforcers (values). So the obvious, logical place to look
for the etiology of those autistic repertoires and values is in the behavioral
history, not the gene. Yet most parents and, maybe, most
behavior analysts hang on to the gene, perhaps in large part
as defense against being considered inept parents and inept professionals.
Unfortunately, the victim-blaming concept of the refrigerator mom still has
not thawed. (The refrigerator mother was the concept invented by psychoanalyst
Bruno Bettelheim (1967) to explain why some children were “autistic”—the
mother’s were too cold, they did not show enough love and affection to
their children. Wow!)
But, the need for such a defense against victim blaming may result from the
difficulty of appreciating the power of subtle behavioral contingencies. The
occasional preschool acquisition of autistic repertoires, etc. may be inevitable,
unless all children are raised by two PhD behavior analysts with specialties
in autism supported by a gang of MA behavior analysts. That
is the point of the prolog. No one is to blame. No one can resist the natural
contingencies, not the child, not the parent, and not even the professional,
at least when no one is looking. And even if Mom or Dad happens to be a professional
behavior analyst, it is one thing to come in a few hours a day and consult
with the classroom teacher or the parents, point out what they are doing wrong
and what they should do right. That is their job and, more importantly, their
only job while they are wearing their consultant’s hat. But I have not
been overwhelmed with the success behavior-analyst parents have had consistently
implementing appropriate behavioral contingencies when they return to their
own homes, where, like all parents, they concurrently wear so many hats they
get headaches. Without outside professional help, it is almost impossible to
do it according to the book, especially with a child who is becoming increasingly
skilled in autistic behaviors. The problem is not so much the refrigerator
moms; it is the warm, caring, loving moms who are doing everything our culture
has trained them to do—attending to their child’s every need, his
every whimper, etc. It just ain’t easy.
Trojan and I (1999) did an ABA PowerPoint presentation of our take on an
earlier version of the Drash and Tudor (1993) behavioral-contingencies analysis
of the etiology of autism. Afterward, one of the most prominent autism experts
came up to me and politely said, Excellent presentation, and then got to the
real point, Of course, you wouldn’t want any autism parent
to hear this. However, the chair of ABA’s Verbal Behavior SIG placed
our PowerPoint presentation on their web site, with our permission. The results
soon demonstrated the reason for the prominent autism expert’s
concern; at least one autism parent was outraged.
The problem is distinguishing between scientific discussion and public relations.
We do not want to hurt the autism parents’ feelings,
for two reasons: First, these parents have already been hurt more than enough;
I can’t imagine the amount of suffering they go through. And second,
they pay the bills; they pay the prominent autism experts.
But behavior-analytic scientists, theorists, and practitioners need to be able
to consider and discuss various view of the etiology of autism,
including the contingency-analysis view, without fear of public-relations censoring.
And where should they do this considering and discussing? At professional conferences
and in scientific journals, of course. Except, who constitutes half the autism
audiences at ABA? Autism professionals? No. Autism parents.
And who reads every behavior-analytic autism article published? Autism professionals?
No. Autism parents. They may be the world’s best informed
laity. Therefore, both parents and professionals must understand that a contingency
analysis of the etiology of autistic repertoires is not a scholarly form of
victim blaming, not an attempt to retrieve the discredited concept of refrigerator
mom from the overflowing junk yard of disreputable psychological concepts.
And it is that understanding I have attempted to enhance in much of the first
part of this article.
And, in this context, let me commend the editors of TAVB for their intellectual
integrity and courage in publishing the controversial Drash and Tudor (2004)
behavioral contingency analysis of the etiology of autism,
in spite of the well founded fears of other professional behavior analysts.
The Gene Made Me Do It
In addition to problems
of public relations, there is another reason for resistance to
an analysis of the etiology of autistic behavior in terms of behavioral
contingencies. As nature abhors a vacuum, humankind abhors a phenomenon
unexplained. First we had the animistic notion that we could explain
why things happen as they do because of the spirits in the trees,
rocks, animals, and people, and because of external spirits not
embodied in the material world, and because of the evil spirits
and the good spirits (Harris, 1983). However, these easy explanations
in terms of invented fictions have tended to give way to more complex,
more painstaking, more difficult scientific analyses that in turn
have generated more effective technologies for dealing with the world, for
guiding it in directions more supportive of a humane environment. We no longer
torturer the mentally ill, in order to drive the evil spirits from their bodies
and souls.
But the complexities and subtleties of human behavior have been a most
recalcitrant subject for scientific analysis, with the result that many
people have switched explanatory fictions, moving from spirits to the mind.
Why do people behave as they do? Because of their minds, because their
minds tell them what to do, because of their cognitions, their cognitive
structures, their IQ, their self-efficacy, their expectancies, their wants;
obviously, if someone does something, it is because they want to; QED,
question answered, and so easily answered. However, for behavior analysts,
these easy explanations in terms of invented fictions have tended to give
way to more complex, more painstaking, more difficult scientific analyses
that, in turn, have generated more effective technologies for dealing with
the world, for guiding it in directions more supportive of a humane environment.
We no longer label children “autistic,” automatically pronounce
them incurable, and stick them in institutions for the rest of their lives.
But in spite of the many successes of behavior analysis, the complexities and
subtleties of human behavior often remain a recalcitrant subject for scientific
analysis, with the result that even behavior analyst have hopped on the band
wagon switch in explanatory fictions, moving from the mind and its cognitions
to the gene. Why do people behave as they do? Because of their genes, because
their genes tell them what to do; question answered, and so easily answered.
However, for some behavior analysts, perhaps only an unhappy few, these easy
explanations in terms of invented fictions are not good enough. The IQ gene,
the criminality gene, the hetero/homo/bi/transsexual gene, the addictive-personality
gene, the autism gene are too simplistic as explanations of complex, subtle
differences in human behavior, even when these new forms of biological determinism
are expressed in terms of blood chemistry, amniotic fluid, brain chemistry,
or whatever; it does not suffice simply to invent a gene or a combination of
genes to account for complex, hard-to-change behavior, such as autistic behavior.
We do not want to be a western version of the Pacific-island cargo cults (Harris,
1983), waiting generation after generation, for the ship to arrive laden with
the gene-fixing, autism-curing pills that will so easily take care of all our
problems.
The Drash-Tudor Contingency Analysis. Therefore, we owe
a great debt to Drash and Tudor (2004) for their pioneering efforts to give
us a more complex, more painstaking, more difficult scientific analyses of
the etiology of autism, in terms of behavioral contingencies, an analysis
that, in turn, may generate more effective technologies for dealing with
the world, for guiding it in directions more supportive of a humane environment,
for helping to prevent early childhood acquisition of autistic repertoires
and values.
I think the Drash and Tudor article is one of the most important in the field
of autism, if not the field of behavior analysis. It is one thing to say, Yeah,
all that autism stuff is learned. But it is something else to point to a plausible
set of detailed environmental configurations and contingencies that could potentially
account for the acquisition of an autistic repertoire of excesses and deficits;
and that plausible environmental analysis is what Drash and Tudor give us.
However, when I read their earlier article that presented a similar analysis
of the contingencies responsible for preschool verbal delays (code words
for autism) (Drash & Tudor, 1993), my enthusiasm was mildly attenuated
by the possibility that they had generated their brilliant analysis from
the comfort of their arm chairs, with little real autism experience. So
I presented their analysis at los Horcones, one of the best and one of
the two oldest behavior-analysis autism programs in the world (over 30
years old). And I asked them how this jelled with their considerable autism
experience. And they unanimously said 100% (los Hocones, personal communication,
1999). Then I had the opportunity to discuss that article with Drash, himself,
and asked him how much was from the armchair and how much was from experience.
He said 100% was based on their extensive history of working with families
and children with autistic behavior (Drash, personal communication, about
2000). And fortunately, Drash and Tudor have sprinkled a few, illustrative
case studies through out their most recent article (2004).
Of course, a few case histories/case studies do not an experimental analysis
make; they may convince only the already convinced. But a few case histories/studies
can be the first step toward the systematic collection of a much larger, more
convincing set of case histories/studies, a set that would more clearly confirm,
or disconfirm, the Drash and Tudor contingency analysis of the etiology of
autism. And I hope the field of behavior analysis broadens its scope of acceptable
research methodologies so that a thousand such studies will blossom.
The Pill. But it will not be easy; the Drash-Tudor
contingency analysis has a well-heeled opposition—the pharmaceutical
industry. That industry is playing a major role in the privatization
of basic, university and medical-school research. Paying the piper,
they are calling the current pop tune which so many biological,
medical, and even behavioral researchers play. The genre of that
pop tune is frame all behavioral problems in terms of biological
determinism, and now with the human genome at the top of the charts,
that specific pop tune is frame all behavioral problems in terms
of the gene.
Why is the pharmaceutical industry spending so much money on basic
genetic and bio-behavioral research? So it can spend even more
money advertising and selling pills it claims will cure those problems,
for example autism. So they can make even more money selling the
pill or the vaccine that will prevent or cure the dreaded genetic
disease, autism. And just as our population is becoming increasingly
obese, while waiting for the fantasy anti-obesity pill, that is
so much more attractive than doing the really hard work of rigorous
diet and exercise, families suffer the increasing horrors of autism, while
searching for the fantasy anti-autism pill, that seems so much more plausible
and reassuring than the 24/7, excruciatingly hard, careful contingency management
needed to reverse their child’s slide into a nearly irreversible set
of autistic behaviors and values; and society waits for the autism-gene marker
rather than doing the really hard work of developing and implementing early
behavioral screening procedures that will detect the early acquisition of autistic
behavior and values early enough to significantly increase positive outcomes
of behavioral interventions. Beware the medical/pharmaceutical-industry complex.
(For a more carefully reasoned presentation of the data supporting my hysterical,
anti-pharmaceutical-industry rant, please see Rampton and Stauber [2000], Valenstein
[1998], and Whitaker, [2001]).
Nature vs. Nurture vs. Nature and Nurture. In a misguided
effort to appear broadminded, most people, including most behavior analysts
say it is not a question of nature vs. nurture. It is a question of nature
and nurture. Everything we do is partially a result of our inherited nature
and partially a result of our nurturing, what we have learned. And, of course
that is true, but only in an obvious, trivial sense. The question is not,
what is the basis for what we do? The question is, what is the basis for
the difference between you and me. And that basis may be all genetic (e.g.,
our different eye colors) or it may be all learned (e.g., my preference for
Thelonius Monk vs. your preference for Britney Spears). And if you are pretty
sure you have a Britney Spears gene, consider this example: Two rats, each
in a Skinner box. We water reinforce left-lever presses for one rat and right-lever
presses for the other, with the obvious results. And that resulting difference
in right vs. left lever pressing is 100% learned—100% a result of the
contingencies of reinforcement. Of course there is a biological basis for
the lever press itself, for the reinforcement process, etc., but no difference
in genes or any other pre-experimental biology accounts for the differences
in right-left lever preferences.
And it is equally meaningful to ask about the basis of the differences in
water reinforced operant responses in two children. One child says, Water
please, and gets a class of water, while another child tantrums and gets
a glass of water. As in the Skinner box, the difference between the two children
in the frequencies of water please vs. tantruming may also be 100% learned—100%
a result of the contingencies of reinforcement described by Drash and Tudor
(2004).
In other words, I suggest that often it is not a question of nature and nurture,
but rather it is meaningful to talk about nature vs. nurture. And nature may
often lose when we are comparing why one person differs from another. Nature
forms the basis of what our unlearned reinforcers, but nurture determines which
lever we press.
Verbal Behavior about Autistic Behavior
It seems like almost everything I read about autistic behavior
starts off explaining that autism is no single disorder,
but rather a rich array of disorders: some kids do not talk,
some do; some tantrum, some do not; some aggress, some do
not; some self-stim, some do not, etc., with all possible
combinations of the preceding problems and many more. My
question is why clump all these problems under the label
of autism? Why not just say there are almost an infinite
variety of ways kid’s
repertoires and values can go awry. And some times some kids end
up with so many problems of such severity that they need
professional help, and then let it go at that. Why do even
we behavior analysts continue to be shackled by our psychodiagnostic
ancestry, with its need to put labels on everyone, labels
that turn into reified, psychodynamic or genetic causes of
human behavior.
Furthermore, many people, including me, are uncomfortable with applying labels
to people, such as saying, Jimmy is autistic. It would be more accurate to say,
Jimmy has an autistic repertoire. Some have started using the expression, with
autism, as in, Jimmy is with autism. And while the desire to stop labeling people
is a noble one, such expressions as with autism may cause even more
problems. They suggest that autism is a thing, like a disease, like a cold,
that a person has caught. This then leads to inferring a causal entity from
a person’s
behavior, an illogical form of analysis—reification, circular reasoning:
Why does Jimmy act strangely? Because he has autism. How do you know he has autism?
Because he acts strangely. Why does he act strangely? Because he has . . . .
And around in the circular argument we go. Better just to say he has a repertoire
of autistic behaviors and then look independently for the causes—for example,
the child’s past and present reinforcement and escape contingencies (Malott & Trojan,
2004).
However, repertoire does not quite cover it. In addition to having too many
inappropriate behaviors, like tantruming and not enough appropriate behaviors,
like verbal behavior (aka, language), the child may have too many inappropriate
aversive stimuli or conditions, like cuddling, and too few appropriate reinforcers,
like smiles. (I use values to encompass a person’s reinforcers and aversive
conditions.) So, it may be safer to talk about a child’s autistic repertoire
(behaviors) and his autistic values (reinforcers and aversive conditions).
This may helps us avoid unthinkingly adopting a simplistic medical/genetic/pharmaceutical
model
The term disorder may also tend to support a reifying medical model, implying
that there is a disease called autism and it is a biological disorder. We would
not say that the Skinner-box rat that has not yet learned to press the lever
has a disorder, nor would we say that I who have not yet learned to speak Russian
have a disorder, not should we say that my tendency toward irony and sarcasm
is a disorder, no matter how offensive it may be. These are all behaviors and
values that have or have not been learned, just like the child’s autistic
behaviors and values that have or have not been learned.
Similarly, we might do well to ban develop from our psychological lexicon,
with its suggestion that we biologically develop passively like a flower or
a tumor. To say autism is a developmental disorder is like saying the rat’s
not learning to press the lever or my not learning Russian is a developmental
disorder.
And the fashionable term communication may also get us in trouble. Even behavior
analysts have a slight tendency to say every inappropriate, autistic act is
the child’s effort to communicate, to express his needs. So of course
we must try to find out what the child needs, we must meet his needs; and,
as a result, we end up reinforcing all sorts of autistic behavior that has
nothing to do with needs but is merely an operant response reinforced by its
consequence.
And, professional behavior analysts may be taking one step backward with every
two steps forward when they cater to this misleading expressive-communication
model by calling the simple differential reinforcement of alternative behavior
functional communication training.
We do a disservice to the important concept of communication, when we attempt
to gain social validity by using communication to justify our basic behavior-analytic
contingencies. We should not debase communication in order to prematurely give
everyone, including ourselves, a warm feeling. We might do better to reserve
communication for our much higher-level language-training goals.
References
Bettelheim, B. (1967).
The empty fortress: Infantile autism and the birth of the self. New York:
The Free Press
Drash, P. W., & Tudor, R. M. (1993). A functional analysis of verbal delay
in preschool children: Implications for prevention and total recovery. The Analysis
of Verbal Behavior, 11, 19-29.
Drash, P. W., & Tudor, R. M. (2004). An analysis of autism as a contingency-shaped
disorder of verbal behavior. The Analysis of Verbal Behavior.
Harris, M. (1983). Cultural Anthropology. Cambridge: Harper & Row.
Malott, R. W. & Suarez-Trojan, E. W. (2004) Principles
of behavior (fifth edition). Upper Saddle River, NJ: Prentice Hall.
Rampton, S., & Stauber, J. (2002). Trust us, we’re experts! New York:
Putnam.
Trojan, E. W., & Malott, R. W. (1999) Autism and Elementary Principles of
Behavior 4.0. Paper presented at the Association for Behavior Analysis, Chicago.
Valenstein, E. S. (1998). Blaming the brain: The truth about drugs and mental
health. New York: The Free Press
Whitaker, R. (2001). Mad in America: Bad science, bad medicine, and the enduring
mistreatment of the mentally ill. Cambridge, MA: Perseus.