FUNCTIONAL ASSESSMENT AND TREATMENT OF PERSEVERATIVE SPEECH ABOUT RESTRICTED TOPICS IN AN ADOLESCENT WITH ASPERGER SYNDROME

An Assessment of Response to Conversation Cues of Uninterest Conducted via Telehealth

Individuals diagnosed with autism spectrum disorder (ASD) exhibit deficits in social interaction and communication. Kronfli, Vollmer, et al. developed an in-person assessment to evaluate participant response to social cues indicating uninterest in a conversation. In the current study, we sought to extend these procedures to the assessment of conversation skills via telehealth given the ongoing pandemic and so that participants in remote areas could receive services. Participants were exposed to a hierarchy of social cues of uninterest ranging in salience from one-word responses to a clear verbal statement of uninterest until they demonstrated sensitivity to a social cue. One participant who did not demonstrate sensitivity to any cues received instruction using Behavioral Skills Training. Initial results support the utility of using a remote assessment model to screen for sensitivity to specific social cues in conversations and to provide services to participants via telehealth.

A translational evaluation of listener interest on the presentation of conversation topics to individuals who exhibit restricted interests

Listener behavior has been shown to influence speaker behavior. However, little is known about the extent to which listener behavior can influence countertherapeutic outcomes. This study evaluated the influence of listener interest on the topics presented by adult participants conversing with an experimenter acting as an individual who exhibited restricted interests. Each session consisted of a 5‐min conversation, during which the participant was instructed to talk about 3 topics. We compared the duration of topic presentation across phases in which the experimenter behaved as an interested listener for 1 topic or for all 3 topics. Results showed that topic presentation was controlled by listener interest and all participants reported that the simulation was believable, acceptable, and useful. Although preliminary, these findings have implications for understanding possible undesirable interactions between individuals diagnosed with autism spectrum disorder who exhibit restricted interests and their peers or caregivers.

Conventions for unconventional language: Revisiting a framework for spoken language features in autism

Background and aims

Autism has long been characterized by a range of spoken language features, including, for instance: the tendency to repeat words and phrases, the use of invented words, and "pedantic" language. These observations have been the source of considerable disagreement in both the theoretical and applied realms. Despite persistent professional interest in these language features, there has been little consensus around terminology, definitions and developmental/clinical interpretation.

Main contribution

This review paper updates and expands an existing framework for unconventional language in autism to include a broader range of non-generative (echolalia and self-repetition) and generative (idiosyncratic phrases, neologisms and pedantic language) features often observed in the language of individuals on the autism spectrum. For each aspect of the framework, we review the various definitions and measurement approaches, and we provide a summary of individual and contextual correlates. We also propose some transitional language features that may bridge non-generative and generative domains (e.g., mitigated echolalia and gestalt language).

Conclusions

This updated framework offers a unified taxonomy and nomenclature that can facilitate further investigation and interpretation of unconventional language in autism.

Implications

There are important implications of this work for our understanding of the complex interplay between autism and language development. Equally important are the clinical ramifications that will guide evidence-based practice in assessment and intervention for individuals on the autism spectrum.

Descriptive assessment of conversational skills: Towards benchmarks for young adults with social deficits

Descriptive assessments are necessary to identify social norms and establish a foundation for experimental analysis. Much of the social skills intervention literature involves goals that have been selected through interviews and direct observation of behavior without a reference to desired outcomes. The purpose of the current study was to extend research on descriptive assessments of conversations by including additional measures and examining conversational behavior across contexts. We conducted a descriptive assessment of social skills exhibited by 16 neurotypical young adults. Participants had 10-min conversations in groups and 1-on-1 with friends and novel individuals. We then assessed variability within and across participants on a wide array of relevant measures. Throughout the conversations, participants shared the conversation time equally, spent most of the conversation time making on-topic comments, and gazed at their conversation partner more frequently while listening than while speaking. These descriptive data extend current research, inform future experimental analyses, and may guide clinical decisions.

A comparison of intervention for problematic speech using reinforcement with and without preferred topics

Previous research has shown that responding to the appropriate and problematic speech of individuals diagnosed with developmental disabilities with interested and uninterested listener responses, respectively, can promote more appropriate conversational engagement. However, Fisher et al. (2013) also responded to appropriate speech with access to preferred conversational topics. This study examined the influence of listener interest on the problematic speech of 8 participants and tested the additive effects of (Study 1) and participant preference for (Study 2) delivering preferred topics as reinforcement for appropriate speech. Interventions were equally effective with or without arranging access to preferred topics, but a majority of participants demonstrated a preference for intervention with contingent access to preferred topics. Caregivers and speech-language pathologists rated the intervention procedures as acceptable and changes in participants' speech satisfactory.

Functional analysis and intervention of perseverative speech in students with high-functioning autism and related neurodevelopmental disabilities

Although perseverative speech is a common characteristic of individuals with high-functioning neurodevelopmental disabilities, little is known about the operant functions of these verbalizations. We conducted analogue functional analyses of perseverative speech for 2 students using reinforcement contingencies that included alone, attention, control, escape, and tangible conditions. Results showed the following patterns: attention only (Charlotte) or multiply determined including an attention function (Paul). We then tested an intervention for perseverative speech maintained by social positive reinforcement that included differential reinforcement of alternative behavior and extinction of perseverative speech for 1 participant. The intervention reduced perseverative speech, but did not increase appropriate speech until we added a prompting component. We then replicated this three-component intervention with Paul. The results showed moderate to high decreases in levels of perseverative speech and increased appropriate verbalizations in both cases. The results systematically replicated the interventions of previous studies by adding a prompting component to the intervention.

A Systematic Review of Parent-Implemented Functional Communication Training for Children With ASD

Supporting parents in reducing challenging behavior of children with autism spectrum disorder (ASD) requires the identification of effective, feasible, and sustainable interventions. Functional communication training (FCT) is one of the most well-established interventions in the behavioral literature and is used increasingly by parents. However, there is a need for additional evaluation of the literature related to parent-implemented FCT. In the present review, we identified 26 peer-reviewed studies on parent-implemented FCT. We conducted systematic descriptive and social validity analyses to summarize the extant literature. Across studies, parent-implemented FCT was effective in reducing child challenging behavior, and in some cases, intervention outcomes maintained and generalized to novel settings and implementers. However, few studies reported fidelity data on parent implementation of FCT, and data regarding sustained use of FCT by parents were limited. Results of the social validity analysis indicate that while FCT is often implemented by natural change agents in typical settings, parent training is often provided by professionals not typically accessible to parents. These findings suggest that future research is warranted in the areas of parent training and long-term sustainability of parent-implemented FCT.

The Survey of Favorite Interests and Activities: Assessing and understanding restricted interests in children with autism spectrum disorder

Restricted interests are an established diagnostic symptom of autism spectrum disorder. While there is considerable evidence that these interests have maladaptive consequences, they also provide a range of benefits. This article introduces a new instrument, the Survey of Favorite Interests and Activities, and uses it to examine the nature of restricted interests in autism spectrum disorder. Respondents report substantial benefits of restricted interests as well as areas of difficulty. The Survey of Favorite Interests and Activities assesses Social Flexibility, Perseveration, Respondent Discomfort, Adaptive Coping, and Atypicality. All scales have Cronbach's α > 0.70. Age and socioeconomic status have little effect on Survey of Favorite Interests and Activities scales; nor does gender with the exception of interest Atypicality. The expected pattern of correlations with existing scales was found. Research and clinical implications are discussed.

Enhancing appropriate and variable responding in young children with autism spectrum disorder

OBJECTIVE

The present study utilized lag schedules of reinforcement, in conjunction with training multiple exemplars and provision of prompts, to promote appropriate variability of social skills.

METHODS

Participants included in three children between the ages of 5 and 7 with ASD. Participants attended a social skills training program twice per week for eight weeks. A multiple probe design across target social skills was used to assess the effects of intervention.

RESULTS

Findings indicate that training multiple exemplars alone did not appreciably increase appropriate and variable responding, whereas the addition of lag schedules of reinforcement and prompting to training multiple exemplars resulted in appropriate and variable responding that exceeded baseline levels.

CONCLUSION

Use of lag schedule of reinforcement in conjunction with prompts was more effective than multiple exemplar training in isolation for increasing appropriate variability of social skills.

Multiple schedules in practical application: Research trends and implications for future investigation

Researchers began studying multiple schedules in basic laboratories, but recent advances have extended research on multiple schedules to a wide variety of socially significant applications, especially during the last decade. Applied researchers have used multiple schedules to (a) promote stimulus control over high-rate appropriate behaviors, (b) thin the schedule of reinforcement following functional communication training, and (c) obtain stimulus control over problem behaviors maintained by automatic reinforcement. In the current paper, we reviewed 31 studies with 147 applications identified through a search of the applied literature on multiple schedules. Using these studies, we (a) reviewed the empirical literature on multiple schedules, (b) recommended multiple-schedule procedures that serve as best practice guidelines for applied behavior analysts, (c) identified the generality and boundaries of current knowledge about the effectiveness of multiple schedules, and (d) critically analyzed the literature to provide directions for future multiple-schedule research.

Thirty years of research on the functional analysis of problem behavior

Hanley, Iwata, and McCord (2003) reviewed studies published through 2000 on the functional analysis (FA) of problem behavior. We update that review for 2001 through 2012, including 158 more recent studies that reported data from 445 FAs. Combined with data obtained from Hanley et al., 435 FA studies, with line graphs for 981 FAs, have been published since 1961. We comment on recent trends in FA research and introduce the studies in the 2013 special issue of the Journal of Applied Behavior Analysis.