Journal of Developmental and Physical Disabilities最新文献

Compared to solids, less paediatric feeding research has targeted liquids, medication, and teaching independence skills (e.g., fork, chopsticks). No research to our knowledge has reported transitioning from spout squeeze ‘baby food’ pouches, increasing finger-feeding, and teaching steps in scooping, sipping, and biting off portions. We detail a clinical case and depict data teaching comprehensive mealtime independence using multi-element and multiple-baseline designs. A 3-year-old male with paediatric feeding disorder, avoidant/restrictive food intake disorder (ARFID), and autism spectrum disorder (level 3) had only one independent skill (yogurt pouch via spout). He did not finger-feed, self-spoon-feed, self-drink, or cup-drink. He participated in a home-based intensive 2-week behaviour-analytic treatment programme. We conducted an assessment comparing novel pouch transition apparatuses, then used pouch-to-spoon fading to teach spoon self-feeding. We taught independence in finger-feeding, open-cup drinking, and four methods of medication administration, then open-cup bolus sipping, self-scooping, biting off portions, fork, and chopsticks (11 skills). He met 100% of goals. Caregivers reported high social validity and relevant culturally significant information, and gains generalised and maintained in follow-up.

Differential reinforcement of alternative behavior (DRA) is a common strategy for escape-maintained behaviors targeted for reduction (i.e., targeted behavior) exhibited by youth with intellectual and developmental disabilities. DRA often involves various methods of prompting to ensure the instruction or task remains in place until contingencies for the DRA are met. Currently, there is little research on client preference for these different prompting strategies in the context of DRA treatments. The current study includes four participants diagnosed with autism spectrum disorder (ASD) who exhibited targeted behavior maintained by escape from instructional tasks. We evaluated efficacy and preference for three prompting strategies (three-step least-to-most, repeated vocal prompt, or a single initial prompt) embedded in a DRA treatment aimed at reducing targeted behavior (e.g., aggression) and improving task completion. For all participants, more than one prompting strategy was effective when positive was combined with negative reinforcement in the DRA. We then implemented a concurrent-chains assessment to determine client preference, a rank-order task for caregiver preference, and an acceptability questionnaire for therapists. Two participants demonstrated a clear preference, and preference was obtained from a total of two caregivers and seven therapists. The initial and repeated verbal prompts were most preferred. Results are discussed in the context of client autonomy and incorporating choice in treatment planning.

Video activity schedules are a combination of video modeling and activity schedules that teach a singular task or a series of tasks to be completed. Instead of a sequence of pictures, videos demonstrate to the learner what is expected to be done. Research has focused heavily on using video activity schedules to teach daily living or vocational skills; however, there is a lack of research on using video activity schedules to teach play skills. In this study, a non-concurrent multiple baseline design across participants was used to evaluate the effect of a video activity schedule to teach four dyads of autistic children how to play cooperative games during a summer day camp. Results indicate that all participants learned how to play the game, including during generalization and maintenance probes. A limitation within the study was a lack of data collected for social communication and social validity. Future research should collect social communication data and/or other measures like indices of happiness (e.g., smiling, laughing, etc.).

Functional communication training (FCT; Carr & Durand, 1985) is frequently utilized as a treatment for socially maintained problem behavior (Tiger et al., 2008). Although FCT is a viable treatment option for the reduction of problem behavior, researchers have identified several variables related to the selection of the functional communication response (FCR) topography that may influence treatment outcomes, including individual and caregiver preference. However, there may be times in which the target individual and caregiver preference do not match. Given this, there is a need for procedures to identify and compare both child and caregiver preferences. Therefore, the purpose of this study was to identify a preferred FCR topography via mand topography assessment and compare results of the mand topography assessment with a formal assessment of caregiver preference. We found that both child and caregiver participants demonstrated a preference for at least one FCR topography. Although we identified a preference for both the child and caregiver participants, child and caregiver preference did not match, except for a partial match for one caregiver-child dyad. Clinical implications and recommendations for navigating next steps when client and caregiver preferences do not align are discussed.

Legislative mandates dictate that students with disabilities are provided instruction, services, and supports needed to progress in school (Individuals with Disabilities Education Act [IDEA] Part B, 2004) which can be in the form of Individualized Education Plans (IEPs), Individualized Family Service Plans (IFSP) for children three and under, and 504 plans. A number of studies have highlighted the ways in which these formal educational processes may increase stress among parents (Rios et al., Research in Autism Spectrum Disorders, 73(March), 101534, 2020). However, formal educational processes may also be protective in the context of parents’ experiences of affiliate stigma and their perceptions of family-school partnerships, which have not been widely examined, particularly among Latino parents of children with disabilities. The current study examined the relationship between affiliate stigma, or the parent’s internalized stigma related to the child’s disability, and family-school partnerships in a sample of 141 Latino parents. In the current study we also examined whether the presence of a formal education plan (e.g., IEP, IFSP, 504 plan) moderated the relationship between affiliate stigma and family-school partnerships. We found that higher parent engagement but not affiliate stigma was related to significantly stronger family-school partnerships. In the sample 60% of parents reported that their child had an education plan, and presence of such a plan moderated the relationship between affiliate stigma and family-school partnerships. Recommendations are made for future research and practice related to supporting Latino parents within the special education system.

Many children with autism spectrum disorder experience feeding difficulties that can lead to increased health risks (e.g., severe nutrition deficiencies, obesity-related illnesses) if left untreated. Intensive feeding programs that use behavior-analytic interventions have reported positive outcomes for treating challenging behavior associated with pediatric feeding disorders at discharge and up to 1 year post discharge. Whether these children achieve and maintain long-term goals is unknown. The purpose of the current study was to evaluate outcomes of behavior-analytic intervention for pediatric feeding disorders among children with and without autism spectrum disorder in an intensive feeding program post discharge. Caregivers of former patients reported on the positive and negative impact of the program and their child’s growth and diet variety at follow-up. 85% of caregivers reported the program had a positive impact. Increases in height-for-age z scores were significant from admission to discharge from the intensive program, and progress in growth and diet variety remained the same or improved for most children at follow-up. Results suggest that behavior-analytic intervention in an intensive feeding program produced positive short- and long-term outcomes for children and their families.

Parent advocacy is often critical for families of individuals with disabilities. Prior research has suggested that parent advocacy occurs across three levels: individual, peer, and systemic. Yet, little empirical research has identified the correlates of advocacy for each level. For this study, we examined the survey responses of 246 parents of individuals with disabilities who were interested in participating in a legislative advocacy program. Analyses included hierarchical regressions to identify the correlates of individual, peer, and systemic advocacy. Parents of children with autism were significantly more likely to engage in individual advocacy. Parents who identified as Black (versus other racial groups) advocated significantly more on a systemic level. Further, malleable factors such as empowerment and motivation correlated positively with advocacy. Implications for research and practice are discussed.

Abstract

Researchers have shown that behavioral interventions that incorporate communication as a focus have demonstrated efficacy for individuals with intellectual and developmental disabilities (IDD). Researchers have demonstrated that individuals with IDD allocate responding to one communicative response modality over others when multiple communicative modalities produce reinforcement in the context of a concurrent-schedules arrangement. Identifying preference for communicative response modality provides one approach to incorporating aspects of social validity in the design of behavioral interventions for individuals with IDD, placing additional importance on demonstrations of the robustness of this preference. In the current study, we evaluated preference among concurrently available communication modalities for 14 individuals with IDD. Results of the study replicated previous, similar research in that the vast majority of individuals demonstrated a preference between communicative response modalities. We discuss the results within the context of social validity and implications for intervention.

To observe changes in three clients with intellectual disabilities and severe behavioral problems and staff in a long-term care residential facility after redesigning the clients’ rooms by making them more personal and homely, adjusting the amount of stimuli, changing the layout, connecting to the outdoor area, and using high-quality natural materials. Relatively many clients with intellectual disabilities exhibit severe problem behaviors, including self-harm, aggression toward others, and repeated destruction of their own rooms, which can eventually result in a barren, inhumane living environment. Research on these clients is limited. Data were collected in a mixed methods study in which quantitative and qualitative data were analyzed. After the redesigns, positive changes were observed in the well-being and behavior of all three clients, for example, with respect to quality of life, privacy, freedom of choice, problem behavior, mood, cognition, activities of daily living, leisure activities, social behavior, self-harm, and constraints. There were no changes in the use of psychotropic medication. Quality of life scores increased in two cases, but were significant in only one. Emotional and behavioral problem scores decreased significantly in two cases, but in only one case these results were maintained at follow-up. Staff experienced a more pleasant, safe, and functional work environment, with improved provision of indicated care and interaction. Absenteeism decreased significantly in two of the three cases. Redesigning clients’ rooms could potentially be a promising intervention for clients with intellectual disabilities and severe chronic behavioral problems.

There are inequities in engagement with established early childhood developmental surveillance programs, eclipsing disadvantaged families. The current study sought to address this by dovetailing developmental surveillance with immunization visits and other opportunistic contacts with children at general practices). While 53 General Practices were recruited, significant COVID-19 disruptions resulted in only 81 children being screened (both parent-administered and GP completed). Of the 81 children, 11 screened positive and all of them along with 5% of screen negatives (i.e. 4 children) received clinician-administered reference-standard assessment for autism and developmental delay (DD) using Autism Diagnostic Observation Schedule (ADOS), Autism Diagnostic Interview Schedule –Revised (ADI-R), and Mullen Scales of Early Learning (MSEL). All children found by reference-standard assessment to have probable autism and/or DD had screened positive during the screening process, and 90.9% of children who screened positive were found by reference-standard assessment to have probable DD or autism. The findings provide early evidence for the feasibility and usefulness of parent completed and GP administered developmental measures during opportunistic contacts with GPs as a promising method to facilitate early identification of DD or autism.