Behavioral Interventions最新文献

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.

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.

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.

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.

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.

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.

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.

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.

A small but growing body of research in pediatric feeding disorders asserts the importance of comprehensively measuring social significance of goals, procedures, and effects of intervention, and incorporating social validity into practice to inform treatment. This report sought to extend this literature by detailing procedures to measure and improve social validity during a clinical case of a 3.5-year-old during a home-based intensive feeding program. A multiple baseline design demonstrated effectiveness of nonremoval and re-presentation added to a treatment package. Repeated choice via direct child preference assessments informed demand fading and gradual progression across six feeding skill domains (medication, cup drinking, independence, texture, volume, variety) and arrangements of response effort (preference, skill) with layers of reinforcer parameters (quality, magnitude, rate, immediacy). Indices of happiness definitions were modified, and extinction bursts examined. Fostering a collaborative approach, caregivers provided detailed input on social validity measures pretreatment, at discharge, and long-term follow-up (6-month, 1-year), inclusive of both qualitative and quantitative responses, written and verbal communication, and permanent product data. Further implications for practitioners included detailing the process for caregiver training and generalization to family meals with siblings and community settings, and providing adaptable full-text guidelines for free access/choice contexts.

Researchers have investigated several schedule-thinning approaches during functional communication training (FCT), including FCT with delay schedules (Delay FCT), FCT with discriminative stimuli (Signaled FCT), and FCT with delay-and-denial tolerance training (DDTT). Despite many publications on these approaches, it is unclear how regularly, how often, and under what conditions behavior analysts use these FCT thinning strategies. We analyzed survey data from 129 board-certified behavior analysts® to determine (a) how often they use the three thinning approaches during FCT, (b) their most preferred thinning method, and (c) the variables (e.g., years of experience, treatment setting) associated with their most used and preferred approaches. DDTT was the most commonly implemented and preferred FCT thinning strategy. Relative to DDTT, Signaled FCT was more frequently used and preferred by doctoral-level behavior analysts and those working in clinical settings. However, regardless of approach, behavior analysts reported several challenges that hold implications for practice and research.