Guest Contributors: Janet Sanchez Enriquez, M.S, BCBA and Alonzo Andrews, M.A, BCBA
Janet Sanchez Enriquez, M.S, BCBA is an OSEP scholar and doctoral candidate at the University of North Carolina Charlotte working under the mentorship of Dr. Rob Pennington. Her research interests include working alongside vulnerable and diverse populations promoting applied behavior analysis for teaching and learning through research and the development of culturally and linguistically diverse verbal behavior assessments and interventions. She is a founding member and Secretary of the non-profit the Mexican Organization of Practitioners of Applied Behavior Analysis (Organización Mexicana de Practicantes del Análisis Conductual Aplicado, serves on the Board of Directors for the World Behavior Analysis Day Alliance, sits on the Executive Council for the Texas Association of Behavior Analysis and is one of CEC’s Division on Autism Developmental Disabilities DEI Student Liaisons.
Alonzo Andrews, MA, BCBA has previously served as the director of the Autism Treatment Center in San Antonio; during his 24-year tenure, he delivered behavioral services and supports to individuals with autism spectrum disorders to include the provision of residential programming for children and adults, on-site operation of state-certified private school, and out-patient rehabilitation therapies. He has taught courses at the University of Texas at San Antonio for the last ten years. Alonzo has co-authored numerous scholarly publications in well-respected journals such as: The Journal of Autism and Developmental Disorders, The Analysis of Verbal Behavior, Behavior Analysis in Practice. His clinical interests have engaged him in diverse projects to include biomedical interventions, video modeling, distance functional assessments, architecture for autism, challenging behavior, verbal behavior, behavioral phenomenology, neurodiversity, and the development of a computer-simulation training program for caregivers of children with autism.
*All images included in this guest blog are original pieces created by Fitz Sanchez and used with his permission. You can follow him on Instagram @sanchezart29!
Culturally Responsive Language Assessment and Learning
Communication difficulties are disproportionately identified among individuals from culturally and linguistically diverse backgrounds, often exacerbating disparities in educational, social services, community, and healthcare outcomes (Stahmer et al., (2019). Traditional approaches to language assessment focus on the formal properties of language (e.g., phonology, syntax, semantics, and pragmatics) without regard to the context in which it is emitted. For example, linguistics focuses on the form rather than function of language and often dominates assessment and intervention programming for learners with an autism spectrum disorder (ASD) and related (dis)abilities. Many standardized assessment tools and curricula are normed for the majority populations and may therefore not be culturally and linguistically valid for children from marginalized communities, potentially negating their diagnostic value and treatment recommendations for these populations.
Although the effectiveness of behavior analytic programming to develop and support language repertoires is well established, the difficulty that some learners with ASD have producing fluent speech can be attributed to stimulus overselectivity, overgeneralization, and imbalance of their verbal operant repertoire. That is, their verbal behavior has been adequately conditioned under some, but not all, relevant properties of the environment. A further challenge in language assessment and intervention is that while all members of a verbal community may speak a common language, not all speakers of a common language are members of the same verbal community. In addition to sharing a common language, members of a verbal community also share mutually reinforcing practices (e.g., the types and amount of hand and facial gestures used). Although translating an assessment into another language addresses issues related to linguistic form, it fails to account for cultural diversity related to linguistic function.
Verbal Behavior Assessments
Behavioral language assessments, while focusing on the different functions of language and translated to multiple languages (e.g., Assessment of Basic Language and Learning Skills—Revised; Verbal Behavior Milestones Assessment and Placement Program) do not account for cultural and linguistic differences. Culturally and Linguistically Diverse (CLD) speakers are more accurately assessed in their heritage language (Novogrodsky & Meir 2022). A more inclusive approach to language assessment, intervention, and services emphasizes environmental factors relevant to verbal behavior rather than topography. Adapting assessment procedures for culturally and linguistically diverse populations is critical to ensure equitable access to effective care for members from these communities. To address the need for culturally responsive behavioral language assessment, the verbal operant experimental (VOX) analysis was developed (Mason & Andrews, 2014; 2021). The VOX was informed by previous work in adapting functional analysis technology to assess the functions of emerging speech in children with developmental disabilities (Lerman et al., 2005).
VOX offers an innovative approach to evaluating language and identifying specific deficits in verbal behavior that can lead to the development of CLD intervention plans that are socially significant and aligned with caregivers’ and community priorities (Enriquez et al., 2023). The use of this analysis helps to inform intervention in a verbal community-centered approach to measuring, directing, and monitoring the progress of developing functional language skills. VOX’s primary metric, the Stimulus Control Ratio Equation (SCoRE), quantifies the proportion of elementary verbal operants by comparing the relative frequency of each response type (i.e., echoing, labeling-tacting), requesting-manding), and commenting-intraverbal responses).
The VOX analysis leads to an individually prescribed teaching protocol that develops a learner’s functional verbal behavior repertoire using their engagement with highly preferred items and/or participation in their favorite activities, reflecting family and cultural preferences (Referent-Based Instruction, RBI, Mason & Andrews, 2014; 2021).
Cultural differences, disparities in service access, difficulties with customized training support, time constraints, and family stressors remain primary concerns for many caregivers raising a child with ASD and related (dis)abilities. Unfortunately, many treatment models may not be accessible, individually tailored, or feasible for families experiencing hardship or having limited resources. Caregiver-implemented intervention, often facilitated via coaching, is an increasingly widespread solution to early intervention for children with or at risk for autism (Tomeny et al., 2020). One study that Janet is currently leading will investigate the effects of a parent-mediated Natural Environment Training (NET) package, based explicitly on a functional analysis of learners’ language (i.e., Parent-Mediated Referent-Based Instruction, PM-RBI) on caregivers’ fidelity in implementing these procedures.
In addition, an app for conducting a VOX analysis that will also generate a verbal behavior treatment plan will soon be available, providing further accessibility to valuable assessment and intervention opportunities across CLD communities. This opportunity will provide caregivers and practitioners the convenience of home-based support that can easily be incorporated into daily routines, as well as allowing for the sharing of data and progress reports with related service providers, educators, or family members, providing a more inclusive, comprehensive support network for caregivers and individuals.
The increasing prevalence of language impairments and ASD among CLD learners requires comprehensive evaluative approaches and interventions. The disparities in diagnosis, treatment accessibility, and outcomes for marginalized communities are significant and often perpetuate a cycle of inequity that impedes individual potential and societal growth. Current diagnostic tools, educational resources, and interventions often do not consider the unique cultural, linguistic, and socio-economic contexts that can influence the presentation and care of learners with ASD in ethnically diverse communities. This oversight may often lead to suboptimal treatment plans that do not meet the nuanced needs of these individuals. VOX, RBI, and PM-RBI present practical solutions recognizing the distinctive characteristics and contexts of vulnerable communities, addressing the critical issues related to language assessment and interventions for learners with ASD, and promoting culturally responsive, collaborative approaches for improved outcomes.
For more information on this assessment and intervention, please consult www.verbalbehavior.org; for a VOX tutorial, Modeling Verbal Behavior Deficits with the Stimulus Control Ratio Equation, SCoRE | Protocol (jove.com). And for a behavior analytic perspective on autism in general, and a specific discussion of over-selectivity and overgeneralization in language and an explanation of sensory differences associated with ASD, https://www.youtube.com/watch?v=2EquXRtHf5Q.
Brown, S. M., & Bebko, J. M. (2012). Generalization, overselectivity, and discrimination in the autism phenotype: A review. Research in Autism Spectrum Disorders, 6(2). https://doi:10.1016/j.rasd.2011.10.012
Enriquez, J., Arechiga, N., Atherkode, S., Otero, M., Andrews, A., & Mason, L. (2023). Culturally responsive language assessment through a verbal operant experimental analysis. Behavior Analysis: Research and Practice, 23(2), 165. https://doi.org/10.1037/bar0000269
Esch, B. E., LaLonde, K. B., & Esch, J. W. (2010). Speech and language assessment: A verbal behavior analysis. The Journal of Speech and Language Pathology—Applied Behavior Analysis, 5(2), 166–191. https://doi.org/10.1037/h0100270
Lerman, D. C., Parten, M., Addison, L. R., Vorndran, C. M., Volkert, V. M., & Kodak, T. (2005). A methodology for assessing the functions of emerging speech in children with developmental disabilities. Journal of Applied Behavior Analysis, 38(3), 303–316. https://doi.org/10.1901/jaba.2005.106-04
Mason, L. L., & Andrews, A. (2014). Referent-based verbal behavior instruction for children with autism. Behavior Analysis in Practice, 7, 107-111. https://doi: 10.1007/s40617-014-0018-zz
Mason, L. L., & Andrews, A. (2021). Referent-Based Instruction to Strengthen the Verbal Behavior of Early Learners with Autism and Related Language Disorders. Behavior Analysis in Practice, 14, 660-672. https://doi.org/10.1007/s40617-020-00491-2
Novogrodsky, R., & Meir, N. (2022). Multilingual children with special needs in early education. In Handbook of Early Language Education (pp. 669-696). Cham: Springer International Publishing.
Partington, J. W. (2006). The assessment of basic language and learning skills—Revised (ABLLS-R). Behavior Analysts.
Reed, S. R., Stahmer, A. C., Suhrheinrich, J., & Schreibman, L. (2013). Stimulus overselectivity in typical development: Implications for teaching children with autism. Journal of Autism and Developmental Disorders, 43, 1249-1257. https://doi.org/ 10.1007/s10803-012-1658-x
Sanchez Enriquez, J. (2023). Effects of parent-mediated referent-based instruction: A verbal behavior training package for young children with autism (Unpublished doctoral dissertation). University of North Carolina Charlotte, North Carolina.
Stahmer, A. C., Vejnoska, S., Iadarola, S., Straiton, D., Segovia, F., Luelmo, P., Morgan, E., Lee, H. S., Javed, A., Bronstein, B., Hochheimer, S., Cho, E., Aranbarri, A., Mandell, D., Hassrick, E. M., Smith, T., & Kasari, C. (2019). Caregiver voices: Cross-cultural input on improving access to autism services. Journal of Racial and Ethnic Health Disparities, 6(4), 752–773. https://doi.org/10.1007/s40615-019-00575-y
Sundberg, M. L. (2008). Verbal behavior milestones assessment and placement program: The VB-MAPP. AVB Press.
Tomeny, K. R., McWilliam, R. A., & Tomeny, T. S. (2020). Caregiver-implemented intervention for young children with autism spectrum disorder: A systematic review of coaching components. Review Journal of Autism and Developmental Disorders, 7, 168-181. https://doi.org/10.1007/s40489-019-00186-7