Training and generalization of affective behavior displayed by youth with autism

A Parent-Focused Creative Approach as a Treatment for a High-Functioning Child with Autism Spectrum Disorder (ASD) in Korea: A Case Study

This study was conducted on a 6-year-old girl with autism spectrum disorder (ASD) in Korea. The case was initiated in February 2015, and intensive treatment was provided for one year. Then, the case was monitored over the course of 6 years until December 2021. The intervention plan was an art therapy-based treatment plan (Individual Therapeutic Education Plan: ITEP) with two integral foci: (1) creative arts-based parent counseling and education and (2) didactic art therapy with the child. This was a new type of integral approach that was not a standard of care practice in Korea, acknowledging the importance of including parents in therapy and the notion of creative arts therapy. There was no scientific evidence supporting this qualitive approach; however, the intervention was a notable success, sustaining a positive outcome—the intervention (1) reduced the anxiety levels of both the mother and the child in the short term; (2) enhanced the child–parent relationship as well as the home environment of the child while the art therapy-based counseling and education increased the mother’s competence; and (3) enhanced the communicative and adaptive functioning of the child and the mother, with art becoming the supportive breakthrough for their emotional obstacles. The findings suggest that a parent-focused creative approach impacts parental changes and child development: the evidence indicates that parent-driven interventions are a viable option for parents and children with ASD to build a better home environment that supports the child’s development.

Can Social Communication Skills for Children Diagnosed With Autism Spectrum Disorder Rehearsed Inside the Video Game Environment of Minecraft Generalize to the Real World?

In this paper, we outline opportunities within the video game environment for building skills applicable to real-world issues faced by some children. The game Minecraft is extremely popular and of particular interest to children diagnosed with autism spectrum disorder. Although the game has been used by support communities to facilitate the social interaction of children and peer support for their parents, little has been done to examine how social skills developed within the game environment generalize to the real world. Social Craft aims to establish a framework in which key social communication skills would be rehearsed in-game with a view to facilitating their replication in a similarly contained real-world environment. Central to this approach is an understanding of the basic principles of behavior and the engagement of a sound methodology for the collection of data inside and outside the respective environments.

Using Multiple Exemplar Training to Teach Empathy Skills to Children with Autism

The purpose of the study was to use multiple exemplar training to teach empathetic responding to two children with autism. Three emotions-happiness, frustration and sadness/pain-were chosen for this purpose. Treatment consisted of verbal prompting and reinforcement of empathetic responses. Four experimenter-defined categories with discriminative stimuli were used for each emotion. The multiple exemplar component of the model consisted of teaching responses in the presence of several discriminative stimuli drawn from the predefined categories for each emotion delivered by two persons across two environments. Results were evaluated using a multiple baseline design across behaviours and indicate a systematic increase in responses with the introduction of treatment across each category for both participants. Generalization of responses from training to non-training stimuli in both participants was observed during probe trials and was maintained during follow-up probes.

Acquisition and Generalization of Complex Empathetic Responses Among Children with Autism

Empathy can be defined as a social interaction skill that consists of four components: (1) a statement voiced in the (2) appropriate intonation, accompanied by a (3) facial expression and (4) gesture that correspond to the affect of another individual. A multiple-baseline across response categories experimental design was used to evaluate the effectiveness of a prompt sequence (video modeling, in vivo modeling, manual and verbal prompting) and reinforcement to increase the frequency of complex empathetic responding by four children with autism. The number of complex empathetic responses increased systematically with the successive introduction of the treatment package. Additionally, generalization was demonstrated to untaught stimuli and a novel adult. Responding maintained over time to varying degrees for all participants. The data illustrate that children with autism can be taught using modeling, prompting, and reinforcement to discriminate between categories of affective stimuli and differentially respond with complex empathetic responses.

Social Referencing and Children with Autism

During social referencing, infants as young as 6 months of age look to others when confronted with unfamiliar or unexpected events in the environment and then respond to these events based on affective cues of the parent or caregiver (e.g., smiling and frowning). Social referencing is important for early communication and language development. Unfortunately, social referencing repertoires are limited or completely lacking in children with autism. Despite these documented social deficits, little research has focused on ameliorating social referencing deficits. The purpose of this paper is to present a behavior-analytic conceptualization of social referencing and the implications for ameliorating social referencing deficits of children with autism.

Affective empathy in schizophrenia: a meta-analysis

BACKGROUND

Affective empathy, or the emotional response one has to the experiences or emotional states of others, contributes to relationship-maintaining behaviors and is key in fostering social connections, yet no work has synthesized the body of literature for people with schizophrenia. The aim of the present meta-analysis was to determine the extent to which those diagnosed with schizophrenia experience deficits in affective empathy.

METHODS

A literature search was conducted of studies examining empathy. Data were analyzed using a random effects meta-analytic model with Hedges' g standardized mean difference effect size.

RESULTS

Individuals with schizophrenia exhibited significant, medium deficits in affective empathy (k=37). Measurement type moderated the affective empathy deficit such that performance-based measures showed larger schizophrenia group deficits than self-report measures.

CONCLUSION

Consistent, significant deficits in affective empathy were found comparing people with schizophrenia to healthy controls, especially when using performance-based assessments. The medium effect suggests an important role for empathy in the realm of social cognitive research, and points to the need for further investigation of measurement techniques and associations with functional outcomes.

Level of Immersion in Virtual Environments Impacts the Ability to Assess and Teach Social Skills in Autism Spectrum Disorder

Virtual environments (VEs) may be useful for delivering social skills interventions to individuals with autism spectrum disorder (ASD). Immersive VEs provide opportunities for individuals with ASD to learn and practice skills in a controlled replicable setting. However, not all VEs are delivered using the same technology, and the level of immersion differs across settings. We group studies into low-, moderate-, and high-immersion categories by examining five aspects of immersion. In doing so, we draw conclusions regarding the influence of this technical manipulation on the efficacy of VEs as a tool for assessing and teaching social skills. We also highlight ways in which future studies can advance our understanding of how manipulating aspects of immersion may impact intervention success.

Training facial expression production in children on the autism spectrum

Children with autism spectrum disorder (ASD) show deficits in their ability to produce facial expressions. In this study, a group of children with ASD and IQ-matched, typically developing (TD) children were trained to produce "happy" and "angry" expressions with the FaceMaze computer game. FaceMaze uses an automated computer recognition system that analyzes the child's facial expression in real time. Before and after playing the Angry and Happy versions of FaceMaze, children posed "happy" and "angry" expressions. Naïve raters judged the post-FaceMaze "happy" and "angry" expressions of the ASD group as higher in quality than their pre-FaceMaze productions. Moreover, the post-game expressions of the ASD group were rated as equal in quality as the expressions of the TD group.

Evaluating posed and evoked facial expressions of emotion from adults with autism spectrum disorder

Though many studies have examined facial affect perception by individuals with autism spectrum disorder (ASD), little research has investigated how facial expressivity in ASD is perceived by others. Here, naïve female observers (n = 38) judged the intensity, naturalness and emotional category of expressions produced by adults with ASD (n = 6) and typically developing (TD) adults (n = 6) in both a posed condition and an evoked condition in which emotions were naturalistically elicited and validated. ASD expressions were rated as more intense and less natural than TD expressions but contrary to prediction were identified with greater accuracy, an effect driven primarily by angry expressions. Naturalness ratings of evoked expressions were positively associated with identification accuracy for TD but not ASD individuals. Collectively, these findings highlight differences, but not a reduction, in facial expressivity in ASD that do not hinder emotion recognition accuracy but may affect social interaction quality.

Effective Behavioural Strategies for the Defining Characteristics of Autism

The following review paper describes the outcomes of data-based behavioural intervention strategies for the defining characteristics of autistic disorder as defined by the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV; American Psychiatric Association, 1994). The results of relevant evaluations of behaviour analytic procedures are reviewed for each of the four potential areas of difficulty under each of the main criteria for autistic disorder, which are: (a) impairment in social interaction, (b) impairment in communication, and (c) restrictive, repetitive, and stereotyped patterns of behaviour, interests, and activities (DSM-IV). The current areas of research activity as well as those domains that have received comparatively little attention by behavioural researchers are identified, and suggestions for future research are discussed.

The effects of imitative vs. Cognitive methods on the speech development of children with autism

OBJECTIVE

The present study was performed to examine the effects of two speech therapy methods on six verbal behaviors of autistic children, including oral speech, listening, organizing, speaking, semantics, and syntax.

MATERIALS & METHODS

IN THIS STUDY, THIRTY CHILDREN WITH AUTISM WERE ASSIGNED TO ONE OF TWO GROUPS: imitative and cognitive groups. Before starting the main procedures of the study, the children of both groups were homogenized concerning their autism level. In the first phase of the study, the speech development level of the two groups was measured in a pre-test, in which both groups showed similar results. Then, both groups of children received 6 months of speech therapy instruction, during which one group was taught using an imitative method, while the other group was being worked with cognitive method.

RESULTS

After 6-month treatment period, a post-test was done, and the t-tests based on the data of the two groups revealed a significant difference between the results.

CONCLUSION

The statistics showed that after the teaching period, autistic that worked with cognitive method gained a better development in their speech abilities, comparing to those worked with the imitative method.

Meta-analysis of social skills interventions of single-case research for individuals with autism spectrum disorders: results from three-level HLM

This meta-analysis used hierarchical linear modeling to examine 115 single-case studies with 343 participants that examined the effectiveness of social skills interventions for individuals with autism spectrum disorder (ASD). The average effect size of the included studies was 1.40 (SD = 0.43, 95% CL = 1.32-1.48, N = 115). In the further, several common predictors including intervention length, age and gender of the participants, and study quality indicators (provision of sufficient, in-depth, and replicable information of participants, settings/materials, independent variables, and dependent variables) were not found to mediate the intervention effectiveness. Only research design that the study employed was found to impact the intervention effectiveness; the studies using multiple baseline or reversal design had larger effect sizes than studies using other designs. Implications of the results and limitations of this study are discussed.

Does facial expressivity count? How typically developing children respond initially to children with autism

Research investigating expressivity in children with autism spectrum disorder has reported flat affect or bizarre facial expressivity within this population; however, the impact expressivity may have on first impression formation has received little research input. We examined how videos of children with autism spectrum disorder were rated for expressivity by adults blind to the condition. We further investigated the friendship ratings given by 44 typically developing children to the same videos. These ratings were compared to friendship ratings given to video clips of typically developing children. Results demonstrated that adult raters, blind to the diagnosis of the children in the videos, rated children with autism spectrum disorder as being less expressive than typically developing children. These autism spectrum disorder children were also rated lower than typically developing children on all aspects of our friendship measures by the 44 child raters. Results suggest that impression formation is less positive towards children with autism spectrum disorder than towards typically developing children even when exposure time is brief.

Assessing stimulus control and promoting generalization via video modeling when teaching social responses to children with autism

We taught social responses to young children with autism using an adult as the recipient of the social interaction and then assessed generalization of performance to adults and peers who had not participated in the training. Although the participants' performance was similar across adults, responding was less consistent with peers, and a subsequent probe suggested that the recipient of the social behavior (adults vs. peers) controlled responding. We then evaluated the effects of having participants observe a video of a peer engaged in the targeted social behavior with another peer who provided reinforcement for the social response. Results suggested that certain irrelevant stimuli (adult vs. peer recipient) were more likely to exert stimulus control over responding than others (setting, materials) and that video viewing was an efficient way to promote generalization to peers.

Multiple exemplar instruction and the emergence of generative production of suffixes as autoclitic frames

We report 2 experiments that tested the effects of multiple exemplar instruction (MEI) across training sets on the emergence of productive autoclitic frames (suffixes) for 6 preschoolers with and without language-based disabilities. We implemented multiple exemplar tact instruction with subsets of stimuli whose "names" contained the suffix "-er" denoting the comparative form of adjectives. Subsets of stimuli included regular, irregular, and contrived tacts containing the target relational autoclitic frame in order to determine if our MEI procedure would induce the abstraction of the frame across all stimulus sets. In the second experiment, additional tasks were introduced to the participants to control for a possible sequence effect. A nonconcurrent multiple probe design was used to evaluate the functional relation between MEI and emergence of untaught tact responses containing the comparative adjective "-er." The results of both experiments showed relations between MEI and novel, untaught tact responses containing the target autoclitic frame; the second experiment showing a functional relation. The results are discussed in terms of environmental sources for productive verbal behavior.

The inclusion of siblings in social skills training groups for boys with Asperger syndrome

This pilot investigation evaluated the effectiveness of siblings as generalisation agents in an 8-week social skills training (SST) program designed for boys with Asperger syndrome (AS). Twenty-one boys aged 8-12 participated in a SST group alone, with a sibling, or remained in a wait-list control group. After training, participants' identification of non-verbal social cues significantly improved and was maintained at 3-month follow-up, irrespective of sibling involvement. Similar trends existed for participants' ability to accurately interpret emotions relative to controls. Improvements did not extend to parent and teacher ratings on standardised social skills measures, suggesting poor generalisation, or questionable sensitivity of measures to taught skills. Results suggest some promise in improving social skills training for children with AS.

Using multiple-exemplar training to teach a generalized repertoire of sharing to children with autism

The current study examined the utility of multiple-exemplar training to teach children with autism to share. Stimuli from 3 of 4 categories were trained using a treatment package of video modeling, prompting, and reinforcement. Offers to share increased for all 3 children following the introduction of treatment, with evidence of skill maintenance. In addition, within-stimulus-category generalization of sharing was evident for all participants, although only 1 participant demonstrated across-category generalization of sharing. Offers to share occurred in a novel setting, with familiar and novel stimuli, and in the presence of novel adults and peers for all participants during posttreatment probes.

A3

HCI studies assessing nonverbal individuals (especially those who do not communicate through traditional linguistic means: spoken, written, or sign) are a daunting undertaking. Without the use of directed tasks, interviews, questionnaires, or question-answer sessions, researchers must rely fully upon observation of behavior, and the categorization and quantification of the participant’s actions. This problem is compounded further by the lack of metrics to quantify the behavior of nonverbal subjects in computer-based intervention contexts. We present a set of dependent variables called A3 (pronounced A-Cubed) or Annotation for ASD Analysis, to assess the behavior of this demographic of users, specifically focusing on engagement and vocalization. This paper demonstrates how theory from multiple disciplines can be brought together to create a set of dependent variables, as well as demonstration of these variables, in an experimental context. Through an examination of the existing literature, and a detailed analysis of the current state of computer vision and speech detection, we present how computer automation may be integrated with the A3 guidelines to reduce coding time and potentially increase accuracy. We conclude by presenting how and where these variables can be used in multiple research areas and with varied target populations.

Teaching empathy skills to children with autism

The purpose of this study was to teach empathetic responding to 4 children with autism. Instructors presented vignettes with dolls and puppets demonstrating various types of affect and used prompt delay, modeling, manual prompts, behavioral rehearsals, and reinforcement to teach participants to perform empathy responses. Increases in empathetic responding occurred systematically with the introduction of treatment across all participants and response categories. Furthermore, responding generalized from training to nontraining probe stimuli for all participants. Generalization occurred from dolls and puppets to actual people in a nontraining setting for 2 participants. Generalization was observed initially to the nontraining people and setting for the other participants, but responding subsequently decreased to baseline levels. Introduction of treatment in this setting produced rapid acquisition of target skills.

Generalized imitation of facial models by children with autism

Imitation is an essential skill in the acquisition of language and communication skills. An initial phase in teaching young children with autism to engage in appropriate affective responding may be to teach the imitation of facial models. Using a multiple baseline across participants design, imitation training (consisting of modeling, prompting, differential reinforcement, and error correction) was introduced successively across 3 participants. Low and inconsistent rates of imitation of facial models were observed in baseline. All of the participants learned to imitate some of the facial models presented during imitation training, but only 2 of the 3 participants demonstrated generalized responding across stimuli.

Social-skills treatments for children with autism spectrum disorders: an overview

Marked advances in the treatment of children with autism spectrum disorders (ASDs) has occurred in the past few decades, primarily using applied behavior analysis. However, reviews of trends in social skills treatment for children with ASDs have been scant, despite a robust and growing empirical literature on the topic. In this selective review of 79 treatment studies, the authors note that the research has been particularly marked by fragmented development, using a range of intervention approaches and definitions of the construct. Modeling and reinforcement treatments have been the most popular model from the outset, with most studies conducted in school settings by teachers or psychologists. Investigators have been particularly attentive to issues of generalization and follow-up. However, large-scale group studies and comparisons of different training strategies are almost nonexistent. These trends and their implications for future research aimed at filling gaps in the existing literature are discussed.

Modifying the affective behavior of preschoolers with autism using in-vivo or video modeling and reinforcement contingencies

The purpose of this study was to modify the affective behavior of three preschoolers with autism in home settings and in the context of play activities, and to compare the effects of video modeling to the effects of in-vivo modeling in teaching these children contextually appropriate affective responses. A multiple-baseline design across subjects, with a return to baseline condition, was used to assess the effects of treatment that consisted of reinforcement, video modeling, in-vivo modeling, and prompting. During training trials, reinforcement in the form of verbal praise and tokens was delivered contingent upon appropriate affective responding. Error correction procedures differed for each treatment condition. In the in-vivo modeling condition, the therapist used modeling and verbal prompting. In the video modeling condition, video segments of a peer modeling the correct response and verbal prompting by the therapist were used as corrective procedures. Participants received treatment in three categories of affective behavior--sympathy, appreciation, and disapproval--and were presented with a total of 140 different scenarios. The study demonstrated that both treatments--video modeling and in-vivo modeling--systematically increased appropriate affective responding in all response categories for the three participants. Additionally, treatment effects generalized across responses to untrained scenarios, the child's mother, new therapists, and time.

The formation of a generalized categorization repertoire: effect of training with multiple domains, samples, and comparisons

The present experiment explored the effects of three variables on the spontaneous categorization of stimuli in perceptually distinct and novel domains. Each of six stimulus domains was created by morphing two images that were the domain endpoints. The endpoints of the domains were male and female faces, two abstract drawings, a car and a truck, two banded-elevation satellite land images, a tree and a cat, and two false-color satellite images. The stimulus variants at each end of a domain defined two potential perceptual classes. Training was conducted in a matching-to-sample format and used stimuli from one or two domains, one or three variants per class as samples, and one or three variants per class as comparisons. The spontaneous categorization of stimuli in the untrained stimulus domains showed the emergence of a generalized categorization repertoire. The proportion of spontaneously categorized stimuli in the new domains was positively related to the number of domains and samples used in training, and was inversely related to the number of comparisons used in training. Differential reaction times demonstrated the discriminability of the stimuli in the emergent classes. This study is among the first to provide an empirical basis for a behavior-analytic model of the development of generalized categorization repertoires in natural settings.

Teaching social skills to people with autism

The treatment of social skills deficits remains one of the most challenging areas in meeting the needs of people with autism. Difficulties in understanding social stimuli, in initiating and responding to social bids, and in appreciating the affect that is intrinsic to social interactions can be baffling for people with autism. Researchers and practitioners of applied behavior analysis have tried a variety of strategies for teaching social skills. This article examines a range of useful procedures for teaching social skills to people with autism, including skills that are adult mediated, peer mediated, and child-with-autism mediated. The authors also consider the potential of classwide interventions in inclusive settings, pivotal response training, and the use of scripts to teach social initiations.