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Training healthcare professionals to discriminate between examples and non-examples of racial microaggressions 培训医护专业人员辨别种族微冒犯的实例和非实例
IF 1.1 4区 心理学 Q3 PSYCHOLOGY, CLINICAL Pub Date : 2024-03-27 DOI: 10.1002/bin.2013
Patrick W. Romani, Tara M. Hays, Jenna Glover, Arletta Swain-Cockrell

President Bill Clinton's Race Advisory Board (1998) discussed racism as being nearly invisible to Americans, and White Americans are often unaware of their role in perpetuating racism today. Microaggressions are a common type of racism that take the form of denigrating comments toward those of racial minority groups (Sue et al., 2007). While often unintentional or unconsciously used, microaggressions adversely affect today's society. The purpose of the current study was to evaluate a differential reinforcement with feedback intervention to facilitate discrimination between examples and non-examples of microaggressions among healthcare workers employed by a tertiary hospital setting. We recruited 26 healthcare workers to complete three surveys via a Qualtrics survey. Baseline data showed moderately high, but variable, accuracy in discriminating examples and non-examples of microaggressions. Following the reinforcement plus feedback intervention, participants' accurate discrimination between (non-) examples of microaggressions increased. We will discuss these results in terms of using behavior-analytic procedures to effectively teach what constitutes microaggressive acts that negatively impact people of color.

比尔-克林顿总统的种族咨询委员会(1998 年)认为,种族主义对美国人来说几乎是无形的,美国白人往往没有意识到他们在当今种族主义的长期存在中所扮演的角色。微词攻击是一种常见的种族主义,其形式是对少数种族群体进行诋毁性评论(Sue et al.)微观诽谤往往是无意或无意识使用的,但却对当今社会产生了不利影响。本研究的目的是评估一种带有反馈的差别强化干预措施,以促进一家三甲医院的医护人员区分微小诽谤的例子和非例子。我们招募了 26 名医护人员通过 Qualtrics 调查完成三项调查。基线数据显示,医护人员辨别微小诽谤实例和非实例的准确率中等偏上,但不尽相同。在强化加反馈干预后,参与者对微小诽谤实例(非实例)的准确辨别能力有所提高。我们将从使用行为分析程序来有效教授什么是对有色人种有负面影响的微侵害行为的角度来讨论这些结果。
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引用次数: 0
Evaluating preference displacement of edible stimuli and social interactions for typically developing preschool children 评估发育正常的学龄前儿童对可食用刺激和社交互动的偏好转移
IF 1.1 4区 心理学 Q3 PSYCHOLOGY, CLINICAL Pub Date : 2024-03-26 DOI: 10.1002/bin.2014
N. R. Lasinski, K. P. Klatt

Edible and leisure items are often used in behavioral intervention to teach skills or reduce problem behavior. Social interactions, however, have also been shown to function as reinforcers for both typically developing children and children diagnosed with autism. Previous research has been conducted investigating preference displacement between edible, leisure and social items. The current study included edible stimuli and social interactions to evaluate whether patterns of displacement would appear with typically developing children. Multiple stimulus without replacement preference assessments were conducted to identify highly preferred stimuli from both edible item and social interaction classes to use in combined assessments to evaluate displacement. Three of six participants showed complete displacement of social interactions by edible items and three participants showed patterns of partial displacement. Two of the participants demonstrating patterns of partial displacement showed a disproportionate preference for social interactions.

在行为干预中,经常使用食用和休闲物品来教授技能或减少问题行为。然而,对于发育正常的儿童和被诊断患有自闭症的儿童来说,社交互动也被证明具有强化作用。此前已有研究调查了可食用物品、休闲物品和社交物品之间的偏好转移。目前的研究包括食用刺激和社交互动,以评估是否会出现典型发育期儿童的偏好转移模式。研究人员进行了多重刺激无替代偏好评估,以从可食用物品和社交互动类别中识别出高度偏好的刺激物,并在综合评估中使用这些刺激物来评估移位情况。在六名参与者中,有三名表现出社交互动完全被可食用物品取代,三名表现出部分取代的模式。在表现出部分移位模式的参与者中,有两名表现出对社交互动的过度偏好。
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引用次数: 0
Discrete-trial teaching: A scoping review 离散试验教学:范围综述
IF 1.1 4区 心理学 Q3 PSYCHOLOGY, CLINICAL Pub Date : 2024-03-23 DOI: 10.1002/bin.2012
Michelle A. Frank-Crawford, John C. Borrero, Alyssa Fisher, Paige Talhelm, Nathalie Fernandez

Discrete-trial teaching (DTT) is an arrangement used in skill acquisition. The components that comprise DTT vary widely across applications, and previous reviews evaluating its efficacy have largely reported on DTT as part of a comprehensive intervention package. The purpose of this scoping review was twofold: to describe the component variations of DTT (descriptive analysis) and to evaluate the general efficacy of DTT in teaching new skills to individuals with disabilities (efficacy analysis). One hundred and thirty-four studies were included in the descriptive analysis of DTT and 82 were included in the efficacy analysis. Results indicated that many of the components of DTT align well with best practice recommendations, including that reinforcers be delivered continuously and immediately following correct responses. Overall, DTT was efficacious in teaching new skills; however, there were limited evaluations of the maintenance, generality, and social validity of the findings. The outcomes are discussed in light of best practice recommendations and as a guide for future practice and research.

离散试验教学(DTT)是一种用于技能学习的安排。在不同的应用中,DTT 的组成要素有很大的不同,而以往对其效果的评估报告大多将 DTT 作为综合干预方案的一部分。本次范围综述的目的有两个:描述 DTT 的组成变化(描述性分析)和评估 DTT 在向残障人士传授新技能方面的总体效果(效果分析)。134 项研究被纳入 DTT 的描述性分析,82 项研究被纳入疗效分析。结果表明,DTT 的许多组成部分与最佳实践建议非常吻合,包括在正确反应后立即持续提供强化物。总体而言,DTT 在教授新技能方面是有效的;但是,对研究结果的维持性、普遍性和社会有效性的评估有限。本文根据最佳实践建议对研究结果进行了讨论,并为未来的实践和研究提供了指导。
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引用次数: 0
Assessment and treatment of multiply maintained self injury for a visually impaired elementary student with autism 对一名患有自闭症的视障小学生的多重维持性自伤进行评估和治疗
IF 1.1 4区 心理学 Q3 PSYCHOLOGY, CLINICAL Pub Date : 2024-03-17 DOI: 10.1002/bin.2011
Sara K. Snyder, Madeline L. Griffin, Kevin M. Ayres

Assessment of challenging behavior via functional analysis (FA) and subsequent treatment including functional communication training (FCT) is a common approach to treating severe problem behavior for individuals with autism and intellectual disability. Assessment and treatment for these behaviors exhibited by individuals who have a co-occurring diagnosis of visual impairment and autism spectrum disorder present unique challenges to this approach. The current study included an 8-year-old White, visually impaired male on the autism spectrum who engaged in self injurious behavior (SIB). Based on the results of the FA, conducted in his classroom, the researchers began FCT to address the multiple maintaining functions of SIB. Results suggest that adaptations to FCT may be necessary for visually impaired individuals on the autism spectrum to make the communication response more salient to the individual and establish independent communication responses.

通过功能分析(FA)对挑战行为进行评估,随后进行包括功能性交流训练(FCT)在内的治疗,是治疗自闭症和智障人士严重问题行为的常用方法。对于同时患有视力障碍和自闭症谱系障碍的患者,评估和治疗他们的这些行为给这种方法带来了独特的挑战。本次研究的对象是一名 8 岁的白人视障男性自闭症谱系障碍患者,他有自伤行为(SIB)。研究人员根据在他的课堂上进行的视力障碍评估结果,开始采用 FCT 来解决 SIB 的多种维持功能问题。研究结果表明,自闭症谱系中的视障人士可能需要对 "自闭症沟通技巧 "进行调整,以使沟通反应对其更加突出,并建立独立的沟通反应。
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引用次数: 0
Exposure-based treatments for fear and reactivity to medical procedures: A systematic review of the literature with implications for research and practice 针对医疗程序恐惧和反应的暴露疗法:文献系统回顾及对研究和实践的启示
IF 1.1 4区 心理学 Q3 PSYCHOLOGY, CLINICAL Pub Date : 2024-03-15 DOI: 10.1002/bin.2010
Awab Abdel-Jalil, Jillian N. Baldwin, Justin B. Leaf

This systematic literature review following updated PRISMA guidelines investigated the application of exposure treatments to address phobias and highly reactive patterns associated with medical procedures. Through a search of APA PsycINFO followed by screening, 62 articles were identified spanning the years 1968–2021, encompassing a total of 715 participants and 11 medical procedures. Multiple variables were assessed across these articles, and common patterns were analyzed. The review reveals general trends within the field and offers valuable insights for future researchers and practitioners. Outcomes related to participants' proximity to receiving necessary medical care were recorded and discussed. Notably, to the authors' knowledge, this review appears to be the first systematic literature review focusing on the use of exposure treatments for addressing phobias related to medical procedures as a comprehensive category.

本系统性文献综述遵循最新的 PRISMA 指南,调查了暴露疗法在解决与医疗程序相关的恐惧症和高反应模式方面的应用。通过对美国心理学会 PsycINFO 的搜索和筛选,共发现了 62 篇文章,时间跨度为 1968 年至 2021 年,涉及 715 名参与者和 11 种医疗程序。对这些文章中的多个变量进行了评估,并分析了共同的模式。综述揭示了该领域的总体趋势,并为未来的研究人员和从业人员提供了宝贵的见解。作者记录并讨论了与参与者是否接近接受必要医疗护理相关的结果。值得注意的是,据作者所知,这篇综述似乎是第一篇系统性文献综述,其重点是将暴露疗法作为一个综合类别,用于解决与医疗程序相关的恐惧症。
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引用次数: 0
A component analysis of ABC assessments as demonstrated through function based interventions 通过基于功能的干预措施对 ABC 评估进行成分分析
IF 1.1 4区 心理学 Q3 PSYCHOLOGY, CLINICAL Pub Date : 2024-03-15 DOI: 10.1002/bin.2009
Lisa M. Tereshko, Mary Jane Weiss, Robert K. Ross, Jill M. Harper, Dennis Keane

Research demonstrates that in order to implement a successful behavior analytic intervention, one must first identify the maintaining contingencies of the target behavior. Descriptive assessments are the most commonly used functional assessment used by behavior analysts (Oliver et al., 2015), although, comparative research further supports the use of analog functional analyses over descriptive assessments. As a way to assess the components of descriptive assessments to increase their accuracy, antecedent-behavior-consequence (ABC) assessments and functional analysis procedures were used to analyze the key components of descriptive assessment and were then verified with the implementation of a function-based intervention. Results indicated that conditional probabilities from the antecedent condition were verified as the function in the functional analysis and treatment. Implications for clinicians and researchers are reviewed.

研究表明,要成功实施行为分析干预,首先必须确定目标行为的维持性或然因素。描述性评估是行为分析师最常用的功能评估(Oliver 等人,2015 年),不过,比较研究进一步支持使用模拟功能分析而非描述性评估。为了评估描述性评估的组成部分以提高其准确性,我们使用了前因后果(ABC)评估和功能分析程序来分析描述性评估的关键组成部分,然后通过实施基于功能的干预措施进行验证。结果表明,前因条件中的条件概率在功能分析和治疗中被验证为功能。本文对临床医生和研究人员的启示进行了综述。
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引用次数: 0
Adapting preference assessments and reinforcement schedules to increase mask wearing with adults with intellectual disabilities 调整偏好评估和强化时间表,增加智障成人佩戴面罩的次数
IF 1.1 4区 心理学 Q3 PSYCHOLOGY, CLINICAL Pub Date : 2024-03-14 DOI: 10.1002/bin.2008
Elizabeth J. Houck, Joseph D. Dracobly, Richard G. Smith, Melanie S. Bauer, Danielle R. Pelletier, Aaron J. Sanchez

New or infrequently contacted stimuli may present challenges for people with intellectual disabilities (ID) and autism spectrum disorder (ASD). Throughout the Covid-19 pandemic, facemasks emerged as a new stimulus that may cause distress, especially for those who may not understand the need for a mask. Further, the inability to tolerate wearing a facemask could limit safe access to public locations for people with ID and ASD. Most approaches to increasing health routines involve some form of escape extinction, a practice that may not be feasible or safe for some individuals and in some settings. As an alternative, approaches based on adapting stimulus features, including preferences, and positive reinforcement, may produce equally effective interventions. To evaluate this, we first assessed preference of eight adults with ID living in a residential facility, for four different types of facemasks and the standard facility face masks. Access to a variety of masks increased mask-wearing for two participants. We then evaluated reinforcement schedule manipulations without escape extinction to increase mask wearing for four participants from Study 1. For all four participants, we successfully increased mask wearing using a reinforcement schedule that was sustainable in their everyday environment.

新的或不常接触的刺激可能会给智障(ID)和自闭症谱系障碍(ASD)患者带来挑战。在 Covid-19 大流行期间,口罩作为一种新的刺激物出现,可能会给患者带来困扰,尤其是对于那些可能不理解是否需要佩戴口罩的人来说。此外,无法忍受佩戴口罩可能会限制智障和自闭症患者安全进入公共场所。大多数增加健康常规的方法都涉及某种形式的逃避,这种做法对于某些人和某些环境来说可能并不可行或不安全。作为一种替代方法,基于调整刺激特征(包括偏好)和正强化的方法可能会产生同样有效的干预效果。为了评估这一点,我们首先评估了居住在养老院的八名成年智障人士对四种不同类型口罩和标准设施口罩的偏好。结果显示,有两名参与者戴口罩的次数有所增加。然后,我们对研究 1 中的四名参与者进行了强化时间表操作评估,以增加他们戴口罩的次数。对于所有四名参与者,我们都成功地使用了在他们的日常生活环境中可持续的强化时间表来增加他们佩戴口罩的次数。
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引用次数: 0
Improving goals written for individuals with autism: Preliminary results on assessing meaningfulness and relevance to adulthood 改进为自闭症患者撰写的目标:评估意义和与成年期相关性的初步结果
IF 1.1 4区 心理学 Q3 PSYCHOLOGY, CLINICAL Pub Date : 2024-03-05 DOI: 10.1002/bin.2006
Shanna Bahry, Peter F. Gerhardt, Mary Jane Weiss, Justin B. Leaf, Kevin M. Ayres

In general, individuals with autism spectrum disorder have poor outcomes in adulthood on almost any measure assessed. Poor outcomes, in part, may be related to inadequate planning leading up to adulthood, including inappropriate goal setting, ineffective communication, and inadequate involvement of all decision-makers needed to inform planning. The skills in the repertoires of individuals on the spectrum have been shown in the research to directly impact the trajectory of outcomes. Yet, at present there is next to no peer-reviewed literature that identifies evidence-based procedures to teach practitioners how to write meaningful goals that will positively impact these outcomes. The present study therefore examined the effects of a treatment package aimed at improving the quality of goals written by clinicians and students of applied behavior analysis. Overall, this study showed that for at least some participants, the independent variable improved the quality of skill acquisition goals, as measured by expert and advanced practitioner ratings as well as self-assessed ratings. Both experiments yielded statistically significant increases in both dependent variables for the experimental group, when compared to the control group. These promising initial findings have implications for practitioners who hope to adequately plan for the future of those they serve by targeting those skills that will positively affect outcomes.

一般来说,自闭症谱系障碍患者成年后在几乎所有评估指标上都表现不佳。结果不佳的部分原因可能与成年前的规划不足有关,包括目标设定不当、沟通无效以及规划所需的所有决策者参与不足。研究表明,谱系障碍者所掌握的技能会直接影响其结果的轨迹。然而,目前几乎还没有同行评议的文献来确定以证据为基础的程序,以指导实践者如何编写有意义的目标,从而对这些结果产生积极的影响。因此,本研究考察了旨在提高临床医生和应用行为分析专业学生撰写目标质量的一揽子治疗方案的效果。总体而言,本研究表明,至少对部分参与者而言,自变量提高了技能习得目标的质量,具体衡量标准包括专家评分、高级从业人员评分以及自我评估评分。与对照组相比,实验组的两个因变量都有统计学意义上的显著提高。这些令人鼓舞的初步研究结果对那些希望通过瞄准那些对结果有积极影响的技能来为其服务对象的未来进行充分规划的从业人员具有重要意义。
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引用次数: 0
The effect of phonics skills intervention on early reading comprehension in an adolescent with autism: A longitudinal study 语音技能干预对自闭症青少年早期阅读理解能力的影响:纵向研究
IF 1.1 4区 心理学 Q3 PSYCHOLOGY, CLINICAL Pub Date : 2024-03-02 DOI: 10.1002/bin.2007
Michael Nicolosi, Karola Dillenburger

Reading comprehension requires phonics skills, described as “blending phonemes in a word”. Adolescents diagnosed with Autism Spectrum Disorder (ASD) often experience poor reading comprehension. The aim of the present study was to explore if it is possible for an adolescent with ASD and intellectual disability to learn reading comprehension skills even without direct teaching, when the focus of the intervention is on teaching phonics skills. An adolescent with ASD, profound intellectual disability and limited behavioral repertoire participated in the study. The participant received intensive ABA-based interventions according to University of California at Los Angeles-Young Autism Project (UCLA-YAP) model and intensive phonics training. Intervention data show emergence of early reading comprehension skills in terms of words/pictures matching and responding to written instructions. It is suggested that implementation of similar interventions could change the opportunities for people with autism who have limited behavioral repertoire and who did not begin an ABA-based interventions until their adolescence.

阅读理解需要语音技能,即 "混合单词中的音素"。被诊断患有自闭症谱系障碍(ASD)的青少年通常阅读理解能力较差。本研究旨在探讨,当干预的重点是教授语音技能时,患有自闭症谱系障碍和智力障碍的青少年是否有可能在没有直接教学的情况下学习阅读理解技能。一名患有自闭症、严重智障且行为能力有限的青少年参与了本研究。根据加州大学洛杉矶分校-青少年自闭症项目(UCLA-YAP)的模式,该受试者接受了以 ABA 为基础的强化干预和强化语音训练。干预数据显示,受试者在单词/图片匹配和响应书面指令方面出现了早期阅读理解能力。建议实施类似的干预措施,以改变那些行为能力有限、直到青春期才开始接受以 ABA 为基础的干预措施的自闭症患者的机会。
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引用次数: 0
An evaluation of training components necessary to teach staff members to conduct an intensive pediatric feeding intervention 评估教导工作人员进行强化儿科喂养干预所需的培训内容
IF 1.1 4区 心理学 Q3 PSYCHOLOGY, CLINICAL Pub Date : 2024-02-25 DOI: 10.1002/bin.2004
Ronald J. Clark, David A. Wilder

In applied behavior analysis, parents or other caregivers are often trained to implement an intervention after the intervention has been demonstrated effective when implemented by professionals. However, training novice staff members to conduct specific behavioral interventions has received less attention. This is particularly true in the context of training staff to implement interventions to treat food refusal. In the current study, we implemented three levels of training to evaluate the level of intensity required to train staff members (i.e., behavior technicians, Registered Behavior Technicians®, and Board-Certified Behavior Analysts®) to implement a feeding protocol with a role play partner. Only one participant met the mastery criteria following the first training phase, which included written instructions and video modeling. Following 72 h of exposure to the instructional materials, we provided participants an opportunity to ask clarifying questions about the procedure (second training phase). Only one participant met mastery in this phase. Three other participants required in vivo feedback and modeling (third training phase) to master the protocol. We discuss clinical implications and future research directions.

在应用行为分析中,家长或其他照护者通常会接受培训,以便在专业人员实施干预措施证明有效后,再实施干预措施。然而,培训新员工实施特定行为干预的工作却较少受到关注。在培训工作人员实施治疗拒食的干预措施方面,情况尤其如此。在当前的研究中,我们实施了三个级别的培训,以评估培训工作人员(即行为技术员、注册行为技术员®和委员会认证行为分析师®)与角色扮演伙伴一起实施喂食方案所需的强度级别。在包括书面指导和视频示范的第一阶段培训后,只有一名参与者达到了掌握标准。在接触教学材料 72 小时后,我们为参与者提供了一个机会,让他们提出有关程序的明确问题(第二培训阶段)。只有一名学员在这一阶段达到了熟练掌握的程度。另外三名参与者需要活体反馈和建模(第三训练阶段)才能掌握操作步骤。我们讨论了临床意义和未来的研究方向。
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引用次数: 0
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Behavioral Interventions
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