Applied Behavior Analysis Research and Application When approaching the target behavior of teaching an autistic child to obey verbal commands, it is important to understand what previous research has presented about this target behavior, how it has defined autism, which treatment methodologies have been tried and shown effectiveness in the past, and which experimental designs can be utilized today to treat the behavior. This paper will examine each of these points and provide a standard for assessing validity.

Defining autism in the field has mainly been the result of Applied Behavior Analysis (ABA). As Wohr and Scattoni (2013) note, "autism is a behaviorally defined disorder" (p. 5). And as Ollendick and Cerny (2010) observe, the method used to define this behavior and to assess treatments are numerous: for example, rating scales can be utilized as well as observation methods, IQ tests and the examination of "the social-cultural-physical environment" in which the child lives, can all be utilized (p. 33). Thus there is no one single method that is needed for validly assessing the target behavior of this study -- and in fact numerous methods may be employed to allow the research to better evaluate and/or test the hypothesis.

Autism has been measured in the field in diverse ways. Stahmer, Collings and Palinkas (2005) use a qualitative approach in a specified setting with a specified sample in order to assess the effectiveness of interventions in communities via focus groups, with self-reporting being a measuring tool. Denne, Thomas, Hastings and Hughes (2015) on the other hand use video ratings, in-situ observation, self-reporting, and Test of Knowledge in order to measure ABA competency levels in education intervention methods. Thus measurements are diverse in the field studies connected to autism and ABA evaluations.

The treatment methodologies and experimental designs utilized to treat the target behavior are equally diverse. The article by Mohammadzaheri, Koegel, Rezaee, and Rafiee (2014) compare two ABA treatments (pivotal response and structured ABA) on autistic children in a classroom setting. They found that the pivotal response treatment (the naturalistic approach as opposed to the structured approach) was more effective in improving target behaviors over a 3-month period. The independent variables are the methods used to "produce more rapid improvements in communication" -- namely, pivotal response treatment and structured ABA. The dependent variables are social skills and attentiveness. The subjects were two groups of children with autism, "matched according to age, sex and mean length of utterance" and the setting was a classroom (Mohammadzaheri, Koegel, Rezaee, Rafiee, 2014, p. 2269). This study is helpful in showing how target behaviors are identified and how ABA can be used to improve target behaviors through the application of a specific method, in this case the naturalistic method of pivotal response treatment.

Callahan and Shukla-Mehta (2010) however define and validate comprehensive treatment models in autism by comparing ABA and TEACHH. By assessing the findings of a social validation survey, the researchers concluded that there was "no clear preference for either model" among special education teachers but that elements of both methods were deemed to have a high degree of social validity (Callahan, Shukla-Mehta, 2010, p. 74). The study itself had external validity, measured by the fact that its findings would be relevant to special education teachers in the field -- but in terms of internal validity, the study was not providing a cause-and-effect analysis of any sort but rather was performing a type of evaluation research, concerning the results of a survey conducted among special education teachers regarding their preference of approach in treating children with autism.

Studies such as this are common as there is no one, clearly defined avenue towards treating the target behavior of this study. Indeed, treating autism itself is something that has several different accepted approaches, and the most effective are related to personal preference and comfort levels of the practitioner. However, Foxx (2008) finds that the only effective treatment approaches for autism are those of the Applied Behavior Analysis approach. As Foxx (2008) notes, "the only interventions that have been shown to produce comprehensive, lasting results in autism have been based on the principles of ABA" (p. 821). Foxx's study has internal validity, as it identifies a cause-and-effect relationship between independent variables and dependent variables -- or between the various methods and approaches utilized as interventions and the impact of them on the autistic child. The study also had external validity...

Thirdly, the study showed social validity, which, according to Rapoff (2010) is rooted in the ABA tradition and "is a broader and more inclusive term than clinical significance" (p. 114). The social validity evident in Foxx's study is evident in the fact that the researcher locates the most useful/helpful method of treating autism in children and identifies it as ABA methodology because this approach makes the best advancements with regard to modifying the behavior of the child and honing in on the target behavior.
According to Rapoff (2010) social validity can be assessed at three different levels -- the goals level, the procedures level, and the effects level. Each of these is, in a way, just as legitimate as the measure of internal and external validity, because they contain within their analysis a degree of assessment of these parts (for without them the study would have no use for anyone -- thus the claim that Rapoff makes is that for ABA, the primary objective should be to discern social validity, as implicit in this discernment would be evidence of internal and external validity). However, while the gist of his argument may have substance, his own article is not so much a study as it is a qualitative assessment of evaluation research on the topic of social validity. The need for internal and external validity remains just as strong and valid, as if these two are not evident, the likelihood of social validity could still exist but the science to support the claims would be missing and therefore rendering the theory/study useless. Thus, Rapoff's assessment is useful as far as measuring social validity is concerned -- and to this end, Rapoff provides considerably significant tools.

Rapoff recommends using goal attaining scaling (GAS) in order to "rate changes in these goals after treatment" which can be a method of quantitatively showing validity and authentic measurement of goals (p. 114), but Rapoff also shows that while treatment methods may be valid and effective, it still depends upon parents and their children to accept/approve them or else they will not be utilized: ultimately the patient and the patient's parent must embrace the method; this is why Rapoff asserts that one of the crucial aspects of measuring social validity depends upon the procedures being acceptable "to consumers in terms of costs, ethics and practicality" (p. 114). Without this acceptance there can be no real evidence of social validity -- unless, of course, the acceptance were to be won over time.

This raises a difficult point about the measurement that Rapoff (2010) raises: can a study or method have social validity even if it is not generally accepted? For instance, what if the method should be accepted but is not because of perceived bias or cultural sensitivity. For instance, a method or approach may have social validity in one society or culture but not in another -- and this is something that research in the medical field has shown numerous times. For example, the model of Transcultural Assessment that Giger and Davidhizar (2002) developed as a result of their study of nursing students was based on six fundamental factors considered to be relevant phenomena in the theoretical model and important in discerning differences in cultural expectations among various patients of different cultural/ethnic backgrounds.

The basic concepts and relationships presented by this theory are that it was meant to be, as Karabudak, Arslan and Basbakkal (2013) observe, a "tool developed to assess cultural values about health and disease behaviors and their effects" (p. 342). It looks to assess how culture relates to beliefs about treating illnesses, diseases and health overall.

The theory applies to all persons of culture who are presenting themselves for treatment regardless of what they are presenting for. The model proposed that various cultures have their own perspectives on health, the body, and medicine, and that those cultural guidelines should be considered when accepting a patient for treatment. The situations in which it may be applied are as diverse as the dimensions of the model itself: everything from time to space to biology play a part in determining the way in which the model helps practitioners to provide the kind of care that is needed. For instance, in terms of communication, the therapist can talk to the patient about his or her background to develop a better cultural understanding of how the patient would like to be treated and what the patient expects in terms of care. Connected to what Rapoff suggests about social validity, this point bears the same argument as…