Funny thing is Skinner wasn't ABA, but rather EAB (experimental analysis of behavior) and radical behaviorism (philosophical/theoretical stuff). I do think that if you work hard enough you can translate cbt/ct stuff into behavioral language, it ultimately isn't necessary.
ACT in particular has a lot of cultish vibes, IME. I've frequently wanted to say, "Steve Hayes is not atheist Jesus!"
He seems to be happy to- at times- cultivate that vibe. However, he did give one of the most professionally and personally motivating talks I've ever attended as his presidential address at the AABT (now ABCT) conference back when I was in grad school in the late 90's. Topic was how humans are the only species we know of that commits suicide, and it's probably because of our ability to represent events with language and self-talk.
While purity of intent would be ideal, acknowledging the existence of neurodiversity and inviting different perspectives to the table us a very big step. Maybe just a first step, bit us humans can be pretty resistant to change and every little step counts.
True--I'm glad we're reaching the point as a field where we can acknowledge that disabled people are actual people. On the other hand, I've known plenty of folks who were happy to throw "neurodiversity" in as a talking point while simultaneously saying "ableism doesn't exist anymore." It feels sort of like "I have disabled/autistic friends!" only it's "I talked to disabled person once--they weren't my friend, but I talked to them!" I dunno--I get exhausted by the ableism in disability-related fields, and then people covering it by saying "well, I have disabled clients, so I'm not ableist." In my first grad program, the director pointedly told me that "we don't know what to do when one of you [a disabled person] wants to become one of us [a psychologist]."
First off- that grad school director is- at least in part- a jerk. Even if you don't have the correct perspective, at least have some tact. I'm sorry you had that experience. I obviously can't personally understand your perspective. Hopefully you can trust me when I say that even though it's not ideal, it's so much better. There's a whole lot more room at the ABA table for multiple perspectives now than there was even a few years ago. Still a whole lotta work to do, but the recognition that there is the need for this work is somewhat refreshing.
Oh for sure - person wasn't a BCBA. Actually primarily a pre-clinical researcher. I've just seen the same attitude in some ABA circles
Think I've said it before, but the cult stuff is always just made weirder by the fact that I have several friends that trained with the cult "deities." They all tended to have pretty balanced perspectives.
I see this all the time in ABA circles. (Also, I've seen a trend online towards calling CBT "gaslighting," which... no).
The croak of his voice is outta control.
I think it's that plus the fact that many--though not all--CBT books written in the past couple of decades are really light on the underlying theory, case formulation, and relationship building elements. I find the older books (70s, 80s, 90s, early 00s) to be much better reads and to emphasize these elements more. Modern CBT books often are 'technique/worksheet-heavy,' by contrast. Also there is a trend of grad students in recent years being trained to implement fixed protocols for syndromes but not being taught to case formulate and treat people competently outside of the explicit structure of a session-by-session manualized protocol.
I totally suck at CBT - I just did a beck institute training. Can yall recommend a training?
I am working my way through one of his audiobooks now. It is a lot. The content is fairly straightforward when he's not in "sage" mode. I like the "you're supposed to feel stuff" angle of ACT, but all the extra bells and whistles seem excessive. It reminds me that I need to catch up on the dismantling literature. I really just finding the "mechanism of action" for a given therapy and get my clients to do it in whatever style they'll tolerate.
Yeah, I used to describe my clinical orientation as ACT-based, but shifted back to regular old CBT. I still use lots of ACT-y elements, but I find myself leaning more heavily toward traditional CBT.
Equating the treatment with handing out worksheets along with a liberal dose of advice on how to live your life is definitely something I have seen from the scores of incompetents out there.
This is good stuff right here, and also @ClinicalABA other's comments on this thread, and so often overlooked. Well said.
Good point. I have seen a few kiddos who were showing signs of ASD at the time of referral, but during the 9-12 month wait time before actually seeing me had tubes placed. Now that they could hear, language took off, and play and behavior soon fell into normal trajectories too. This didn't happen for all kiddos who got tubes. A lot of the toddlers that I see get tubes, and it usually doesn't translate to ASD symptoms ameliorating, but the number of kids for whom it did is non-zero.
Wait and see model drives me crazy. It's kind of funny - but I am like the only psychologist in my state who will even see Deaf/HH kids for autism evaluations. I've developed this competency over a few years, but had ASL as my foreign language. Usually, Deaf or CODAs have pretty good nonverbals.
Yeah- my experience has been similar in that deaf/HH children have had very good non-verbal communication skills, even if still having difficulties in other areas of social interaction.
Ya know, I recently saw a CODA (because the word is out in the Deaf community in my area). I noticed something interesting. Both parents are Deaf. During the eval, I kept switching into signing and Deaf communication mode, even though the kid can hear. I'd find myself smacking a table or waving my hand in his peripheral to get his attention. His lack of responding to name, poor interaction, actually fooled me at times... Because he was mostly exposed to ASL, I actually approached the eval as if I was doing it with a Deaf kid. I didn't use the ADOS-2 modifications that are published, but I made sure to have an ASL interpretor with me during all interactions, just to have the best chances of getting good info from him.
Wow- glad you guys caught that and things worked out. I'm constantly amazed at how much problems with hearing and speech can negatively impact so many other areas of development (including, as was your case, motor skills). And- of course you pull any strings you can where your kid is concerned. That's just evolution, and you can't do anything differently about that!
But yes - the linkage across these things is interesting. Its certainly a bit of a mystery to me why they were reluctant to make the referral. Than again, we were on the edge of the timeline when it would be considered a developmental delay and likely came across as anxious Type-A's so she may have just assumed we were overly worried. I assumed we had the science on this fairly locked down by now, but we very much do not.
Emily Oster does some interesting work on walking milestones and evidence based pregnancy/development stuff. Sort of interesting from an econometric point of view. I really like how she and economists in general, discuss decisions as preferences. I think our field would benefit form such an approach.Well, inner-ear infections impacting balance is not exactly news
That said, having now looked into it, I'm wildly unimpressed with the quality of the science behind "developmental milestones" (note - not discussing formal evaluations, just the "Kids should walk by X age" checklists pediatricians and the like follow). Standard deviations are so large that most seem almost useless. Not to mention the fact that so many toddler behaviors are somewhat...open to interpretation
Becoming a parent has certainly opened my eyes to exactly how limited the science is on many early childhood topics. Don't even get me started on the breastfeeding literature.
She's a bit controversial, in that she's an economist with a good understanding of stats but no real training in psychology, child development, or medicine but writes books for lay audiences on those topics,
I just find it refreshing since so much of early child development is still dominated Piagetian/constructivist/tabula rosa/etc. perspectives and tends to overlook data, genes, neuroscience, etc.
I agree. It's just I've also seen researchers who specialize in some of the areas she reports on saying she came to a different conclusion than the data actually show. (Parenting/child development is just as populated by misunderstood science and people promoting sketchy things as clinical psychology is).
A lot of ppl hate her because she (correctly) advocated for schools opening sooner.
The complaints I saw pre-dated the pandemic and weren't (arguably) political, FWIW. I have no doubt some, perhaps most, of her work is good, but I've seen enough researchers saying "I specialize in this, and that's not really what the literature says" that I do take her work with a grain of salt. (As an aside, I think re-opening or not was kind of damned if you do and damned if you don't, IMO--weighing instructional/social lose v. the spread of COVID was always going to be tricky, especially because COVID was very novel and epidemiological and health science around it was evolving and changing a lot in the height of the pandemic).
I take them all with a grain of salt. The "specialists" are often so ideologically captured that they've p-hacked their whole narrative into a replication crisis. Probably motivated by tenure, citation indexes, selling a silver bullet for development, hucking feel good messages to vulnerable parents on social media, etc.
And you think Oster has nothing to sell?
The logical conclusion to this is that ANY research is bad/faked/untrustworthy. What then are we left with when identifying truths in our world? Appeal to emotion? Appeal to authority? Picking a different method for each truth you want to identify, based on a priori beliefs about what those truths should be. Whatever- topic for another thread.
The home page on her website is literally pictures of the books she has for sale. Doesn't mean what's in the books isn't true, just that she clearly has something to sell. If the heuristic is "people with something to sell should not be trusted," it would be illogical to trust her.
Most communication to patients is extremely poor--I've been helping my parents with medical stuff as they get older, and I'm routinely shocked by how poorly some providers explain everything and how poorly my parents actually understand when they walk out of the appointment. Hell, my own PCP frequently prescribed medications and refused to tell me anything about them, even what exactly they were for, This is a whole area of health services research, actually--examining systemic, provider, and patient factors that influence this and how to improve it.
The main selling point of her book seems to be "it's okay to regularly drink alcohol during pregnancy!", which did not go over well with people who do fetal health research, I mean, is one or two drinks during pregnancy going to doom your baby? Probably not. Does the science overwhelmingly indicate that it's best not to drink during pregnancy, especially because people tend to underestimate how much they drink? Yes. Is it irresponsible to suggest that women should drink regularly during pregnancy as a matter of course? IMO, yes--there's tons of potential risks introduced with very little benefit.
