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Quail KR, Ward CL. Using Non-Violent Discipline Tools: Evidence Suggesting the Importance of Attunement. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:7187. [PMID: 38131738 PMCID: PMC10742770 DOI: 10.3390/ijerph20247187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Revised: 12/07/2023] [Accepted: 12/07/2023] [Indexed: 12/23/2023]
Abstract
Training in non-violent discipline is important to prevent violence against children and ensure that their caregivers remain a safe base for them. This paper aims to deepen understanding of non-violent discipline by exploring attunement as a mechanism in the effectiveness of non-violent discipline tools. Attunement describes the sensitive responsiveness of caregivers towards their children and has been found to be central to the formation of secure attachment bonds and development of self-regulation. It includes understanding or being "in tune with" the child's needs and signals, matching these with appropriate responses. The objective of this paper is to explore attunement in relation to non-violent discipline. Peer-reviewed systematic reviews previously included in a systematic overview of evidence on non-violent discipline options were screened for information relevant to attunement. All reviews were published in English between 1999 and 2018 and offered evidence on at least one non-violent discipline tool. Although no reviews explicitly addressed attunement, evidence was found suggesting its importance in the use and effectiveness of discipline methods. Research directly investigating attunement in discipline is needed.
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Affiliation(s)
- Karen R. Quail
- Department of Psychology, Faculty of Humanities, University of Cape Town, Cape Town 7700, South Africa;
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Nilles C, Amorelli G, Pringsheim TM, Martino D. "Unvoluntary" Movement Disorders: Distinguishing between Tics, Akathisia, Restless Legs, and Stereotypies. Semin Neurol 2023; 43:123-146. [PMID: 36854394 DOI: 10.1055/s-0043-1764164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
Abstract
Tics, stereotypies, akathisia, and restless legs fall at different places on the spectrum of discrete, unwanted and potentially disabling motor routines. Unlike tremor, chorea, myoclonus, or dystonia, this subgroup of abnormal movements is characterized by the subject's variable ability to inhibit or release undesired motor patterns on demand. Though it may be sometimes clinically challenging, it is crucial to distinguish these "unvoluntary" motor behaviors because secondary causes and management approaches differ substantially. To this end, physicians must consider the degree of repetitiveness of the movements, the existence of volitional control, and the association with sensory symptoms, or cognitive-ideational antecedent. This review aims to summarize the current existing knowledge on phenomenology, diagnosis, and treatment of tics, stereotypies, akathisia, and restless leg syndrome.
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Affiliation(s)
- Christelle Nilles
- Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Gabriel Amorelli
- Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Tamara M Pringsheim
- Department of Clinical Neurosciences, Psychiatry, Pediatrics and Community Health Sciences, University of Calgary, Calgary, Alberta, Canada.,Mathison Centre for Mental Health Research and Education, Calgary, Alberta, Canada.,Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
| | - Davide Martino
- Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.,Mathison Centre for Mental Health Research and Education, Calgary, Alberta, Canada.,Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
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Zwilling M, Romano A, Hoffman H, Lotan M, Tesler R. Development and validation of a system for the prediction of challenging behaviors of people with autism spectrum disorder based on a smart wearable shirt: A mixed-methods design. Front Behav Neurosci 2022; 16:948184. [DOI: 10.3389/fnbeh.2022.948184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 11/10/2022] [Indexed: 11/30/2022] Open
Abstract
BackgroundMost people with autism spectrum disorder (ASD) present at least one form of challenging behavior (CB), causing reduced life quality, social interactions, and community-based service inclusion.ObjectivesThe current study had two objectives: (1) to assess the differences in physiological reaction to stressful stimuli between adults with and without high-functioning ASD; (2) to develop a system able to predict the incoming occurrence of a challenging behaviors (CBs) in real time and inform the caregiver that a CB is about to occur; (3) to evaluate the acceptability and usefulness of the developed system for users with ASD and their caregivers.MethodsComparison between physiological parameters will be conducted by enrolling two groups of 20 participants with and without ASD monitored while watching a relaxing and disturbing video. To understand the variations of the parameters that occur before the CB takes place, 10 participants with ASD who have aggressive or disruptive CBs will be monitored for 7 days. Then, an ML algorithm capable of predicting immediate CB occurrence based on physiological parameter variations is about to be developed. After developing the application-based algorithm, an efficient proof of concept (POC) will be carried out on one participant with ASD and CB. A focus group, including health professionals, will test the POC to identify the strengths and weaknesses of the developed system.ResultsHigher stress level is anticipated in the group of people with ASD looking at the disturbing video than in the typically developed peers. From the obtained data, the developed algorithm is used to predict CBs that are about to occur in the upcoming 1 min. A high level of satisfaction with the proposed technology and useful consideration for further developments are expected to emerge from the focus group.Clinical trial registration[https://clinicaltrials.gov/], identifier [NCT05340608].
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Ledford JR, Trump C, Chazin KT, Windsor SA, Eyler PB, Wunderlich K. Systematic review of interruption and redirection procedures for autistic individuals. BEHAVIORAL INTERVENTIONS 2022. [DOI: 10.1002/bin.1905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
| | - Cary Trump
- University of Northern Colorado Greeley Colorado USA
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Ryan J, Rosales R, Rowe E. A review of response interruption and redirection: 2007–2021. BEHAVIORAL INTERVENTIONS 2022. [DOI: 10.1002/bin.1886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Joseph Ryan
- Department of Psychology University of Massachusetts Lowell Lowell Massachusetts USA
| | - Rocío Rosales
- Department of Psychology University of Massachusetts Lowell Lowell Massachusetts USA
| | - Emily Rowe
- Department of Psychology University of Massachusetts Lowell Lowell Massachusetts USA
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Scibelli J, Scibelli F, Luiselli JK, Hrdina J, Anglin K, Orchanian S. Clinical Safety and Treatment of Severe Aggression: Behavioral-Pharmacological Intervention Evaluation in a Young Adult With Autism Spectrum Disorder. Clin Case Stud 2022. [DOI: 10.1177/15346501221081254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This case study concerned clinical safety and behavioral-pharmacological intervention with an 18-year-old man who had autism spectrum disorder and high-frequency aggression toward care providers at a specialized school. A multicomponent behavior support plan included antecedent, differential reinforcement, environmental modification, and physical management procedures subsequently combined with psychotropic medication (aripiprazole). Clinical safety components emphasized comprehensive care provider training, continuous supervision, function-based treatment, and prevention-focused strategies. The behavioral-pharmacological intervention eliminated implementation of aggression-contingent physical restraint and was associated with increased transition compliance during the school day. Throughout the 7.5 months duration of the study, there were no injuries to the participant or other students and a single injury was sustained by one care provider. Intervention effects were long-standing, and care providers rated their training, implementation fidelity, and therapeutic outcome favorably.
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Bruinsma E, van den Hoofdakker BJ, Groenman AP, Hoekstra PJ, de Kuijper GM, Klaver M, de Bildt AA. Non-pharmacological interventions for challenging behaviours of adults with intellectual disabilities: A meta-analysis. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2020; 64:561-578. [PMID: 32558050 PMCID: PMC7384078 DOI: 10.1111/jir.12736] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Revised: 03/24/2020] [Accepted: 04/09/2020] [Indexed: 05/10/2023]
Abstract
BACKGROUND Non-pharmacological interventions are recommended for the treatment of challenging behaviours in individuals with intellectual disabilities by clinical guidelines. However, evidence for their effectiveness is ambiguous. The aim of the current meta-analysis is to update the existing evidence, to investigate long-term outcome, and to examine whether intervention type, delivery mode, and study design were associated with differences in effectiveness. METHOD An electronic search was conducted using the databases Medline, Eric, PsychINFO and Cinahl. Studies with experimental or quasi-experimental designs were included. We performed an overall random-effect meta-analysis and subgroup analyses. RESULTS We found a significant moderate overall effect of non-pharmacological interventions on challenging behaviours (d = 0.573, 95% CI [0.352-0.795]), and this effect appears to be longlasting. Interventions combining mindfulness and behavioural techniques showed to be more effective than other interventions. However, this result should be interpreted with care due to possible overestimation of the subgroup analysis. No differences in effectiveness were found across assessment times, delivery modes or study designs. CONCLUSIONS Non-pharmacological interventions appear to be moderately effective on the short and long term in reducing challenging behaviours in adults with intellectual disabilities.
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Affiliation(s)
- E. Bruinsma
- University of Groningen, University Medical Centre Groningen, Department of Child and Adolescent PsychiatryGroningenThe Netherlands
| | - B. J. van den Hoofdakker
- University of Groningen, University Medical Centre Groningen, Department of Child and Adolescent PsychiatryGroningenThe Netherlands
- University of GroningenDepartment of Clinical Psychology and Experimental PsychopathologyGroningenThe Netherlands
| | - A. P. Groenman
- University of Groningen, University Medical Centre Groningen, Department of Child and Adolescent PsychiatryGroningenThe Netherlands
| | - P. J. Hoekstra
- University of Groningen, University Medical Centre Groningen, Department of Child and Adolescent PsychiatryGroningenThe Netherlands
| | - G. M. de Kuijper
- University of Groningen, University Medical Centre Groningen, Department of Child and Adolescent PsychiatryGroningenThe Netherlands
- Centre for Intellectual Disability and Mental HealthAssenThe Netherlands
| | - M. Klaver
- University of Groningen, University Medical Centre Groningen, Department of Child and Adolescent PsychiatryGroningenThe Netherlands
- Centre for Intellectual Disability and Mental HealthAssenThe Netherlands
| | - A. A. de Bildt
- University of Groningen, University Medical Centre Groningen, Department of Child and Adolescent PsychiatryGroningenThe Netherlands
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Bland VJ, Cowie S, Elliffe D, Podlesnik CA. Does a negative discriminative stimulus function as a punishing consequence? J Exp Anal Behav 2018; 110:87-104. [PMID: 29926923 DOI: 10.1002/jeab.444] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Accepted: 05/09/2018] [Indexed: 11/12/2022]
Abstract
The study and use of punishment in behavioral treatments has been constrained by ethical concerns. However, there remains a need to reduce harmful behavior unable to be reduced by differential-reinforcement procedures. We investigated whether response-contingent presentation of a negative discriminative stimulus previously correlated with an absence of reinforcers would punish behavior maintained by positive reinforcers. Across four conditions, pigeons were trained to discriminate between a positive discriminative stimulus (S+) signaling the presence of food, and a negative discriminative stimulus (S-) signaling the absence of food. Once learned, every five responses on average to the S+ produced S- for a duration of 1.5 s. S+ response rate decreased for a majority of pigeons when responses produced S-, compared to when they did not, or when a neutral control stimulus was presented. In Condition 5, choice between two concurrently presented S+ alternatives shifted away from the alternative producing S-, despite a 1:1 reinforcer ratio. Therefore, presenting contingent S- stimuli punishes operant behavior maintained on simple schedules and in choice situations. Development of negative discriminative stimuli as punishers of operant behavior could provide an effective approach to behavioral treatments for problem behavior and subverting suboptimal choices involved in addictions.
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Affiliation(s)
| | | | | | - Christopher A Podlesnik
- The University of Auckland.,Florida Institute of Technology and The Scott Center for Autism Treatment
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Lydon S, Moran L, Healy O, Mulhern T, Enright Young K. A systematic review and evaluation of inhibitory stimulus control procedures as a treatment for stereotyped behavior among individuals with autism. Dev Neurorehabil 2017; 20:491-501. [PMID: 28010153 DOI: 10.1080/17518423.2016.1265604] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
PURPOSE Stereotypy is pervasive among persons with autism and may impact negatively on social inclusion and learning. The implementation of resource-intensive behavioral interventions to decrease these behaviors has been questioned. Inhibitory stimulus control procedures (ISCPs) comprise a type of antecedent-based intervention that has been proposed as an effective treatment approach for stereotypy but has received limited research attention to date. METHOD The current systematic review sought to examine and synthesize the literature reporting applications of ISCPs in the treatment of stereotypy among persons with autism. Treatment outcomes were analyzed quantitatively and the status of ISCPs as evidence-based practice was evaluated in accordance with the National Autism Center's National Standards Report guidelines. RESULTS A total of 11 studies were reviewed with results indicating that ISCPs constituted an emerging treatment for the stereotypy exhibited by persons with autism. CONCLUSIONS ISCPs comprise a promising intervention for stereotyped behavior but further research is required.
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Affiliation(s)
- Sinéad Lydon
- a Discipline of General Practice, National University of Ireland , Galway, Co. Galway , Ireland.,b School of Psychology, Trinity College Dublin , Co. Dublin , Ireland
| | - Laura Moran
- c School of Psychology, National University of Ireland , Galway, Co. Galway , Ireland
| | - Olive Healy
- b School of Psychology, Trinity College Dublin , Co. Dublin , Ireland
| | - Teresa Mulhern
- c School of Psychology, National University of Ireland , Galway, Co. Galway , Ireland
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Mulhern T, Lydon S, Healy O, Mollaghan G, Ramey D, Leoni M. A systematic review and evaluation of procedures for the induction of speech among persons with developmental disabilities. Dev Neurorehabil 2017; 20:207-227. [PMID: 27058303 DOI: 10.3109/17518423.2016.1150360] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE Deficits in vocal speech are common among those with developmental disabilities. This review examines interventions for teaching speech to individuals who presented as nonspeaking, or with low levels of vocalizations at baseline, and assesses evidence-based practice in this area. METHODS Systematic searches identified 78 studies suitable for inclusion. These studies were evaluated in terms of (a) participants, (b) intervention, (c) intervention setting, (d) intervention agent, (e) treatment efficacy, (f) generalization and maintenance of treatment effects, and (g) research rigor. RESULTS A variety of interventions, primarily behavioral, intended to induce vocal speech were delivered to participants with developmental disabilities aged between six months and 57 years. Treatment efficacy was variable (PND M = 52.9%; range 0%-100%); however, results indicated that behavioral interventions constituted evidence-based practice. Non-behavioral strategies were shown to have received insufficient research evaluation to date. CONCLUSION Results indicate that a number of procedures can induce speech among individuals with developmental disabilities.
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Affiliation(s)
- Teresa Mulhern
- a School of Psychology , National University of Ireland , Galway , Ireland
| | - Sinéad Lydon
- a School of Psychology , National University of Ireland , Galway , Ireland.,b School of Psychology , Trinity College Dublin , Dublin 2 , Ireland
| | - Olive Healy
- b School of Psychology , Trinity College Dublin , Dublin 2 , Ireland
| | - Gerard Mollaghan
- a School of Psychology , National University of Ireland , Galway , Ireland
| | - Devon Ramey
- b School of Psychology , Trinity College Dublin , Dublin 2 , Ireland
| | - Mauro Leoni
- c Disability Department , Fondazione Sospiro Onlus , CR , Italy
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Technology-Aided Interventions for Employment Skills in Adults with Autism Spectrum Disorder: A Systematic Review. REVIEW JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS 2016. [DOI: 10.1007/s40489-016-0093-x] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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A Systematic Review and Evaluation of Video Modeling, Role-Play and Computer-Based Instruction as Social Skills Interventions for Children and Adolescents with High-Functioning Autism. REVIEW JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS 2016. [DOI: 10.1007/s40489-015-0065-6] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Kurtz PF, Chin MD, Robinson AN, O'Connor JT, Hagopian LP. Functional analysis and treatment of problem behavior exhibited by children with fragile X syndrome. RESEARCH IN DEVELOPMENTAL DISABILITIES 2015; 43-44:150-166. [PMID: 26183339 DOI: 10.1016/j.ridd.2015.06.010] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/09/2014] [Revised: 06/16/2015] [Accepted: 06/25/2015] [Indexed: 06/04/2023]
Abstract
The efficacy of function-based interventions for the treatment of severe problem behavior exhibited by individuals with intellectual and developmental disabilities (IDD) is well established. However, few studies have reported on behavioral interventions in fragile X syndrome (FXS) specifically. The present study is a consecutive case-series analysis that reports on functional analysis and treatment of problem behavior of nine children with FXS. Assessment findings were consistent with previous research indicating that among individuals with FXS, problem behavior is more commonly maintained by escape from demands and access to tangible items, relative to the broader population of individuals with IDD. Functional analysis-based behavioral interventions resulted in a mean reduction in problem behavior of 95.2% across the nine participants. Additionally, generalization of treatment effects from controlled clinical settings to home, school, and community was demonstrated. The current findings suggest that function-based behavioral interventions shown to be effective with the broader population of individuals with IDD are also effective for individuals with FXS. Our results in combination with those of previous studies describing functional analysis outcomes provide additional evidence for a unique functional behavioral phenotype for severe problem behavior in individuals with FXS. Implications of study findings for early intervention and prevention of problem behavior in children with FXS are discussed.
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Affiliation(s)
- Patricia F Kurtz
- Kennedy Krieger Institute, Baltimore, MD, United States; Johns Hopkins University School of Medicine, Baltimore, MD, United States.
| | | | - Ashley N Robinson
- Kennedy Krieger Institute, Baltimore, MD, United States; Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Julia T O'Connor
- Kennedy Krieger Institute, Baltimore, MD, United States; Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Louis P Hagopian
- Kennedy Krieger Institute, Baltimore, MD, United States; Johns Hopkins University School of Medicine, Baltimore, MD, United States
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Lydon S, Healy O, Moran L, Foody C. A quantitative examination of punishment research. RESEARCH IN DEVELOPMENTAL DISABILITIES 2015; 36C:470-484. [PMID: 25462507 DOI: 10.1016/j.ridd.2014.10.036] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/22/2014] [Accepted: 10/23/2014] [Indexed: 06/04/2023]
Abstract
The current review examined 368 articles, published between 1967 and 2013, which evaluated punishment-based procedures for the treatment of challenging behavior among persons with developmental disabilities and quantitatively analyzed: (a) the amount of research that has assessed different types of punishment procedures; (b) the characteristics of the participants, behaviors, and treatments included in these studies, and (c) the relative efficacy of the various punishment procedures in general and with regard to the inclusion of reinforcement-based components, method of treatment selection and development, and function of the targeted challenging behaviors. Further, the study evaluated the included studies for the presence of important quality indicators. It was intended that such an analysis would provide a useful overview of the extant research on punishment procedures as a behavior reduction technique. Suggestions regarding research methodology and areas for further investigation are made for future research evaluating punishment-based interventions.
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Affiliation(s)
| | | | - Laura Moran
- National University of Ireland, Galway, Ireland
| | - Ciara Foody
- National University of Ireland, Galway, Ireland
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