Defining independence in autism education and treatment

Ronald Lee, Ph.D., BCBA-D, LABA

Because independence is a major focus of educational and treatment approaches for people with ASD, it’s easy to assume its “definition” stays the same from one educator, therapy provider, or parent to another. However, the definition of independence can change greatly depending on the situation. Independence is taught in various contexts, such as communication and social interaction, playing with toys and leisure materials, attending to instructors and activities, understanding and following instructions, and engaging in academic activities. Not to mention, independence only becomes more important as learners age, especially in areas such as self-help, daily living and self-advocacy.

While this may sound simple, it’s incredibly important to align educators, therapy providers, parents and others involved in the care and treatment of people with ASD on how independence is defined in treatment. This alignment (or misalignment) can have major implications on treatment outcomes; a lack of consensus will result in inconsistency in treatment and hindered progress.

So, what are the causes of disagreement when it comes to independence in autism treatment? In order to illustrate these sources of disagreement, let’s look at these two examples:

• Scenario 1: A learner with ASD has a target behavior of sweeping the floor. If this learner consistently requires hand-over-hand guidance to assist him or her in sweeping the floor, most would agree they are not demonstrating independence in completing the task. Similarly, if the learner completes the target behavior of sweeping the floor, but only after being told to do so, that learner is characterized as being dependent on a prompt (the instruction) and thus, is not independent with that task. What if the same learner completes sweeping the floor and other cleaning tasks with the aid of a picture schedule – a sequence of pictures that cues the learner for what to do next? Using picture (or other) cues is a well-documented, evidence-based technique that is used to facilitate independence. In fact, the technique is referred to as an “Independent Activity Schedule.” This learner no longer needs instructions from another person but is still reliant on specific cues to complete a sequence of activities.

• Scenario 2: Imagine a learner with ASD is capable of doing much more in the classroom than he or she shows; i.e., “the underperformer,” and therefore their target behavior is to actively participate more frequently in class. The teacher decides to implement a motivational system to encourage this target behavior. If the teacher’s motivational system is effective, does that mean the learner is showing more independence than before? As with Scenario 1, there may be differing opinions on the definition of independence depending on whether additional rewards or motivational systems are required. Some members of the student’s support team might conclude that the motivational system increased independent participation, while others might conclude that active participation is not independent until the supplemental motivation has been removed altogether.

These two scenarios provide straightforward examples of the difficulties that come along with defining independence and supplemental supports. One’s perception of the type of support used in treatment (i.e., hand-over-hand guidance versus picture cues) can influence the way a target behavior is defined and whether the learner has made progress toward their goal of independence in completing a task.
To help members of a learner’s support team find a mutual definition of independence (and the supplemental supports that can influence the learner’s progress toward independence), I’ve compiled some practical tools that I shared in “Lessons from School Psychology: Practical Strategies and Evidence-Based Practice for Professionals and Parents.” The following considerations can help determine the right course of action:

1) Has the intervention improved the individual’s ability to function in his or her environment? If so,
2) Is it likely that the individual’s social community and environment will support that performance and the use of whatever supplemental components are needed for that performance to occur?

In the example involving an Independent Activity Schedule within Scenario 1, many people consider the use of schedules and cues to be a natural part of navigating one’s day. Most people carry their independent activity schedules in their SmartPhones now (e.g., planners and calendars)! As a result, this type of support is likely to be accepted and continued, therefore the student’s ability to sweep the floor after seeing photo cues can be defined as independent behavior. This might not be the case with the example in Scenario 2, where the use of additional motivational systems and rewards might be considered a more work-intensive support less likely to be accepted and maintained by the larger community.

While there are countless factors that can influence a learner with ASD’s success in autism treatment, defining independence and supplemental supports can be a great starting point. Over time, making these seemingly small adjustments can make a great impact not only on the learner’s success, but also on their surrounding community as the learner reaches his or her potential.