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Bottema-Beutel K, McKinnon R, Mohiuddin S, LaPoint SC, Kim SY. Problems with "problem behavior": A secondary systematic review of intervention research on transition-age autistic youth. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2024; 28:1872-1888. [PMID: 38389134 DOI: 10.1177/13623613241229159] [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] [Indexed: 02/24/2024]
Abstract
LAY ABSTRACT In a previous study, we looked at research done on strategies to support autistic people who were between 14 and 22 years old. For this study, we looked at all of the studies in our previous study that tried to decrease or stop autistic people from doing certain things-many researchers call these things "problem behavior." There were 48 studies that tried to reduce problem behavior, and most of them used strategies like prompting and reinforcement to try get autistic people to change their behavior. We found many things wrong with these studies. Most of them did not define the group of behaviors they were trying to stop autistic people from doing. None of the studies looked at whether any side effects happened when they tried the strategy they were studying. Also, most of the studies tried to stop autistic people from doing behaviors that probably were not harmful, like stereotypic behavior. Most of the studies did not say how they decided that the behaviors they tried to stop were a problem for the autistic people in the study, and most studies did not try to figure out why the autistic people in the study did the behaviors the researchers were trying to stop them from doing.
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2
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Edelstein ML, Pogue ED, Singer HS. Development and Validation of an Assessment-Driven Behavioral Intervention for Primary Complex Motor Stereotypies in Young Children. Behav Modif 2024:1454455241255085. [PMID: 38819977 DOI: 10.1177/01454455241255085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2024]
Abstract
Complex motor stereotypies are rhythmic, repetitive, fixed, and non-goal directed movements (e.g., bilateral flapping/waving movements of the hands/arms). Movements typically begin in early childhood and can occur in otherwise normally developing ("primary") or autistic ("secondary") children. Stereotypies persist, occur multiple times a day, have prolonged durations, can be socially stigmatizing, and may lead to bullying and isolation. Prior behavioral treatment studies have focused on older children (ages 6-12) and report modest reductions in stereotypy (i.e., between 14% and 33%). The current study involves the functional assessment and treatment of five children with Primary Complex Motor Stereotypy using a modified awareness training procedure, differential reinforcement of other behavior, and schedule thinning in a nonconcurrent multiple baseline design. Results suggest a 99% reduction of motor stereotypy from baseline across all participants.
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Affiliation(s)
- Matthew L Edelstein
- Department of Behavioral Psychology, Kennedy Krieger Institute, Baltimore, MD, USA
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Emily D Pogue
- The Hospital for Sick Children, University of Toronto, Ontario, Canada
| | - Harvey S Singer
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
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3
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Muething C, Cariveau T, Bottini S, Slocum S, Williams C, Gillespie S, Scheithauer M. Descriptive characteristics of extinction bursts: A record review. J Appl Behav Anal 2024; 57:372-382. [PMID: 38226687 DOI: 10.1002/jaba.1054] [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: 10/06/2022] [Accepted: 12/10/2023] [Indexed: 01/17/2024]
Abstract
Procedural extinction is sometimes associated with a temporary increase in responding known as an extinction burst. Extinction bursts present unique challenges in the context of treating behavior targeted for reduction. The present study updates the prevalence of extinction bursts using a clinical sample (N = 108) receiving treatment for targeted behavior. The prevalence of extinction bursts in our sample (24%) was consistent with that in prior literature. The extinction-burst magnitude decreased across sessions after extinction was contacted during treatment, but this sample did not demonstrate decreased persistence or magnitude of extinction bursts across successive transitions from baseline to treatment. We also examined the prevalence and magnitude of extinction bursts based on the function and topography of targeted behavior and treatment components and found no consistent relation among these variables. These findings should lead clinicians to prepare for transient extinction bursts when implementing extinction-based treatment for challenging behavior.
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Affiliation(s)
- Colin Muething
- Marcus Autism Center, Emory University School of Medicine, Atlanta, GA, USA
| | - Tom Cariveau
- Department of Psychology, University of North Carolina Wilmington, Wilmington, NC, USA
| | - Summer Bottini
- Marcus Autism Center, Emory University School of Medicine, Atlanta, GA, USA
| | - Sarah Slocum
- Marcus Autism Center, Emory University School of Medicine, Atlanta, GA, USA
| | - Catherine Williams
- Marcus Autism Center, Emory University School of Medicine, Atlanta, GA, USA
| | - Scott Gillespie
- Marcus Autism Center, Emory University School of Medicine, Atlanta, GA, USA
| | - Mindy Scheithauer
- Marcus Autism Center, Emory University School of Medicine, Atlanta, GA, USA
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4
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Hurd AM, Brown KR, Randall KR. Stimulus Avoidance Assessment: A Systematic Literature Review. Perspect Behav Sci 2024; 47:139-166. [PMID: 38660499 PMCID: PMC11035527 DOI: 10.1007/s40614-024-00398-1] [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: 01/15/2024] [Indexed: 04/26/2024] Open
Abstract
Board certified behavior analysts are ethically required to first address destructive behavior using reinforcement-based and other less intrusive procedures before considering the use of restrictive or punishment-based procedures (ethics standard 2.15; Behavior Analyst Certification Board, 2020). However, the inclusion of punishment in reinforcement-based treatments may be warranted in some cases of severe forms of destructive behavior that poses risk of harm to the client or others. In these cases, behavior analysts are required to base the selection of treatment components on empirical assessment results (ethics standard 2.14; Behavior Analyst Certification Board, 2020). One such preintervention assessment is the stimulus avoidance assessment (SAA), which allows clinicians to identify a procedure that is likely to function as a punisher. Since the inception of this assessment approach, no studies have conducted a systematic literature review of published SAA cases. These data may be pertinent to examine the efficacy, generality, and best practices for the SAA. The current review sought to address this gap by synthesizing findings from peer-reviewed published literature including (1) the phenomenology and epidemiology of the population partaking in the SAA; (2) procedural variations of the SAA across studies (e.g., number of series, session length); (3) important quality indicators of the SAA (i.e., procedural integrity, social validity); and (4) how the SAA informed final treatment efficacy. We discuss findings in the context of the clinical use of the SAA and suggest several avenues for future research.
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Affiliation(s)
- Alyssa M. Hurd
- Department of Psychology, Utah State University, Sorenson Center for Clinical Excellence, 6405 Old Main Hill, Logan, UT 84321 USA
| | - Katherine R. Brown
- Department of Psychology, Utah State University, Sorenson Center for Clinical Excellence, 6405 Old Main Hill, Logan, UT 84321 USA
| | - Kayla R. Randall
- Department of Psychology, Georgia Southern University, Savannah, GA USA
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5
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Nuhu NN, Muething C, Gillespie SE, Mevers JL, Scheithauer M. Individualized Parent-Mediated Behavioral Treatment for Challenging Behavior: A Program Description. Behav Modif 2024; 48:111-127. [PMID: 37864323 DOI: 10.1177/01454455231201957] [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] [Indexed: 10/22/2023]
Abstract
Past research suggests behavioral treatments are effective for challenging behavior in children and young adults with neurodevelopmental disorders, such as autism spectrum disorder (ASD). However, access to these services can be limited and require substantial resources. To address this issue, the current study provides a programmatic description of an individualized parent-mediated service model targeting moderate challenging behavior. In the program, therapists coached parents to implement functional analyses and individualized function-based treatment packages. Forty-one families of children and young adults with neurodevelopmental disorders participated. Most clients (75.6%) met all admission treatment goals and parents reported significant decreases in frequency and severity of challenging behaviors at discharge. Parents also reported less stress at discharge. Outcomes of the study suggest this parent-mediated treatment model is a viable option to treating moderate challenging behavior in children and young adults with intellectual and developmental disorders.
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Affiliation(s)
- Nadrat N Nuhu
- Emory University School of Medicine, Atlanta, GA, USA
- Marcus Autism Center, Atlanta, GA, USA
- Children's Healthcare of Atlanta, GA, USA
| | - Colin Muething
- Emory University School of Medicine, Atlanta, GA, USA
- Marcus Autism Center, Atlanta, GA, USA
- Children's Healthcare of Atlanta, GA, USA
| | | | - Joanna Lomas Mevers
- Emory University School of Medicine, Atlanta, GA, USA
- Marcus Autism Center, Atlanta, GA, USA
- Children's Healthcare of Atlanta, GA, USA
| | - Mindy Scheithauer
- Emory University School of Medicine, Atlanta, GA, USA
- Marcus Autism Center, Atlanta, GA, USA
- Children's Healthcare of Atlanta, GA, USA
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6
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Ju X, Liu H, Xu J, Hu B, Jin Y, Lu C. Effect of Yoga Intervention on Problem Behavior and Motor Coordination in Children with Autism. Behav Sci (Basel) 2024; 14:116. [PMID: 38392469 PMCID: PMC10886297 DOI: 10.3390/bs14020116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2023] [Revised: 01/31/2024] [Accepted: 02/01/2024] [Indexed: 02/24/2024] Open
Abstract
Children with autism exhibit more pronounced symptoms of both problem behaviors and motor coordination difficulties. Yoga, recognized as an effective intervention modality, can be valuable after assessing its efficacy in addressing problem behaviors and motor coordination challenges, ultimately contributing to symptom alleviation in autism. The randomized controlled trial (RCT) was used to divide 17 children with autism into an intervention group (n = 9) and a control group (n = 8). The intervention group participated in an 8-week yoga intervention training (three sessions/week, 45-50 min/session), and the control group did not participate in yoga training but only in daily program activities. Pre-test, mid-test, post-test, and after delayed test, teachers assessed the effect of yoga intervention on problem behaviors of children with autism through the Aberrant Behavior Checklist (ABC) and the effect of yoga intervention on motor coordination through the Movement Assessment Battery for Children-Second Edition (MABC2). Results show that the yoga intervention is effective in reducing problem behaviors and improving motor coordination in children with autism. Yoga intervention significantly reduces irritability and social withdrawal in children with autism. Yoga intervention had the most significant improvement in ball skills and static and dynamic balance.
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Affiliation(s)
- Xingda Ju
- School of Psychology, Northeast Normal University, Changchun 130000, China
- Jilin Provincial Key Laboratory of Cognitive Neuroscience and Brain Development, Changchun 130000, China
| | - Huanhuan Liu
- School of Psychology, Northeast Normal University, Changchun 130000, China
| | - Jing Xu
- School of Life Sciences, Northeast Normal University, Changchun 130000, China
| | - Bo Hu
- School of Psychology, Northeast Normal University, Changchun 130000, China
| | - Yunlei Jin
- Children's Hospital of Changchun, Changchun 130000, China
| | - Chang Lu
- School of Psychology, Northeast Normal University, Changchun 130000, China
- Jilin Provincial Key Laboratory of Cognitive Neuroscience and Brain Development, Changchun 130000, China
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7
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Friedel JE, Cox AD, Davis S. Further Progress Toward Automating Functional Analysis Interpretation. Behav Modif 2024; 48:75-106. [PMID: 37688442 DOI: 10.1177/01454455231195825] [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] [Indexed: 09/10/2023]
Abstract
It is considered best practice to conduct a functional analysis and visually inspect data collected to determine the function of problem behavior, which then informs the intervention approaches applied. Visual inspection has been described as a "subjective" process that may be affected by factors unrelated to the data. Structured decision-making guidelines have been established to address some of these shortcomings. The current paper is a follow-up to earlier work describing positive outcomes related to the viability of a decision support system based on structured criteria from Roane et al. Here, we demonstrate important improvements in a computer script's interpretation of functional analysis data, including improvement in agreement between the updated computer script version and experienced human raters (89%) compared to our original agreement outcomes (81%). This paper further supports the use of decision support systems for functional analysis interpretation.
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Affiliation(s)
| | | | - Sarah Davis
- Brock University, St. Catharines, ON, Canada
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8
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Thomas BR, Ludwig NN, Falligant JM, Kurtz PF, Smith-Hicks C. Severe behavior problems in SYNGAP1-related disorder: A summary of 11 consecutive patients in a tertiary care specialty clinic. Epilepsy Behav 2024; 150:109584. [PMID: 38096660 DOI: 10.1016/j.yebeh.2023.109584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 11/24/2023] [Accepted: 12/05/2023] [Indexed: 01/14/2024]
Abstract
SYNGAP1-related disorder (SYNGAP1-RD) is a neurodevelopmental disorder that is commonly associated with epilepsy, autism spectrum disorder (ASD), and disruptive behaviors. In this study, behavior problems in 11 consecutive patients with SYNGAP1-RD are described and quantified based on a behavioral screening conducted within the context of a multi-disciplinary tertiary care specialty clinic visit. The behavioral phenotype was then compared to published samples of behavior problems in ASD and other genetic cause of epilepsy occurring in the context of neurodevelopmental disorders using results from the Aberrant Behavior Checklist-Community (ABC-C), an empirically derived outcome measure. We report common antecedent and consequent events surrounding problem behavior across individuals. Additionally, we report on the management approach of caregivers and the impact of problem behaviors on the family. Our results suggest a number of commonalities between behavioral profiles in SYNGAP1-RD with ASD and other genetic causes of developmental and epileptic encephalopathies, and also highlight severe behavior problems as a specific behavioral phenotype of SYNGAP1-RD.
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Affiliation(s)
- Benjamin R Thomas
- Kennedy Krieger Institute, 707 N Broadway, Baltimore, MD 21205, USA.
| | - Natasha N Ludwig
- Kennedy Krieger Institute, 707 N Broadway, Baltimore, MD 21205, USA; Johns Hopkins University School of Medicine, USA
| | - John Michael Falligant
- Kennedy Krieger Institute, 707 N Broadway, Baltimore, MD 21205, USA; Johns Hopkins University School of Medicine, USA
| | - Patricia F Kurtz
- Kennedy Krieger Institute, 707 N Broadway, Baltimore, MD 21205, USA; Johns Hopkins University School of Medicine, USA
| | - Constance Smith-Hicks
- Kennedy Krieger Institute, 707 N Broadway, Baltimore, MD 21205, USA; Johns Hopkins University School of Medicine, USA
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Call NA, Bernstein AM, O’Brien MJ, Schieltz KM, Tsami L, Lerman DC, Berg WK, Lindgren SD, Connelly MA, Wacker DP. A comparative effectiveness trial of functional behavioral assessment methods. J Appl Behav Anal 2024; 57:166-183. [PMID: 38049887 PMCID: PMC10843530 DOI: 10.1002/jaba.1045] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 11/03/2023] [Indexed: 12/06/2023]
Abstract
Clinicians report primarily using functional behavioral assessment (FBA) methods that do not include functional analyses. However, studies examining the correspondence between functional analyses and other types of FBAs have produced inconsistent results. In addition, although functional analyses are considered the gold standard, their contribution toward successful treatment compared with other FBA methods remains unclear. This comparative effectiveness study, conducted with 57 young children with autism spectrum disorder, evaluated the results of FBAs that did (n = 26) and did not (n = 31) include a functional analysis. Results of FBAs with and without functional analyses showed modest correspondence. All participants who completed functional communication training achieved successful outcomes regardless of the type of FBA conducted.
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Affiliation(s)
- Nathan A. Call
- Marcus Autism Center, Atlanta, Georgia, USA
- Children’s Healthcare of Atlanta, Atlanta, Georgia, USA
- Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Alec M. Bernstein
- Department of Pediatrics, Children’s Mercy Hospital, Kansas City, Missouri, USA
- Department of Pediatrics, University of Missouri-Kansas City School of Medicine, Kansas City, Missouri, USA
| | - Matthew J. O’Brien
- Stead Family Department of Pediatrics, University of Iowa College of Medicine, Iowa City, Iowa, USA
| | - Kelly M. Schieltz
- Stead Family Department of Pediatrics, University of Iowa College of Medicine, Iowa City, Iowa, USA
| | - Loukia Tsami
- Center for Autism and Developmental Disabilities, University of Houston-Clear Lake, Houston, Texas, USA
| | - Dorothea C. Lerman
- Center for Autism and Developmental Disabilities, University of Houston-Clear Lake, Houston, Texas, USA
| | - Wendy K. Berg
- Stead Family Department of Pediatrics, University of Iowa College of Medicine, Iowa City, Iowa, USA
| | - Scott D. Lindgren
- Stead Family Department of Pediatrics, University of Iowa College of Medicine, Iowa City, Iowa, USA
| | - Mark A. Connelly
- Department of Pediatrics, Children’s Mercy Hospital, Kansas City, Missouri, USA
- Department of Pediatrics, University of Missouri-Kansas City School of Medicine, Kansas City, Missouri, USA
| | - David P. Wacker
- Stead Family Department of Pediatrics, University of Iowa College of Medicine, Iowa City, Iowa, USA
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10
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Fisher WW, Greer BD, Mitteer DR. Additional Comments on the Use of Contingent Electric Skin Shock. Perspect Behav Sci 2023; 46:339-348. [PMID: 37425986 PMCID: PMC10323055 DOI: 10.1007/s40614-023-00382-1] [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: 05/09/2023] [Indexed: 07/11/2023] Open
Abstract
Prior to the ABAI member vote to decide between two alternative position statements on contingent electric skin shock (CESS), the current authors helped draft a consensus statement supporting the abolition of CESS. In this commentary, we provide additional, supporting information for that consensus statement by (1) showing that the extant literature does not support the supposition that CESS is more efficacious than less-intrusive interventions; (2) providing data showing that implementing interventions that are less intrusive than CESS does not lead to overreliance on the use of physical or mechanical restraint to control destructive behavior; and (3) discussing the ethical and public relations issues that arise when behavior analysts use painful skin shock to reduce destructive behavior in persons with autism or intellectual disability.
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Affiliation(s)
- Wayne W. Fisher
- Children’s Specialized Hospital, Rutgers University Center for Autism Research, Education, and Services (CSH–RUCARES), 888 Easton Avenue, Somerset, NJ 08873 USA
- Department of Pediatrics, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ USA
- Rutgers Brain Health Institute, Piscataway, NJ USA
| | - Brian D. Greer
- Children’s Specialized Hospital, Rutgers University Center for Autism Research, Education, and Services (CSH–RUCARES), 888 Easton Avenue, Somerset, NJ 08873 USA
- Department of Pediatrics, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ USA
- Rutgers Brain Health Institute, Piscataway, NJ USA
| | - Daniel R. Mitteer
- Children’s Specialized Hospital, Rutgers University Center for Autism Research, Education, and Services (CSH–RUCARES), 888 Easton Avenue, Somerset, NJ 08873 USA
- Department of Pediatrics, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ USA
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Como DH, Goodfellow M, Hudak D, Cermak SA. "A scoping review: Social stories supporting behavior change for individuals with Autism". JOURNAL OF OCCUPATIONAL THERAPY, SCHOOLS & EARLY INTERVENTION 2023; 17:154-175. [PMID: 39050966 PMCID: PMC11263915 DOI: 10.1080/19411243.2023.2168824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 01/11/2023] [Indexed: 01/28/2023]
Abstract
Social Stories (also known as social narratives) help individuals participate in and understand social situations. This scoping review identifies and synthesizes social narrative research targeting behavior change in individuals with ASD. Using the following questions as a guide: (a) What is the scope of social narrative interventions used for individuals with ASD, (b) What behavior change outcome measures are evaluated, and (c) What research designs are used; five databases were searched from 2007-to-2018. Fifty-six articles met the criteria. Primary outcomes were sorted into two macro-categories: Reduce Disruptive Behaviors and Increase Desired Behaviors. Most, but not all, studies were found to be effective for various behaviors such as aggressive actions, verbal protests, identifying emotions, executive functioning, following directions, and responding in social situations. Social narratives can be used to promote skills/behaviors in individuals with ASD to enable participation, an important goal in occupational therapy practice. They are an accessible and feasible intervention that can be implemented in various settings for behaviors including activities of daily living, social skills, independence, and self-regulation. Most research reviewed the single subject design, which is a limitation of the research as it makes results difficult to generalize. However, through replication, functional relationships can be determined. Additional research utilizing randomized control trials is recommended.
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Affiliation(s)
- Dominique H Como
- University of Southern California, Mrs. T.H. Chan Division of Occupational Science and Occupational Therapy
| | - Margaret Goodfellow
- University of Southern California, Mrs. T.H. Chan Division of Occupational Science and Occupational Therapy
| | - Delaney Hudak
- University of Southern California, Mrs. T.H. Chan Division of Occupational Science and Occupational Therapy
| | - Sharon A Cermak
- University of Southern California, Mrs. T.H. Chan Division of Occupational Science and Occupational Therapy
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12
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Edelstein ML, Sullivan A, Becraft JL. Feasibility and Acceptability of a Compressed Caregiver Training Program to Treat Child Behavior Problems. Behav Modif 2022; 47:752-776. [PMID: 36384311 DOI: 10.1177/01454455221137329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
In an effort to address some of the criticisms of Behavioral Parent Training programs (BPT; high attrition, reliance on caregiver report measures), the current study examined the feasibility, acceptability, and outcome of an intensive behavior treatment program (120-minute sessions for 5 days/week over the course of 2 weeks). Using a changing criterion single case experimental design, 12 children ( M child age = 4.9 years) and their primary caregivers completed the 2-week function-based intervention procedure designed to increase children’s frustration tolerance via a wait training procedure based on the principles of applied behavior analysis. Using both direct observation and standardized measures, results indicated that the treatment was effective in reducing childhood behavior problems, both within and between appointments (Cohen’s ds = 3.2 and 1.37, respectively). Preliminary evidence suggests that a compressed treatment package designed to train caregivers in function-based intervention strategies is feasible and acceptable.
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Affiliation(s)
- Matthew L. Edelstein
- Kennedy Krieger Institute and Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Alicia Sullivan
- Kennedy Krieger Institute and Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Jessica L. Becraft
- Kennedy Krieger Institute and Johns Hopkins University School of Medicine, Baltimore, MD, USA
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MacNaul H, Wimberley J, Labay A, Neely L, Novotny M, Morgan B. Effects of an Adapted Telehealth Training Curriculum for Registered Behavior Technicians®. ADVANCES IN NEURODEVELOPMENTAL DISORDERS 2022; 7:1-12. [PMID: 36160310 PMCID: PMC9483257 DOI: 10.1007/s41252-022-00285-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 09/07/2022] [Indexed: 06/16/2023]
Abstract
Objectives We evaluated a telehealth training curriculum to prepare Registered Behavior Technicians® (RBTs®) to conduct caregiver coaching on behavior analytic skills via telehealth. Methods A non-concurrent multiple baseline across therapists design was used to evaluate the training procedures delivered by Board Certified Behavior Analysts® (BCBAs®). All therapists (RBTs) worked with one family during the baseline and training phases and an additional session was conducted with a different family during the novelty probe condition to see if therapists were able to perform the newly acquired skills without BCBA support. Results Seven therapists who received behavioral skills training on the curriculum reached mastery criteria within three sessions. All RBTs were able to provide caregiver coaching via telehealth with high degrees of fidelity and were able to independently conduct a telehealth session with a new family without support from the BCBA. Conclusions Results of the current study provide support for the use of the telehealth training curriculum to prepare RBTs to conduct ABA services via telehealth.
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Affiliation(s)
- Hannah MacNaul
- Department of Educational Psychology, University of Texas at San Antonio, San Antonio, TX USA
| | | | | | - Leslie Neely
- Department of Educational Psychology, University of Texas at San Antonio, San Antonio, TX USA
| | - Marissa Novotny
- Department of Educational Psychology, University of Texas at San Antonio, San Antonio, TX USA
- Autism Treatment Center, San Antonio, TX USA
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Quail KR, Ward CL. Nonviolent Discipline Options for Caregivers and Teachers: A Systematic Overview of the Evidence. TRAUMA, VIOLENCE & ABUSE 2022; 23:620-638. [PMID: 33111651 DOI: 10.1177/1524838020967340] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Violence against children is a widespread problem with devastating consequences, and corporal punishment is a risk factor for more serious forms of physical abuse. One reason for the persistence of corporal punishment may be the lack of awareness of positive disciplinary alternatives. Nonviolent options offered to caregivers and teachers must be effective in addressing challenging behavior, or they may be rejected in favor of a return to physical punishment. There is an urgent need to determine which discipline options are evidence-supported and what that evidence says so that robust alternatives to corporal punishment can be made available. The primary objective of this research was to find, and explore the state of the science on, individual nonviolent interventions for challenging behavior, in so doing forming a "tool kit" for use by caregivers and teachers. A systematic overview of systematic reviews was conducted. Included systematic reviews were peer-reviewed and published in English between 1999 and 2018. Screening, quality assessment using AMSTAR, and data extraction were performed independently by two reviewers. A total of 223 reviews were included, covering data from 3,921 primary studies. A wide range of evidence-supported interventions exist, many of which have been found effective with severely challenging behavior. Important positive outcomes shown suggest that the use of these tools should be promoted not only for the prevention of violence but also for optimum child development. More research is needed on the use of these methods in home situations and on de-escalation skills.
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Affiliation(s)
- Karen R Quail
- Department of Psychology, University of Cape Town, South Africa
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15
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Busch L, Saini V, Karim S, Jones R. Evaluation and Maintenance of Behavioral Interventions for 22q11.2 Deletion Syndrome. Dev Neurorehabil 2022; 25:170-177. [PMID: 34340650 DOI: 10.1080/17518423.2021.1960919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
22q11.2-deletion syndrome is a genetic disorder caused by a small deletion of chromosome 22. This deletion often results in developmental delays, learning disabilities, medical conditions, and comorbid psychiatric conditions. Patients with 22q11.2DS may present with a variety of behavioral phenotypes including obsessiveness and rigidity, poor social skills, and anxiety. In some cases, the phenotype can consist of destructive and inappropriate behavior including harming self and others. Behavioral difficulties are reported as one of the most challenging aspects of 22q11.2-deletion syndrome for families of patients, however, few studies have examined behavioral interventions as a possible therapeutic treatment for this population. Using principles derived from operant-behavioral psychology, we conducted functional assessments to determine the environmental correlates of destructive and inappropriate behaviors in two adult men with 22q11.2-deletion syndrome. Subsequently, behavioral interventions based on differential reinforcement were incorporated into each participant's natural environment to eliminate these behaviors. Significant reductions in destructive and inappropriate behavior were observed with both participants and therapeutic gains were maintained at follow-up. We discuss the role of behavioral interventions in combination with appropriate psychotropic medication when addressing challenging behaviors in this population.
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Affiliation(s)
- Louis Busch
- Centre for Addiction and Mental Health, Toronto, Canada
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16
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Development and Implementation of a Function-Based Clinical Interview to Evaluate Childhood Behavior Problems. COGNITIVE AND BEHAVIORAL PRACTICE 2022. [DOI: 10.1016/j.cbpra.2022.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Lakatošová S, Janšáková K, Babková J, Repiská G, Belica I, Vidošovičová M, Ostatníková D. The Relationship of Steroid Hormones, Genes Related to Testosterone Metabolism and Behavior in Boys With Autism in Slovakia. Psychiatry Investig 2022; 19:73-84. [PMID: 35042285 PMCID: PMC8898604 DOI: 10.30773/pi.2021.0094] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Accepted: 07/27/2021] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE Purpose of the study was to identify the relationship among actual plasmatic levels of steroid hormones and behavioral manifestations in boys with autism and to assess the genetic contribution to these manifestations. METHODS 172 boys with autism under 10 years of age and 135 neurotypical boys attended the study. ADI-R and ADOS-2 were used to evaluate the core symptom severities. Problem behavior was assessed using BPI-01 questionnaire. Levels of testosterone, estradiol, dehydroepiandrosterone, dehydroepiandrosterone-sulfate and sex hormone binding globulin (SHBG) were measured in plasma of autistic boys. Three SNPs (in ESR1, SHBG, SRD5A2 genes) and one STR in AR gene (number of CAG repeats in first exon) were assessed. Hormonal levels and number of CAG repeats in AR gene were used for correlation analysis with behavioral measures. Genotype and allelic frequencies were compared among autistic and neurotypical boys. RESULTS We found negative relationship among SHBG levels and restricted, repetitive behaviors (measured by ADOS-2) and positive relationship among actual testosterone levels and frequency of stereotyped behavior (measured by BPI-01). CONCLUSION Actual levels of SHBG and testosterone are related to severities of restricted and repetitive behaviors in boys with autism. Mechanisms of action of these hormones in brain require further investigation.
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Affiliation(s)
- Silvia Lakatošová
- Comenius University in Bratislava Faculty of Medicine, Institute of Physiology, Bratislava, Slovakia
| | - Katarína Janšáková
- Comenius University in Bratislava Faculty of Medicine, Institute of Physiology, Bratislava, Slovakia
| | - Jaroslava Babková
- Comenius University in Bratislava Faculty of Medicine, Institute of Physiology, Bratislava, Slovakia
| | - Gabriela Repiská
- Comenius University in Bratislava Faculty of Medicine, Institute of Physiology, Bratislava, Slovakia
| | - Ivan Belica
- Comenius University in Bratislava Faculty of Medicine, Institute of Physiology, Bratislava, Slovakia
| | - Mária Vidošovičová
- Comenius University in Bratislava Faculty of Medicine, Institute of Physiology, Bratislava, Slovakia
| | - Daniela Ostatníková
- Comenius University in Bratislava Faculty of Medicine, Institute of Physiology, Bratislava, Slovakia
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18
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Cengher M, O'Connor JT, Strohmeier CW. Assessment and treatment of problem behavior maintained by escape from attention. BEHAVIORAL INTERVENTIONS 2021. [DOI: 10.1002/bin.1838] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Mirela Cengher
- Department of Psychology University of Maryland, Baltimore County Baltimore Maryland USA
| | - Julia T. O'Connor
- Kennedy Krieger Institute and Johns Hopkins University School of Medicine Baltimore Maryland USA
| | - Craig W. Strohmeier
- Kennedy Krieger Institute and Johns Hopkins University School of Medicine Baltimore Maryland USA
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Salvatore GL, Simmons CA, Tremoulet PD. Physician Perspectives on Severe Behavior and Restraint Use in a Hospital Setting for Patients with Autism Spectrum Disorder. J Autism Dev Disord 2021; 52:4412-4425. [PMID: 34657221 PMCID: PMC8520455 DOI: 10.1007/s10803-021-05327-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/07/2021] [Indexed: 12/28/2022]
Abstract
Hospitals, with many features that can evoke severe behavior in patients with autism spectrum disorder (ASD), often use restraint as a behavior management strategy. Prior research on restraint in patients with ASD has primarily focused on children or specific departments. Twenty-five physicians and medical trainees from an urban teaching hospital participated in discussions about experiences managing severe behavior in patients with ASD across the lifespan. Twenty themes emerged from thematic analysis of participant transcripts. The five most salient themes included: lack of procedural knowledge with restraint implemented by other hospital professionals; alternative strategies to manage severe behavior; negative perceptions of restraint; helpful role of caregivers; and limited experience treating patients with ASD, and critical need for training in function-based management.
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Affiliation(s)
- Giovanna L. Salvatore
- Department of Psychology, Rowan University, 201 Mullica Hill Road, Robinson Hall Suite 117, Glassboro, NJ 08028 USA
| | - Christina A. Simmons
- Department of Psychology, Rowan University, 201 Mullica Hill Road, Robinson Hall Suite 117, Glassboro, NJ 08028 USA
| | - Patrice D. Tremoulet
- Department of Psychology, Rowan University, 201 Mullica Hill Road, Robinson Hall Suite 117, Glassboro, NJ 08028 USA
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20
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Gardner-Hoag J, Novack M, Parlett-Pelleriti C, Stevens E, Dixon D, Linstead E. Unsupervised Machine Learning for Identifying Challenging Behavior Profiles to Explore Cluster-Based Treatment Efficacy in Children With Autism Spectrum Disorder: Retrospective Data Analysis Study. JMIR Med Inform 2021; 9:e27793. [PMID: 34076577 PMCID: PMC8209527 DOI: 10.2196/27793] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Revised: 04/23/2021] [Accepted: 04/29/2021] [Indexed: 11/13/2022] Open
Abstract
Background Challenging behaviors are prevalent among individuals with autism spectrum disorder; however, research exploring the impact of challenging behaviors on treatment response is lacking. Objective The purpose of this study was to identify types of autism spectrum disorder based on engagement in different challenging behaviors and evaluate differences in treatment response between groups. Methods Retrospective data on challenging behaviors and treatment progress for 854 children with autism spectrum disorder were analyzed. Participants were clustered based on 8 observed challenging behaviors using k means, and multiple linear regression was performed to test interactions between skill mastery and treatment hours, cluster assignment, and gender. Results Seven clusters were identified, which demonstrated a single dominant challenging behavior. For some clusters, significant differences in treatment response were found. Specifically, a cluster characterized by low levels of stereotypy was found to have significantly higher levels of skill mastery than clusters characterized by self-injurious behavior and aggression (P<.003). Conclusions These findings have implications on the treatment of individuals with autism spectrum disorder. Self-injurious behavior and aggression were prevalent among participants with the worst treatment response, thus interventions targeting these challenging behaviors may be worth prioritizing. Furthermore, the use of unsupervised machine learning models to identify types of autism spectrum disorder shows promise.
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Affiliation(s)
- Julie Gardner-Hoag
- Schmid College of Science and Technology, Chapman University, Orange, CA, United States
| | - Marlena Novack
- Center for Autism and Related Disorders, Woodland Hills, CA, United States
| | | | - Elizabeth Stevens
- Fowler School of Engineering, Chapman University, Orange, CA, United States
| | - Dennis Dixon
- Center for Autism and Related Disorders, Woodland Hills, CA, United States
| | - Erik Linstead
- Fowler School of Engineering, Chapman University, Orange, CA, United States
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21
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Dallman AR, Artis J, Watson L, Wright S. Systematic Review of Disparities and Differences in the Access and Use of Allied Health Services Amongst Children with Autism Spectrum Disorders. J Autism Dev Disord 2021; 51:1316-1330. [PMID: 32683545 DOI: 10.1007/s10803-020-04608-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Individuals with autism spectrum disorder (ASD) often benefit from allied health services such as occupational therapy, speech and language pathology, and applied behavioral analysis. While there is consistent evidence of disparities in access and use of medical services (e.g. dentistry), no such systematic review has examined disparities and differences in allied health use amongst children with ASD. In this systematic review, we examine disparities and differences in service access and use for children with ASD. Our findings suggest that children who are older, have less severe ASD symptoms, are from minority groups, and those from particular geographic regions are less likely to receive allied health services. Limitations and future directions are discussed.
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Affiliation(s)
- Aaron R Dallman
- Department of Allied Health Sciences, University of North Carolina at Chapel Hill, 200 N. Greensboro St., D-12, Carrboro, NC, 27510, USA.
| | - Jonet Artis
- Department of Allied Health Sciences, University of North Carolina at Chapel Hill, 200 N. Greensboro St., D-12, Carrboro, NC, 27510, USA
| | - Linda Watson
- Department of Allied Health Sciences, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Sarah Wright
- Health Sciences Library, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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22
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van Deurs JR, McLay LK, France KG, Blampied NM. Sequential Implementation of Functional Behavior Assessment-Informed Treatment Components for Sleep Disturbance in Autism: A Case Study. Behav Sleep Med 2021; 19:333-351. [PMID: 32397846 DOI: 10.1080/15402002.2020.1758701] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Background: Sleep disturbances are a significant problem for people with autism spectrum disorder (ASD). Existing research supports the use of parent-implemented, functional behavior assessment (FBA)-informed interventions for sleep problems in children with ASD. There is also emerging evidence for combined parent- and young person-implemented behavioral sleep interventions for older children and adolescents with ASD. However, the active treatment components of such interventions have not been identified in previous studies, as components have not been evaluated independently of one another.Methods: The current study sequentially implemented FBA-informed treatment components (in the order of least to most restrictive and time intensive) within a single-case AB design, to evaluate at which point treatment resulted in a statistically and clinically substantive reduction in target sleep variables. Combined parent- and young person-implemented intervention components consisted of: (a) white noise; (b) white noise and relaxation instruction; and (c) white noise, relaxation instruction, and stimulus control.Participant: The participant was a 9-year-old girl with autism and selective mutism.Results: The combined use of white noise, relaxation instruction, and stimulus control resolved the participant's sleep problems. Other more restrictive and/or time intensive interventions were unnecessary. Treatment effects were maintained at 10-week follow-up.Conclusions: The current study illustrates the feasibility of administering FBA-informed treatment components sequentially, to ensure application of minimally sufficient interventions.
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Affiliation(s)
- Jenna R van Deurs
- College of Education, Health and Human Development, University of Canterbury, Christchurch, New Zealand
| | - Laurie K McLay
- College of Education, Health and Human Development, University of Canterbury, Christchurch, New Zealand
| | - Karyn G France
- College of Education, Health and Human Development, University of Canterbury, Christchurch, New Zealand
| | - Neville M Blampied
- School of Psychology, Speech and Hearing, University of Canterbury, Christchurch, New Zealand
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Jessel J, Rosenthal D, Hanley GP, Rymill L, Boucher MB, Howard M, Perrin J, Lemos FM. On the Occurrence of Dangerous Problem Behavior during Functional Analysis: An Evaluation of 30 Applications. Behav Modif 2021; 46:834-862. [PMID: 33890495 DOI: 10.1177/01454455211010698] [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: 11/17/2022]
Abstract
Functional analyses are often conducted by behavior analysts to understand the environmental variables contributing to an individual's problem behavior to better inform treatment implementation. While functional analyses are integral for designing function-based interventions, they often arrange contingencies to evoke and reinforce dangerous problem behavior. In Study 1 we reviewed 22 functional analyses with open-contingency classes including non-dangerous topographies of problem behavior and we found that participants were more likely to exhibit the non-dangerous behavior in 82% of the applications. We then conducted a single-subject comparison of closed and open-contingency classes with four additional participants in Study 2. Our results suggest that the functional analyses with the open-contingency class reduced the likelihood of observing dangerous problem behavior.
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Affiliation(s)
- Joshua Jessel
- Queens College of the City University of New York, NY, USA
| | | | | | | | | | | | - Jesse Perrin
- Pathways Strategic Teaching Center, Warwick, RI, USA
| | - Felipe M Lemos
- Federal University of São Carlos (UFSCar), Sao Carlos, Brazil
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24
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Avery SK, Akers JS. The Use of Demand Assessments: A Brief Review and Practical Guide. Behav Anal Pract 2021; 14:410-421. [PMID: 34150456 DOI: 10.1007/s40617-020-00542-8] [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: 12/09/2020] [Indexed: 11/29/2022] Open
Abstract
It is important for practitioners to first conduct an indirect demand assessment to identify appropriate stimuli to include during the direct demand assessment. Information obtained from an indirect demand assessment is useful not only for identifying which demands to evaluate during the direct assessment but also for selecting stimuli associated with each demand. Conducting an indirect demand assessment with caregivers provides practitioners the opportunity to identify whether specific demand stimuli are associated with more challenging behavior (e.g., writing with a pen vs. a pencil) and whether demand presentation may be an establishing operation for challenging behavior (e.g., presenting one math problem at a time vs. presenting an entire math worksheet). The purpose of this article is to review the current literature on demand assessment procedures and to provide practitioners with a practical guide for conducting demand assessments in clinical settings. We provide a summary of our findings along with a brief description of the procedures used for implementing the indirect and direct demand assessments. Further, we created a decision-making guide to help practitioners select which type of demand assessment to conduct with their clients.
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Affiliation(s)
- Suzannah K Avery
- Department of Educational Psychology, Baylor University, Waco, TX USA
| | - Jessica S Akers
- Department of Educational Psychology, Baylor University, Waco, TX USA
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25
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Brown K. The Use of Isolated and Synthesized Latency Functional Analyses in the Assessment and Treatment of Clothing Removal Exhibited by a Child with Autism. Clin Case Stud 2020. [DOI: 10.1177/1534650120974448] [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: 11/16/2022]
Abstract
The case of a 9-year-old male with autism spectrum disorder (ASD) who presented with problem behavior in the form of high-frequency clothing removal is reported. Descriptive data indicated the behavior occurred when tasks were presented and commonly delayed task demands and resulted in staff attention. Two latency functional analyses with isolated and synthesized contingencies were completed to clarify the operant function of the behavior. Initial results of the synthesized analysis indicated clothing removal was sensitive to attention and escape. However, a subsequent functional analysis with isolated contingencies indicated that the behavior was maintained only by attention. A function-based intervention package consisting of attention extinction, response blocking, and differential reinforcement of other behavior (DRO) effectively reduced the frequency of clothing removal to near-zero levels. Results of the intervention were partially generalized to a new therapist. The use of latency functional analyses as a means to rapidly examine isolated and synthesized contingencies maintaining problem behavior is discussed as well as the effects of the treatment package on the behavior of clothing removal.
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26
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Craig AR, Sullivan WE, Roane HS. Further evaluation of a nonsequential approach to studying operant renewal. J Exp Anal Behav 2020; 112:210-223. [PMID: 31589339 DOI: 10.1002/jeab.546] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Revised: 06/24/2019] [Accepted: 08/25/2019] [Indexed: 12/19/2022]
Abstract
Basic-laboratory assessments of renewal may inform clinical efforts to maintain reduction of severe destructive behavior when clients transition between contexts. The contextual changes arranged during standard renewal procedures, however, do not necessarily align with those that clients experience during outpatient therapy. More specifically, clients transition between clinical (associated with extinction for target behavior) and home/community (associated with reinforcement for target behavior) contexts during outpatient treatment. Standard renewal assessments do not incorporate these contextual alternations during treatment. The present experiment aimed to directly compare renewal of rats' lever pressing following a standard ("sequential") ABA renewal procedure (i.e., baseline in Context A, extinction in Context B, renewal test in Context A) and a "nonsequential" renewal assessment wherein treatment consisted of daily alternation between Context A (associated with reinforcement for lever pressing) and Context B (associated with extinction). Lever pressing renewed to a greater extent for rats in the Nonsequential group than for rats in the Sequential group, suggesting the contextual changes that clients experience during outpatient treatment for severe destructive behavior may be a variable that is important to consider in translational research on renewal. Potential implications of these findings for basic and clinical research on renewal are discussed.
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27
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Collateral Effects of Behavioral Treatment for Problem Behavior on Caregiver Stress. J Autism Dev Disord 2020; 51:2852-2865. [PMID: 33104925 DOI: 10.1007/s10803-020-04694-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
When individuals with autism and intellectual and developmental disabilities exhibit severe problem behavior, assessment and treatment are often warranted. Parents of such individuals are at high risk for developing parenting stress. In this study, 194 parents completed the Parenting Stress Index-Short Form at their child's time of admission to and discharge from inpatient or outpatient treatment for severe problem behavior. Parent stress was examined in relation to rate and function of child problem behavior as determined via functional analysis. Repeated measures analyses of variance were conducted, and differential effects were observed when child participants exhibited an attention, automatic, or mands function for problem behavior. These findings highlight the importance of considering function of problem behavior in relation to parenting stress.
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28
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Cho Blair K, Park E, Kim W. A meta‐analysis of Tier 2 interventions implemented within School‐Wide Positive Behavioral Interventions and Supports. PSYCHOLOGY IN THE SCHOOLS 2020. [DOI: 10.1002/pits.22443] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Kwang‐Sun Cho Blair
- Department of Child and Family Studies, College of Behavioral and Community Sciences University of South Florida Tampa Florida USA
| | - Eun‐Young Park
- Department of Secondary Special Education, College of Education Jeonju University Jeonju South Korea
| | - Won‐Ho Kim
- Department of Physical Therapy Ulsan College Ulsan South Korea
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29
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Crockett JL, Becraft JL, Phillips ST, Wakeman M, Cataldo MF. Rapid Conversion from Clinic to Telehealth Behavioral Services During the COVID-19 Pandemic. Behav Anal Pract 2020; 13:725-735. [PMID: 33082924 PMCID: PMC7561238 DOI: 10.1007/s40617-020-00499-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/04/2020] [Indexed: 11/24/2022] Open
Abstract
Survival often depends on behavior that can adapt to rapid changes in contingencies, which should be particularly well suited to a contingency-sensitive and data-based discipline such as applied behavior analysis (ABA). The speed and scale with which contingencies shifted in early March 2020 due to the effects of COVID-19 represent a textbook case for rapid adaptation with a direct impact on the survival of many types of enterprises. We describe here the impact, changes, and outcomes achieved by a large, multifaceted ABA clinical program that has (a) ongoing data that forecasted and tracked changes, (b) staff well practiced with data-based shifts in operations (behavior), and (c) up-to-date information (data) on policy and regulations. The results showed rapid shifts in client and staff behavior on a daily basis, shifts in services from in-person services to telehealth, and increases in volumes, revenue, and margins. We detail regulations and provide actionable steps that clinical organizations can take pertinent to this shift now and in the future. The challenges of the COVID-19 pandemic underscore the importance of maintaining robust coordination and communication across our field in order to address crises that affect our field.
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Affiliation(s)
- Jennifer L Crockett
- Kennedy Krieger Institute, Baltimore, MD USA.,Johns Hopkins University School of Medicine, Baltimore, MD USA
| | - Jessica L Becraft
- Kennedy Krieger Institute, Baltimore, MD USA.,Johns Hopkins University School of Medicine, Baltimore, MD USA
| | | | | | - Michael F Cataldo
- Kennedy Krieger Institute, Baltimore, MD USA.,Johns Hopkins University School of Medicine, Baltimore, MD USA.,Department of Behavioral Psychology, Kennedy Krieger Institute, 707 N. Broadway, Suite 200L, Baltimore, MD 21205 USA
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30
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Strohmeier CW, Schmidt JD, Furlow CM. Family Accommodation and Severe Problem Behavior: Considering Family-Based Interventions to Expand Function-Based Treatment. J Am Acad Child Adolesc Psychiatry 2020; 59:914-917. [PMID: 32736731 DOI: 10.1016/j.jaac.2020.01.021] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Revised: 01/22/2020] [Accepted: 02/12/2020] [Indexed: 12/01/2022]
Abstract
Family involvement in routines that exacerbate and maintain child anxiety is referred to as family accommodation. Family involvement is also related to maintenance of severe problem behavior (SPB) demonstrated by children with intellectual and developmental disabilities (IDD). Family members may deliver attention, tangible items, or remove aversive task demands that produce temporary cessation, or avoidance of SPB, but long-term maintenance. This Clinical Perspectives article describes parallels between the treatment of family accommodation in child anxiety and the assessment and treatment process for SPB. Suggestions are described for borrowing the concept of family accommodation to help caregivers of children who demonstrate SPB begin to approach previously avoided contexts. A case vignette is provided to illustrate strategies for targeting family accommodation as an expansion of function-based treatments for SPB.
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Affiliation(s)
- Craig W Strohmeier
- Kennedy Krieger Institute and Johns Hopkins University School of Medicine, Baltimore, Maryland.
| | - Jonathan D Schmidt
- Kennedy Krieger Institute and Johns Hopkins University School of Medicine, Baltimore, Maryland
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31
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Inoue M, Oda M. Consultation on the Functional Assessment of Students with Severe Challenging Behavior in a Japanese Special School for Intellectual Disabilities. Yonago Acta Med 2020; 63:107-114. [PMID: 32494216 DOI: 10.33160/yam.2020.05.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Accepted: 04/28/2020] [Indexed: 11/05/2022]
Abstract
Background It is important to intervene early and treat children and individuals with behavioral disorders. We conducted a functional assessment-based consultation for teachers of several students with severe behavioral disorders and examined the effects of the consultation. Methods Eight students with severe behavioral disorders were selected from two special schools for intellectual disabilities in western Japan. An external consultant team conducted a functional assessment-based consultation in cooperation with a team of teachers. Consultations were held once a month, and comprised three to six sessions per student. Results As a result of the functional assessment, only 8 out of 10 behaviors with some communication function, and 2 with only sensory enhancements were estimated. The Effects of consultations based on functional assessment were presented. It was found that 6 out of 10 target behaviors had obtained high effects. The total score for each behavioral scale showed a statistically significant improvement. Conclusion Although consultations lasted for only six months and occurred from three to six times for each student, scale scores for problem behavior before and after intervention were improved, overall. Each case report suggested that many factors influence the difference in the effects of consultation among individual students. This study is significant in that it provides a model for the consultation system that operates on a short-term basis, and presents a means for small-scale group consultations for students with intellectual disabilities and autism in cooperation with external specialized institutions in special schools in Japan.
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Affiliation(s)
- Masahiko Inoue
- Department of Clinical Psychology, Tottori University Graduate School of Medical Sciences, Yonago 683-8503, Japan
| | - Mayumi Oda
- Department of Clinical Psychology, Tottori University Graduate School of Medical Sciences, Yonago 683-8503, Japan
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32
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Saini V, Ubdegrove K, Biran S, Duncan R. A Preliminary Evaluation of Interrater Reliability and Concurrent Validity of Open-Ended Indirect Assessment. Behav Anal Pract 2020; 13:114-125. [PMID: 32231972 DOI: 10.1007/s40617-019-00364-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Indirect assessments are a commonly used component of functional behavior assessment by behavior analysts in practice who work with individuals with severe behavior disorders. Although used frequently, closed-ended indirect assessments have repeatedly been shown to have low to moderate interrater reliability and poor concurrent validity with functional analysis. Recently, the use of open-ended interviews has become more commonly adopted in applied clinical practice, despite no studies evaluating the psychometric properties of such assessments. In the present study, we evaluated the interrater reliability and concurrent validity of an open-ended functional assessment interview. We compared the results of two open-ended indirect assessments conducted with a common caregiver and subsequently conducted functional analyses in an attempt to validate hypotheses generated from the interviews. Interrater agreement for the open-ended interviews was higher than previous research on closed-ended interviews (75%); however, concurrent validity with functional analysis was relatively poor (50%). We discuss these findings in the context of assessment and treatment for severe behavior disorders, as well as best practice methods during functional behavior assessment.
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Affiliation(s)
- Valdeep Saini
- 1Department of Applied Disability Studies, Brock University, 1812 Sir Isaac Brock Way, St. Catherines, ON Canada
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33
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Jessel J, Hanley GP, Ghaemmaghami M. On the Standardization of the Functional Analysis. Behav Anal Pract 2020; 13:205-216. [PMID: 32231982 PMCID: PMC7070124 DOI: 10.1007/s40617-019-00366-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
The functional analysis procedures described in the seminal Iwata et al. (1982/1994) study are prominent in the applied behavior analytic literature, having been replicated hundreds of times over the past 30 years (Beavers, Iwata, & Lerman, 2013; Hanley, McCord, Iwata, 2003). However, the extent to which particular components of this functional analysis model have become more or less prominent over time is not clear from these literature reviews. We therefore conducted a review of the functional analysis literature between the years of 1965 and 2016 to determine the trends in the usage of particular components over time and to determine if the published literature reflects a standardization of the manner in which functional analyses of problem behavior are conducted. Furthermore, we discuss whether or not this standardization of a functional analysis model is currently necessary.
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Affiliation(s)
- Joshua Jessel
- Queens College, 65-30 Kissena Boulevard, Queens, NY 11367 USA
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35
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Saini V, Kadey HJ, Paszek KJ, Roane HS. A systematic review of functional analysis in pediatric feeding disorders. J Appl Behav Anal 2019; 52:1161-1175. [PMID: 31523816 DOI: 10.1002/jaba.637] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2017] [Accepted: 08/16/2019] [Indexed: 11/07/2022]
Abstract
We conducted a systematic review of the functional analysis of inappropriate mealtime behavior in peer-reviewed studies in PsycINFO, ERIC, PubMed, and the Journal of Applied Behavior Analysis between 2000-2016. We identified 18 studies involving 86 functional analyses. We coded descriptive data and calculated summary statistics in addition to conducting a quality appraisal of the literature. We identified escape, exclusively or in part, as the maintaining reinforcer for inappropriate mealtime behavior in 92% of cases. Results indicate that differentiated functional analyses of inappropriate mealtime behavior can be obtained, and outcomes are consistent with etiological theories of food refusal behavior. We discuss procedural differences across studies as well as directions for future research.
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Bruno JL, Hosseini SH, Lightbody AA, Manchanda MK, Reiss AL. Brain circuitry, behavior, and cognition: A randomized placebo-controlled trial of donepezil in fragile X syndrome. J Psychopharmacol 2019; 33:975-985. [PMID: 31264943 PMCID: PMC6894490 DOI: 10.1177/0269881119858304] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
BACKGROUND Fragile X syndrome, the most common inherited cause for intellectual disability, is associated with alterations in cholinergic among other neurotransmitter systems. This study investigated the effects of donepezil hydrochloride, a cholinesterase inhibitor that has potential to correct aberrant cholinergic signaling. METHOD Forty-two individuals with fragile X syndrome (mean age=19.61 years) were randomized to receive 2.5-10.0 mg of donepezil (n=20, seven females) or placebo (n=22, eight females) per day. One individual in the active group withdrew at week 7. Outcomes included the contingency naming test, the aberrant behavior checklist, and behavior and brain activation patterns during a functional magnetic resonance imaging gaze discrimination task. RESULTS There were no significant differences between active and placebo groups on cognitive (contingency naming task) or behavioral (total score or subscales of the aberrant behavior checklist) outcomes. At baseline, the active and placebo groups did not differ in functional magnetic resonance imaging activation patterns during the gaze task. After 12 weeks of treatment the active group displayed reduced activation in response to the averted vs direct gaze contrast, relative to the placebo group, in the left superior frontal gyrus. CONCLUSIONS Reduced functional brain activation for the active group may represent less arousal in response to direct eye gaze, relative to the placebo group. Change in functional magnetic resonance imaging activation patterns may serve as a more sensitive metric and predictor of response to treatment when compared to cognitive and behavioral assessments. Our results suggest that donepezil may have an impact on brain functioning, but longer term follow-up and concomitant behavioral intervention may be required to demonstrate improvement in cognition and behavior.
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Affiliation(s)
- Jennifer L. Bruno
- Center for Interdisciplinary Brain Sciences Research, Stanford University.,To whom correspondence should be addressed: 401 Quarry Road, Palo Alto, CA 94304, Phone: 818-415-9119, Fax: (650) 724-4761,
| | - S.M. Hadi Hosseini
- Center for Interdisciplinary Brain Sciences Research, Stanford University
| | - Amy A. Lightbody
- Center for Interdisciplinary Brain Sciences Research, Stanford University
| | - Mai K. Manchanda
- Center for Interdisciplinary Brain Sciences Research, Stanford University
| | - Allan L. Reiss
- Center for Interdisciplinary Brain Sciences Research, Stanford University.,Department of Radiology, Stanford University.,Department of Pediatrics, Stanford University
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A randomization test wrapper for synthesizing single-case experiments using multilevel models: A Monte Carlo simulation study. Behav Res Methods 2019; 52:654-666. [PMID: 31270794 DOI: 10.3758/s13428-019-01266-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Multilevel models (MLMs) have been proposed in single-case research, to synthesize data from a group of cases in a multiple-baseline design (MBD). A limitation of this approach is that MLMs require several statistical assumptions that are often violated in single-case research. In this article we propose a solution to this limitation by presenting a randomization test (RT) wrapper for MLMs that offers a nonparametric way to evaluate treatment effects, without making distributional assumptions or an assumption of random sampling. We present the rationale underlying the proposed technique and validate its performance (with respect to Type I error rate and power) as compared to parametric statistical inference in MLMs, in the context of evaluating the average treatment effect across cases in an MBD. We performed a simulation study that manipulated the numbers of cases and of observations per case in a dataset, the data variability between cases, the distributional characteristics of the data, the level of autocorrelation, and the size of the treatment effect in the data. The results showed that the power of the RT wrapper is superior to the power of parametric tests based on F distributions for MBDs with fewer than five cases, and that the Type I error rate of the RT wrapper is controlled for bimodal data, whereas this is not the case for traditional MLMs.
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38
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Inoue M. Assessments and Interventions to Address Challenging Behavior in Individuals with Intellectual Disability and Autism Spectrum Disorder in Japan: A Consolidated Review. Yonago Acta Med 2019; 62:169-181. [PMID: 31320821 PMCID: PMC6584262 DOI: 10.33160/yam.2019.06.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Accepted: 06/03/2019] [Indexed: 11/05/2022]
Abstract
Intellectual disability and autism spectrum disorder are neurodevelopmental disorders that emerge during the developmental period. A significant barrier that impedes the social adaptation of individuals with these disorders is the exhibition of problem behaviors, such as self-injurious, stereotyped, and aggressive/destructive behaviors. In recent years, these problem behaviors have been collectively referred to as "challenging behavior," in accordance with the contention that they result from an interaction between the individual and his or her social environment. Evidence-based psychosocial interventions that adopt the functional approach to treating challenging behavior are increasing. However, in order to effectively implement such interventions in educational settings and welfare facilities, it is essential to develop staff training programs and usable psychometric assessments. Accordingly, a brief overview of research studies on challenging behavior that have been conducted in Japan, as well as the various support systems that are available to individuals who exhibit challenging behavior, are presented in this article. The discussion makes it apparent that, in order to improve treatment systems in Japan that are aimed at addressing challenging behavior, it is necessary to establish not only better staff training programs, but also reliable and valid assessments measuring challenging behavior that can be readily used by teachers and parents. On the basis of this discussion, it is proposed that technological advancements must be applied to psychosocial approaches in the study of problem behaviors, in order to develop assessment system using software applications and automatic measurement system of target behaviors using sensing technology.
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Affiliation(s)
- Masahiko Inoue
- Department of Clinical Psychology, Tottori University Graduate School of Medical Sciences, Yonago 683-8503, Japan
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39
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den Haan PJ, de Kroon MLA, van Dokkum NH, Kerstjens JM, Reijneveld SA, Bos AF. Risk factors for emotional and behavioral problems in moderately-late preterms. PLoS One 2019; 14:e0216468. [PMID: 31048855 PMCID: PMC6497297 DOI: 10.1371/journal.pone.0216468] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2019] [Accepted: 04/23/2019] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE To assess which factors, including maternal, lifestyle, pregnancy- and delivery-related, fetal and neonatal factors adjusted for socio-economic status, are related to emotional and behavioral problems in moderately-late preterm born children (MLPs; gestational age 32.0-35.9 weeks) at 4 years of age. MLPs are at greater risk of emotional and behavioral problems than full-term born children. Especially for MLPs, knowledge about factors that increase or decrease the risk of emotional and behavioral problems is scarce. DESIGN AND SETTING We assessed emotional and behavioral problems in 809 MLPs between ages 41 and 49 months from the prospective community-based Longitudinal Preterm Outcome Project (LOLLIPOP), using the parent-reported Child Behavior Checklist (CBCL). We collected potential risk factors from hospital records and parental questionnaires. Univariable and multiple logistic regression analyses were applied. MAIN OUTCOME MEASURES (Sub)clinical CBCL scores. RESULTS Perinatal infection increased the risk of CBCL total problem scores with an OR 2.22 (p<0.01). Perinatal infection, maternal smoking, and male gender increased the risk of CBCL externalizing problem scores with ORs between 1.64 and 2.46 (all p<0.05). Multiple birth decreased the risk of CBCL internalizing problem scores with an OR 0.63 (p<0.05). CONCLUSIONS Risk factors for behavioral problems in MLPs are male gender, perinatal infection and maternal smoking, the latter two being potentially modifiable. Multiple birth is a protective factor for emotional problems in MLPs. These results suggest potential factors for targeting preventive intervention in MLPs, comprising the large majority of all preterm born children.
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Affiliation(s)
- Pauline J. den Haan
- Department of Pediatrics, Division of Neonatology, Beatrix Children’s Hospital, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
- * E-mail:
| | - Marlou L. A. de Kroon
- Department of Health Sciences, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Nienke H. van Dokkum
- Department of Pediatrics, Division of Neonatology, Beatrix Children’s Hospital, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
- Department of Health Sciences, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Jorien M. Kerstjens
- Department of Pediatrics, Division of Neonatology, Beatrix Children’s Hospital, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Sijmen A. Reijneveld
- Department of Health Sciences, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Arend F. Bos
- Department of Pediatrics, Division of Neonatology, Beatrix Children’s Hospital, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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40
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Surfing the Urge: An informal mindfulness practice for the self-management of aggression by adolescents with autism spectrum disorder. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2019. [DOI: 10.1016/j.jcbs.2018.10.003] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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41
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Saini V, Jessel J, Iannaccone JA, Agnew C. Efficacy of functional analysis for informing behavioral treatment of inappropriate mealtime behavior: A systematic review and meta‐analysis. BEHAVIORAL INTERVENTIONS 2019. [DOI: 10.1002/bin.1664] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Valdeep Saini
- Department of Applied Disability StudiesBrock University St. Catharines Canada
| | - Joshua Jessel
- Department of PsychologyQueens College New York NY United States of America
| | | | - Charlene Agnew
- Department of PsychologyQueens College New York NY United States of America
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42
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Laraway S, Snycerski S, Pradhan S, Huitema BE. An Overview of Scientific Reproducibility: Consideration of Relevant Issues for Behavior Science/Analysis. Perspect Behav Sci 2019; 42:33-57. [PMID: 31976420 PMCID: PMC6701706 DOI: 10.1007/s40614-019-00193-3] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
For over a decade, the failure to reproduce findings in several disciplines, including the biomedical, behavioral, and social sciences, have led some authors to claim that there is a so-called "replication (or reproducibility) crisis" in those disciplines. The current article examines: (a) various aspects of the reproducibility of scientific studies, including definitions of reproducibility; (b) published concerns about reproducibility in the scientific literature and public press; (c) variables involved in assessing the success of attempts to reproduce a study; (d) suggested factors responsible for reproducibility failures; (e) types of validity of experimental studies and threats to validity as they relate to reproducibility; and (f) evidence for threats to reproducibility in the behavior science/analysis literature. Suggestions for improving the reproducibility of studies in behavior science and analysis are described throughout.
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Affiliation(s)
- Sean Laraway
- Department of Psychology, San José State University, San José, CA 95192-0120 USA
| | - Susan Snycerski
- Department of Psychology, San José State University, San José, CA 95192-0120 USA
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43
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Jessel J, Metras R, Hanley GP, Jessel C, Ingvarsson ET. Evaluating the boundaries of analytic efficiency and control: A consecutive controlled case series of 26 functional analyses. J Appl Behav Anal 2019; 53:25-43. [PMID: 30734285 DOI: 10.1002/jaba.544] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Accepted: 12/11/2018] [Indexed: 11/07/2022]
Abstract
We conducted this study to determine if the efficiency of the functional analysis could be improved without detrimental effects on control. In Experiment 1, we reanalyzed functional analyses conducted for the problem behavior of 18 children. We analyzed rates of problem behavior during the first 5 min and first 3 min of the original 10-min sessions and evaluated if changes in the level of control over problem behavior by the programmed contingency were evident from the analyses of shorter session duration. In Experiment 2, we conducted 8 consecutive functional analyses with 3-min sessions to further evaluate the utility of brief session durations. We found that control over problem behavior was demonstrated when conducting functional analyses with sessions as brief as 3 min.
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44
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Hodnett J, Scheithauer M, Call NA, Mevers JL, Miller SJ. Using a Functional Analysis Followed by Differential Reinforcement and Extinction to Reduce Challenging Behaviors in Children With Smith-Magenis Syndrome. AMERICAN JOURNAL ON INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2018; 123:558-573. [PMID: 30421967 DOI: 10.1352/1944-7558-123.6.558] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Smith-Magenis syndrome (SMS) is a genetic disorder, commonly caused by a 17p11.2 deletion, affecting the Retinoic Acid Induced 1 gene. It affects approximately 1 in 25,000 individuals, with over 90% engaging in challenging behaviors. Function-based treatments, using the principles of applied behavior analysis, have consistently been shown to decrease challenging behaviors exhibited by individuals with developmental delays. However, additional research is needed to determine the effects of these interventions with specific diagnostic subsets, including SMS. The current study identified the function of challenging behavior for 2 children with SMS and found a function-based treatment, consisting of differential reinforcement and extinction, reduced challenging behavior for both.
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Affiliation(s)
- Jennifer Hodnett
- Jennifer Hodnett, Marcus Autism Center, Atlanta, GA; Mindy Scheithauer, Nathan A. Call, Joanna Lomas Mevers, and Sarah J. Miller, Marcus Autism Center; Emory University School of Medicine; Atlanta, GA
| | - Mindy Scheithauer
- Jennifer Hodnett, Marcus Autism Center, Atlanta, GA; Mindy Scheithauer, Nathan A. Call, Joanna Lomas Mevers, and Sarah J. Miller, Marcus Autism Center; Emory University School of Medicine; Atlanta, GA
| | - Nathan A Call
- Jennifer Hodnett, Marcus Autism Center, Atlanta, GA; Mindy Scheithauer, Nathan A. Call, Joanna Lomas Mevers, and Sarah J. Miller, Marcus Autism Center; Emory University School of Medicine; Atlanta, GA
| | - Joanna Lomas Mevers
- Jennifer Hodnett, Marcus Autism Center, Atlanta, GA; Mindy Scheithauer, Nathan A. Call, Joanna Lomas Mevers, and Sarah J. Miller, Marcus Autism Center; Emory University School of Medicine; Atlanta, GA
| | - Sarah J Miller
- Jennifer Hodnett, Marcus Autism Center, Atlanta, GA; Mindy Scheithauer, Nathan A. Call, Joanna Lomas Mevers, and Sarah J. Miller, Marcus Autism Center; Emory University School of Medicine; Atlanta, GA
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45
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Lomas Mevers JE, Noell GH, Scheithauer M, Miller S, Alvarez JP, Fischer AJ. The impact of stimulus preference, order-effects, and treatment component omission in evaluating treatment integrity. J Sch Psychol 2018; 69:45-55. [DOI: 10.1016/j.jsp.2018.05.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Revised: 02/05/2018] [Accepted: 05/02/2018] [Indexed: 11/29/2022]
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46
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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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47
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Using response ratios for meta-analyzing single-case designs with behavioral outcomes. J Sch Psychol 2018; 68:99-112. [DOI: 10.1016/j.jsp.2018.02.003] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Revised: 09/29/2017] [Accepted: 02/24/2018] [Indexed: 10/17/2022]
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48
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Jessel J, Ingvarsson ET, Metras R, Whipple R, Kirk H, Solsbery L. Treatment of elopement following a latency-based interview-informed, synthesized contingency analysis. BEHAVIORAL INTERVENTIONS 2018. [DOI: 10.1002/bin.1525] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Joshua Jessel
- University of North Texas; Denton TX USA
- Queens College; New York NY USA
| | | | - Rachel Metras
- University of North Texas; Denton TX USA
- Child Study Center; New York NY USA
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49
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Herman C, Healy O, Lydon S. An interview-informed synthesized contingency analysis to inform the treatment of challenging behavior in a young child with autism. Dev Neurorehabil 2018; 21:202-207. [PMID: 29446700 DOI: 10.1080/17518423.2018.1437839] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
PURPOSE Experimental Functional analysis (EFA) is considered the "gold standard" of behavioural assessment and its use is predictive of treatment success. However, EFA has a number of limitations including its lengthy nature, the high level of expertise required, and the reinforcement of challenging behaviour. This study aimed to further validate a novel interview-informed synthesised contingency analysis (IISCA). METHODS An open-ended interview and brief direct observation informed an IISCA for a young boy with autism who engaged in challenging behaviour. Resulting data supported the hypothesis that the target behaviour was multiply controlled by escape from demands and access to tangible items. An intervention comprised of most-to-least prompting, escape extinction, differential reinforcement and a high-probability instruction sequence was evaluated using a reversal design. RESULTS This intervention reduced challenging behaviour to low levels and resulted in increased compliance. CONCLUSIONS Findings support the status of the IISCA as a valid, practical, and effective process for designing function-based interventions.
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Affiliation(s)
- Ciara Herman
- a School of Psychology , Trinity College Dublin , Dublin , Ireland
| | - Olive Healy
- a School of Psychology , Trinity College Dublin , Dublin , Ireland
| | - Sinéad Lydon
- a School of Psychology , Trinity College Dublin , Dublin , Ireland.,b Discipline of General Practice , National University of Ireland , Galway , Ireland
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50
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Scheithauer M, Muething CS, Silva MR, Gerencser KR, Krantz J, Call NA. Using caregiver report on the impact of challenging behavior exhibited by children with autism spectrum disorder to guide treatment development and outcomes. INTERNATIONAL JOURNAL OF DEVELOPMENTAL DISABILITIES 2018; 65:265-276. [PMID: 34141347 PMCID: PMC8115479 DOI: 10.1080/20473869.2018.1428521] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Objectives: Evaluations of treatments using applied behavior analysis (ABA) for challenging behavior have relied mostly on direct behavioral observation. While observation is crucial, qualitative information can also be beneficial. In this study, we describe methods for using qualitative information in ABA treatments for challenging behavior. Method: Three participants were undergoing treatment for challenging behavior. Information was collected through caregiver interviews at the start and end of the admission. Directed content analysis identified themes in the interviews and we compared treatment outcomes using qualitative and quantitative measures. Results: Three themes emerged: description, frequency, and impact of the behavior. Quantitative and qualitative measures both suggested successful interventions for two participants. For the third, direct observation suggested treatment was effective while caregiver report did not. Conclusion: Incorporation of qualitative information into outcomes allowed for a more comprehensive view of treatment success and guided assessment and treatment decisions. Treatments based on applied behavior analysis (ABA) are commonly studied for the treatment of challenging behavior, but these studies rely mostly on direct behavioral observation. While observation is crucial, qualitative information is also useful in ensuring meaningful results. In this study, we describe a method of collecting, analyzing, and using qualitative information collected from caregivers and compare qualitative to quantitative outcomes.
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Affiliation(s)
- Mindy Scheithauer
- School of Medicine, Marcus Autism Center, Emory University, Atlanta, GA, USA
- Marcus Autism Center, Atlanta, GA, USA
| | - Colin S. Muething
- School of Medicine, Marcus Autism Center, Emory University, Atlanta, GA, USA
- Marcus Autism Center, Atlanta, GA, USA
| | - Meghan R. Silva
- Marcus Autism Center, Atlanta, GA, USA
- May Institute, Randolph, MA, USA
| | | | - Joelle Krantz
- Marcus Autism Center, Atlanta, GA, USA
- Behavioral Psychology, Kennedy Krieger Institute, Baltimore, MD, USA
| | - Nathan A. Call
- School of Medicine, Marcus Autism Center, Emory University, Atlanta, GA, USA
- Marcus Autism Center, Atlanta, GA, USA
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