Considerations for practitioners using applied behavior analysis therapy with autistic deaf/hard of hearing clients

There is scarce research on adapting evidence-based practices, such as Applied Behavior Analysis (ABA)-based therapy, for Deaf/Hard of Hearing (DHH) children diagnosed with autism spectrum disorder (ASD). The current case involved delivering intensive ABA-based intervention for improving communication skills to a 5-year-old child, Lilly, with dual diagnoses of DHH and ASD. Teaching procedures were modified to include consideration of deaf cultural norms, incorporation of American Sign Language (ASL)-specific instructional procedures, and consultation with an ASL interpreter within all intervention sessions. Outcome data measured by the Verbal Behavior Milestones Assessment and Placement Program (VB-MAPP) reflected rapid skill acquisition across multiple verbal operants within a 7-month admission. Recommendations on how to deliver intensive ABA-based intervention services to children with dual diagnoses of DHH and ASD are provided for further research and discussion. Utilizing modified behavior analytic procedures can provide increased access to needed services for this population.