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Rahaman JA, Luczynski KC. Evaluating the efficacy and generality of a skill-based approach for promoting universal behavioral readiness. J Appl Behav Anal 2024; 57:131-152. [PMID: 38158227 DOI: 10.1002/jaba.1028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Accepted: 09/17/2023] [Indexed: 01/03/2024]
Abstract
Behavioral readiness can take the form of communication and self-control skills during challenging situations that are correlated with the development of problem behavior. A skill-based approach can teach behavioral readiness using procedures that involve synthesized reinforcement, probabilistic reinforcement, and contingency-based delays; however, this approach is commonly used to address severe behavior under specific situations. There is limited research evaluating a skill-based approach to teaching behavioral readiness and addressing emerging problem behavior. Also, it is unclear whether teaching effects under specific situations transfer across other, functionally distinct, situations. We evaluated the generality of a skill-based approach by teaching skills systematically across primary challenging situations involving the interruption of play, presentation of instructions, and removal of reinforcers. Teaching increased communication and self-control skills, and most skills transferred to secondary challenging situations (treatment extension probes) and caregiver-implemented sessions. We discuss challenging situations that required teaching, the generality of teaching, and procedural considerations.
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Affiliation(s)
- Javid A Rahaman
- Prosocial Interactions Program, University of Nebraska Medical Center's Munroe-Meyer Institute, Omaha, Nebraska, USA
| | - Kevin C Luczynski
- Prosocial Interactions Program, University of Nebraska Medical Center's Munroe-Meyer Institute, Omaha, Nebraska, USA
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2
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Cowell R, Vostanis A, Langdon PE. Increasing Face Mask Wearing in Autistic Individuals Using Behavior Analytic Interventions: A Systematic Review and Meta-analysis. J Autism Dev Disord 2023:10.1007/s10803-023-06128-x. [PMID: 37751092 DOI: 10.1007/s10803-023-06128-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/29/2023] [Indexed: 09/27/2023]
Abstract
The current review aimed to evaluate the effectiveness of behavior-analytic procedures in increasing face mask-wearing in autistic individuals. This comes following recommended guidance during the COVID-19 pandemic. A systematic review and meta-analysis were completed of peer-reviewed and grey literature. Six databases were searched and seven studies using single-case experimental designs met the eligibility criteria which were then quality appraised. Data were extracted on participant characteristics, study design, independent and dependent variables, fidelity, generalization, maintenance, and social validity outcomes. Both the non-overlap of all pairs and Baseline Corrected TAU were used to estimate effect size. Two studies were rated strong and borderline strong quality and five were rated as adequate or below. All studies showed positive outcomes for mask-wearing, with an average of 0.92 for non-overlap of all pairs and 0.47 for Baseline Corrected Tau effect sizes. The most common and effective procedures for increasing mask-wearing were graded exposure and differential and positive reinforcement. Factors such as mode of delivery, implementer, and setting did not appear to influence study outcomes. Procedures were found to be rated as acceptable by parents and professionals in five of the studies. The existing literature on increasing face mask-wearing in autistic individuals provides promising findings to add to existing literature around increasing tolerance to medical equipment and hygiene practices in autistic populations. However, these findings are based on a small sample size, with six of the studies taking place in the United States with varying study quality.
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Affiliation(s)
- Rebekah Cowell
- Tizard Centre, University of Kent, Cornwallis North East, Canterbury, Kent, CT2 7NF, UK
| | - Athanasios Vostanis
- Tizard Centre, University of Kent, Cornwallis North East, Canterbury, Kent, CT2 7NF, UK.
| | - Peter E Langdon
- Centre for Research in Intellectual and Developmental Disabilities (CIDD), University of Warwick, Coventry, CV4 8UW, UK
- Coventry and Warwickshire Partnership NHS Trust, Coventry, CV6 6NY, UK
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Ratchatavech K, Techasatian L, Panombualert S, Uppala R. The Adverse and Advantage Effects of Wearing a Facemask in Thai Children: A Survey During the COVID-19 Pandemic. J Prim Care Community Health 2022; 13:21501319221131704. [PMID: 36300437 PMCID: PMC9614596 DOI: 10.1177/21501319221131704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND There is little information on facemask use during the COVID-19 pandemic in the pediatric population. This became the main purpose of the present study to investigate demographic data of facemask wearing in children, types, and length of facemask, as well as the benefits, drawbacks, and negative consequences of facemask wearing in this population. METHODS A cross-sectional study was conducted using a structured questionnaire sent via Google Forms. Caregivers for consecutive convenience were asked in the survey (parents of children under the age of 18). RESULTS A total number of 706 children were enrolled. There were 320 boys (45.33%), and 386 girls (54.67%). The children's ages range between 4 months and 18 years, with a median age of 9 years. A surgical mask (549, 77.76%) was the most frequent type of facemask in the study population, followed by a cloth mask (86, 12.18%). Facemasks have been shown to be beneficial in the pediatric population. When compared to a former time when facemasks were not used routinely, there were considerably fewer respiratory infections, reduced diarrhea symptoms, and a drop in hospital admissions. In 317 cases (44.9%), children were shown to have negative consequences from wearing facemasks. The most prevalent adverse effect observed in the study population was non-cutaneous (respiratory discomfort/breathing difficulty) which were found in 240 cases (33.99%). Double masking method (surgical + surgical) and wearing a facemask oversize revealed a higher risk in the presence of facemask adverse effects, whereas wearing a proper size facemask reduces the risk of adverse effects from facemask use in children (Adjusted OR [95% CI] = 0.55 [0.38-0.78], P .0003). CONCLUSIONS Wearing a proper-size facemask reduces the risk of adverse effects from facemask use in children. The future suggestion of an appropriate facemask size for a certain age will aid in the avoidance of facemask adverse effects in the pediatric population.
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Affiliation(s)
| | - Leelawadee Techasatian
- Khon Kaen University, Khon Kaen,
Thailand,Leelawadee Techasatian, Dermatology
Division, Pediatric Department, Faculty of Medicine, Khon Kaen University, Khon
Kaen 40000, Thailand.
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Driscoll NM, Rothschild AW, Luiselli JK, Goldberg S, Crawley J, Fofanah D, Wangaga J. Brief Report: A Pilot Investigation of Safety Concerns Among Direct Service Providers for Adults with Intellectual and Developmental Disabilities. JOURNAL OF DEVELOPMENTAL AND PHYSICAL DISABILITIES 2022; 35:1-8. [PMID: 36311269 PMCID: PMC9592869 DOI: 10.1007/s10882-022-09880-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/26/2022] [Indexed: 06/16/2023]
Abstract
We designed and distributed a survey that assessed safety concerns experienced by direct service providers (DSPs) (N = 59) of adults with intellectual and developmental disabilities (IDD) in community-based group homes at a single human services organization. Results indicated relatively few safety concerns among the respondents from a list of 25 survey statements. Possible influences on the findings are presented such as safety training of the DSPs, comprehensive safety guidelines in place at the group homes, and conditions occasioned by the COVID-19 pandemic. Current safety research in IDD supports the necessity of assessment to inform prevention and intervention strategies.
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Affiliation(s)
| | | | - James K. Luiselli
- Clinical Development and Research, Melmark New England, Andover, MA United States
| | - Sharon Goldberg
- Community Services, Seven Hills Foundation, Worcester, MA United States
| | - Jillian Crawley
- Community Services, Seven Hills Foundation, Worcester, MA United States
| | - David Fofanah
- Community Services, Seven Hills Foundation, Worcester, MA United States
| | - Joshua Wangaga
- Community Services, Seven Hills Foundation, Worcester, MA United States
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McHugh CL, Dozier CL, Diaz de Villegas SC, Kanaman NA. Using synchronous reinforcement to increase mask wearing in adults with intellectual and developmental disabilities. J Appl Behav Anal 2022; 55:1157-1171. [PMID: 35920113 DOI: 10.1002/jaba.950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 07/15/2022] [Indexed: 11/06/2022]
Abstract
In 2020 the Centers for Disease Control provided the public with recommendations to slow the spread of COVID-19 by wearing a mask in the community. In the current study, experimenters coached group home staff via telehealth to implement synchronous schedules of reinforcement to increase mask wearing for 5 adults with intellectual and developmental disabilities. Results showed the intervention effectively increased mask wearing for all participants for up to 30 min. Additionally, some participants for whom we assessed generalization of mask wearing demonstrated generalization to various community environments. Furthermore, procedural integrity data suggested staff could be coached via telehealth to implement the intervention, and staff surveys suggested the procedures and coaching were socially valid.
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Jennings AM, Mery JN, Quiroz LS, Vladescu JC. A Scoping Review of the Healthcare and Hygiene Literature for Individuals with Intellectual and Developmental Disabilities. ADVANCES IN NEURODEVELOPMENTAL DISORDERS 2022; 6:237-252. [PMID: 35308895 PMCID: PMC8918892 DOI: 10.1007/s41252-022-00249-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/26/2022] [Indexed: 06/14/2023]
Abstract
OBJECTIVES Previous reviews highlight the similarities in teaching healthcare and hygiene routines to individuals with and without intellectual and developmental disabilities. Additionally, similar interventions are used when interfering behaviors occur. Although these routines are topographically distinct, there are enough similarities to suggest effective procedures for one routine may be used to inform another. This scooping review aims to identify effective teaching and intervention procedures for healthcare and hygiene routines specifically for individuals with intellectual and developmental disabilities. We also evaluated the extent to which functional analyses were conducted; a dimension not included in previous reviews. METHODS Eligible articles targeted compliance or tolerance within the context of a defined healthcare or hygiene routine as a dependent variable and used an experimental design with a demonstration of experimental control. Articles were identified through PsycINFO, PubMed, and Academic Search Premier databases. Additionally, a hand search of five related journals was conducted. Data were collected on dependent variables, functional analyses, baseline contingencies, teaching procedures, and additional experimental components. RESULTS A total of 52 articles met inclusion criteria. Most experiments produced positive outcomes. The findings show all experiments involved a treatment package with multiple components. The most common teaching procedures were graduated exposure and DRA. A lack of functional analyses and social validity was noted. CONCLUSIONS Component analyses are needed to identify the most effective and efficient procedures. Pyramidal training to teach medical professionals how to provide preventative pyramidal training should be explored. SUPPLEMENTARY INFORMATION The online version contains supplementary material available at 10.1007/s41252-022-00249-7.
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Affiliation(s)
- Adrienne M. Jennings
- Department of Applied Behavior Analysis, Caldwell University, 120 Bloomfield Avenue, Caldwell, NJ 07006 USA
| | | | | | - Jason C. Vladescu
- Department of Applied Behavior Analysis, Caldwell University, 120 Bloomfield Avenue, Caldwell, NJ 07006 USA
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Luiselli JK, Gardner RM, Bird F, Maguire H, Harper JM. Organizational behavior management in human services settings: Conducting and disseminating research that improves client outcomes, employee performance, and systems development. JOURNAL OF ORGANIZATIONAL BEHAVIOR MANAGEMENT 2022. [DOI: 10.1080/01608061.2022.2027319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- James K. Luiselli
- Melmark New England, 461 River Road, Andover, Massachusetts, 01810, USA
| | - Rita M. Gardner
- Melmark New England, 461 River Road, Andover, Massachusetts, 01810, USA
| | - Frank Bird
- Melmark New England, 461 River Road, Andover, Massachusetts, 01810, USA
| | - Helena Maguire
- Melmark New England, 461 River Road, Andover, Massachusetts, 01810, USA
| | - Jill M. Harper
- Melmark New England, 461 River Road, Andover, Massachusetts, 01810, USA
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Bördlein C, Richling SM, Seniuk H. Editorial: An Introduction to the Special Section on International Perspectives on Cultural and Social Issues. BEHAVIOR AND SOCIAL ISSUES 2021; 30:276-279. [PMID: 38624992 PMCID: PMC8562934 DOI: 10.1007/s42822-021-00079-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
| | - Sarah M. Richling
- Department of Psychological Sciences, Auburn University, 226 Thach Hall, Auburn University, Auburn, AL 36849-5214 USA
| | - Holly Seniuk
- Behavior Analyst Certification Board, Littleton, CO USA
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Ertel HM, Wilder DA, Hodges AC. Evaluation of a Graduated Exposure Procedure to Teach Extended Mask Wearing in Various Settings to Children With Autism. Behav Modif 2021; 46:1218-1235. [PMID: 34612710 DOI: 10.1177/01454455211049546] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
During the COVID-19 outbreak, the Center for Disease Control (CDC) recommended that everyone 2 years and older wear a face mask while in a community setting. However, children with autism may be reluctant to wear a mask, particularly for extended durations. In the current study, we implemented a graduated exposure procedure to teach mask wearing for a minimum of 1 hour in an early intensive behavioral (EIBI) intervention clinic to three children diagnosed with autism. We subsequently probed mask wearing, and if necessary implemented the graduated exposure procedure, in each participant's home and in a mock physician's office. Finally, we collected probe data on mask wearing in another community setting and 1 month post-treatment maintenance data in the EIBI clinic. During baseline, participants wore masks for 0 second to 5 minutes. After treatment, all participants wore the mask for at least 1 hour in each setting, with maintenance probes indicating 4 to 5 hour mask tolerance.
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Affiliation(s)
- Hallie M Ertel
- Florida Institute of Technology, Melbourne, USA.,Nemours Children's Hospital, Orlando, FL, USA
| | | | - Ansley C Hodges
- Florida Institute of Technology, Melbourne, USA.,Nemours Children's Hospital, Orlando, FL, USA
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Pazhoohi F, Forby L, Kingstone A. Facial masks affect emotion recognition in the general population and individuals with autistic traits. PLoS One 2021; 16:e0257740. [PMID: 34591895 PMCID: PMC8483373 DOI: 10.1371/journal.pone.0257740] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Accepted: 09/08/2021] [Indexed: 11/25/2022] Open
Abstract
Facial expressions, and the ability to recognize these expressions, have evolved in humans to communicate information to one another. Face masks are equipment used in healthcare by health professionals to prevent the transmission of airborne infections. As part of the social distancing efforts related to COVID-19, wearing facial masks has been practiced globally. Such practice might influence affective information communication among humans. Previous research suggests that masks disrupt expression recognition of some emotions (e.g., fear, sadness or neutrality) and lower the confidence in their identification. To extend the previous research, in the current study we tested a larger and more diverse sample of individuals and also investigated the effect of masks on perceived intensity of expressions. Moreover, for the first time in the literature we examined these questions using individuals with autistic traits. Specifically, across three experiments using different populations (college students and general population), and the 10-item Autism Spectrum Quotient (AQ-10; lower and higher scorers), we tested the effect of facial masks on facial emotion recognition of anger, disgust, fear, happiness, sadness, and neutrality. Results showed that the ability to identify all facial expressions decreased when faces were masked, a finding observed across all three studies, contradicting previous research on fear, sad, and neutral expressions. Participants were also less confident in their judgements for all emotions, supporting previous research; and participants perceived emotions as less expressive in the mask condition compared to the unmasked condition, a finding novel to the literature. An additional novel finding was that participants with higher scores on the AQ-10 were less accurate and less confident overall in facial expression recognition, as well as perceiving expressions as less intense. Our findings reveal that wearing face masks decreases facial expression recognition, confidence in expression identification, as well as the perception of intensity for all expressions, affecting high-scoring AQ-10 individuals more than low-scoring individuals.
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Affiliation(s)
- Farid Pazhoohi
- Department of Psychology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Leilani Forby
- Department of Psychology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Alan Kingstone
- Department of Psychology, University of British Columbia, Vancouver, British Columbia, Canada
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Halbur M, Kodak T, McKee M, Carroll R, Preas E, Reidy J, Cordeiro MC. Tolerance of face coverings for children with autism spectrum disorder. J Appl Behav Anal 2021; 54:600-617. [PMID: 33772777 PMCID: PMC8250735 DOI: 10.1002/jaba.833] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 03/13/2021] [Accepted: 03/13/2021] [Indexed: 11/06/2022]
Abstract
Healthcare professionals and government officials have advised the use of personal protective equipment, such as face masks and face shields, to assist with limiting the spread of the SARS‐CoV‐2 (COVID‐19). Due to the prevalence of challenging behavior associated with other medical routines, the present study evaluated a treatment package composed of graduated exposure, prompts, reinforcement, and escape extinction on tolerance of wearing a face covering for up to 5 min for 12 children with ASD in a systematic replication of Cox et al. (2017) and Sivaraman et al. (2020). We also extended previous research by measuring generalization of face covering type (i.e., face shield) and the efficacy of a treatment extension for tolerating a face covering for up to 15 min during the participants' trial‐based instruction and play periods.
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Affiliation(s)
- Mary Halbur
- University of Nebraska Medical Center's Munroe-Meyer Institute
| | | | | | - Regina Carroll
- University of Nebraska Medical Center's Munroe-Meyer Institute
| | - Elizabeth Preas
- University of Nebraska Medical Center's Munroe-Meyer Institute
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