Dennis H. Reid

Specifying Criteria for Meaningful Versus Nonmeaningful Activities

The first step in an evidence-based process for moving a center’s participant activities from nonmeaningful to meaningful is having applicable criteria available to help center staff distinguish between the two types of activities. This chapter provides five guidelines for specifying meaningful activities. The guidelines were derived from existing literature on identifying meaningful instructional tasks for adults with severe disabilities and applied behavior analysis (ABA) research that socially validated the guidelines. The guidelines also coincide with the previously described professional consensus about meaningful activities for adults with autism. Each guideline specifies that for any task in which an adult with autism is engaged in a center-based program to be meaningful, the activity necessary to complete the task and the materials involved in performing the task must meet the guideline for meaningfulness. Examples of how each guideline can be used to differentiate meaningful versus nonmeaningful activities and materials are likewise provided.

Assessing Meaningful Versus Nonmeaningful Task Participation

Once criteria have been established to help staff differentiate between meaningful and nonmeaningful activities, the next step in the evidence-based process for improving the meaningful utility of a center’s services is to assess the ongoing task involvement of center participants. Assessing the degree of participation in meaningful versus nonmeaningful tasks is necessary to determine where subsequent intervention is necessary, to establish a baseline level of meaningful task involvement, and to allow a center to compare its level of meaningful task participation with that of other programs for social validation and normative purposes. This chapter describes a step-by-step assessment process to provide a quantitative measure of participant involvement in meaningful tasks. The process described has been used in applied behavior analysis (ABA) investigations focusing on increasing meaningful task involvement in center-based programs as well as in a number of clinical applications.

A Staff Training and Supervision Plan to Increase Meaningful Activities

Helping a center move from providing nonmeaningful to meaningful activities requires effectively working with direct support staff to accomplish the change process. A behavioral staff training and supervision approach is described that can be used by a behavior analyst and other practitioners to promote staff provision of meaningful activities. The approach was developed through applied behavioral analysis research specifically focusing on increasing meaningful task participation in center-based programs. We first describe how a practitioner can lay the groundwork to implement the approach, focusing on identifying the lead change agent, enlisting the support of agency executive personnel, and recruiting the involvement of front-line staff supervisors. Next, we describe the components of the process in stepwise fashion including how to train, prompt, reinforce, and correct staff behavior to change activities from nonmeaningful to meaningful. Case examples are provided illustrating how the staff training and supervision process has been successfully applied.

Historical Challenges and Needed Improvements in Center-Based Services for Adults With Autism

Applied behavior analysis (ABA) provides an evidence-based means for helping people with autism live to their fullest potential. To date, the majority of ABA services have been provided for children who have autism. Many adults with autism, and particularly those on the severe end of the spectrum, attend center-based programs as part of the general adult service sector for people with developmental disabilities. Although adult center-based programs provide necessary supports, they are often lacking in ABA services and have received criticism due to frequent provision of activities that do little to promote productive, independent, or enjoyable adult lifestyles. This chapter summarizes historical concerns with center-based programs. Subsequently an approach based on ABA research and application is introduced that practitioners can use to move such programs from a traditional focus on nonmeaningful activities to more meaningful and purposeful experiences for center participants.

Chapter 3 – An Evidence-Based Protocol for Improving the Meaningful Utility of Center-Based Activities

An evidence-based protocol has been developed through applied behavior analysis research and application for helping center-based programs move from providing nonmeaningful activities for center participants to more meaningful and purposeful experiences. This chapter introduces the key components of the protocol, which include specifying criteria for meaningful versus nonmeaningful activities, assessing individual participation in meaningful versus nonmeaningful activities, developing and implementing a staff training and supervision plan for changing activities, and continuing assessment and supervision to maintain meaningful activity participation over time. The important role of behavior analysts and other practitioners is then highlighted in regard to successful application of the protocol to improve the quality of activities in center-based programs.

Maintaining Meaningful Activity Participation

After improvements have been made in providing meaningful activities for adults with autism in a center-based program, specific actions are necessary to ensure the improvements maintain over time. This chapter describes what supervisors as well as behavior analysts and other clinicians can do to help maintain provision of meaningful activities. Initially, a maintenance goal for participant involvement in meaningful activities should be established. Subsequently, supervisors should monitor staff performance in providing meaningful activities and present feedback to the staff on a scheduled basis. In turn, clinicians should provide feedback to the supervisors regarding how they carry out their monitoring and feedback duties. Clinicians should also periodically assess the integrity of the supervisors’ monitoring and regularly inform agency executives about the success of the supervisors’ actions. Other considerations discussed include training needs of staff that may arise over time and efforts necessary to promote meaningful activities through community integration.

Chapter 2 – Current Professional Consensus Regarding Meaningful Activities

A professional consensus exists regarding what constitutes meaningful weekday activities for adults with developmental disabilities including autism. The consensus is based on the concepts of normalization and inclusion as well as outcome research on quality of life. The consensus focuses on supporting adults with autism in working real jobs for real pay as the most meaningful, followed in turn by supported work in community jobs, sheltered work, and center-based activities of a work and nonwork nature. This chapter discusses the consensus and the advantages and disadvantages of the different types of daily activities. It also stresses that center-based activities of a congregate nature usually present the most difficulties in providing truly meaningful experiences for adults with autism, and the need for improving the quality of center-based services.