Colombo Richard A, Wallace Michele, Taylor Rachel
Center for Applied Behavior Analysis, 11150 W. Olympic Blvd, Los Angeles, CA 90064 USA.
Behav Anal Pract. 2020 May 22;13(2):306-311. doi: 10.1007/s40617-020-00432-z. eCollection 2020 Jun.
In the United States, applied behavior analysis (ABA) is broadly recognized as a medically necessary treatment for individuals diagnosed with autism and related disorders (Association of Professional Behavior Analysts, 2020, Guidelines for practicing applied behavior analysis during COVID-19 pandemic, Retrieved from https://cdn.ymaws.com/www.apbahome.net/resource/collection/1FDDBDD2-5CAF-4B2A-AB3F-DAE5E72111BF/APBA_Guidelines_-_Practicing_During_COVID-19_Pandemic_040920.pdf). We argue that this designation should not be called into question in light of a particular disaster and that it is critical to consider that an interruption of services can have long-lasting effects on the treatment of the individual (practitioners are ethically obligated to uphold the continuity of services while doing no harm). This dilemma might be ameliorated by a decision model that considers the prioritization of immediate needs, the vulnerability of clients, and the competency of service providers. Just as the medical field prioritizes immediate needs during crisis situations and defers routine appointments (e.g., physicals, checkups), the ABA field can make similar evidence-based decisions. The purpose of the current article is to provide a decision model for ABA practitioners who find themselves questioning the need for essential service delivery during the current COVID-19 pandemic. The impact of this model goes beyond the needs of this crisis and can be applied to any emergency situation where services are at risk of interruption.
在美国,应用行为分析(ABA)被广泛认可为对被诊断患有自闭症及相关障碍的个体的一种医学必需治疗方法(专业行为分析师协会,2020年,《COVID-19大流行期间应用行为分析的实践指南》,取自https://cdn.ymaws.com/www.apbahome.net/resource/collection/1FDDBDD2-5CAF-4B2A-AB3F-DAE5E72111BF/APBA_Guidelines_-_Practicing_During_COVID-19_Pandemic_040920.pdf)。我们认为,鉴于某一特定灾难,这一认定不应受到质疑,并且至关重要的是要考虑到服务中断可能对个体治疗产生长期影响(从业者在不造成伤害的情况下,在道德上有义务维持服务的连续性)。一个考虑到即时需求的优先级、客户的脆弱性以及服务提供者的能力的决策模型可能会缓解这一困境。正如医疗领域在危机情况下优先处理即时需求并推迟常规预约(如体检、检查)一样,应用行为分析领域也可以做出类似的基于证据的决策。本文的目的是为那些在当前COVID-19大流行期间对基本服务提供的必要性产生质疑的应用行为分析从业者提供一个决策模型。该模型的影响超出了这场危机的需求,可应用于任何服务面临中断风险的紧急情况。