Description of a practitioner model for identifying preferred stimuli with individuals with autism spectrum disorders

Advancing Methods in Animal-Assisted Intervention: Demonstration of Starting Points in Clinical Practice for Children with Autism Spectrum Disorder

Therapy animals have been frequently included in interventions for children with autism spectrum disorder (ASD); however, direct and systematic procedures such as assessing preference for and reinforcing efficacy of the animals are rarely conducted. Assessing preference for stimuli is valuable when determining how to make interventions for children with ASD most effective. We conducted paired-stimulus preference assessments and follow-up reinforcer assessments to determine if a therapy dog might be an effective reinforcer. We found one third of participants preferred the dog the least, one third of participants moderately preferred the dog, and one third of participants highly preferred the dog relative to other stimuli. Furthermore, we found preference predicted reinforcing efficacy for five of six participants. We suggest clinicians systematically conduct assessments to clearly identify the role of the therapy animal, to improve quality of, and demonstrate efficacy of interventions including animals for clinical populations.

Stimulus Preference Assessment Decision-Making System (SPADS): A Decision-Making Model for Practitioners

A stimulus preference assessment (SPA) is a fundamental tool used by practitioners to predict stimuli that function as reinforcers. The Behavior Analyst Certification Board (BACB) requires that all certified behavior analysts and behavioral technicians be trained in SPA methodology (BACB, 2017). SPA procedures are used by nearly 9 out of 10 behavior analysts in the field (Graff & Karsten, 2012). Over the last 4 decades, there has been a litany of research on SPA procedures. Despite the universality of training, application, and research, discussions on the selection of SPA procedures have been sparse. Two peer-reviewed articles have focused on clinical decision making in the selection of SPA procedures. Karsten et al. (2011) introduced an in situ decision-making model, whereas Virues-Ortega et al. (2014) developed an a priori algorithm based on client and stimuli characteristics. The SPADS addresses the limitations of prior models by considering the effects of stimuli dimensions, client characteristics, relative administration times, and the outcomes agreement between two potentially efficacious, context-specfic SPA procedures.

Adapting Direct Services for Telehealth: A Practical Tutorial

Due to the pandemic brought on by the novel coronavirus (COVID-19), consumers of applied behavior-analytic interventions may be experiencing disrupted access to services. In response to the need for services, behavior analysts and therapists may find themselves treading unchartered waters as they use telehealth to provide direct intervention to consumers. Direct service provision via telehealth extends beyond the bounds of existing telehealth research, which primarily focuses on caregiver training and consultation. In the transition to telehealth, behavior analysts can consider how to adapt an existing evidence base of behavior-analytic strategies from a face-to-face format to intervention via a teleconferencing platform (i.e., Zoom). In this tutorial, we provide practice recommendations, task analyses, and a curated list of Zoom walk-throughs to help behavior analysts construct conceptually systematic learning opportunities in their direct telehealth services. Leveraging teleconferencing features to provide behavior-analytic intervention directly to consumers could spur future research to support these need-inspired practices and guide telehealth applications during and beyond the current pandemic.

Supplementary Information

The online version contains supplementary material available at 10.1007/s40617-020-00529-5.

Use of an Online Training with Virtual Role Play to Teach Preference Assessment Implementation

Identification of reinforcers is critical to the effectiveness of behavioral interventions. Stimulus preference assessments (SPA) are a frequently used method to identify putative reinforcers. Given the fluctuating nature of individual preferences, there is need for efficient training of providers that may regularly implement SPAs. The present study evaluated the utility of a web-delivered training with virtual role play to train SPA implementation. This study builds upon previous literature by utilizing a larger sample and incorporating role-play, a component often omitted from other efficient methods of training. Study 1 trained 40 undergraduate students to implement an SPA via web or in vivo. Results suggest both trainings were equivalently effective, and the web-delivered training reduced trainer time by approximately 25 min. Live role-play and feedback was still necessary with web-delivered training, consistent with suggestions that rehearsal and feedback is a vital component of training. Results also suggest web-delivered training may identify areas of weakness following training. A follow-up clinical pilot showed that the web-delivered training was also effective at training eight novice providers to competently implement the SPA with children with ASD in a special education school. This study demonstrates that web-delivered training with virtual role-play is likely another efficient training method for implementation of behavioral procedures.

Incorporating Preference Assessment into Transition Planning for People with Autism Spectrum Disorder

Learners with Autism Spectrum Disorder (ASD) often struggle with communicating preferences integral to the transition planning process. Systematic preference assessments (SPAs) are objective methods for observing and documenting learner responses to a variety of environmental stimuli. An extensive literature-base exists supporting the inclusion of SPAs when identifying potentially reinforcing stimuli for educational programming. Although these methodologies are effective, in the transition planning process they may be useful beyond identifying potentially reinforcing stimuli. The following commentary provides an overview of the transition planning process, as well as how preference assessment may enhance that process.

Web-based stimulus preference assessment and reinforcer assessment for videos

This study replicated and extended the use of a web-based multiple-stimulus-without-replacement preference assessment (Curiel, Curiel, Li, Deochand, & Poling, 2018) by adding a web-based single-operant reinforcer assessment. Five adults diagnosed with autism spectrum disorder participated in this study. The web-based program identified preference hierarchies for 4 of the 5 participants, and the single-operant reinforcer assessment confirmed that the highly preferred videos functioned as reinforcers. Advantages of computer-based stimulus preference and reinforcer assessments are discussed.

Assessing preferences of individuals with developmental disabilities using alternative stimulus modalities: A systematic review

The purpose of this systematic review was to identify investigations comparing the efficacy of alternative modality (e.g., pictorial, verbal, video) stimulus preference assessments for individuals with developmental disabilities. We identified articles by searching peer-reviewed journals using the PsycINFO and ERIC databases, conducting table of contents searches of common behavioral outlets, and conducting ancestral searches of recent reviews and practitioner summaries of preference assessment methodology. A total of 32 articles met our inclusion criteria. These studies were then coded across a variety of features to gain a better understanding of the efficacy of alternative format preference assessments for individuals with developmental disabilities. In addition, we reviewed this literature for the use of prerequisite-skill assessments and contingent-reinforcer access to further investigate the relation between these variables and the accuracy of pictorial, verbal, and video preference assessments. A variety of methodological concerns are discussed as well as suggestions for future research.

Examining a Web-Based Procedure for Assessing Preference for Videos

A web-based program was developed to conduct brief multiple-stimulus without replacement preference assessments for videos (e.g., movies, cartoons, music videos). The preference assessment program was used with two populations: young adults with developmental disabilities and school-age children with emotional and behavioral needs. Stimulus preference hierarchies were identified for all participants, indicating that a web-based preference assessment procedure is an efficient procedure for isolating highly preferred videos, which might be useful as reinforcers in a variety of settings.

Further examination of video-based preference assessments without contingent access

The first purpose of this study was to attempt to replicate previous findings that video-based preference assessments without access to selected stimuli may accurately predict relative reinforcing efficacy of stimuli. To do this, we conducted a concurrent operant reinforcer assessment in which we evaluated the relative reinforcing value of highly preferred and less preferred items identified in a video-based preference assessment. The second purpose of this study was to begin to evaluate the potential behavioral mechanisms responsible for the validity of this assessment. To conduct this analysis, we evaluated the relative reinforcing value of those same stimuli depicted in video format and then compared results to results obtained during the reinforcer assessment for tangible stimuli. For all five participants, stimuli identified as highly preferred functioned as reinforcers, and four of five participants, responding during the reinforcer assessment was similar in the presence of tangible stimuli and videos depicting those stimuli.

A Survey-Based Method to Evaluate Optimal Treatment Selection for Escape-Maintained Problem Behavior

Geiger, Carr, and LeBlanc (2010) developed a decision-making model for escape-maintained problem behavior that could be used to guide the course of treatment selection. We used a digital survey to evaluate the model's potential usefulness. We presented novice and expert practitioners' written hypothetical scenarios and asked them to determine the optimal treatment in a given situation. Some participants were given the model, whereas others were instructed to use their best clinical judgment. Using logistic regression analyses, the general findings for our scenarios were the following: (a) experts without the aid of a decision model had better odds of selecting the optimal treatment than novices without the decision model, (b) experts with the decision model did not have greater odds of selecting optimal treatment than experts without the model, and

A Practitioner Model for Increasing Eye Contact in Children With Autism

Although many teaching techniques for children with autism spectrum disorder (ASD) require the instructor to gain the child's eye contact prior to delivering an instructional demand, the literature contains notably few procedures that reliably produce this outcome. To address this problem, we evaluated the effects of a sequential model for increasing eye contact in children with ASD. The model included the following phases: contingent praise only (for eye contact), contingent edibles plus praise, stimulus prompts plus contingent edibles and praise, contingent video and praise, schedule thinning, and maintenance evaluations for up to 2 years. Results indicated that the procedures increased eye contact for 20 participants (one additional participant did not require consequences). For 16 participants, praise (alone) was not sufficient to support eye contact; however, high levels of eye contact were typically maintained with these participants when therapists used combined schedules of intermittent edibles or video and continuous praise. We discuss some limitations of this model and directions for future research on increasing eye contact for children with ASD.

Assessing the efficacy of pictorial preference assessments for children with developmental disabilities

Past research has demonstrated that pictorial preference assessments can predict subsequent reinforcement effects for individuals with developmental disabilities only when access to the selected stimulus is provided contingent on a pictorial selection. The purpose of the present investigation was to assess more comprehensively the feasibility of the pictorial format with children with developmental disabilities. In Experiment 1, prerequisite skill assessments were conducted, and the role of a contingent reinforcer was assessed by comparing the results from the pictorial assessment without contingent access to a reinforcer assessment. If contingent access was found to be necessary, the effects of schedule thinning were evaluated to determine whether a pictorial format could be made more practical in Experiment 2. The pictorial format without contingent access was successful with only some participants. However, schedule thinning was found to be an effective method to establish conditioned reinforcement properties for pictorial stimuli to create a more practical assessment for a subset of participants.

An Evaluation of a Brief Video-Based Multiple-Stimulus Without Replacement Preference Assessment

We evaluated a brief multiple-stimulus without replacement (MSWO) preference assessment conducted in video format with four children with autism. Specifically, we compared the results of a video-based MSWO to the results of a tangible MSWO. Toys identified as highly preferred (HP) in the video-based MSWO were also HP in the tangible MSWO for three of four participants, and correlations between video-based and tangible MSWO assessment results across participants were strong and statistically significant. Therefore, video-based MSWOs may be an accurate compliment to tangible MSWOs for children with autism.

Clinical decision making and preference assessment for individuals with intellectual and developmental disabilities

Individuals with intellectual or developmental disabilities are able to reliably express their likes and dislikes through direct preference assessment. Preferred items tend to function as rewards and can therefore be used to facilitate the acquisition of new skills and promote task engagement. A number of preference assessment methods are available and selecting the appropriate method is crucial to provide reliable and meaningful results. The authors conducted a systematic review of the preference assessment literature, and developed an evidence-informed, decision-making model to guide practitioners in the selection of preference assessment methods for a given assessment scenario. The proposed decision-making model could be a useful tool to increase the usability and uptake of preference assessment methodology in applied settings.

Assessing preferences of individuals with developmental disabilities: a survey of current practices

Although professionals working with individuals with developmental disabilities have much to gain from using systematic methods of reinforcer identification, practitioner knowledge and use of stimulus preference assessments (SPA) has rarely been examined. The purpose of this survey was to assess awareness and implementation of SPAs among professionals who serve people with developmental disabilities within and outside the field of applied behavior analysis. A total of 406 individuals responded to the survey; 246 respondents were recruited via direct email, and 160 respondents were recruited from Internet postings. Fewer than 60% of respondents across all disciplines (i.e., applied behavior analysis, psychology, and special education) reported knowledge of the term stimulus preference assessment. While nearly 90% of behavior analysts reported using at least one direct method of SPA (i.e., an assessment involving direct observation and measurement of behavior), many reported personal lack of knowledge (18.6%) and lack of time (81.4%) as barriers to conducting these assessments on a regular basis. Survey results are discussed in terms of (1) the need for greater awareness and acceptance of reinforcer identification methods among behavior analysts, educators, and other service providers and (2) barrier-specific solutions to potentially increase the regularity of SPA usage in the education and treatment of individuals with developmental disabilities.

Comparison of the predictive validity and consistency among preference assessment procedures: a review of the literature

We reviewed 14 experimental studies comparing different preference assessments for individuals with developmental disabilities that were published in peer-reviewed journals between 1985 and 2012. Studies were summarized based on the following six variables: (a) the number of participants, (b) the type of disability, (c) the number and type of stimuli, (d) the average duration of administration, (e) compared procedures, and (f) results. Studies were also classified in terms of the predictive validity and consistency of the preference assessment results. The results suggest the preference assessment procedures that may produce more accurate predictions for the reinforcing effects of identified stimuli and consistent preference results. The findings are discussed in relation to the previous literature. Evidence based modifications of the most efficient preference assessment are also discussed.

Teaching receptive language skills: recommendations for instructors

Receptive language refers to responding appropriately to another person's spoken language. Most curricula dedicate a proportion of early intervention to developing receptive language skills. The specific terms used to refer to the receptive language programs and the recommendations for teaching such skills vary considerably across the early intervention curricula. The present paper will provide a conceptual analysis of the desired controlling variables for different receptive language programs, teaching recommendations, a brief review of the literature to substantiate the teaching recommendations, and a discussion of the potential negative effects of deviating from the recommendations.